The rate of invasive cervical cancer in US Hispanic women is nearly doubled that of non-Hispanics. Using in-depth interviews and content/grade level analysis of educational materials, this study explores the relevance of cervical cancer education materials to the needs of Mexican immigrant women. It also addresses health literacy issues that create barriers to learning. Findings show aspects of language, content, reading level, structure, and visual images in 22 cervical cancer pamphlets from 11 health care sites in a Midwest city were not relevant to the learning needs or health literacy levels of local Mexican immigrant women. Further research is recommended to establish an evidence base regarding optimal presentation of key elements of the cervical cancer educational message for Mexican immigrant women.
References
1.
Health literacy:report of the Council on Scientific Affairs. Ad Hoc Committee on Health Literacy for the Council on Scientific Affairs, American Medical Association.JAMA.1999; 281: 552–557.
2.
ChavezL.R., McMullinJ.M., MishraS.I.. Beliefs matter: cultural beliefs and the use of cervical cancer-screening tests.Am Anthropol.2001; 103: 1114–1129.
3.
RuddR., KirschI., YamamotoK.. Literacy and Health in America: Policy Information Report.Princeton, NJ: Center for Global Assessment Educational Testing Service;2004.
4.
LindauS.T., TomoriC., LyonsT.. The association of health literacy with cervical cancer prevention knowledge and health behaviors in a multiethnic cohort of women.Am J Obstet Gynecol.2002; 186: 938–943.
5.
SankaranarayananR., BudukhA.M., RajkumarR.. Effective screening programmes for cervical cancer in low-and middle-income developing countries.Bull World Health Organ.2001; 79: 954–962.
6.
Freeman HP Poverty, culture, and social injustice:determinants of cancer disparities.CA Cancer J Clin.2004; 54: 72–77.
7.
Centers for Disease Control and Prevention (CDC).Invasive cervical cancer among Hispanic and non-Hispanic women: United States, 1992-1999.MMRWMorb Mortal Wkly Rep.2002; 51: 1067–1070.
8.
CoughlinS.S., UhlerR.J.. Breast and cervical screening practices among Hispanic women in the United States and Puerto Rico, 1998-1999.Prev Med.2002; 34: 242–251.
9.
CoughlinS.S., UhlerR.J., RichardsT.. Breast and cervical cancer screening practices among Hispanic and non-Hispanic women residing near the United States-Mexico border, 1999-2000.Fam Community Health.2003; 26: 130–139.
10.
Jennings-DozierK., LawrenceD.. Sociodemographic predictors of adherence to annual cervical cancer screening in minority women.Cancer Nurs.2000; 23: 350–358.
11.
RandolphW.M., FreemanD.H., FreemanJ.L.. Pap smear use in a population of older Mexican-American women.Women Health.2002; 36: 21–31.
12.
ScarinciI.C., BeechB.M., KovachK.W.. An examination of sociocultural factors associated with cervical cancer screening among low-income Latina immigrants of reproductive age.J Immigr Health.2003; 5: 119–128.
13.
Corbie-SmithG., FlaggE.W., DoyleJ.P.. Influence of usual source of care on differences by race/ethnicity in receipt of preventive services.J Gen Intern Med.2002; 17: 458–464.
14.
HubbellA.F., ChavezL.R., MishraS.I.. Beliefs about sexual behavior and other predictors of Papanicolaou smear screening among Latinas and Anglo women.Arch Intern Med.1996; 156: 2353–2358.
15.
LobellM., BayR.C., RhoadsK.V.. Barriers to cancer screening in Mexican-American women.Mayo Clin Proc.1998; 73: 301–308.
16.
MorganC., ParkE., CortesD.E.. Beliefs, knowledge, and behavior among urban Hispanic women.J Natl Cancer Inst Monogr.1995; 18: 57–63.
17.
SelvinE., BrettK.M.. Breast and cervical cancer screening: sociodemographic predictors among White, Black, and Hispanic women.Am J Public Health.2003; 93: 618–623.
18.
SuarezL., RocheR.A., NicholsD.. Knowledge, behavior and fears concerning breast and cervical cancer among older low-income Mexican-Amer- ican women.Am J Prev Med.1997; 13: 137–142.
19.
Tortolero-LunaG., GloberG.A., VillarrealR.. Screening practices and knowledge, attitudes and beliefs about cancer among Hispanic and non-His- panic white women 35 years old or older in Nueces County, Texas.J Natl Cancer Inst Monogr.1995; 18: 49–56.
20.
MeadeC.D., RiveraM., CalvoA (producers). Project Toolbox: Platique- mos Acerca de Su Salud — Breast /Cervical Cancer Education for Hispanic Migrant and Seasonal Farmworker.Evatone, Tampa, Fla: State of Florida Dept of Health (funders);2001.
21.
NavarroA.M., SennK.L., KaplanR.M.. Porla vida intervention model for cancer prevention in Latinas.J Natl Cancer Inst Monogr.1995; 18: 137–145.
22.
Perez-StableE.J., Otero-SabogalR., SabogalF.. Pathways to early cancer detection for Latinas: en accion contra el cancer.Health Educ Q.1996; 23: S41–S59.
23.
LewisM.K., RuizR.A.. “La Promesa del Progreso”: Examination of the Social, Economic, Educational, and Civic Realities of Latino Immigrants in the Kansas City Metropolitan Area, 2003.Kansas City, Ks: El Centro Inc;2003.
24.
HunterJ.. Cervical Cancer in Iquito, Peru: A Tragedy of Postponed Priority [dissertation].Lawrence, Ks: University of Kansas;2002.
25.
HunterJ.. Cervical cancer in Iquitos, Peru: local realities to guide prevention planning.Cad Saude Publica.2004; 20: 160–171.
26.
HunterJ.. Better late than never: reflections on the delayed prioritization of cervical cancer in international health.Health Care Women Int.2006. In press.
27.
HunterJ.. Emelda's story: applying ethnographic insights to cultural assessment and cervical cancer control.J Transcult Nurs.2005; 16: 322–330.
28.
LabuskiC.. “Something's wrong down there”: negotiating genital risk and symptoms in a diseased medical milieu. Presented at: The Society for Applied Anthropology 64th Annual Meeting, March 31-April 4, 2004; Dallas, Tex.
MunozN., BoschF.X.. The causal link between HPV and cervical cancer and its implications for prevention of cervical cancer.Bull Pan Am Health Organ.1996; 30: 362–377.
31.
WrightT.C., RichartR.M.. Pathogenesis and diagnosis of preinvasive lesions of the lower genital tract. In: HoskinsW.J., PerezC.A., YoungR.C., eds. Principles and Practice of Gynecologic Oncology, 2nd ed.Philadelphia, Pa: Lippincott-Raven Publishers; 1997: 675–715.
32.
SaslowD., RunowiczC.D., SolomonD.. American Cancer Society guideline for the early detection of cervical neoplasia and cancer.CA Cancer J Clin.2002; 52: 342–362.
33.
GilliamB., PenaS., MoutainL.. The Fry graph applied to Spanish readability.The Reading Teacher. January 1980: 426–430.
34.
DoakC.C., DoakL.G., RootJ.H.. Learner verification and revision of materials. In: DoakC.C., DoakL.G., RootJ.H.. Teaching Patients with Low Literacy Skills.2nd ed.Philadelphia, Pa: Lippincott-Raven Publishers; 1996.
