Las doñas : health literacy and cervical cancer screening among older Mexican-American women
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Cancer is the leading cause of death for Hispanics, and cervical cancer incidence is higher (64%) for Hispanics than for non-Hispanic whites. In Texas Hispanic women 50 and older are the lowest screened and present with higher incidence of invasive cervical cancer as compared to non-Hispanic white women. They are diagnosed at a peak age of 65-74, which suggests that Hispanic women need to be screened past the recommended screening age. An estimated 90 million people in the U.S. lack basic literacy skills and low literacy may contribute to low screening. Few studies have addressed the relationship between low health literacy and cervical cancer screening among older women of Mexican-American ancestry. This study sought to uncover the cervical cancer screening beliefs, practices, health literacy, knowledge, and experiences of English and/or Spanish-speaking older women of Mexican-American ancestry. Thirty women participated in focus group or individual interviews in English and/or Spanish. Women 50 years of age or older living in the community were recruited from senior centers in South Texas from a purposeful convenience sample. Data collection was conducted through audio-taped semi-structured interviews following a moderator guide developed using Zarcadoolas, Pleasant, and Greer’s (2005) health literacy model. Data were transcribed, analyzed in original language, translated for meaning, aggregated for analysis using qualitative content analysis; matrices were developed and analyzed individually, and then data were aggregated. The Newest Vital Sign, a health literacy tool, was used to partially assess fundamental literacy. Major themes elucidated were (a) Reasons “I don’t go” [fundamental literacy], (b), Prevention of cancer and “everything else” [science literacy], (c) We are different,[cultural literacy], (d) There is always “consejos” (advice, messages) [civic literacy], and media literacy, (e) Telenovelas (soap-operas) teach a lot, and (f) Learning from Internet brochures. The study supports a multidimensional model of health literacy and focus group research, accounting for the group’s cultural norms, language, and educational preferences. It adds information for nurse clinicians about providing holistic care, for nurse educators regarding communication strategies for diverse older populations, and for researchers to continue developing strategies that improve health literacy and health outcomes for minority older women.