Impact of a Cancer Education Curriculum on Appalachian Kentucky Middle and High School Students.

Appalachian Kentucky is disproportionately affected by elevated cancer incidence and mortality rates. This disparity is driven by inequities in health behaviors and social determinants of health including decreased education attainment levels that cause lower health literacy. To increase cancer literacy in the region, a three-part cancer education curriculum was designed for Appalachian Kentucky middle and high school students. This study was designed to evaluate the effect the curriculum had on students' cancer literacy. The curriculum lessons were disseminated to Appalachian Kentucky middle and high school teachers who engaged 223 students with the material. For each lesson, students filled out a 10-question pretest and an identical 10-question posttest. The average and median percent of correct responses from the pre- to posttests were analyzed. The average percentage of correct responses significantly increased from 40% to 70%, 52% to 69%, and 33% to 53% on lessons 1, 2, and 3, respectively. A significant increase in the average percentage of correct responses on each individual question was also observed. The results demonstrate that the three-part cancer education curriculum intervention can significantly increase Appalachian Kentucky middle and high school students' cancer literacy. Increased cancer knowledge has the potential to encourage behavioral modifications that could reduce cancer incidence and mortality rates over time. Future work will include further improving the content relative to the target age/grade level and implementing the material with a broader group of teachers and students.

A Brief Educational Intervention Enhances Basic Cancer Literacy Among Kentucky Middle and High School Students.

Kentucky experiences the highest overall cancer incidence and mortality rates in the USA with the greatest burden in the eastern, Appalachian region of the state. Cancer disparities in Kentucky are driven in part by poor health behaviors, poverty, lack of health care access, low education levels, and low health literacy. Individuals with inadequate health literacy are less likely to participate in preventive measures such as obtaining screenings and making healthy lifestyle choices, thus increasing their chances of developing and dying from cancer. By increasing cancer literacy among youth and adults, it may be possible to decrease cancer disparities across Kentucky. This study aimed to establish connections with middle and high schools in Kentucky that would facilitate pilot implementation of a brief cancer education intervention and assessment of cancer health literacy among these student populations. A baseline pretest cancer literacy survey consisting of 10 items was given to 349 participants, followed by the delivery of a cancer education presentation. Immediately following the presentation, participants were given a posttest with identical items to the pretest. Participants were primarily Caucasian (89.4%), female (68.7%), and in 10th through 12th grade (80.5%). Significant (p < 0.0001) increases in both average and median percent of correctly marked items were observed between the pretest and posttest (average, pretest = 56% versus posttest = 85%; median, pretest = 60% versus posttest = 90%). The scores for all individual items increased after the brief intervention. The results demonstrated a significant increase in cancer literacy levels immediately after the pilot educational intervention. We suggest that it may be possible to improve cancer literacy rates in Kentucky by integrating cancer education into middle and high school science and/or health education curricula. This could ultimately drive changes in behaviors that may help lower cancer incidence and mortality rates. Plans for future interventional studies measuring long-term cancer knowledge retention and resultant behavioral changes among middle and high school students as well as the feasibility of integrating cancer education into middle and high school curricula are also discussed.

Assessing Cancer Health Literacy among Spanish-Speaking Latinos.

Health literacy is a dynamic construct that changes with specific health conditions; thus, new disease-specific health literacy tools are needed. Since cancer is the leading cause of death among Latinos, the largest and fastest-growing minority population in the nation, there is a need to develop tools to assess cancer health literacy (CHL) among the Spanish-speaking population. The Cancer Health Literacy Test, Spanish version (CHLT-30-DKspa) was applied to identify Spanish-speaking individuals with low CHL and ascertain which items in the tool best discriminate between CHL level groups. Cross-sectional field test of the CHLT-30-DKspa among Spanish-speaking Latinos. Latent class analysis (LCA) identified participants with varying CHL levels. Probability of correct answers, odds ratios, and standardized errors were used to identify the items that allow the classification of individuals among the latent classes. LCA resulted in a three-latent-class model predicting 39.4% of participants to be in the HIGH class, 43.3% in the MEDIUM class, and 17.3% in the LOW class. Eleven items (the CHLT-11-DKspa) meet the criteria to clearly separate participants with HIGH and LOW classes of CHL. Although the best model fit was a three-class solution, results showed a clear separation of individuals from HIGH versus LOW levels of CHL, but separation of those in the MEDIUM level was not as clear. The CHLT-11-DKspa is a shorter measure that may be relatively easy to use in a clinical encounter to identify Spanish-speaking patients with the poorest levels of CHL who may require additional support to understand medical instructions and care plans.

