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Predicting Health Literacy Among English-as-a-Second-Language Older Chinese Immigrant Women to Canada: Comprehension of Colon Cancer Prevention Information

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Abstract

Inadequate health literacy has been identified as a barrier to the utilization of health-care services, including cancer screening. This study examined predictors of health literacy among 106 older Chinese immigrant women to Canada and how colon cancer information presented in their first versus second language affected health literacy skill. Only 38.7% of the women had adequate health literacy based on Short Test of Functional Health Literacy for Adults, and 54.3% had adequate comprehension of the colon cancer information. Comprehension of the cancer information was significantly lower among women who received the information in English compared with those who received the information in Chinese. Age, acculturation, self-reported proficiency reading English, and education were significant predictors of health literacy but varied depending on the measure of health literacy used and language of the information. Presentation of cancer prevention information in one’s first rather than second language improves health literacy but does not eliminate comprehension difficulties for older ESL Chinese immigrants.

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References

  1. Canadian Cancer Society/National Cancer Institute of Canada (2008) Canadian cancer statistics 2008. Toronto, Canada

  2. Hewitson P, Glaszlov PP, Watson E, Towler B, Irwig L (2008) Cochrane systematic review of colorectal cancer screening using the fecal occult blood test (Hemoccult): an update. Am J Gastroenterol 103(6):1541–1549

    Article  PubMed  Google Scholar 

  3. Mandel JS, Bond JH, Church TR, Snover DC, Bradley GM, Schuman LM et al (1993) Reducing mortality from colorectal cancer by screening for fecal occult blood: Minnesota colon cancer control study. New Engl J Med 328(19):1365–1371

    Article  PubMed  CAS  Google Scholar 

  4. Wilkins K, Shields M. Colorectal cancer testing in Canada-2008. Health Reports 2009; 20(3). Statistics Canada Catalogue no. 82-003-X. http://www.statcan.gc.ca/pub/82-003-x/2009003/article/10874-eng.htm. Accessed 22 May 2010.

  5. Sun Z, Xiong H, Kearney A, Zhang J, Liu W, Huang G, Wang PP (2010) Breast cancer screening among Asian immigrants women in Canada. Cancer Epidemiol 34(1):73–78

    Article  PubMed  Google Scholar 

  6. Kandula NR, Wen M, Jacobs EA, Lauderdale DS (2006) Low rates of colorectal, cervical, and breast cancer screening in Asian Americans compared with non-Hispanic whites: cultural influences of access to care? Cancer 107(1):184–192

    Article  PubMed  Google Scholar 

  7. Yip MP, Tu SP, Chun A, Yasui Y, Taylor VM (2006) Participation in colorectal cancer screening among Chinese Americans. Asian Pac J Cancer Prev 7(4):645–650

    PubMed  Google Scholar 

  8. Jerant AF, Fenton JJ, Franks P (2008) Determinants of racial/ethnic colorectal cancer screening disparities. Arch Intern Med 168(12):1317–1324

    Article  PubMed  Google Scholar 

  9. Davis TC, Dolan NC, Ferreira MR, Tomori C, Green KW, Sipler AM, Bennett CL (2001) The role of inadequate health literacy skills in colorectal cancer screening. Cancer Investig 19(2):193–200

    Article  CAS  Google Scholar 

  10. Peterson NB, Dwyer KA, Mulvaney SA, Dietrich MS, Rothman RL (2007) The influence of health literacy on colorectal cancer screening knowledge, beliefs and behavior. J Natl Med Assoc 99(10):1105–1112

    PubMed  Google Scholar 

  11. Nutbeam D (2000) Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st century. Health Promot Int 1(5):259–267

    Article  Google Scholar 

  12. Canadian Council on Learning (2007) Health Literacy in Canada: initial results from the International Adult Literacy and Skills Survey 2007. Ottawa

  13. Statistics Canada. Building our competencies: Canadian results of the international adult literacy and skills survey. Catalogue no. 89-617-XIE. Ottawa. http://www.statcan.ca/bsolc/english/bsolc?catno=89-617-X. Accessed 8 July 2009.

  14. Statistics Canada (2008) Canada’s ethnocultural mosaic. Statistics Canada Catalogue no 97-562-XWE2006001. Ottawa. April 9. Analysis Series, 2006 Census

  15. Cancer Care Ontario. Colon Cancer Fact Sheet (2009) http://coloncancercheck.ca/factsheets.html. Accessed 21 July 2009

  16. Taylor W (1953) Cloze procedure: a new tool for measuring readability. Journal Q 30:415–433

    Google Scholar 

  17. Parker RM, Baker DW, Williams MV, Nurss JR (1995) The test of functional health literacy in adults: a new instrument for measuring patients' literacy skills. J Gen Intern Med 10(10):537–541

    Article  PubMed  CAS  Google Scholar 

  18. Estey A, Musseau A, Keehn L (1994) Patient’s understanding of health information: a multihospital comparison. Patient Educ Couns 24(1):73–78

