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183807 Health literacy among women presenting with abnormal cervical cancer screens in Chicago

Monday, October 27, 2008

Melissa A. Simon, MD, MPH , Department of Obstetrics and Gynecology, Feinberg School of Medicine at Northwestern University, Chicago, IL
Talar Markossian, MPH , Health Policy and Administration, University of Illinois at Chicago School of Public Health, Chicago, IL
Julia Shklovskaya, MPPA , Administrative Offices: Research Department, Access Community Heatlh Network, Chicago, IL
Phyllis Ferguson-Collum, MSW , Health Policy and Administration, University of Illinois at Chicago School of Public Health, Chicago, IL
Julie Darnell, MHSA, AM , School of Public Health, Division of Health Policy and Administration, University of Illinois, Chicago, Chicago, IL
Charles Bennett, MD, PhD, MPH , Feinberg School of Medicine, Northwestern University, Chicago, IL
Elizabeth Calhoun, PhD , School of Public Health, Division of Health Policy and Administration, University of Illinois, Chicago, Chicago, IL
Background: Many low income women face multiple barriers with follow-up of abnormal cancer screening tests and treatment. We highlight health literacy as one of these barriers.

Methods: In the context of a randomized controlled trial through the Chicago Cancer Navigation Project (CCNP), patient navigators consisting of social worker and lay health navigators identified, tracked and resolved barriers to follow-up. We report the preliminary data from our CCNP among a cohort underserved women with an emphasis on their health literacy levels.

Results: 90 study participants had abnormal pap smears and ranged in age from 18-64. 81 were Black, 7 Hispanic, and 2 white. 88% had income less than $19,000. 27 (30%) reported an education of some high school and 1 reported less than eighth grade level. All women took the REALM-66 to measure health literacy. 41 (46%) had literacy levels eighth grade or below. 49 (54%) had literacy levels above eighth grade. Among women with low literacy, 82% had pap results of squamous intraepithelial lesions (LGSIL or HGSIL). 66% of women with high literacy had LGSIL or HGSIL. On biopsy, 71% of women with low literacy had cervical intraepithelial neoplasia (CIN) level 1 and 29% had CIN level 2 or greater. 27% of high literacy women had CIN 1 and 20% had CIN level 2 or greater.

Conclusion: Women with low literacy were more likely to present with pap and biopsy results of a higher grade. These data highlight the importance of addressing health literacy among women with abnormal cancer screens.

Learning Objectives:
1. To recognize the role of health literacy in cancer screening behaviors 2. To discuss the role of health literacy in cervical health. 3. To assess the importance of addressing health literacy in health education and provider-patient communication among low income wome

Keywords: Health Literacy, Cervical Cancer

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am conducting this research under my NIH career development Women's Reproductive Health Research Award as a faculty member of Northwestern University.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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