Abstract PO-038: Assessing Spanish health literacy and cervical cancer knowledge, attitudes, and behaviors in a student-run free clinic
Authors: Fusani Anna Ulyanenkova , Jones Nat , Hewitt Sage , Martinez Valeria Pereira , Guerra Lucy , Gonzalez Eduardo 
Published: January 2022

It is well-established that Hispanic populations in the United States have a higher incidence of invasive cervical cancer compared to non-Hispanic populations. Variations in cancer screening utilization and socioeconomic status are thought to account for much of this observed difference, and examination of health literacy has the potential to illuminate further aspects of this disparity. In addition to an association between English health literacy and Papanicolau (Pap) test knowledge, research has shown that in the setting of Spanish health materials low Spanish health literacy is strongly associated with never having a Pap test. This indicates that even when health information is provided in Spanish, low functional health literacy limits adequate care. The objective of this project is to examine Spanish health literacy and cervical cancer screening knowledge, attitudes, and behaviors in the patient population of the BRIDGE Healthcare Clinic; a student-run free clinic that serves primarily Spanish-speaking populations in the Tampa area. Spanish health literacy will be measured by the Short Assessment of Health Literacy–Spanish (SAHL-S), a validated health literacy questionnaire. A short questionnaire examining functional cervical cancer health literacy will measure the knowledge and attitudes of BRIDGE patients. Cervical cancer screening behaviors will be measured via the electronic medical record. Patients will be approached for recruitment as they wait for their appointments. Eligibility criteria include having a cervix, speaking Spanish as a primary language, and being over 21. Spanish health literacy will be assessed using the SAHL-S followed by a Spanish questionnaire assessing cervical cancer screening knowledge and attitudes. This questionnaire will consist of simple words and short sentences, with question structure based on previous studies of cancer health literacy. Patients will be asked to agree or disagree with knowledge statements such as “HPV causes cervical cancer” as well as attitude statements such as “I think it is important to get regular Pap smears.” Data quality will be monitored as the questionnaires are completed and manually transcribed into an Excel file. All data will be managed and analyzed using SPSS. This project is not powered to test hypotheses, but to robustly describe Spanish health literacy and cervical cancer screening knowledge, attitudes, and behaviors using descriptive statistics. Results will be used to generate information on how Spanish health literacy may mediate adequacy of cervical cancer screening. Additionally, quality improvement will be pursued by creating targeted cervical cancer educational materials for BRIDGE patients. There is also potential for future projects, such as re-administering the knowledge and attitudes questionnaire after an educational intervention. Ultimately, this project will illuminate understudied aspects of the widening disparity in Hispanic cervical cancer incidence and identify future directions for addressing this disparity from a health literacy perspective.

Citation Format: Anna Ulyanenkova Fusani, Nat Jones, Sage Hewitt, Valeria Pereira Martinez, Lucy Guerra, Eduardo Gonzalez. Assessing Spanish health literacy and cervical cancer knowledge, attitudes, and behaviors in a student-run free clinic [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-038.