"Endo-whatever": Can confusion or clarity be predicted from perceived health literacy?

9 out of 10 Americans have trouble processing everyday health information, with the aging population disproportionately affected.  Older individuals may not be participating in preventive health screenings, including colonoscopies, due to a lack of awareness and understanding of the importance/process.  With 60% colorectal cancer deaths preventable with early screening, it is imperative to understand how perceived health literacy may influence motivations, barriers, and experiences of individuals undergoing colonoscopies. This study qualitatively explore patients' experiences and opinions on colorectal cancer, colonoscopy, and colorectal screenings across three health literacy groups. As part of a larger study to understand health disparities in colorectal cancer and colorectal cancer screenings, patients were randomly selected for a structured, phone interview two weeks post-procedure.  Sixty-two interviews (n=62) were transcribed and organized into low, medium, or high health literacy based on the responses given on Chew et al.’s screener items. Data are currently being analyzed using a thematic approach requiring an iterative process in which codes are developed and continuously refined as analyses progress. Participants with low literacy scores demonstrate logic confusion, semantic confusion, and language substitution of known words for medical terms, as well as a higher level of trust with physicians and a tendency to rely on family and friends as sources of information. Participants with low and medium literacy had inflated self-ratings of their knowledge. Perceived health literacy may be useful in identifying individuals that are not undergoing screenings. Results can help tailoring materials and interventions to encourage preventive behaviors to reduce cancer disparities.