Awareness and knowledge of Colorectal Cancer Screening among Latinos in Omaha, Nebraska.

BACKGROUND: Colorectal cancer (CRC) screening rates remain low in Latino communities. We sought to determine the screening awareness and attitudes in Omaha, Nebraska. METHODS: We interviewed 150 Latinos at an urban Federally Qualified Health Center, June-October 2017. Chi-square or Fisher-exact tests and multiple logistic regression models were used for data analysis. RESULTS: Participants reported low educational attainment, low income, and limited access to insurance or a primary provider. Less than one-third of participants aged 50 + had ever heard of FOBT (32.6%) or colonoscopy (30.4%). For individuals 50+, access to a primary care provider (p = .03) and knowing the screening initiation age (p = .03) were associated with ever having a colonoscopy. Higher knowledge score was a strong predictor of any CRC screening. DISCUSSION: Knowledge predicted screening, suggesting interventions should aim to educate this population regarding CRC screening guidelines and options and work with stakeholders to make CRC screening more accessible.

The psychometric testing of the functional, communicative, and critical health literacy tool.

OBJECTIVE: The purpose of this study is to assess the validity and reliability of the English version of the FCCHL tool in urban and rural, socioeconomically vulnerable or unstable, chronic comorbid adults in the United States. METHODS: A cross-sectional study measuring both validity and reliability. RESULTS: A total of 276 participants were recruited. Internal consistency was measured using Cronbach's alpha of α = 0.87. External reliability was measured by test-retest methodology. Construct validity was measured using Confirmatory Factor Analysis that showed good fit. Criterion validity was measured by comparing the mean scores of the FCCHL tool sub-scales. Concurrent validity was measured by comparison of means of the FCCHL tool and education level compared to the NVS and s-TOFHLA. CONCLUSION: The results demonstrated that the FCCHL tools is measuring three different concepts. Overall, the FCCHL tool was seen to have good validity and reliability in the identified population. PRACTICE IMPLICATIONS: The FCCHL tool is a 14-item, self-report health literacy tool measuring more than functional health literacy. The tool can be used in practice to improve not only functional health literacy, but also communicative and critical which is highly applicable.

The influence of medical providers on HPV vaccination among children of Mexican mothers: a comparison between Mexico and the Midwest region of the United States.

BACKGROUND: Among cervical cancer patients in the U.S., a disproportionate number are Hispanics/Latinos. Also, about a third of patients diagnosed with cervical cancer annually in Mexico die of the disease. Vaccines are available to protect against HPV, the cause of cervical cancer. METHODS: A cross-sectional study was conducted with 200 mothers of Mexican origin in the U.S. Midwest and Xalapa, Veracruz, Mexico. Based on a validated bilingual questionnaire, this study elicited information about knowledge and attitudes regarding HPV vaccination and cervical cancer. RESULTS: Mothers living in Mexico showed better knowledge about HPV and HPV vaccine (77.8%) than participants living in the U.S. (48%) p < .0001. Logistic regression revealed that receiving information about the HPV vaccine from medical providers was a significant predictor of mothers' willingness to vaccinate their children. CONCLUSIONS: A need for increasing public health education of Mexican mothers in the Midwest on HPV/HPV vaccination, may lead to improving utilization of the vaccination and eventually a reduction of cervical cancer. HPV vaccination for boys is critical for reducing the risk of transmission to sexual partners and decreasing the risk of HPV- related diseases in the population. Therefore, we recommend increasing efforts to vaccine boys and increasing knowledge that boys must also be vaccinated, especially in Mexico.

Assessing the Prevalence and Association of Acculturation and Health Literacy Levels in Spanish-Speaking Hispanic Patients at Midwestern Community Health Centers in the USA.

BACKGROUND: Predictions from the US census indicate that by 2060 one of every three individuals living in the nation will be of Hispanic origin. Hispanics experience health disparities manifested with higher rates of chronic conditions such as hypertension and diabetes in contrast with other US population groups. Health literacy and acculturation have been well identified as key contributors for this issue. However, very few studies have examined the association between health literacy and levels of acculturation in Spanish-speaking Hispanics living in rural and urban areas of the USA. OBJECTIVE: To assess the prevalence and association of acculturation with low levels of health literacy and demographic variables in Spanish-speaking Hispanics in the US Midwest. METHODS: We measured levels of acculturation in Spanish-speaking adult Hispanics (N = 401) accessing community health centers in rural and urban Nebraska. We used a survey that included the Bidimensional Acculturation Scale for Hispanics/Linguistic Proficiency Subscale (BAS/LP) and the Short Assessment of Health Literacy in Spanish (SAHL-S). RESULTS: We observed similar acculturation levels with rural and urban status participants. A total of 85% of the total participants had low levels of acculturation to US culture. Of the 15% of the participants who showed themselves to be bicultural, 81% reported adequate levels of health literacy in Spanish. CONCLUSIONS: Our findings are consistent with previous studies that report the associations between acculturation and health literacy levels are significant. This study underscores the importance of considering the cultural aspects of the Hispanic community for the development of health literacy interventions and education programs.

Assessing health literacy levels of Spanish-speaking Hispanic patients in Spanish at federally qualified health centers (FQHCs) in the Midwest.

OBJECTIVE: Evaluate health literacy levels in Spanish-speaking Hispanic adults accessing health care services in the Midwest. METHODS: Cross-sectional study of patients (n = 402) at two Midwestern federally qualified health centers. The assessment tool used in this study contained the Short Assessment of Health Literacy-S. RESULTS: A total of 36% of the participants had a low health literacy level (LHLL). Forty-five percent of males versus 31% of females demonstrated LHLL (p < .05). With respect to education level, 61% with less than a 7th grade education had LHLL compared with 17% with 7th grade education or more (p < .05). Additionally, 29% of the participants of Mexican origin had LHLL contrasted with 55% of the participants of non-Mexican origin (p < .05). CONCLUSIONS: Low levels of health literacy reported in this study are consistent with previous assessments. We observed statistically significant differences in LHLL based on gender, education level, and country of origin.