Role of health literacy and self efficacy in depressive symptoms in mothers of newborn infants

Background: Mothers with limited literacy skills are more likely to have depressive symptoms; interventions that increase maternal literacy skills may also improve symptoms of depression, and associations are recognized between low health literacy and adverse health outcomes, yet research has yet to be conducted in a large sample of mothers of newborn infants. This study explored the relationship between depressive symptoms and health literacy among low-income mothers of newborn infants. Methods: 429 mothers (M age = 26 years) of diverse racial/ethnic backgrounds (47% Hispanic, 29% Black, 27% white, 44% other) completed the Parent Health Literacy Assessment Test (PHLAT), CES-D to examine depression, and a measure of maternal locus of control during their child's 2 month well-child doctor's visit. Analysis used proportional odds logistic regression and adjusted for a priori covariates, maternal self-efficacy, caregiver's age, race, ethnicity, level of English fluency, income, work status, and education. Results: A ten-unit increase in PHLAT was associated with increased odds of having a higher depression score (OR=1.11, 95% CI (1.04, 1.18)). Higher depression scores were also associated with decreased maternal self-efficacy (OR=1.68, 95% CI (1.27, 2.22)) and with unemployment status (OR=2.52, 95% CI (1.66, 3.83)); however, self-efficacy did not mediate the relationship between health literacy and depression. Conclusions: Prevention programs to screen mothers for depressive symptoms may be beneficial and allow for targeted interventions to increase literacy and self-efficacy skills, possibly improving health for mother and child.