An evaluation of health literacy (HL) in a consecutive sample of patients (pts) with cancer (ca) of the head and neck (H+N) region.

Abstract

9069 Background: HL refers to the capacity to seek, understand, and utilize health information to make informed health decisions. Pts with low HL experience worse outcomes. Understanding HL issues may result in strategies to enhance pt outcomes. This study assessed (1) level of HL in pts treated for H+N ca, and (2) associations between HL and demographic factors (age, sex, education level, socioeconomic status) and level of distress. Methods: Consecutive English-speaking pts were approached within 1 month of diagnosis. HL was assessed using the shortened Test of Functional Health Literacy in Adults (S-TOFHLA), which assesses literacy and numeracy using health-related materials (scores 0-53 = inadequate, 54-66 marginal and 67-100 adequate HL), distress with the Distress Thermometer (DT, 0-10). Data collection was by 1:1 interview. Relationships between S-TOFHLA scores, demographic factors and DT scores were explored using Spearman's rho for continuous variables and Mann-Whitney U (of Kruskal-Wallis H) for nominal variables. Results: Response rate was 73.2% (82 approached, 64 consented, 60 completed). Mean age 62.4 (SD 13.9, range 27-92), 86.7% were male. 5% of pts had inadequate HL, 6.7% marginal and 88.3% adequate HL. Pts with inadequate HL were all males, without university education and from lower socioeconomic status. Individual items of S-TOFHLA showed 73.3% of all pts could not interpret prescription labels and 35% were unable to understand a standard appointment card. Pts with university education had a higher median HL score compared to those without (U=232, p=0.008; median=92, IQR: 85–93 and median=84, IQR: 75–91 respectively). The relationship between age and HL was weak but not significant (rho=−0.25, p=0.056). The corresponding relationship with distress was negligible (rho=−0.002, p > 0.1). 45% pts had high levels of distress (DT ≥4). Conclusions: Prevalence of less than adequate HL was 11.7% in this sample of Australian H+N ca pts. However many pts with adequate HL according to S-TOFHLA were unable to understand important basic health information. There were no clear associations between HL and distress or demographic factors, aside from university education. No significant financial relationships to disclose.