Breast cancer literacy and health beliefs related to breast cancer screening among American Indian women.

The purpose of this article is to examine the health beliefs and literacy about breast cancer and their relationship with breast cancer screening among American Indian (AI) women. Using the Health Belief Model (HBM) and hierarchical logistic regression with data from a sample of 286 AI female adults residing in the Northern Plains, we found that greater awareness of breast cancer screening was linked to breast cancer screening practices. However, perceived barriers, one of the HBM constructs, prevented such screening practices. This study suggested that culturally relevant HBM factors should be targeted when developing culturally sensitive breast cancer prevention efforts.

Immigrant grandmothers' and mothers-in-law's cancer literacy within their family context.

Data from focus groups held in Montréal (Canada) with 13 women born in Cameroon, Colombia, and Democratic Republic of Congo were used to explore cancer knowledge among immigrant grandmothers and mothers-in-law and their influence over family cancer-preventative practices. Thematic analysis identified the following leading themes: cancer literacy and influence over family cancer preventative and early detection practices, cancer literacy in relation to family health behaviors, and barriers to accessing health services. Perceived external causes of cancer and its prevention are countered by healthy eating and exercises. Cancer literacy was contextualized by the development of women's ways of being and doing.

The Emerging Role of Large Language Models in Improving Prostate Cancer Literacy.

This study assesses the effectiveness of chatbots powered by Large Language Models (LLMs)-ChatGPT 3.5, CoPilot, and Gemini-in delivering prostate cancer information, compared to the official Patient's Guide. Using 25 expert-validated questions, we conducted a comparative analysis to evaluate accuracy, timeliness, completeness, and understandability through a Likert scale. Statistical analyses were used to quantify the performance of each model. Results indicate that ChatGPT 3.5 consistently outperformed the other models, establishing itself as a robust and reliable source of information. CoPilot also performed effectively, albeit slightly less so than ChatGPT 3.5. Despite the strengths of the Patient's Guide, the advanced capabilities of LLMs like ChatGPT significantly enhance educational tools in healthcare. The findings underscore the need for ongoing innovation and improvement in AI applications within health sectors, especially considering the ethical implications underscored by the forthcoming EU AI Act. Future research should focus on investigating potential biases in AI-generated responses and their impact on patient outcomes.

The Role of Health Information Sources on Cervical Cancer Literacy, Knowledge, Attitudes and Screening Practices in Sub-Saharan African Women: A Systematic Review.

Cervical cancer is the leading cause of cancer deaths among Sub-Saharan African women. This systematic review aimed to identify information sources and their relation to cervical cancer knowledge, literacy, screening, and attitudes. Peer-reviewed literature was searched on 2 March 2022, and updated on 24 January 2023, in four databases-CINAHL Plus, Embase, PubMed, and Web of Science. Eligible studies included those that were empirical, published after 2002, included rural women, and reported on information sources and preferences. The quality of the selected articles was assessed using the Mixed Methods Appraisal Tool. Data extraction was conducted on an Excel spreadsheet, and a narrative synthesis was used to summarize findings from 33 studies. Healthcare workers were the most cited information sources, followed by mass media, social networks, print media, churches, community leaders, the Internet, and teachers. Community leaders were preferred, while healthcare workers were the most credible sources among rural women. There was generally low cervical cancer knowledge, literacy, and screening uptake, yet high prevalence of negative attitudes toward cervical cancer and its screening; these outcomes were worse in rural areas. A content analysis revealed a positive association of health information sources with cervical cancer literacy, knowledge, screening, and positive screening attitudes. Disparities in cervical cancer prevention exist between rural and urban Sub-Saharan African women.

