Parental health literacy profiling in a diverse migrant population in Norway

Abstract Background Parents make numerous decisions to promote their children's health and manage illnesses or accidents. The current “infodemic” and increasingly complex health systems place demands on parents’ health literacy, which in turn is associated with child health outcomes. Migrant parents face additional challenges such as language barriers, cultural differences in health management, divergent expectations of staff and services, and difficulties accessing the health system. As European countries become more diverse, understanding and addressing the health literacy needs of migrant parents may help reduce health inequalities. Methods We conducted a mixed methods cross-sectional study to map the parental health literacy of migrants in Oslo, Norway. Inclusive data collection was conducted using the Health Literacy Questionnaire (HLQ)-parent version in 15 languages and analyzed using hierarchical cluster analysis. Qualitative interviews were conducted with a subset of parents and analyzed using directed content analysis. Results The HLQ was answered by 107 parents and 12 participated in interviews. Overall, parents scored lowest on HLQ domains involving feeling supported by health providers; social support; and navigating the health system. Cluster analysis identified four health literacy profiles: A=low scores (9%), B=low to medium scores (30%), C=medium scores (45%), and D=high scores (16%). Interviewees from clusters A and B described challenges engaging and communicating with health staff, difficulties accessing information and services, limited social support and concerns about parenting in a new country. Conclusions While a majority of parents reported medium-to-high health literacy, the analysis reveals subgroups with significant unmet needs. The integrated data on these groups will guide the co-design and testing of tailored actions aimed at increasing parental health literacy and health service responsiveness to the health literacy needs of migrant parents. Key messages • Migrant parents experience important health literacy challenges in establishing supportive relationships with health providers, navigating health systems and developing social support networks. • Insights into subgroups of parents facing the most challenges can guide co-design of actions to increase individual health literacy and the responsiveness of staff and services.