Health Literacy, Health Numeracy, and Cancer Screening Patterns in the Zuni Pueblo: Insights from and Limitations of “Standard” Questions

Authors

Kate Cartwright, School of Public Administration, University of New Mexico, Albuquerque, NM, USA
Samantha Leekity, Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM, USA
Judith Sheche, Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM, USA
Deborah Kanda, Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM, USA
Mikaela Kosich, Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM, USA
Joseph Rodman, Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM, USA
Madison Gonya, School of Public Administration, University of New Mexico, Albuquerque, NM, USA
Keith Kelly, Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM, USA
Nicholas Edwardson, School of Public Administration, University of New Mexico, Albuquerque, NM, USA
V Shane Pankratz, Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM, USA; Department of Internal Medicine, University of New Mexico, Albuquerque, USA
Shiraz I. Mishra, Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM, USA; Departments of Pediatrics and Family and Community Medicine, University of New Mexico, Albuquerque, NM, USA

Document Type

Article

Publication Date

11-2022

Abstract

American Indians experience disparities in cancer screening, stage at disease diagnoses, and 5-year cancer survival. This study investigates how health literacy and health numeracy may be linked to cancer screening behaviors of Zuni Pueblo members using a survey exploring screening behaviors related to breast, cervical, and colorectal cancers. As part of a larger community-based cancer prevention and control project, Zuni Health Initiative staff conducted surveys from October 2020 through April 2021 of 281 participants (men ages 50–75 and women ages 21–75) from the Zuni Pueblo. Bivariate and multivariable analyses investigated associations between health literacy/numeracy measures and cancer screening behaviors. Bivariate analyses showed some associations between distinct measures of health literacy/numeracy and colorectal cancer (CRC) screening, including both colonoscopy (health literacy) and fecal occult blood testing (FOBT) (health numeracy), as well as cervical cancer screening (health literacy). There were no statistically significant associations between health literacy/numeracy measures and mammogram screening for breast cancer. In multivariable analyses, there were no consistent patterns between health literacy/numeracy and screening for any cancer. There are some individual findings worth noting, such as statistically significant findings for health numeracy and FOBT (those reporting lower health numeracy were less likely to report FOBT). An important finding of this study is that questions used to assess health literacy/numeracy did not identify associations aligned with previous research. We reflect on the ways the “standard” questions may not be sufficiently tailored to the Zuni experience and may contribute to health equity barriers.

DOI

10.1007/s13187-022-02227-y

Recommended Citation

Cartwright, K., Leekity, S., Sheche, J. et al. Health Literacy, Health Numeracy, and Cancer Screening Patterns in the Zuni Pueblo: Insights from and Limitations of “Standard” Questions. J Canc Educ 38, 1023–1033 (2023). https://doi.org/10.1007/s13187-022-02227-y