Pathways linking parental health literacy with health behaviours directed at the child: a scoping review

Summary Health literacy (HL) is thought to be crucial for the management of the manifold demands relating to child health which parents are faced with. Albeit many studies have investigated parental HL and health behaviours (HBs) directed at the child, knowledge about the pathways which link parental HL with HB is scarce. The aim of this scoping review was to identify and comprehensively describe the variety of pathways linking parental HL with HBs directed at the child which were empirically analysed in previous studies. Following established scoping review methods database searches were conducted in MEDLINE, EMBASE, PsycINFO and WebofScience on 5 March 2020. Eligibility criteria included primary, empirical studies assessing parental HL and HB directed at the child in the general parent population. Titles and abstracts were screened independently by six reviewers for potentially relevant publications and data were extracted using standardized data extraction forms. The search identified 6916 articles for title and abstract screening. After full-text review, 50 studies were included in this review. Most studies (N = 24) assumed a direct association between HL and HBs and only few studies (N = 4) used more complex models investigating different pathways or mediation and/or moderation models. Overall, the evidence on the underlying pathways linking parental HL and HBs directed at the child is mixed and fairly limited. Therefore, hypothesis-driven research and integration of results into theoretical frameworks is needed for advancing both the research on HL and public health practice. Lay Summary This systematic overview of existing literature aimed at comprehensively describing the association between parental health literacy (HL) and health behaviours (HBs) directed at the child and how this linkage was analysed in previous studies. HL can be defined as the capacity an individual has to access and effectively use health-related information, in order to promote and maintain good health. A particularly relevant group is the parent population as prior to and during parenthood they are confronted with manifold information regarding child health care. Many studies investigated parental HL and HBs directed at the child but knowledge about how they are connected with each other is scarce. The 50 studies included in this review varied widely in how they measured HL and HBs and how data were analysed. Overall, most studies (24 studies) assumed a direct association b