Abstract B28: Effects of low- versus high-literacy materials on knowledge and risk perceptions regarding cervical dysplasia

Health literacy is an important determinant of health status. Developing and evaluating health education materials for low-literate audiences is a priority and critical to helping individuals participate in health care decisions and self-management. However, questions remain as to whether low-literacy materials are appropriate for all audiences. We sought to determine if low-literacy materials would be appropriate and effective in educating individuals at wide ranges of health literacy, or if materials should be tailored to a patient’s health literacy level.

Eighty patients returning for follow-up colposcopy appointments were randomized to read a brochure about cervical dysplasia that was written at either a high (8^th grade) or low (4^th grade) reading level. Before reading the brochure, patients completed assessments of health literacy (Short Test of Functional Health Literacy in Adults, STOFHLA; Rapid Assessment of Adult Literacy in Medicine, REALM), knowledge, and perceived risk. After reading, knowledge, perceived risk, and brochure evaluation assessments were completed.

Overall, patients had a high level of health literacy (STOFHLA M=70.1, SD=2.3; REALM, 4 patients 7-8^th grade level, 76 patients 9^th grade level and above). Average knowledge score before reading was 12.9 (SD=2.4) on a 17-point scale. Patients receiving either high- or low-reading level brochures improved their knowledge scores after reading (M_pst = 14.4, SD_pst=1.7, p<0.001). Change in knowledge score did not differ between the two groups (p=0.664). Groups did not differ significantly in their ratings of brochure quality (e.g., completeness, clarity and organization, interest, credibility, relevance).

Brochures written at low reading levels can improve knowledge about cervical dysplasia, even for patients with high health literacy, and are judged by patients to be similar in quality.

Citation Information: Cancer Prev Res 2008;1(7 Suppl):B28.