Mazor K M, Williams A E, Roblin D W, Gaglio B, Cutrona S L, Costanza M E, Han P K J, Wagner J L, Fouayzi H, Field T S
Meyers Primary Care Institute, University of Massachusetts Medical School, 630 Plantation Street, Worcester, MA, 01605, USA,
J Cancer Educ. 2014 Dec;29(4):698-701. doi: 10.1007/s13187-014-0629-7.
Several studies have found a link between health literacy and participation in cancer screening. Most, however, have relied on self-report to determine screening status. Further, until now, health literacy measures have assessed print literacy only. The purpose of this study was to examine the relationship between participation in cervical cancer screening (Papanicolaou [Pap] testing) and two forms of health literacy-reading and listening. A demographically diverse sample was recruited from a pool of insured women in Georgia, Massachusetts, Hawaii, and Colorado between June 2009 and April 2010. Health literacy was assessed using the Cancer Message Literacy Test-Listening and the Cancer Message Literacy Test-Reading. Adherence to cervical cancer screening was ascertained through electronic administrative data on Pap test utilization. The relationship between health literacy and adherence to evidence-based recommendations for Pap testing was examined using multivariate logistic regression models. Data from 527 women aged 40 to 65 were analyzed and are reported here. Of these 527 women, 397 (75 %) were up to date with Pap testing. Higher health literacy scores for listening but not reading predicted being up to date. The fact that health literacy listening was associated with screening behavior even in this insured population suggests that it has independent effects beyond those of access to care. Patients who have difficulty understanding spoken recommendations about cancer screening may be at risk for underutilizing screening as a result.
多项研究发现健康素养与癌症筛查参与度之间存在关联。然而，大多数研究都依赖自我报告来确定筛查状态。此外，直到现在，健康素养测评仅评估了印刷品读写能力。本研究的目的是检验宫颈癌筛查（巴氏试验）参与度与两种健康素养形式——阅读和听力之间的关系。2009年6月至2010年4月期间，从佐治亚州、马萨诸塞州、夏威夷州和科罗拉多州的参保女性群体中招募了一个人口统计学特征多样的样本。使用癌症信息素养测试——听力版和癌症信息素养测试——阅读版来评估健康素养。通过巴氏试验利用情况的电子管理数据确定宫颈癌筛查的依从性。使用多变量逻辑回归模型检验健康素养与遵循巴氏试验循证建议之间的关系。对527名年龄在40至65岁之间的女性的数据进行了分析并在此报告。在这527名女性中，397名（75%）的巴氏试验是最新的。听力而非阅读方面的较高健康素养得分预示着筛查是最新的。即使在这个参保人群中，健康素养听力与筛查行为相关这一事实表明，它具有超出获得医疗服务之外的独立影响。因此，那些难以理解关于癌症筛查的口头建议的患者可能存在筛查利用不足的风险。
