Health literacy and cancer screening in rural populations
Methods and Design: As part of a pilot intervention to improve cancer screening in rural populations, we assessed demographics and current cancer screening behavior at baseline (following USPSTF guidelines) for four preventable cancers: Breast, Cervical, Colorectal, and Prostate. An audible, third grade literacy level, self-administrated pre-intervention survey was conducted using tablet computers in the presence of a facilitator. An intensive CBPR approach guided survey development and participant recruitment. The Rapid Estimate of Adult Literacy in Medicine (REALM-R) was used to measure health literacy. Limited health literacy was defined as a REALM-R score of less than 6.
Results: During 6 weeks of recruitment, 443 participants completed a pre-intervention survey. Mean age was 42.9 years, 63.5% were women, 55% were white, 35% completed high school or less, 38% had insurance and 71% had a primary care provider. 25.3% had low REALM-R scores. Average screening rates in the overall sample were Cervical-66.7%, Colorectal-57.1%, Breast-46.4%, and Prostate-32.1%. Limited health literacy was associated with lower current colorectal cancer screening (41.2% versus 64.1%, p=0.0058) but not with breast, cervical and prostate cancers.
Conclusion: Patients with limited health literacy have a significantly lower uptake of preventative colorectal cancer screening.
Learning Areas:Assessment of individual and community needs for health education
Planning of health education strategies, interventions, and programs
Public health or related research
Describe one innovative approach for administering surveys in a limited health literacy population. List one preventable cancer where limited health literacy is associated with lower screening rates in a rural community.
Keyword(s): Cancer Screening, Rural Health Care
Qualified on the content I am responsible for because: I have a scientific interest in cancer screening in limited health literacy populations.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.