Exploring Health Literacy and Clinical Outcomes Among Caregivers of Children Undergoing Gastrostomy Tube Placement.

BACKGROUND: Surgical gastrostomy tubes (G-tubes) are common pediatric surgery procedures; however, they require caregiver perioperative education for appropriate management. One factor that has not been well explored is the impact of caregiver health literacy on the effectiveness of G-tube education. This study aimed to understand caregiver health literacy levels and associated clinical outcomes to inform design of future education interventions. METHODS: A prospective cohort analysis was performed for caregivers of children who underwent initial G-tube placement from 11/2024-7/2025. Data collection included demographic information, assessment of sociodemographic factors, assessment of health literacy using the validated Parental Health Literacy Activities Test (PHLAT-8) score, and presence of complications and health resource utilization 30 days after surgery. Descriptive statistics were reported. PHLAT-8 scores were compared by education and annual household income level. Poisson and logistic regression models were used to predict clinical outcomes. RESULTS: Of the 86 eligible caregivers approached, 49 consented to participate in the study. The median PHLAT-8 score was 6 (IQR 6-8). Higher scores were associated with higher attained education levels and higher annual household income (p < 0.05 for both). There was no association between PHLAT-8 scores and health utilization or complications 30 days after surgery. CONCLUSION: All caregivers in our study demonstrated adequate health literacy. In contrast to prior data, this series did not find any differences in health care utilization or complication rates based on parental health literacy, indicating our population may have appropriate literacy levels to understand the management of pediatric G-tubes. LEVEL OF EVIDENCE: III.