201630 Acculturation and comprehension of cancer information by older immigrant women to Canada

Sunday, November 8, 2009

Maria Thomson, MSc , Deparatment of Health Studies and Gerontology, University of Waterloo, Waterloo, ON, Canada
Laurie Hoffman-Goetz, PhD, MPH , Health Studies and Gerontology, University of Waterloo, Waterloo, ON, Canada

Colon cancer, the second leading cause of cancer death among older Canadians, can be treated successfully if detected early. English-as-a-second-language (ESL) immigrants have lower cancer screening rates which may be related to acculturation and language barriers. We hypothesized that ESL immigrants would have better comprehension of cancer prevention information with increasing levels of acculturation.


ESL (Spanish-speaking) immigrant women [n=78, mean=53±0.8 (SE) years] in Ontario, Canada completed two measures of comprehension: the S-TOFHLA and a Cloze procedure. The Cloze procedure was applied to a one-page colon cancer pamphlet. Acculturation was assessed using the Bidimensional Acculturation Scale (BAS) and immigration year. Multiple linear regression was used to determine the relationship between comprehension and the independent variables of BAS, immigration year, education, employment, age, hours of English television exposure, and Internet use.


Twenty-three percent of the variation in Cloze was explained by BAS, television use and education [F (3, 69) = 6.763, p = .000] whereas 42% of the variation in S-TOFHLA was explained by BAS, age, television and Internet use [F (4, 68) = 12.134, p = .000]. Increasing acculturation and fewer hours of television predicted comprehension on both measures. Year of immigration and employment were not significantly related to comprehension.

Implications for Practice

In addition to age, a known predictor of comprehension, lower acculturation to an English language environment may compromise older ESL immigrant women's ability to understand cancer prevention information. Multilingual, culturally and age appropriate cancer resources are recommended for ESL seniors. (Supported by SSHRC Canada)

Learning Objectives:
1. Become familiar with instruments to measure prose comprehension in older adults. 2. Identify the primary predictors of older ESL immigrant women’s prose comprehension on two measures. 3. Discuss the implications for public health practice identified by this set of predictors of older ESL immigrant women’s comprehension.

Keywords: Health Communications, Immigrant Women

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I collected and analyzed the data in this abstract for my thesis
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.