Health Literacy: Cancer Prevention Strategies for Early Adults

Abstract

Health literacy, the degree to which individuals have the capacity to obtain, process, and understand health information and services needed to make health decisions, is an essential element for early adults (aged 18-44 years) to make informed decisions about cancer. Low health literacy is one of the social determinants of health associated with cancer-related disparities. Over the past several years, a nonprofit organization, a university, and a cancer center in a major urban environment have developed and implemented health literacy programs within healthcare systems and in the community. Health system personnel received extensive health literacy training to reduce medical jargon and improve their patient education using plain language easy-to-understand written materials and teach-back, and also designed plain language written materials including visuals to provide more culturally and linguistically appropriate health education and enhance web-based information. Several sustainable health system policy changes occurred over time. At the community level, organizational assessments and peer leader training on health literacy have occurred to reduce communication barriers between consumers and providers. Some of these programs have been cancer specific, including consumer education in such areas as cervical cancer, skin cancer, and breast cancer that are targeted to early adults across the cancer spectrum from prevention to treatment to survivorship. An example of consumer-driven health education that was tested for health literacy using a comic book-style photonovel on breast cancer with an intergenerational family approach for Chinese Americans is provided. Key lessons learned from the health literacy initiatives and overall conclusions of the health literacy initiatives are also summarized.

Standardized activities for lay patient navigators in breast cancer care: Recommendations from a citywide implementation study

“…There are now standardized screening tools for social determinants . In addition to screening tools, there are local and national online tools that provide linkages between social needs and free or low‐cost community resources that navigators and patients can access to address identified needs . Several of the activities are focused beyond direct interactions with specific patients.…”

“…[28][29][30][31][32][33] In addition to screening tools, there are local and national online tools that provide linkages between social needs and free or low-cost community resources that navigators and patients can access to address identified needs. [34][35][36][37] Several of the activities are focused beyond direct interactions with specific patients. They include communication with members of the care team on behalf of patients to ensure coordination between navigators and other team members.…”

“…Disparities in cancer care based on ethnicity, health literacy, health insurance coverage, out‐of‐pocket costs for care despite insurance coverage, socioeconomic status, access to care, and social determinants of health have been extensively described and have persisted despite broad adoption of patient navigation . National efforts to reduce cancer morbidity and mortality are threatened if we fail to address critical factors that impede access to and delivery of care to all patients.…”

“…Disparities in cancer care based on ethnicity, health literacy, health insurance coverage, out-of-pocket costs for care despite insurance coverage, socioeconomic status, access to care, and social determinants of health have been extensively described and have persisted despite broad adoption of patient navigation. 10,11,22,[37][38][39] National efforts to reduce cancer morbidity and mortality are threatened if we fail to address critical factors that impede access to and delivery of care to all patients. Despite scientific evidence showing that patient navigation can mitigate the negative impact of social determinants of health, alleviate barriers to cancer treatment, and improve outcomes and despite widespread adoption of patient navigation activities at cancer centers, there have been limited improvements and, in many cases, widening of health disparities in cancer outcomes.…”

A Brief Educational Intervention Enhances Basic Cancer Literacy Among Kentucky Middle and High School Students

“…Youth represent both a vulnerable population that are at risk of beginning harmful activities that can increase cancer risk (e.g., smoking, tanning) and a population that may be more amenable to cancer prevention and control interventions. These interventions include those associated with improving cancer literacy, which have the potential to lower cancer incidence and mortality rates [15][16][17]. With this in mind, the purpose of this pilot study was to establish connections with middle and high schools in Kentucky that would allow for the assessment of aspects of basic, functional cancer literacy in students prior to and immediately after participation in a brief cancer education intervention.…”