The Potential Impact of Large Language Models on Doctor-Patient Communication: A Case Study in Prostate Cancer.

BACKGROUND: In recent years, the integration of large language models (LLMs) into healthcare has emerged as a revolutionary approach to enhancing doctor-patient communication, particularly in the management of diseases such as prostate cancer. METHODS: Our paper evaluated the effectiveness of three prominent LLMs-ChatGPT (3.5), Gemini (Pro), and Co-Pilot (the free version)-against the official Romanian Patient's Guide on prostate cancer. Employing a randomized and blinded method, our study engaged eight medical professionals to assess the responses of these models based on accuracy, timeliness, comprehensiveness, and user-friendliness. RESULTS: The primary objective was to explore whether LLMs, when operating in Romanian, offer comparable or superior performance to the Patient's Guide, considering their potential to personalize communication and enhance the informational accessibility for patients. Results indicated that LLMs, particularly ChatGPT, generally provided more accurate and user-friendly information compared to the Guide. CONCLUSIONS: The findings suggest a significant potential for LLMs to enhance healthcare communication by providing accurate and accessible information. However, variability in performance across different models underscores the need for tailored implementation strategies. We highlight the importance of integrating LLMs with a nuanced understanding of their capabilities and limitations to optimize their use in clinical settings.

Geographic, Demographic, and Socioeconomic Disparities and Factors Associated With Cancer Literacy in China: National Cross-sectional Study.

BACKGROUND: Cancer literacy is associated with several health-related behaviors and outcomes. However, there is still a lack of nationwide surveys for cancer literacy in China. OBJECTIVE: This study aims to evaluate cancer literacy in China, explore disparities, and provide scientific evidence for policy makers. METHODS: A cross-sectional survey was conducted in mainland China in 2021 using the multistage probability proportional to the size sampling method. Both the reliability and validity of the questionnaire were evaluated. The awareness levels were adjusted by sampling weights and nonrepresentativeness weights to match the actual population distributions. The Rao-Scott adjusted chi-square test was applied to test geographic, demographic, and socioeconomic disparities. A generalized linear model was used to explore potential factors. RESULTS: A total of 80,281 participants aged 15-74 years were finally enrolled from 21 provinces, with an overall response rate of 89.32%. The national rate of cancer literacy was 70.05% (95% CI 69.52%-70.58%). The rates were highest regarding knowledge of cancer management (74.96%, 95% CI 74.36%-75.56%) but were lowest regarding basic knowledge of cancer (66.77%, 95% CI 66.22%-67.33%). Cancer literacy was highest in East China (72.65%, 95% CI 71.82%-73.49%), Central China (71.73%, 95% CI 70.65%-72.81%), and North China (70.73%, 95% CI 68.68%-72.78%), followed by Northeast (65.38%, 95% CI 64.54%-66.22%) and South China (63.21%, 95% CI 61.84%-64.58%), whereas Southwest (59.00%, 95% CI 58.11%-59.89%) and Northwest China (57.09%, 95% CI 55.79%-58.38%) showed a need for improvement. Demographic and socioeconomic disparities were also observed. Urban dwellers, the Han ethnic group, and population with higher education level or household income were associated with prior knowledge. The questionnaire showed generally good internal and external reliability and validity. CONCLUSIONS: It remains important for China to regularly monitor levels of cancer literacy, narrow disparities, and strengthen health education for dimensions with poor performance and for individuals with limited knowledge to move closer to the goal of Healthy China 2030.

The Chinese Version of the Breast Cancer Literacy Assessment Tool: Translation, Adaptation, and Validation Study.

