{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T13:26:47Z","timestamp":1769088407869,"version":"3.49.0"},"reference-count":87,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2020,3,31]],"date-time":"2020-03-31T00:00:00Z","timestamp":1585612800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","award":["1U54GM104944"],"award-info":[{"award-number":["1U54GM104944"]}],"id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Health literacy is understudied in the context of social networks. Our pilot study goal was to consider this research gap among vulnerable, low-income mothers of minority ethnic background in the state of Hawai\u2018i, USA. Recruitment followed a modified snowball sampling approach. First, we identified and interviewed seven mothers (\u201cegos\u201d) in a state-sponsored home visiting program. We then sought to interview individuals whom each mother said was part of her health decision-making network (\u201cfirst-level alters\u201d) and all individuals whom the first-level alters said were part of their health decision-making networks (\u201csecond-level alters\u201d). Health literacy was self-reported using a validated item. A total of 18 people were interviewed, including all mothers (n = 7), 35% of the first-level alters (n = 7\/20), and 36% of the second-level alters (n = 4\/11). On average, the mothers made health decisions with 2.9 people (range: 1-6); partners\/spouses and mothers\/mothers-in-law were most common. One mother had low health literacy; her two first-level alters also had low health literacy. Across the full sample, the average number of people in individuals\u2019 health decision networks was 2.5 (range: 0\u20137); 39% of those interviewed had low health literacy. This can inform the design of future studies and successful interventions to improve health literacy.<\/jats:p>","DOI":"10.3390\/ijerph17072356","type":"journal-article","created":{"date-parts":[[2020,3,31]],"date-time":"2020-03-31T11:36:42Z","timestamp":1585654602000},"page":"2356","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Considering Health Literacy, Health Decision Making, and Health Communication in the Social Networks of Vulnerable New Mothers in Hawai\u2018i: A Pilot Feasibility Study"],"prefix":"10.3390","volume":"17","author":[{"given":"Tetine","family":"Sentell","sequence":"first","affiliation":[{"name":"Office of Public Health Studies, University of Hawai\u2018i at M\u0101noa, Honolulu, HI 96822, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joy","family":"Agner","sequence":"additional","affiliation":[{"name":"Community and Cultural Psychology Department, University of Hawai\u2018i at M\u0101noa, Honolulu, HI 96822, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruth","family":"Pitt","sequence":"additional","affiliation":[{"name":"Office of Public Health Studies, University of Hawai\u2018i at M\u0101noa, Honolulu, HI 96822, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Davis","sequence":"additional","affiliation":[{"name":"John A. Burns School of Medicine, University of Hawai\u2018i, Honolulu, HI 96813, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6883-1781","authenticated-orcid":false,"given":"Mary","family":"Guo","sequence":"additional","affiliation":[{"name":"School of Nursing and Dental Hygiene, University of Hawai\u2018i School of Nursing and Dental Hygiene, Honolulu, HI 96822, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"McFarlane","sequence":"additional","affiliation":[{"name":"Office of Public Health Studies, University of Hawai\u2018i at M\u0101noa, Honolulu, HI 96822, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,3,31]]},"reference":[{"key":"ref_1","unstructured":"Ratzan, S., and Parker, R. (2000). 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