269009 Identifying Health Literacy Barriers, Patient Navigation Needs, and Community Resources Among Rural Cancer Patients

Monday, October 29, 2012 : 8:48 AM - 9:06 AM

Ana Martinez-Donate, PhD , Department of Population Health Sciences, University of Wisconsin - Madison, Madison, WI
Jeanne Schaaf Strickland, MA , Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI
Julie Halverson, MA, MS , Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI
Alyssa Levy, PhD , Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI
Rebecca Linskens, MA , Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI
Aaliya Bibi, MPH , Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI
Xinyi Wang, PhD , Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI
Paul Smith, MD , Department of Family Medicine, University of Wisconsin-Madison, Madison, WI
Ticiana Leal, MD , Department of Medicine, University of Wisconsin-Madison, Madison, WI
William Schelman, MD , Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI
Amy Trentham-Dietz, PhD , Department of Population Health Sciences, Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI
Background: Limited health literacy results in poor utilization of health care services and negative health outcomes among cancer patients. Approximately 33% of rural cancer patients in Wisconsin report health literacy difficulties. The Rural Oncology Literacy Enhancement Study (ROLES) is aimed at: a) Assessing the health literacy barriers and patient navigation needs among Wisconsin rural cancer patients; and b) developing and evaluating a pilot intervention to improve cancer care based on the results. Here we report the results of the first aim of the ROLES. Methods: We used a mixed (qualitative and quantitative) methods approach, including: in-depth interviews, health literacy assessments, and phone surveys with cancer patients (N=53) from 6 rural oncology clinics in Wisconsin; 6 focus groups, 5 key informant interviews, and 45 self-administered surveys on health literacy practices with staff in these clinics; and shadowing of 34 patient-provider appointments. The Chronic Care Model was used to integrate the study findings. Results: Our study uncovered multiple barriers to optimal cancer care related to the community (e.g., limited resources, cultural perceptions of care), self-management support (e.g., limited use of patient-provider communication best practices), delivery system design (e.g., insurance/financial barriers to care, suboptimal care coordination), decision support (e.g., non-systematic assessment and management of non-medical needs), and clinical information systems (e.g., limited access to previous medical records, lack of communication across multiple providers). Conclusions: Interventions are needed to incorporate universal health literacy practices, standardize the assessment and management of non-medical needs, and improve coordination across providers and practices in rural cancer clinics.

Learning Areas:
Planning of health education strategies, interventions, and programs
Social and behavioral sciences
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
1. Identify rural cancer patientsí health literacy barriers and patient navigation needs during cancer treatment; 2. Explain the perception of and need for services of cancer patients in rural communities

Keywords: Cancer, Health Literacy

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have a MA in Health Communication and currently research health literacy, healthcare delivery, and quality of life among cancer patients. I am a student in good standing with the Department of Population Health Sciences and have a key person in the design, implementation, and evaluation of the formative assessment component of the ROLES.
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.