Low parental numeracy and severe asthma exacerbations in a prospective study of Puerto Rican youth.

BACKGROUND: Numeracy is the mathematical knowledge required to understand and act upon instructions from healthcare providers. Whether persistently low parental numeracy is linked to childhood asthma exacerbations is unknown.

OBJECTIVE: To examine whether low parental numeracy at two timepoints is associated with asthma exacerbations and worse lung function in Puerto Rican youth.

METHODS: Prospective study of 225 youth with asthma in San Juan (PR) who participated in two visits ∼5.3 years apart, the first at ages 6-14 years and the second at ages 9-20 years. Parental numeracy was assessed with a modified version of the Asthma Numeracy Questionnaire (score range=0-3 points), and persistently low parental numeracy was defined as a score ≤1 point at both visits. Asthma exacerbation outcomes included ≥1 emergency department (ED) visit, ≥1 hospitalization, and ≥1 severe exacerbation (≥1 ED visit or ≥1 hospitalization) for asthma in the year prior to the second visit. Spirometry was conducted using an EasyOne spirometer (NDD Medical Technologies, Andover, MA).

RESULTS: In an analysis adjusting for age, sex, parental education, use of inhaled corticosteroids, and the time between study visits, persistently low parental numeracy was associated with ≥1 ED visit for asthma (odds ratio [OR]=2.17, 95% confidence interval [CI]=1.10-4.26), ≥1 hospitalization for asthma (OR=3.92, 95% CI=1.42-10.84) and ≥1 severe asthma exacerbation (OR=1.99, 95% CI=1.01-3.87) in the year prior to the follow-up visit. Persistently low parental numeracy was not significantly associated with change in lung function measures.

CONCLUSION: Persistently low parental numeracy is associated with asthma exacerbation outcomes in Puerto Rican youth.