BACKGROUND: Breast cancer is the most common cancer among Chinese women, with an age-standardized prevalence of 21.6 cases per 100,000 women. Limited cancer health literacy reduces females' ability to engage in cancer prevention and detection. It is necessary to assess Chinese women's breast cancer literacy to deliver targeted interventions and effective education. However, there is no Breast Cancer Literacy Assessment Tool (B-CLAT) available in China currently. OBJECTIVE: This study aimed to translate and linguistically and culturally adapt the B-CLAT into a simplified-Chinese version (C-B-CLAT), and then validate its psychometric properties by administering it to Chinese college students. METHODS: First, we translated the B-CLAT into a simplified-Chinese version and verified its validity and reliability using rigorous translation and validation guidelines proposed in previous studies. We then evaluated the psychometric properties among 50 female participants with a mean age of 19.62 (SD 1.31) years recruited from Nantong University, China. RESULTS: Items 1, 6, 8, 9, 10, 16, 17, 20, 21, 22, 23, 24, 25, 26, 29, and 30 were deleted to increase the relevant subscale internal consistency. Items 3, 12, 13, 14, 18, 20, 27, and 31 were deleted due to their Cronbach α being lower than .5 in the test-retest analysis. After deletion, the internal consistency of the entire scale was fair with α=.607. The prevention and control subscale had the highest internal consistency with α=.730, followed by the screening and knowledge subscale with α=.509, while the awareness subscale had the lowest internal consistency with α=.224. The intraclass correlation coefficient for the C-B-CLAT (items 2, 4, 5, 7, 11, 15, 28, 32, 33, and 34) was fair to excellent (odds ratio [OR] 0.88, 95% CI 0.503-0.808). The values of Cronbach α for items 2, 4, 5, 7, 11, 15, 28, 32, 33, and 34 ranged from .499 to .806, and the α value for the C-B-CLAT was .607. This indicates fair test-retest reliability. The mean difference in the C-B-CLAT scores between stage 1 and stage 2 was 0.47 (OR 0.67, 95% CI -0.53 to 1.47), which was not significantly different from zero (t48=0.945; P=.35). This result implies that the C-B-CLAT produced the same scores at stage 1 and stage 2 on average, thus showing good agreement in the C-B-CLAT scores between stage 1 and stage 2. The SD of the difference was 3.48. The 95% limits of agreement were -6.34 to 7.28. CONCLUSIONS: We developed a simplified-Chinese version of the B-CLAT through translation and adaptation. Psychometric properties testing has proven this version valid and reliable for assessing breast cancer literacy among Chinese college students.

Translation and Cross-Cultural Adaptation of the Cancer Health Literacy Test for Portuguese Cancer Patients: A Pre-Test.

Assuming the multidimensionality of health literacy, new complex and comprehensive approaches are more adequate to specific disease contexts, such as cancer. Assessing cancer literacy levels is a priority, since it entails potential serious implications for disease outcomes and patient's quality of life. This article reports on the translation and cultural adaptation of the Cancer Health Literacy Test to measure cancer literacy in Portuguese cancer patients. A multidisciplinary team of experts ensured the translation and cultural adaptation of the CHLT-30. A pre-test was conducted in two stages to evaluate the Portuguese version (CHLT-30 PT) in a sample of cancer patients (n = 71). Descriptive statistics were used to characterize the sample. Reliability (test-retest and internal consistency) and construct validity of CHLT-30 PT were assessed. The results obtained show a good internal consistency of the tool, respectively (Cronbach's alpha = 0.86 in the test and 0.80 in the retest). Patients' raw score mean in both test (23.96) and retest (25.97) and the distribution of scores categories are not statistically different. A suggestive association between higher education level and better total score was found compared to the results reported in CHLT-30-DKspa. The results obtained in the pre-test are favorable, and the instrument is now suitable for the next steps of the validation process. A Portuguese version of this tool will allow outlining patients' cancer literacy along the cancer care continuum, enabling the identification and implementation of adequate socio-educational strategies with highly positive impacts on health outcomes.

The Relationship Between e-Health Literacy and Breast Cancer Literacy Among Saudi Women.

