{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T06:55:39Z","timestamp":1783407339601,"version":"3.54.6"},"reference-count":28,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,8,11]],"date-time":"2019-08-11T00:00:00Z","timestamp":1565481600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Public Health Nursing"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Healthcare spending in the US is $3.2 trillion. $1.1 trillion is attributed to hospital care, including emergency department (ED) visits and hospitalizations. There is a relationship between ED utilization, hospitalizations, and health literacy in the general population. Health literacy may play a role in frequent ED visits and hospitalizations in patients with sickle cell disease (SCD). The purpose of this paper is to describe the relationship among health literacy levels, annual hospital encounters, annual clinic visits, annual ED visits, and annual hospitalizations in 134 Black, non\u2010Hispanic adolescents aged 10\u201319\u00a0years with SCD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>This is a cross\u2010sectional, descriptive correlational study evaluating facilitators and barriers to health literacy and clinical outcomes in adolescents with SCD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Sample<\/jats:title><jats:p>Data were collected from 134 Black, non\u2010Hispanic adolescents with SCD at a large, tertiary care center in Texas.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>The Newest Vital Sign and REALM\u2010Teen health literacy instruments were used to evaluate health literacy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Contrasting previous studies evaluating the influence of health literacy on ED visits and hospitalizations in the general population, there were no significant relationships within this sample.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study gives insight into future research to evaluate other potential influences on ED utilization and hospitalizations in pediatric patients with SCD.<\/jats:p><\/jats:sec>","DOI":"10.1111\/phn.12643","type":"journal-article","created":{"date-parts":[[2019,8,12]],"date-time":"2019-08-12T01:49:11Z","timestamp":1565574551000},"page":"765-771","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["The influence of health literacy on emergency department utilization and hospitalizations in adolescents with sickle cell disease"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7134-077X","authenticated-orcid":false,"given":"Elizabeth Perry","family":"Caldwell","sequence":"first","affiliation":[{"name":"Louise Herrington School of Nursing Baylor University Dallas Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,8,11]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.92.8.1278"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-017-4267-y"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.378"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.21570"},{"key":"e_1_2_10_6_1","volume-title":"Emergency department visits","author":"Centers for Disease Control and Prevention","year":"2017"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2006-1139"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2011-3049"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1207\/s15327906mbr2603_7"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/1545109708328130"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.21408"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2010-3686"},{"key":"e_1_2_10_13_1","volume-title":"The health literacy of America's adults: Results from the 2003 National Assessment of Adult Literacy","author":"Kutner M.","year":"2006"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/her\/cym069"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2016.1330"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.22069"},{"key":"e_1_2_10_17_1","doi-asserted-by":"crossref","DOI":"10.17226\/10883","volume-title":"Health literacy: A prescription to end confusion","author":"Nielson\u2010Bohlman L.","year":"2004"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pedn.2017.05.012"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcl.2013.09.006"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2009-07-233700"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.15171\/ijhpm.2015.151"},{"key":"e_1_2_10_22_1","volume-title":"National library of medicine current bibliographies in medicine: Health literacy","author":"Ratzan S. 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