Health literacy screening prior to education for patients with cancer.

Abstract

155 Background: We have developed and tested the Personal Patient Profile-Prostate (P3P), an efficacious decision intervention for men with localized prostate cancer (LPC). Usability evaluations in minority men of varying education levels suggested additional development needs for this web-based intervention. Establishing the link between health literacy and comprehension and use of education materials is important as we develop interventions for all patients with cancer and is critical to assuring informed consent to treatment and adherence to therapeutic regimens. Appropriate methods of literacy assessment are infrequently used in clinical settings. Methods: The purpose of this analysis was to explore feasibility of health literacy testing prior to P3P use in minority men with a new diagnosis of LPC. Black and Hispanic men were recruited at 3 Boston hospitals. Prior to using the P3P, patients completed the Short Assessment of Health Literacy-English (SAHL-E), an 18-item measure of an adult’s ability to read and understand medical terms. Scores >14 indicate adequate health literacy. Assessment duration was recorded and demographic information collected. Results: Nine men participated in the first 3 months of the study. All identified as Black/African-American, and three also identified as Hispanic/Latino (Dominican, Central American, Cape Verdean). Participants’ median age was 68 (range 52-77), and education level ranged from less than high school diploma to post-graduate degree. Administration of the SAHL-E took from 4 to 12 minutes (median=5). Data completeness was high. Scores ranged from 5 to 18 (median=16), with two patients scoring below 14; these two with low health literacy were the only two without any college education and also required at least 10 minutes to complete the screening. Conclusions: The SAHL-E was a feasible approach to screening for health literacy in a sample of minority men prior to providing a patient decision support intervention. Preliminary results suggest some ability to identify those patients who will require greater support during use of educational interventions or understanding written documents.