title: Comparison of Cancer-specific and General Health Literacy Assessments in an Educated Population: Correlations and Modifying Factors.
abstract: An information onslaught accompanies cancer diagnoses, but patient comprehension (health literacy; HL) is frequently low, impacting both immediate care and longer term follow-up. Knowledge and adoption of preventive measures is especially important for cancer survivors due to their increased risk of secondary malignant neoplasms. We sought to evaluate the Test of Functional Health Literacy Adult (S-TOFHLA) against the recently developed cancer-specific Cancer Message Literacy Test (CMLT-r) among an educated population of both cancer survivors and those cancer-free. Participants were recruited 2013 (May through December) from various units within a local hospital and from several local churches, and each completed the S-TOFHLA and CMLT-r and provided demographic information and cancer status. The 109 participants had a mean age of 58 years and were as follows: 65.1 % female; 92.7 % white, 50.4 % college graduates, and 41.3 % cancer survivors. S-TOFHLA scores ranged from 12-36 (mean 34.1) and non-significantly varied by gender, education, cancer status, and age. CMLT-r scores ranged from 28.6-100 % (mean 86.4 %) and significantly varied by education (p = 0.013), but not by gender, cancer status, or age. Overall, CMLT-r and S-TOFHLA significantly correlated (p < 0.001). Assessment scores were skewed towards the maximum with non-significant differences by cancer status. As cancer survivorship improves and as the population becomes more educated, more refined approaches to assess health literacy should be considered. Increased education does not imply increased health literacy, and cancer survivorship does not imply higher health or cancer literacy. Concerted efforts to improve patient understanding and implementation of preventive measures are imperative.
authors.affiliation: Population Health Science Program, Southern Illinois University School of Medicine, 801 N. Rutledge St, Springfield, IL, 62794-9664, USA. wjenkins@siumed.edu.
authors.forename: Wiley D
authors.initials: WD
authors.lastname: Jenkins
authors.affiliation: Population Health Science Program, Southern Illinois University School of Medicine, 801 N. Rutledge St, Springfield, IL, 62794-9664, USA.
authors.forename: Whitney E
authors.initials: WE
authors.lastname: Zahnd
authors.affiliation: Population Health Science Program, Southern Illinois University School of Medicine, 801 N. Rutledge St, Springfield, IL, 62794-9664, USA.
authors.forename: Allison
authors.initials: A
authors.lastname: Spenner
authors.affiliation: Memorial Medical Center, Springfield, IL, USA.
authors.forename: Celeste
authors.initials: C
authors.lastname: Wiley
authors.affiliation: Memorial Medical Center, Springfield, IL, USA.
authors.forename: Rhonda
authors.initials: R
authors.lastname: Roles
authors.affiliation: Southern Illinois University School of Medicine, Springfield, IL, USA.
authors.forename: Yogitha
authors.initials: Y
authors.lastname: Potini
authors.affiliation: Memorial Medical Center, Springfield, IL, USA.
authors.forename: Linda S
authors.initials: LS
authors.lastname: Jones
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D032882:Comprehension; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D017741:Survivors; D055815:Young Adult
keywords: CMLT; Cancer survivors; Health literacy; Preventive cancer care; TOFHLA
references.citation: Patient Educ Couns. 2008 Jun;71(3):345-50
references.pmid: 18374536
references.citation: MMWR Morb Mortal Wkly Rep. 2011 Mar 11;60(9):269-72
references.pmid: 21389929
references.citation: J Gen Intern Med. 1995 Oct;10(10):537-41
references.pmid: 8576769
references.citation: J Natl Cancer Inst. 2010 Jul 21;102(14):1083-95
references.pmid: 20634481
references.citation: J Cancer Surviv. 2013 Sep;7(3):455-63
references.pmid: 23645522
references.citation: CA Cancer J Clin. 2002 May-Jun;52(3):134-49
references.pmid: 12018928
references.citation: Nurs Clin North Am. 2011 Sep;46(3):321-33, vi-vii
references.pmid: 21791267
references.citation: Ann Oncol. 2011 Apr;22(4):761-72
references.pmid: 20870912
references.citation: Patient Educ Couns. 2012 Jul;88(1):54-60
references.pmid: 22244323
references.citation: J Gen Intern Med. 2012 Aug;27(8):1033-46
references.pmid: 22798214
references.citation: Asia Pac J Clin Oncol. 2012 Mar;8(1):14-23
references.pmid: 22369440
references.citation: BMC Womens Health. 2014 Mar 26;14:49
references.pmid: 24666887
references.citation: Oncologist. 2011;16(12 ):1800-5
references.pmid: 22128118
references.citation: Patient Educ Couns. 2008 Jun;71(3):356-64
references.pmid: 18372142
references.citation: J Clin Oncol. 2012 Oct 20;30(30):3734-45
references.pmid: 23008293
references.citation: Health Aff (Millwood). 2013 Feb;32(2):357-67
references.pmid: 23381529
references.citation: Patient Educ Couns. 2013 Jan;90(1):96-102
references.pmid: 23058682
references.citation: Patient Educ Couns. 2012 Oct;89(1):69-75
references.pmid: 22789147
references.citation: Cancer. 2012 Aug 1;118(15):3842-51
references.pmid: 22180041
references.citation: Ann Fam Med. 2005 Nov-Dec;3(6):514-22
references.pmid: 16338915
references.citation: J Gen Intern Med. 2006 Aug;21(8):878-83
references.pmid: 16881951