Health literacy and colorectal cancer screening decision-making among African Americans
African Americans are disproportionately impacted by colorectal cancer (CRC) incidence and mortality. Early detection of CRC can lead to reduced incidence and mortality. However, African Americans are screened for CRC at lower rates than Whites. The ability to make an informed decision regarding CRC screening is related to increased screening completion. Health literacy has been linked to increased CRC screening knowledge, however research investigating the link between health literacy and CRC screening decision-making is limited. The study was conducted in the context of Project HEAL (Health through Early Awareness and Learning), a church-based intervention focusing on cancer early detection intervention. A total of 97 participants attended a series of 3 workshops and completed surveys at baseline and 12-months, and an additional follow-up survey at 14-months focusing on health literacy and decision-making. Health literacy was a significant predictor of decisional conflict, decisional self-efficacy, and state of decision-making for CRC screening. Individuals with greater health literacy had greater decisional self-efficacy (β = .39, p < .001) and health literacy was inversely related to decisional conflict (β = -.41, p < .001). Lastly, individuals with increased health literacy were closer to making a CRC screening decision (β = .32, p < .05). The findings suggest health literacy is associated with CRC screening decision-making among this sample of church-attending African Americans. Future studies should further investigate the relationship between health literacy and decision-making as well as the inclusion of health literacy in decision-making tools for CRC screening.
Public health or related education
Public health or related research
Social and behavioral sciences
Identify the association between health literacy and informed decision making for colorectal cancer screening in African Americans.
Explain the importance of decisional conflict, decisional self-efficacy, and informed decision making on colorectal cancer screening behaviors.
Keyword(s): Decision-Making, Health Literacy
Presenting author's disclosure statement:
Qualified on the content I am responsible for because: I am a PhD candidate in Behavioral and Community Health and have been a graduate assistant on an NCI-funded implementation trial focusing on cancer early detection in African Americans. Among my scientific interest has been the decision making process for cancer screening and the various factors that may influence this process.
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.