Breast cancer is the most common cancer in women and represents a significant burden among women worldwide. The concept of health literacy is relatively new to the Gulf states, particularly to Saudi Arabia. Research on this topic is scarce, and no study has empirically explored the influence of e-health literacy on breast cancer literacy. The purpose of this study was to measure the impact of e-health literacy on breast cancer literacy among Saudi women in Riyadh city, Saudi Arabia. A cross-sectional survey was conducted online in a cohort of 336 women and disseminated via social media using the e-Health Literacy Scale (eHEALS) and Breast Cancer Literacy Assessment Tool (Breast-CLAT). Multiple regression analysis was executed to identify the sociodemographic factors that influence the e-health literacy and breast cancer literacy of participants. The participants showed high level of e-health literacy with total eHEALS score of 28.79, and better breast cancer literacy with total Breast-CLAT score of 23.44. This study yielded three significant findings: (1) e-health literacy is influenced by age and education which implies that youngest participants showed higher eHEALS scores than their older counterparts and that having increased education level reflected increased eHEALS scores, (2) breast cancer literacy is predicted by education and income which suggests that those who have higher levels of education and higher monthly incomes have increased levels of breast cancer literacy, and (3) breast cancer literacy and e-health literacy were associated which shows that participants with higher eHEALS scores were more likely have increased level of breast cancer literacy. The study revealed that the participants had high level of e-health literacy which correlated to their increased level of breast cancer literacy. The study findings implied that it is important for Saudi women to possess high levels of e-health literacy about breast cancer as more breast cancer educational resources are online nowadays.

Can popular films instil carcinophobia? Images of cancer in popular Polish cinema.

Introduction: Although cancer is currently considered a serious socio-medical challenge and health education in Poland has been positioned as a public health priority, the impact of popular culture on people's ideas about cancer has been neglected. This study therefore aims to analyse the way popular Polish films portray cancer and the experience of cancer. Material and Methods: Seven popular Polish films featuring cancer were analysed both quantitatively and qualitatively. The main categories included in the coding frame were disease, therapy, patient, physicians/oncologists and psychosocial issuses related to cancer. Results: Polish films fail to provide the audience with basic information about the disease, its diagnoses and treatment and cancer is often represented as a mysterious disease with an unclear cause, an unpredictable and unsuccessful course of treatment, characterised by pain, suffering and inevitable death. Films may therefore instil carcinophobia. Since films accurately reflect problems of daily life faced by cancer patients and their families they have educational potential. Conclusion: Although Polish films reinforce harmful stereotypes about cancer, its treatment, oncological institutions and specialists, cinema has the ability to raise the public's and health professionals' awareness regarding the psycho-social and emotional strains faced by cancer patients and the medical problems related to cancer.

Cancer Screening Literacy among Vietnamese Population: Does Annual Checkup Improve Cancer Screening Literacy?

BACKGROUND: Colorectal, breast, and cervical cancers disproportionately impact the Vietnamese population. However, research on cancer prevention among this population was very limited. The purpose of this study is to examine the cancer screening literacy levels for these three types of cancers among rural Vietnamese and investigate correlates of cancer screening literacy. METHODS: A sample of 226 Vietnamese men and women aged 25-70 years old was recruited from rural Vietnam and finished a self-administered questionnaire. Andersen's Behavioral Model was used to guide this cross-sectional study to identify modifiable variables. Bivariate analysis was used to explore the relationship between demographic factors and cancer screening literacy levels. Multiple linear regressions were also used to identify significant factors for cancer literacy levels. RESULTS: Cancer screening literacy levels of Vietnamese men and women were low regarding all three types of cancers, especially HPV symptom questions. Only about 24% of women answered correctly on "most people with genital HPV have no visible signs/symptoms" and less than 18% answered correctly on "I can transmit HPV to my partner(s) even if I have no HPV symptoms." Findings suggested that having an annual checkup was associated with higher colorectal (ß=.15, p <.05), breast (ß=.25, p <.001), and cervical (ß=.18, p <.01) cancer screening literacy. CONCLUSIONS: Public health efforts should focus on encouraging annual checkups in the Vietnamese population. During the annual checkup, health care professionals should educate patients about importance of cancer screening and provide recommendations for regular cancer screenings to reduce cancer health disparities.

