a Department of Neurobiology, Care Sciences and Society, Division of Nursing , Karolinska Institutet , Stockholm , Sweden.
b Department of Public Health and Caring Sciences , Uppsala University , Uppsala , Sweden.
Acta Oncol. 2018 Jun;57(6):743-749. doi: 10.1080/0284186X.2017.1420911. Epub 2018 Jan 8.
Sweden has not yet implemented a national screening program for colorectal cancer, but a nationwide study is ongoing; the Screening of Swedish Colons (SCREESCO). Previous research shows that the use of health care services, together with several health-related outcomes, is associated with an individual's level of health literacy. However, the relation between health literacy and participation in colorectal cancer screening has produced varying results reported within the few studies addressing this issue and therefore, further research is warranted.
The aim was to explore health literacy and views about being invited to screening, among participants and non-participants in a national colorectal cancer screening program. They were randomly sampled to fecal immunochemical test or colonoscopy and a mixed methods approach was applied, using questionnaires, focus group discussions and interviews.
The majority of individuals, whether they were participants or non-participants in the SCREESCO program, had an acceptable level of health literacy and no significant differences in health literacy levels between the groups were found. Participants expressed that it was important and appreciated to be able to choose information sources on an individual basis. Among non-participants, the importance of receiving invitations with a clear message that quickly draws one's attention was highlighted. However, both groups expressed a positive outlook towards the invitation. The mixed methods approach revealed that findings from interviews and focus group discussions corresponded to items in the health literacy scales.
A majority of individuals displayed acceptable levels of health literacy, regardless of whether they chose to participate or not. Similarities between the groups were seen in the qualitative findings regarding views of the invitation. Currently, the SCREESCO invitation letter is distributed by regular mail, but in the future a more dynamic approach could be valuable to increase clarity in the message about importance of screening.
瑞典尚未实施全国性的结直肠癌筛查计划，但正在进行一项全国性研究，即瑞典结肠筛查（SCREESCO）。先前的研究表明，医疗保健服务的使用以及与健康相关的多种结果与个体的健康素养水平相关。然而，健康素养与结直肠癌筛查参与之间的关系在少数研究中存在差异，因此需要进一步研究。
本研究旨在探讨参加和未参加全国结直肠癌筛查计划的参与者的健康素养和对被邀请参加筛查的看法。他们是通过粪便免疫化学试验或结肠镜检查随机抽样的，采用问卷调查、焦点小组讨论和访谈相结合的混合方法。
大多数参与者，无论是参加还是未参加 SCREESCO 计划，其健康素养水平都处于可接受水平，且两组之间的健康素养水平无显著差异。参与者表示，能够根据个人情况选择信息来源非常重要且受到赞赏。在未参与者中，突出强调了收到带有明确信息且能迅速引起关注的邀请的重要性。然而，两组都对邀请持积极态度。混合方法的结果表明，访谈和焦点小组讨论的发现与健康素养量表的项目相符。
大多数参与者的健康素养水平都处于可接受水平，无论他们是否选择参加。两组在邀请的看法方面的定性发现存在相似之处。目前，SCREESCO 的邀请信通过普通邮件分发，但在未来，更具动态性的方法可能会提高关于筛查重要性的信息的清晰度，从而更有价值。
