Pagán José A, Brown Cynthia J, Asch David A, Armstrong Katrina, Bastida Elena, Guerra Carmen
Department of Health Management and Policy, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX 76107, USA.
J Cancer Educ. 2012 Mar;27(1):132-7. doi: 10.1007/s13187-011-0239-6.
Breast cancer is the main cause of cancer deaths for Hispanic women. This study analyzes the role of functional health literacy on mammography screening behavior and adherence of Hispanic women. Survey data from 722 Mexican American women age 40 and over residing in the Lower Rio Grande Valley of Texas in 2008 were used to estimate logistic regression models to assess the role of functional health literacy on mammography screening behavior and adherence. About 51% of survey respondents had a functional health literacy level deemed as inadequate or marginally functional. After adjusting for other factors, women with adequate health literacy levels were more likely to report to have ever had a mammogram (odds ratio [OR] = 2.92; 95% confidence interval [CI] = 1.62-5.28), to have had a mammogram within the last 2 years (OR = 1.70; 95% CI = 1.14-2.53) or to have had one within the last year (OR = 2.30; 95% CI = 1.54-3.43), compared to women with inadequate or marginally adequate functional health literacy levels. Inadequate/marginal functional health literacy is strongly associated with lower mammography screening. Large improvements in breast cancer control in this population may come from either basic advances in health literacy or by tailored approaches to help women with low literacy navigate local health care systems.
乳腺癌是西班牙裔女性癌症死亡的主要原因。本研究分析了功能性健康素养对西班牙裔女性乳房X光检查筛查行为和依从性的作用。利用2008年居住在得克萨斯州下里奥格兰德河谷的722名40岁及以上墨西哥裔美国女性的调查数据,估计逻辑回归模型,以评估功能性健康素养对乳房X光检查筛查行为和依从性的作用。约51%的调查受访者的功能性健康素养水平被认为不足或勉强够用。在对其他因素进行调整后,与功能性健康素养水平不足或勉强够用的女性相比,健康素养水平足够的女性更有可能报告曾进行过乳房X光检查(优势比[OR]=2.92;95%置信区间[CI]=1.62-5.28)、在过去2年内进行过乳房X光检查(OR=1.70;95%CI=1.14-2.53)或在过去1年内进行过乳房X光检查(OR=2.30;95%CI=1.54-3.43)。功能性健康素养不足/勉强够用与较低的乳房X光检查筛查率密切相关。该人群乳腺癌控制方面的大幅改善可能来自健康素养的基本提升,或来自帮助低素养女性应对当地医疗保健系统的针对性方法。