Testing the Preliminary Validity of a Multidimensional Framework for Studying the Effects of Cancer Health Literacy on Cancer Screening Behaviors among Diverse Populations.

The objective of this study was to evaluate the applicability of a multidimensional framework to explore factors associated with cancer literacy and its effects on receiving cancer screenings among diverse populations. Based on the conceptual framework, we developed and pilot-tested the Multidimensional Cancer Literacy Questionnaire (MCLQ) among 1500 individuals (African Americans, Latinos and Whites) in Louisiana. Exploratory factor analysis was used to identify the MCLQ underlying structure and predominant factors explaining each of the dimensions in the model. A total of 82 items (explaining 67% of the total variance) in the MCLQ were grouped into 20 factors associated with three key dimensions related to cancer literacy. Preliminary validity of the MCLQ was supported: Cronbach alpha for the scale score was 0.89 and internal consistency reliability coefficients for each factor were all above 0.67. The Facilitators Domain included five factors (28 items) that may positively influence individuals to have early-detection cancer screenings. The Barriers Domain included seven factors (26 items) explaining aspects that may negatively influence individuals to have cancer screenings. The Cultural Domain included eight factors (28 items) related to aspects that influence positively or negatively individuals' perceptions regarding cancer as a disease, screenings and treatments. A multidimensional framework to study cancer literacy, including cultural attitudes, beliefs and practices, as well as facilitators and barriers, among diverse populations, will increase understanding of factors influencing individuals' approach to cancer prevention and screening. Results will inform further testing of the multidimensional framework and questionnaire.

Literacy of Breast Cancer and Screening Guideline in an Immigrant Group: Importance of Health Accessibility.

Little is known about predictors of breast cancer literacy among immigrant women. A cross-sectional survey investigated predisposing, enabling, and need factors of breast cancer literacy among 233 Korean American women living in a southeastern U.S. city. Breast cancer literacy was measured by questions that asked awareness of cancer screening methods and a 5-item questionnaire derived from the American Cancer Society's breast cancer screening guidelines and risk factors. Annual checkup was an enabling factor of awareness of Clinical Breast Exam (CBE) and mammogram, and also for breast cancer literacy covering the knowledge of breast cancer screening guidelines and risk factors. Health status was a need factor of CBE awareness. Marital status was a predisposing factor of mammogram awareness, and age and years of residence in the US were predisposing factors of breast cancer literacy. The findings of the study illuminate probable avenues of intervention to promote breast health knowledge for Korean American women.

The call for a strategic framework to improve cancer literacy in Europe.

BACKGROUND: Health literacy is increasingly being recognized as a widespread public health challenge in Europe. This commentary explores the importance of health literacy amongst cancer patients (ie, cancer literacy) and examines how cancer literacy can be improved through the practical application of health literacy principles within the context of providing timely, patient-centered, value-based care in Europe. MAIN BODY: Despite implementation of evidence-based cancer prevention programs and increased cancer survival rates, low cancer literacy may impact the personal capacity to manage risks and adversely impact behavior and outcomes. Cancer literacy poses a unique set of challenges compared to other types of health literacy, as patient decisions regarding screening, treatment, and side effect management are often complex, and timely decision-making is more critical. Accordingly, European health policies increasingly recognize the importance of health literacy. The European Patients Forum, European Cancer Patient Coalition, and the Association of European Cancer Leagues supported a joint statement, "Europe Let's Do More for Health," which emphasizes the need to empower citizens and patients by addressing health literacy, self-management, and shared decision-making. Implementation of comprehensive programs and strategies will be important to improve health literacy. Cancer literacy can be improved through application of health literacy principles in the communication and cooperation with professionals, patients and caregivers for providing timely, patient-centered, value-based care. Recommendations are made for further action to improve cancer literacy in Europe through coordinated efforts among providers, organizations, patients, and research. A policy paper developed by the European Joint Action on Cancer Control provides practical recommendations that Member States can take to reduce social inequalities in cancer care and defines focus areas that are closely connected with the need to improve cancer literacy. CONCLUSION: Improved personal cancer literacy combined with health literate organizations and systems can potentially improve the quality of care and health outcomes among patients with cancer. National Cancer Control Plans and Europe's Beating Cancer Plan can strengthen cancer literacy.

