Health Literacy among Medically Underserved: The Role of Demographic Factors, Social Influence, and Religious Beliefs

Abstract

The current study examined the sociodemographic and psychosocial variables that predicted being at risk for low health literacy among a population of racially and ethnically diverse patients accessing primary care services at community-based clinics. Participants (N = 416) were aged 50–75 years, currently not up-to-date with colorectal cancer (CRC) screening, at average CRC risk, and enrolled in a randomized controlled trial (RCT) aimed at promoting CRC screening. Participants completed a baseline interview that assessed health literacy as measured by Rapid Estimate of Adult Literacy in Medicine-Revised, sociodemographic factors, and psychosocial variables (e.g., health beliefs) prior to randomization and receipt of an intervention. Thirty-six percent of the participants were found to be at risk for low health literacy. Sociodemographic and psychosocial variables were assessed as predictors of being at risk for low health literacy using logistic regression. In the final model, predictors were male gender, being from a racial/ethnic minority group, being unable to work, having higher social influence scores, and having higher religious belief scores. These findings suggest several patient characteristics that may be associated with low health literacy, and highlight the importance of supporting all patients through simplified and clear communications and information to improve understanding of CRC screening information.

Acknowledgments

A portion of the results was presented at the 2016 American Psychosocial Oncology Society annual meeting.

Funding

The study was funded by 1U54 CA153509 from the Center to Reduce Cancer Health Disparities at the National Cancer Institute (PIs: C.K. Gwede and C.D. Meade). The efforts of Drs. Christy, Chavarria, and Davis were supported by grant #R25CA090314 (PI: P. B. Jacobsen [prior PI]/T.H. Brandon [current PI]) from the National Cancer Institute. This work was also supported in part by the Biostatistics Core and the Survey Methods Core at the H. Lee Moffitt Cancer Center & Research Institute, an NCI-designated Comprehensive Cancer Center (NIH/NCI Grant Number: P30-CA076292). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute. The authors declare that they have no conflicts of interest.

Additional information

Funding

The study was funded by 1U54 CA153509 from the Center to Reduce Cancer Health Disparities at the National Cancer Institute (PIs: C.K. Gwede and C.D. Meade). The efforts of Drs. Christy, Chavarria, and Davis were supported by grant #R25CA090314 (PI: P. B. Jacobsen [prior PI]/T.H. Brandon [current PI]) from the National Cancer Institute. This work was also supported in part by the Biostatistics Core and the Survey Methods Core at the H. Lee Moffitt Cancer Center & Research Institute, an NCI-designated Comprehensive Cancer Center (NIH/NCI Grant Number: P30-CA076292). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute. The authors declare that they have no conflicts of interest.