From the Markey Cancer Center, University of Kentucky, Lexington, and the Department of Toxicology and Cancer Biology, College of Medicine, University of Kentucky, Lexington.
South Med J. 2020 Nov;113(11):541-548. doi: 10.14423/SMJ.0000000000001171.
Although cancer is seen in every state in the United States, it does not affect every geographic area and population equally. Kentucky has the highest cancer incidence and mortality rates in the country, with an unusually high number of cases localized in its Appalachian region. Risk factors such as sun exposure, tobacco use, poor diet/exercise, poverty, and lack of access to healthcare centers contribute to this disparity. Because education levels in the area are low, cancer literacy (defined as how well a person can understand the advice of a healthcare professional and make appropriate lifestyle decisions) also is low. In this study, we examined the short-term and long-term effects of a brief cancer-related intervention on the cancer literacy of Kentucky middle and high school students.
This study targeted middle and high school students in Kentucky. We administered an online 10-item cancer literacy pretest, followed by a brief educational intervention and a posttest to 164 students at six Kentucky middle and high schools. This posttest also included questions asking how likely students would be to change their habits or to encourage others to change their habits as a result of the intervention. All of the participating students also were sent a 3-month follow-up online survey with items identical to the pretest; 48 students completed the 3-month follow-up test, leading to a response rate of 29.2%. The data were summarized as frequencies, averages, median, and confidence intervals (CIs) of correctly marked answers. A paired test was used to test for significance.
We observed an increase in the overall average test score from 50.2% (95% CI 47.8%-52.6%) on the pretest to 77.1% (95% CI 74.6%-79.7%) on the posttest immediately following the intervention. There also was an increase in the average number of correct responses on each item. The 3-month follow-up test similarly showed average test score improvement (75.4%). When asked how likely students would be to change their habits as a result of the intervention on a scale from 1 to 10 (1 = extremely unlikely, 10 = extremely likely), the median was 6. When asked how likely students would be to encourage another to change their habits, the median was an 8.
These results provide evidence that a brief educational intervention can increase cancer literacy, improve cancer knowledge retention, and encourage behavior change in Appalachian Kentucky students. Increasing cancer literacy may result in increased participation in preventive cancer screenings and improved health habits, which could ultimately lower cancer rates in the region.
尽管癌症在美国各州都有发生，但它在地理区域和人群中的影响并不均衡。肯塔基州的癌症发病率和死亡率在全美最高，其阿巴拉契亚地区的病例数量异常之多。阳光照射、吸烟、不良饮食/运动、贫困以及缺乏医疗保健中心等风险因素导致了这一差异。由于该地区的教育水平较低，癌症知识（定义为一个人理解医疗保健专业人员建议并做出适当生活方式决策的能力）也较低。在这项研究中，我们调查了短期和长期的简要癌症干预对肯塔基州中学生癌症知识的影响。
本研究针对肯塔基州的中学生。我们对六所肯塔基州中学的 164 名学生进行了在线癌症知识 10 项预测试，随后进行了简短的教育干预和后测。该后测还包括询问学生由于干预措施他们改变习惯或鼓励他人改变习惯的可能性有多大。所有参与的学生还收到了一份为期 3 个月的在线跟进调查，其中包含与预测试相同的项目；有 48 名学生完成了 3 个月的后续测试，响应率为 29.2%。数据以正确标记答案的频率、平均值、中位数和置信区间（CI）进行总结。使用配对 t 检验来检验显著性。
我们观察到，在干预后立即进行的后测中，总体平均测试分数从预测试的 50.2%（95%CI 47.8%-52.6%）增加到 77.1%（95%CI 74.6%-79.7%）。每个项目的平均正确答案数量也有所增加。3 个月的后续测试同样显示出平均测试成绩的提高（75.4%）。当被问及由于干预措施，他们改变习惯的可能性有多大（1 分表示极不可能，10 分表示极有可能）时，中位数为 6 分。当被问及他们鼓励他人改变习惯的可能性有多大时，中位数为 8 分。
这些结果表明，简短的教育干预可以提高阿巴拉契亚肯塔基州学生的癌症知识，提高癌症知识的保留率，并鼓励他们改变行为。提高癌症知识可能会导致更多人参与预防性癌症筛查和改善健康习惯，最终降低该地区的癌症发病率。
