title: Application of the health literacy framework to diet-related cancer prevention conversations of older immigrant women to Canada.
abstract: Health literacy, conceptualized as a framework involving basic (functional), interactive and critical skill sets, is a key determinant of health. Application of the health literacy framework (HLF) to immigrant populations has been limited. Our objective was to apply the HLF to discourses about diet-related colon cancer prevention among English-as-a-Second-Language (ESL) immigrant women. We also explored whether these discussions could inform the development of culturally appropriate information and potentially increase health literacy. Interviews were conducted with 64 older Spanish-speaking ESL immigrant women. Directed content analysis guided by the HLF was used to identify themes. Diet-related conversations were initiated by 43 (67%) participants. Four themes were identified: general information requests-low functional health literacy (FHL) (n = 23/43), specific nutrition inquiries-high FHL (n = 17/43), actions for healthy eating-low interactive health literacy (IHL) (n = 8/43) and community communication issues-high IHL (n = 3/43). No conversations representing critical health literacy were identified. Five women discussed both FHL and IHL themes. Women's diet-related conversations followed a continuum of increasing information needs supporting the HLF.
authors.affiliation: Department of Social and Behavioral Health, Faculty of Medicine, Virginia Commonwealth University,1112 E. Clay Street, Richmond, VA 23298, USA. lhgoetz@uwaterloo.ca
authors.forename: M D
authors.initials: MD
authors.lastname: Thomson
authors.forename: L
authors.initials: L
authors.lastname: Hoffman-Goetz
mesh_terms: D000368:Aged; D002170:Canada; D002489:Central America / Q000208:ethnology; D015179:Colorectal Neoplasms / Q000208:ethnology / Q000517:prevention & control*; D003462:Cuba / Q000208:ethnology; D004032:Diet; D054242:Emigrants and Immigrants; D005260:Female; D057220:Health Literacy; D006801:Humans; D007407:Interviews as Topic; D008800:Mexico / Q000208:ethnology; D008875:Middle Aged; D013020:South America / Q000208:ethnology; D013030:Spain / Q000208:ethnology