    Article  PubMed  CAS  Google Scholar 

  19. Suinn R, Rikard-Figueroa K, Lew S, Vigil P (1987) The suinn-lew asian self-identity acculturation scale: an initial report. Educ Psychol Meas 47(2):401–407

    Article  Google Scholar 

  20. Wilson E, Chen AH, Grumbach K, Wang F, Fernandez A (2005) Effects of limited English proficiency and physician language on health care comprehension. J Gen Intern Med 20(9):800–806

    Article  PubMed  Google Scholar 

  21. Ngo-Metzger Q, Sorkin DH, Phillips RS, Greenfield S, Massagli MP, Clarridge B, Kaplan SH (2007) Providing high-quality care for limited English proficient patients: the importance of language concordance and interpreter use. J Gen Intern Med 22(2):324–330

    Article  PubMed  Google Scholar 

  22. Cheng EM, Chen A, Cunningham W (2007) Primary language and receipt of recommended health care among Hispanics in the United States. J Gen Intern Med 22(2):283–238

    Article  PubMed  Google Scholar 

  23. Landrine H, Klonoff EA (2004) Culture change and ethnic-minority health behavior: an operant theory of acculturation. J Behav Med 27(6):527–555

    Article  PubMed  Google Scholar 

  24. Shaw SJ, Huebner C, Armin J, Orzech K, Vivian J (2009) The role of culture in health literacy and chronic disease screening and management. J Immigr Minor Health 11(6):460–467

    Article  PubMed  Google Scholar 

  25. Zanchetta MS, Poureslami IM (2006) Health literacy within the reality of immigrants’ culture and language. Can J Public Health 97(2):S26–S30

    PubMed  Google Scholar 

  26. Williams MV, Parker RM, Parikh BDW, NS PK, Coates WC et al (1995) Inadequate functional health literacy among patients at two public hospitals. JAMA 274(21):1677–1682

    Article  PubMed  CAS  Google Scholar 

  27. Rootman I, El-Bihbety D (2008) Vision for a health literate Canada: report of the expert panel on health literacy. http://cpha.ca/en/portals/h-l/resources.aspx. Accessed 9 July 2009.

  28. Baker DW, Gazamaraian JA, Sudano J, Paterson M (2000) The association between age and health literacy among elderly persons. J Gerontol B Psychol Sci Soc Sci 55(6):S368–S374

    PubMed  CAS  Google Scholar 

  29. Schrauf RW (2009) English among older bilingual immigrants in linguistically concentrated neighborhoods: social proficiency and internal speech as intracultural variation. J Cross Cult Gerontol 24(2):157–179

    Article  PubMed  Google Scholar 

  30. Carson JE, Carrell PL, Silberstein S, Kroll B (1990) Reading and writing relationships in first and second languages. TESOL Quarterly 24(2):245–266

    Article  Google Scholar 

  31. Ilyin D, Spurling S, Seymour S (1987) Do learner variables affect cloze correlations? System 15:149–160

    Article  Google Scholar 

  32. Cranney AG (1972) The construction of two types of cloze reading tests for college students. J Read Behav 5:60–64

    Google Scholar 

  33. Porter D (1976) Modified cloze procedure: a more valid reading comprehension test. ELT Journal XXX(2):151

    Article  Google Scholar 

  34. Muljani D, Koda K, Moates DR (1998) The development of word recognition in a second language. Appl Psycholing 19(1):99–113

    Article  Google Scholar 

  35. Neuhauser L, Kreps GL (2008) Online cancer communication: meting the literacy, cultural and linguistic needs of diverse audiences. Patient Educ Couns 71(3):365–377

    Article  PubMed  Google Scholar 

  36. Tu SP, Taylor V, Yasuai Y, Chun A, Yip MP, Acorda E, Li L, Bastani R (2006) Promoting culturally appropriate colorectal cancer screening through a health educator: a randomized control trial. Cancer 107(5):959–966

    Article  PubMed  Google Scholar 

  37. Statistics Canada (2008) Low income cut-offs for 2007 and low income measures for 2006. Catalogue no. 75F0002M. Ottawa. www.statcan.gc.ca/pub/75f0002m/75f0002m2008004-eng.pdf. Accessed 28 April 2010

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Acknowledgements

The authors thank E. Harvey for expert statistical help, C. Wu for translation services, our community partner (the Cancer Prevention and Early Detection Network of Waterloo Region), and the women who participated in this study. This work was funded by a grant from the Social Sciences and Humanities Research Council of Canada.

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Authors and Affiliations

  1. Department of Health Studies and Gerontology, Faculty of Applied Health Sciences, University of Waterloo, Waterloo, ON, Canada, N2L 3G1

    Laura Todd & Laurie Hoffman-Goetz

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  1. Laura Todd
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  2. Laurie Hoffman-Goetz
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Correspondence to Laurie Hoffman-Goetz.

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Todd, L., Hoffman-Goetz, L. Predicting Health Literacy Among English-as-a-Second-Language Older Chinese Immigrant Women to Canada: Comprehension of Colon Cancer Prevention Information. J Canc Educ 26, 326–332 (2011). https://doi.org/10.1007/s13187-010-0162-2

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