The Relationship between Maternal Health Literacy and Knowledge and Attitudes about Newborn Screenings in Different Ethnic Groups

Abstract

Introduction Newborn screening (NBS) programs play a crucial role in early diagnosis and prevention of neonatal morbidity and mortality. Maternal health literacy is a key factor influencing mothers' understanding, perceptions, and engagement with these programs. Ethnic disparities in health literacy and knowledge may affect equitable access and adherence. This study aimed to examine the relationship between maternal health literacy and mothers' knowledge and attitudes regarding newborn screenings across three ethnic groups, Turkish, Arab, and Kurdish, in the multicultural city of Mardin, Turkey. Methods This descriptive cross-sectional study was conducted with 568 mothers (189 Turkish, 189 Arab, 190 Kurdish) who had children aged 0-1 years. Data were collected through face-to-face interviews between March and June 2025 using a socio-demographic form, the Maternal Knowledge and Attitudes about Newborn Screening Survey (MKANSS), and the Turkey Health Literacy Scale-32. Data analysis included descriptive statistics, chi-square tests, one-way ANOVA, Pearson correlations, and linear regression. Results Significant ethnic differences were identified in maternal health literacy and NBS-related knowledge and attitudes. Turkish mothers demonstrated the highest health literacy scores, followed by Kurdish and Arab mothers. Similarly, Turkish mothers scored significantly higher on all MKANSS sub-dimensions compared with Arab and Kurdish mothers. Health literacy was strongly correlated with total NBS knowledge-attitude scores in the Turkish group, moderately in the Kurdish group, and weakly in the Arab group. Regression analyses showed that health literacy significantly predicted NBS knowledge-attitude scores in all ethnic groups, with the strongest effect observed among Turkish mothers. Conclusion Maternal health literacy is associated with mothers' knowledge and attitudes toward newborn screenings, with disparities across ethnic groups. Arab mothers demonstrated lower health literacy and less favourable knowledge and attitudes, indicating the need for targeted, culturally and linguistically appropriate educational interventions. Improving health literacy may enhance maternal engagement with NBS programs and help reduce ethnic disparities in neonatal health outcomes.