HEALTH LITERACY, GENETIC LITERACY, AND NUMERACY IN A DIVERSE POPULATION OF PREGNANT WOMEN: IMPLICATIONS FOR PRENATAL TESTING DECISION MAKING

Purpose: To measure health literacy, genetic literacy, and numeracy in a diverse population of pregnant women.

Method: Cross-sectional study of pregnant women at less than 20 weeks gestation. Participants completed an interviewer-administered questionnaire, which included sociodemographic information and validated measures of health literacy (Short Test of Functional Health Literacy), genetic literacy (Rapid Estimate of Adult Literacy in Genetics) and numeracy (Numeracy Scale). Numeracy scores were dichotomized into high and low, literacy was defined as adequate, marginal, or inadequate, and low genetic literacy was defined as scoring at ≤ 6^th grade level. Descriptive analyses were performed to profile the sample. Multivariate logistic regression was utilized to examine predictors of numeracy and genetic literacy.

Result: 383 women participated in the study. Their mean age was 30.8. The sample was racially/ethnically diverse (51% White, 25% Black, 9.1% Latina, 16% Asian), highly educated (61% college graduates), and over half were nulliparous (56%). 99% had adequate health literacy, but 10% had low genetic literacy, and 41% had low numeracy. General health and genetic literacy were moderately correlated (ρ = 0.59, p<0.05); the correlation between health literacy and numeracy was not as strong (ρ = 0.41, p<0.05). In multivariate analysis, educational level was the only significant predictor of numeracy or genetic literacy. However, while 99% of college graduates had adequate genetic literacy, only 79% of these women had high numeracy.

Conclusion: In this sample, educational level was the only significant predictor of genetic literacy and numeracy; however, even among college graduates, nearly 20% demonstrated low numeracy. Low numeracy may impact women’s ability to understand information regarding the risk of genetic conditions and obstetrical procedures. This problem is further compounded by lack of understanding of health and genetic terminology in lower literacy populations. These issues should be considered when counseling women about risk during pregnancy.