Do health literacy disparities explain racial disparities in family-centered care for youths with special health care needs?

The study is cross-sectional, so it cannot show that health literacy caused family-centered care differences. The sample was limited to English-speaking families in one Medicaid accountable care organization in Ohio, so results may not apply to other languages, payers, or regions. Most contacted families did not participate, and the authors say people with very limited health literacy may have declined, which could bias results toward no finding. Family-centered care was measured from family perceptions, not from observed provider behaviour, so it does not show whether clinicians actually spent less time or used time differently. Analyses excluded families identifying as other or multiracial because the subgroup was small, so the study does not speak to those groups. Self-reported health literacy correlated weakly with measured health literacy, so asking families about comfort may not identify who needs accommodations.

The supplied publication metadata says the work was supported by NIH extramural research. The article text provided does not include a conflicts of interest declaration.

Do not conclude that improving health literacy alone will close racial gaps in family-centered care. The mediation analysis was not significant, and lower perceptions of clinician time persisted after adjustment for health literacy.