Journal of Cancer Education

, Volume 33, Issue 6, pp 1333–1340 | Cite as

Assessing Cancer Health Literacy among Spanish-Speaking Latinos

  • Margarita Echeverri
  • David Anderson
  • Anna María Nápoles


Health literacy is a dynamic construct that changes with specific health conditions; thus, new disease-specific health literacy tools are needed. Since cancer is the leading cause of death among Latinos, the largest and fastest-growing minority population in the nation, there is a need to develop tools to assess cancer health literacy (CHL) among the Spanish-speaking population. The Cancer Health Literacy Test, Spanish version (CHLT-30-DKspa) was applied to identify Spanish-speaking individuals with low CHL and ascertain which items in the tool best discriminate between CHL level groups. Cross-sectional field test of the CHLT-30-DKspa among Spanish-speaking Latinos. Latent class analysis (LCA) identified participants with varying CHL levels. Probability of correct answers, odds ratios, and standardized errors were used to identify the items that allow the classification of individuals among the latent classes. LCA resulted in a three-latent-class model predicting 39.4% of participants to be in the HIGH class, 43.3% in the MEDIUM class, and 17.3% in the LOW class. Eleven items (the CHLT-11-DKspa) meet the criteria to clearly separate participants with HIGH and LOW classes of CHL. Although the best model fit was a three-class solution, results showed a clear separation of individuals from HIGH versus LOW levels of CHL, but separation of those in the MEDIUM level was not as clear. The CHLT-11-DKspa is a shorter measure that may be relatively easy to use in a clinical encounter to identify Spanish-speaking patients with the poorest levels of CHL who may require additional support to understand medical instructions and care plans.


Cancer health literacy Latinos Hispanics Assessment Psychometric evaluation Spanish Assessment tools Cancer literacy levels 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflicts of interest.

Grant Support

Dr. Magarita Echeverri’s contribution was supported in part by the Research Centers in Minority Institutions Program (RCMI) of the National Institute on Minority Health and Health Disparities (NIMHD) grant number 2G12MD007595, the NIMHD grant number 5S21MD0000100, and the grant number 1U54GM104940 from the National Institute of General Medical Sciences of the National Institutes of Health which funds the Louisiana Clinical and Translational Science Center (LA CaTS). Dr. Anna María Nápoles’ contribution was supported by the Resource Centers for Minority Aging Research program of the National Institute on Aging grant number P30 AG15272 and the National Cancer Institute grant number 1U54CA153511.

Ethical Approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the Xavier University of Louisiana’s Institutional Review Board (study no. 511) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Supplementary material

13187_2017_1255_MOESM1_ESM.docx (94 kb)
ESM 1 (DOCX 94.2 kb)


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Copyright information

© American Association for Cancer Education 2017

Authors and Affiliations

  1. 1.Educational Coordinator Health Disparities, Diversity and Cultural Competence, Center for Minority Health and Health Disparities Research and EducationXavier University of Louisiana, College of PharmacyNew OrleansUSA
  2. 2.Department of MathematicsXavier University of LouisianaNew OrleansUSA
  3. 3.Department of Medicine, Center for Aging in Diverse CommunitiesUniversity of California San FranciscoSan FranciscoUSA

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