Health literacy, numeracy, and interpretation of graphical breast cancer risk estimates.
OBJECTIVE
Health literacy and numeracy are necessary to understand health information and to make informed medical decisions. This study explored the relationships among health literacy, numeracy, and ability to accurately interpret graphical representations of breast cancer risk.


METHODS
Participants (N=120) were recruited from the Facing Our Risk of Cancer Empowered (FORCE) membership. Health literacy and numeracy were assessed. Participants interpreted graphs depicting breast cancer risk, made hypothetical treatment decisions, and rated preference of graphs.


RESULTS
Most participants were Caucasian (98%) and had completed at least one year of college (93%). Fifty-two percent had breast cancer, 86% had a family history of breast cancer, and 57% had a deleterious BRCA gene mutation. Mean health literacy score was 65/66; mean numeracy score was 4/6; and mean graphicacy score was 9/12. Education and numeracy were significantly associated with accurate graph interpretation (r=0.42, p<0.001 and r=0.65, p<0.001, respectively). However, after adjusting for numeracy in multivariate linear regression, education added little to the prediction of graphicacy (r(2)=0.41 versus 0.42, respectively).


CONCLUSIONS
In our highly health-literate population, numeracy was predictive of graphicacy.


CONCLUSIONS
Effective risk communication strategies should consider the impact of numeracy on graphicacy and patient understanding.
Brown
Sandra M
SM
Saddleback Memorial Medical Center, USA.
Culver
Julie O
JO
Osann
Kathryn E
KE
MacDonald
Deborah J
DJ
Sand
Sharon
S
Thornton
Andrea A
AA
Grant
Marcia
M
Bowen
Deborah J
DJ
Metcalfe
Kelly A
KA
Burke
Harry B
HB
Robson
Mark E
ME
Friedman
Susan
S
Weitzel
Jeffrey N
JN
D000328:Adult; D000368:Aged; D001296:Audiovisual Aids; D001943:Breast Neoplasms / Q000453:epidemiology*; D003142:Communication; D032882:Comprehension; D003657:Decision Making; D005260:Female; D057220:Health Literacy; D006801:Humans; D008433:Mathematics; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods; D057240:Patient Preference; D011336:Probability; D011594:Psychometrics; D018570:Risk Assessment; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult