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Abstract
For many people limited health literacy is a major barrier to effective preventive health behavior such as cancer screening, yet a comprehensive health literacy measure that is specific to breast and cervical cancer screening is not readily available. The purpose of this article is to describe the development and testing of a new instrument to measure health literacy in the context of breast and cervical cancer screening, the Assessment of Health Literacy in Cancer Screening (AHL-C). The AHL-C is based on Baker's conceptualization of health literacy and modeled from the two most popular health literacy tests, the Rapid Estimate of Adult Literacy in Medicine and the Test of Functional Health Literacy in Adults. The AHL-C consists of four subscales; print literacy, numeracy, comprehension, and familiarity. We used baseline data from 560 Korean American immigrant women who participated in a community-based randomized trial designed to test the effect of a health literacy-focused intervention to promote breast and cervical cancer screening. Rigorous psychometric testing supports that the AHL-C is reliable, valid, and significantly correlated with theoretically selected variables. Future research is needed to test the utility of the AHL-C in predicting cancer screening outcomes.
Acknowledgments
The authors are grateful to all Korean American women and community health workers who participated in this study, and to the research staff, Jeong-A Ahn, Hyekyung Chin, and Myunghee Kim.
Notes
a Sum of reading test, clause test, and numeracy.
b Sum of comprehension and familiarity.
c Sum of reading fluency and prior knowledge.
*p < .05. **p < .01.
a Indicates subscales for which there were baseline differences.
b Between-group difference in change scores (calculated by Scores at 6 Months – Scores at Baseline) after controlling for baseline values.
*Recalibrated from 0 to 4 points to 0 to 1 point for ease of understanding.