Colorectal cancer screening: Understanding the health literacy needs of hispanic rural residents

Abstract

Purpose Hispanics residing in rural areas are among those who are least likely to be screened for colorectal cancer (CRC) and more likely to present with late stage CRC than other racial or ethnic groups. We conducted a pilot study utilizing a mixed-method approach to explore perceptions of CRC and CRC screening among Hispanic adults residing in South Texas rural communities and to identify health literacy needs associated with CRC screening uptake. Methods A convenience sample of 58 participants, aged 35–65, were recruited to complete questionnaires and participate in focus groups, ranging in size from 4 to 13 participants. Six focus groups were conducted across 3 adjacent rural counties. A semi-structured moderator's guide was designed to elicit discussion about participants' experiences, knowledge, and perceptions of CRC and CRC screening. Findings Lack of knowledge of CRC and CRC screening as cancer prevention was a common theme across focus groups. A majority, 59%, reported never been screened. Thirty-nine percent reported they had been screened for colon cancer and 5% reported they did not know if they had been screened. Participants with lower educational levels perceived themselves at high risk for developing CRC polyps, would not want to know if they had CRC, and if they did have CRC, would not want to know until the very end. Limited information about CRC and CRC screening, a lack of specialized providers, limited transportation assistance, and compromised personal privacy in small-town medical facilities were perceived to be barriers to CRC screening. Conclusions Low screening rates persist among rural Hispanics. Improving CRC screening literacy and addressing factors unique to rural Hispanics may be a beneficial strategy for reducing screening disparities in this at-risk population.

The impact of research on health education/health literacy on policymaking in Latin America and the Caribbean Region

“…Concerning citations, a V-size distribution can be observed for most policy documents, obtaining a significant counting frequency for studies with low <1–2> and high <12–15> numbers of citations. Regarding the strength of evidence, studies with case study and qualitative research design [1] , as well as descriptive ones [2] were more frequent within the cited studies than the experimental studies [4] and systematic reviews with meta-analysis [5] (see Figures 1 and 2 ).…”

“…However, there are limitations and gaps in these policies, such as the need for funding, clear goals, and evaluation of policy implementation [3] . For example, the education sector plays a crucial role in achieving health literacy goals, as health literacy can be obtained and used across various settings, including schools [4] , [5] . Despite recognizing its importance, health literacy must be more included as an agenda item in education policies [6] .…”

Cancer screening behaviors and health literacy levels of women aged 30 and over in the northwest Turkey

“…In light of these findings, it is unlikely that participants with low health literacy, as well as those with excellent health literacy, will exhibit high levels of participation in cancer screening. Indeed, previous research has indicated that individuals with poor health literacy are less likely to adhere to colorectal screening, presenting a significant barrier to their participation in screening initiatives [6,45].…”

Influences of relative deprivation on health inequality of rural residents in China: A moderated mediation model

“…In contrast, the healthcare delivery system in rural areas is still under constant development and reform adjustment, with lower accessibility and fewer quality resources ( Cai et al, 2021 ) and a weaker environment still in need of improvement ( Kozhimannil and Henning-Smith, 2021 ). In contrast, the new rural cooperative medical insurance introduced in China has led to changes in the budget constraints of rural households, influencing the economic resources, living arrangements, and care patterns of rural residents ( Wittich et al, 2019 ), which has had some positive effects on their health status, but is far from adequately meeting the high level of demand for quality healthcare resources in rural areas ( Cheng et al, 2018 ). In addition to further improving healthcare conditions in rural areas, strengthening the social security system in rural areas, and achieving full coverage of county and rural healthcare institutions ( Li et al, 2021 ), policy options for achieving health poverty alleviation in rural areas could also start with improving income inequality ( Sun et al, 2022 ).…”