Development and Evaluation of a Cancer Literacy Intervention to Promote Mammography Screening Among Navajo Women: A Pilot Study.

PURPOSE: Develop and evaluate a mammography intervention that provides hope about cancer prevention and treatment. DESIGN: Pilot randomized controlled trial. SETTING: Two communities on the Navajo Nation. PARTICIPANTS: Navajo women and support persons. INTERVENTION: Both groups received standard care: one home visit discussing mammography pros/cons and barriers. The treatment group received an intervention based on Navajo language via an additional home visit with health education materials (written and oral) in English and Navajo, including a Navajo Cancer Glossary with a new descriptive phrase for cancer. ANALYSIS: Between control and intervention conditions, we compared baseline sociodemographics; changes from baseline to 3 months on mammography completion and breast cancer literacy scores. MEASURES: (1) intervention feasibility; (2) self- and clinic-reported mammography screening completion; (3) breast cancer literacy. RESULTS: A total of 25 participants were randomly assigned (13 treatment, 12 control), with 7 support persons in each arm. Mean age was 53 years, 90% had a high school degree or higher, 86% spoke Navajo and English. At 3 months, 44% had a clinically verified mammogram. Mammography completion was 57% among those with a support person and 27% among those without (P = .14). Intervention women reported more breast cancer beliefs consistent with mammography (P = .015). CONCLUSIONS: Increases in breast cancer beliefs consistent with mammography show promise. Findings highlight a need to tailor education materials to Navajo culture/language and focus on enhancing support.

Adapting a Cancer Literacy Measure for Use Among Navajo Women.

PURPOSE: The authors designed a community-based participatory research study to develop and test a family-based behavioral intervention to improve cancer literacy and promote mammography among Navajo women. METHOD: Using data from focus groups and discussions with a community advisory committee, they adapted an existing questionnaire to assess cancer knowledge, barriers to mammography, and cancer beliefs for use among Navajo women. Questions measuring health literacy, numeracy, self-efficacy, cancer communication, and family support were also adapted. RESULTS: The resulting questionnaire was found to have good content validity, and to be culturally and linguistically appropriate for use among Navajo women. CONCLUSIONS: It is important to consider culture and not just language when adapting existing measures for use with AI/AN (American Indian/Alaskan Native) populations. English-language versions of existing literacy measures may not be culturally appropriate for AI/AN populations, which could lead to a lack of semantic, technical, idiomatic, and conceptual equivalence, resulting in misinterpretation of study outcomes.

Breast Cancer Screening Paved with Good Intentions: Application of the Information-Motivation-Behavioral Skills Model to Racial/Ethnic Minority Women.

Racial/ethnic minority women experience disparities in breast cancer. Studies suggest that this may be partly related to later stage of diagnosis. Adherence to breast cancer screening guidelines is frequently lower in racial/ethnic minority populations, which may contribute to this disparity. The purpose of this study was to examine the predictors of intentions to obtain breast cancer screening based on established guidelines using the information-motivation-behavioral skills model. Data for this study were obtained from the community-based Kin KeeperSM Cancer Prevention Intervention study and included 278 racial/ethnic minority women (Black = 138; Latina = 68; Arab = 80). Data were collected between 2009 and 2010 and analyzed in 2013. Structural equation models were tested to examining the effects of functional breast cancer literacy, motivation, and breast cancer screening behavior. Motivation was significantly associated with breast cancer screening. Breast cancer literacy (information) is positively associated with breast cancer screening. The findings indicate that the higher the level of breast cancer literacy and the more motivated patients are, the more likely they are to be screened. In addition, there was a significant association between the covariate race and other model constructs. Functional breast cancer literacy and motivation interventions are important factors to consider when designing breast cancer screening interventions in racial/ethnic minority women. These interventions should consider cultural and contextual factors that are associated with screening behavior.