PreventionUse of a Pictographic Diagram to Decrease Parent Dosing Errors With Infant Acetaminophen: A Health Literacy Perspective
Section snippets
Design
An experimental design was used to assess whether parents given a pictographic dosing diagram along with text instructions would make fewer dosing errors with infant acetaminophen compared to parents given text-only instructions. Institutional review board approval was obtained from the New York University School of Medicine and Bellevue Hospital Center.
Participants, Recruitment, and Randomization
A convenience sample was enrolled of parents presenting with their child to the pediatric outpatient clinic at Bellevue Hospital Center, an
Results
From October through December 2008, a sample of 302 caregivers were enrolled. Research assistants approached study subjects as they waited with their children to be seen for their appointment; approximately two-thirds agreed to participate. Of those who refused to participate, most refused as a result of concern about missing or being delayed for their appointment.
Of 302 parents, 3 caregivers did not complete the dosing assessment and were therefore excluded from analyses. A total of 299
Discussion
This study reveals that many parents, especially low SES parents, have difficulty dosing infant acetaminophen, with over half of parents in our sample making errors. Of particular concern, 5% of parents receiving standard instructions in our study made overdosing errors of 1.5 times above the recommended dose.
The high rate of dosing error we found is consistent with prior studies examining parent dosing accuracy with liquid medications.1, 2, 3, 18, 22 Although there has been limited study of
Acknowledgment
This research was supported in part by a grant under The Robert Wood Johnson Foundation Physician Faculty Scholars Program (Dr Yin). At the time the study was conducted, Dr Yin was supported by the Pfizer Fellowship in Health Literacy/Clear Health Communication. Funding for this project was also provided by KiDS of NYU and the NYU School of Medicine Department of Pediatrics Joseph Dancis Research Fund.
Additional contributions Nancy Linn, MFA, helped design the graphics used in the study.
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The authors have no conflicts of interest to disclose.