Testing models for reducing "just in case" decisions by low literacy parents

This paper reports the results of a recent process evaluation to assess the effectiveness of a newly created training curriculum that introduced an easy-to-comprehend health care manual to low income parents of young children who utilize services at five geographically dispersed community health clinics in Kansas. Building on a former nationwide study among Head Start parents, this project attempted to determine if similar materials could be successfully introduced in the community clinic environment having less structural support for parent education. Each site used the same curriculum guide but employed a different model for delivering the intervention. The study asked: 1) does the education of parents by clinic staff on the use of a medical book for home treatment of minor childhood illnesses and injuries, result in deceased use of inappropriate "just-in-case" health care services (such as emergency room visits); and, 2) does such education result in increased feelings of confidence by parents to provide appropriate self care for their ill or injured child? Controlling for indicators of literacy level, insurance status, and primary language spoken in the home, pre and post interviews with more than 300 parents and agency staff members are examined to determine if the outcomes vary by methods employed in introducing and/or reinforcing the book and its contents. Social and structural barriers and facilitators of program success are shared.