Social determinants of health literacy among parents and caregivers in the US-Affiliated Pacific.

Health literacy is understudied in the US-Affiliated Pacific (USAP), where local populations have historically experienced social marginalization and disproportionate health inequities caused by the social determinants of health (SDOH). This cross-sectional study analyzed several SDOH indicators-acculturation, use of food assistance programs and demographic characteristics (race and ethnicity, household income, primary language spoken at home and educational attainment)-and their relationship to health literacy among 1305 parents/caregivers of young children ages 2-8 years old who participated in the Children's Healthy Living (CHL) program in Alaska, American Samoa, Commonwealth of the Northern Mariana Islands (CNMI), Guam, and Hawai'i. Significantly increased odds of low health literacy were found among parents/caregivers with households where a language other than English was the primary language compared to English-only households (OR = 1.86, 95% CI = 1.22, 2.82), household income of <$35 000 compared to ≥$35 000 (OR = 2.15, 95% CI = 1.13, 4.07), parents/caregivers of Asian children compared to parents/caregivers of White children (OR = 2.68, 95% CI = 1.05, 6.84), parent/caregivers with less than or some high school education compared to high school completion (1st- to 8th-grade OR = 4.46, 95% CI = 2.09, 9.52; 9th- to 11th-grade OR 1.87, 95% CI = 1.06, 3.30) and parent/caregivers with acculturation status defined as marginalized as compared to integrated (OR = 2.31, 95% CI = 1.09, 4.86). This study indicates that some USAP parents/caregivers may lack the capacity to acquire health information, utilize health resources, and navigate health decision making. Future efforts to understand and improve health literacy in the USAP should be population specific, thoroughly assess personal and organizational health literacy, and inventory community health care capacity.

Does size matter? An investigation into the Rey Complex Figure in a pediatric clinical sample.

The Rey Complex Figure Test (RCF) copy requires visuoconstructional skills and significant attentional, organizational, and problem-solving skills. Most scoring schemes codify a subset of the details involved in figure construction. Research is unclear regarding the meaning of figure size. The research hypothesis of our inquiry is that size of the RCF copy will have neuropsychological significance. Data from 95 children (43 girls, 52 boys; ages 6-18 years) with behavioral and academic issues revealed that larger figure drawings were associated with higher RCF total scores and significantly higher scores across many neuropsychological tests including the Wechsler Individual Achievement Test-Second Edition (WIAT-II) Word Reading (F = 5.448, p = .022), WIAT-II Math Reasoning (F = 6.365, p = .013), Children's Memory Scale Visual Delay (F = 4.015, p = .048), Trail-Making Test-Part A (F = 5.448, p = .022), and RCF Recognition (F = 4.862, p = .030). Results indicated that wider figures were associated with higher cognitive functioning, which may be part of an adaptive strategy in helping facilitate accurate and relative proportions of the complex details presented in the RCF. Overall, this study initiates the investigation of the RCF size and the relationship between size and a child's neuropsychological profile.

Differential response patterns on the Personality Assessment Inventory (PAI) in compensation-seeking and non-compensation-seeking mild traumatic brain injury patients.

There is relatively little research on the Personality Assessment Inventory (PAI) with mild traumatic brain injury (MTBI) populations. There is also little research on how compensation-seeking status affects personality assessment results in MTBI patients. The current study examined the PAI scales and subscales in two MTBI groups, one composed of compensation-seeking MTBI patients and the other consisting of non-compensation-seeking MTBI patients. Results indicated significant differences on several scales and subscales between the two MTBI groups, with the compensation-seeking MTBI patients having significantly higher elevations on scales related to somatic preoccupation (Somatic Complaint Scale, SOM), emotional distress (Anxiety Scale, ANX; Anxiety Related Disorders Scale, ARD; Depression Scale, DEP), and the Negative Impression Management, NIM, validity scale. All the SOM subscales and the Anxiety Cognitive (ANX-C) and ANX Affective, ANX-A, subscales were also elevated in the compensation-seeking group. Results indicated that several scales on the PAI were sensitive to group differences in compensation-seeking status in MTBI patients.