Abstract
Several studies have found a link between health literacy and participation in cancer screening. Most, however, have relied on self-report to determine screening status. Further, until now, health literacy measures have assessed print literacy only. The purpose of this study was to examine the relationship between participation in cervical cancer screening (Papanicolaou [Pap] testing) and two forms of health literacy—reading and listening. A demographically diverse sample was recruited from a pool of insured women in Georgia, Massachusetts, Hawaii, and Colorado between June 2009 and April 2010. Health literacy was assessed using the Cancer Message Literacy Test-Listening and the Cancer Message Literacy Test-Reading. Adherence to cervical cancer screening was ascertained through electronic administrative data on Pap test utilization. The relationship between health literacy and adherence to evidence-based recommendations for Pap testing was examined using multivariate logistic regression models. Data from 527 women aged 40 to 65 were analyzed and are reported here. Of these 527 women, 397 (75 %) were up to date with Pap testing. Higher health literacy scores for listening but not reading predicted being up to date. The fact that health literacy listening was associated with screening behavior even in this insured population suggests that it has independent effects beyond those of access to care. Patients who have difficulty understanding spoken recommendations about cancer screening may be at risk for underutilizing screening as a result.
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Funding/Support and Role of Sponsor
The study was a core project of the HMO Cancer Research Network (CRN), Health Literacy and Cancer Prevention: Do People Understand What They Hear? funded by the National Cancer Institute (U19 CA079689). Additional funding for participation of a fourth CRN site was provided by a pilot grant through the CRN Cancer Communication Research Center (CCRC), also funded by the National Cancer Institute (P20 CA137219). Additional investigator support was provided by the National Center for Research Resources at the National Institutes of Health (KL2 RR031981). The funding agencies did not contribute to the study design, data collection, analysis, or interpretation; or the decision to submit the manuscript for publication.
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Mazor, K.M., Williams, A.E., Roblin, D.W. et al. Health Literacy and Pap Testing in Insured Women. J Canc Educ 29, 698–701 (2014). https://doi.org/10.1007/s13187-014-0629-7
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DOI: https://doi.org/10.1007/s13187-014-0629-7