INTRODUCTION
Atopic dermatitis (AD) is a common inflammatory dermatologic condition, affecting upwards of 20% of children worldwide.1 Although AD typically responds quickly to treatment, nonadherence is a common barrier to treatment success in the pediatric population, with up to two-thirds of patients and their caregivers not utilizing topical medications exactly as prescribed.2 Common reasons for treatment nonadherence in AD include cost, unclear or difficult to understand treatment instructions and concerns about side effects.3-5
Health literacy, "the ability to read, understand and use health information to make appropriate healthcare decisions," is an essential aspect for health care providers to consider in their patients.6,7 Low caregiver health literacy has been linked to deleterious health outcomes for many children.8 Therefore, a caregiver's understanding of treatment, influenced by the provider's specific phrasing, may be associated with their willingness to treat childhood AD. In clinical practice, topical corticosteroids are often initially presented to caregivers as either a "topical medication" or "topical steroid." Some caregivers may benefit from education that topical corticosteroids share many similarities with the glucocorticoids produced naturally by the adrenal glands in the body.
Health literacy, "the ability to read, understand and use health information to make appropriate healthcare decisions," is an essential aspect for health care providers to consider in their patients.6,7 Low caregiver health literacy has been linked to deleterious health outcomes for many children.8 Therefore, a caregiver's understanding of treatment, influenced by the provider's specific phrasing, may be associated with their willingness to treat childhood AD. In clinical practice, topical corticosteroids are often initially presented to caregivers as either a "topical medication" or "topical steroid." Some caregivers may benefit from education that topical corticosteroids share many similarities with the glucocorticoids produced naturally by the adrenal glands in the body.
Tailoring the language used when presenting topical corticosteroids to caregivers to best address their unique needs and understanding of treatment may increase willingness to initiate treatment; however, substitute language framing has not been well defined in this population. The purpose of this study was to assess caregivers' willingness to treat childhood AD with either a "topical steroid," "topical medication," or "treatment, similar to the all-natural signals produced by the adrenal glands in the body."
