Predicting Health Literacy Among English-as-a-Second-Language Older Chinese Immigrant Women to Canada: Comprehension of Colon Cancer Prevention Information

Abstract

Inadequate health literacy has been identified as a barrier to the utilization of health-care services, including cancer screening. This study examined predictors of health literacy among 106 older Chinese immigrant women to Canada and how colon cancer information presented in their first versus second language affected health literacy skill. Only 38.7% of the women had adequate health literacy based on Short Test of Functional Health Literacy for Adults, and 54.3% had adequate comprehension of the colon cancer information. Comprehension of the cancer information was significantly lower among women who received the information in English compared with those who received the information in Chinese. Age, acculturation, self-reported proficiency reading English, and education were significant predictors of health literacy but varied depending on the measure of health literacy used and language of the information. Presentation of cancer prevention information in one's first rather than second language improves health literacy but does not eliminate comprehension difficulties for older ESL Chinese immigrants.

Coping with a New Health Culture: Acculturation and Online Health Information Seeking Among Chinese Immigrants in the United States

“…However, we also found resistance to adapting to the new health culture. Even though our participants were younger and more educated, as well as demonstrated a higher level of health literacy in English than participants in previous studies [e.g., [2,31], some of them still choose to not to connect with the new culture by using their original language and web sources hosted in their original culture for online health information. The phenomenon may have doublesided effects.…”

A Qualitative Study of Cancer Information Seeking Among English-as-a-Second-Language Older Chinese Immigrant Women to Canada: Sources, Barriers, and Strategies

“…Participants (n=50) were part of a larger study examining cancer screening utilization and comprehension of colon cancer information [22,23]. Participants were recruited from two Ontario communities between October 2009 and February 2010.…”

“…Details about the use of S-TOFHLA with ESL Chinese language immigrants to Canada are described elsewhere [22,23]. S-TOFHLA is scored on a scale of 0 to 36, with scores >22 as adequate, 17-22 as marginal, and <17 as inadequate health literacy.…”

Health Literacy as a Social Determinant of Health in Asian American Immigrants: Findings from a Population-Based Survey in California

“…4(p. 2) Combined with linguistic and cultural barriers, health literacy is a critical determinant of immigrant health, as it provides individuals with the motivation and ability to understand and use information to promote their health or manage health conditions. 5 Limited health literacy is associated with a lack of knowledge about health services, and this leaves individual immigrants vulnerable to underutilization of necessary medical care. 5,6 For example, limited health literacy negatively affects the use of preventive services, 7,8 adherence to medical instructions, 9,10 and self-management skills.…”