Caregiver Health Literacy and Treatment-Seeking Behaviors: A Prospective Study Comparing Caregivers of Orthopaedic Patients with Chronic Versus Acute Conditions

Health literacy (HL) is the degree to which individuals comprehend information and services to inform health-related decisions and is a strong predictor of health outcomes. This study investigates whether increased exposure to the healthcare system equips caregivers of children with a chronic disease – cerebral palsy (CP) – with higher baseline HL compared to caregivers of otherwise healthy pediatric patients seeking acute surgical treatment This prospective study utilized a single pediatric referral healthcare system over a 15-month period to recruit caregivers of pediatric patients with CP undergoing planned orthopaedic surgery (CP group) and caregivers of otherwise healthy pediatric patients undergoing planned surgical treatment for acute fractures (fracture group). Baseline HL was assessed pre-operatively with the Newest Vital Sign survey; charts were reviewed for no-shows, cancellations, and advice-only calls. Mann-Whitney U tests and pair-wise post hoc tests were utilized to compare cohorts. Ninety patients were included for analysis, of which 37 (41.1%) were in the CP group and 53 (58.9%) were in the fracture group. There was no difference in baseline caregiver HL between cohorts (CP: 3.76 ± 1.62; fracture: 3.55 ± 2.09, p = 0.790). However, the fracture cohort had significantly higher no-show (CP: 0.03 ± 0.16; fracture: 0.49 ± 1.17, p = 0.008) and canceled appointments (CP: 1.16 ± 1.69; fracture: 1.94 ± 2.43, p = 0.032). Conversely, the CP group had significantly higher advice-only calls (CP: 2.51 ± 3.42; fracture: 0.06 ± 0.31, p <0.001). Despite more interaction with the healthcare system, caregivers of children with CP do not have measurably higher HL compared to caregivers of children seeking acute, episodic fracture care. While these two cohorts demonstrate comparable baseline HL levels, their needs and utilization of healthcare differ considerably. These findings emphasize the importance of tailoring education to individual caregivers, providing counseling and resources at each visit, and ensuring caregiver comprehension regardless of patient status, system familiarity or healthcare utilization. II; Lesser-quality prospective study 1. Caregivers of children with CP do not demonstrate higher baseline HL compared to caregivers of children with acute fractures. 2. Despite similar HL scores, caregivers in the CP group made significantly more advice-only calls, suggesting greater post-operative care needs. 3. Tailored educational support is essential, as healthcare system exposure alone does not equate to improved caregiver health literacy.