A critical undertaking in designing research interventions that study effective ways to reduce health disparities among racial/ethnic and underserved women is to have instruments that are linguistically and culturally appropriate and that have been validated for use in those specific populations. Health literacy is increasingly recognized as an important variable and related to breast and cervical cancer disparities. However, the current health literacy measurement tools are not sufficient to assess a woman's functional cancer literacy. In this developmental phase of our research, our goal is to determine the psychometric properties of two newly created measures of cancer literacy. The cancer literacy assessment tools (CLAT) will measure a woman's functional understanding of breast and cervical cancer. This research will produce two instruments for use in English, Spanish and Arabic women for measuring a women's functional understanding of breast and cervical cancer. The instruments will be validated with Black, Latina and Arab women, within the context of a female-family home-based educational intervention. Working with a recruitment model we have used successfully in prior research, we will recruit women who are connected with established public health programs who will serve as liaisons by recruiting other females in their families to take the cancer literacy assessments. Qualitative and quantitative analysis will be used to produce two instruments with good psychometric properties, including reliability, cross cultural measurement invariance, and predictive validity. Measurement invariance including identification of differential item functioning (DIF) will be established using multigroup structural equation modeling with means structures. Multilevel modeling will be used to take the hierarchical nature of the sampling into account. By having baseline cancer literacy measures, this research study will be increasing the capacity of the community of science and public health agencies to more effectively design interventions that promote screening and early detection among women who are at high risk for breast and cervical cancer mortality.
Results from this research will directly impact public health agencies and research on planning and intervention design;as to more effectively promote breast and cervical screening and early detection for medically underserved women. This will be done by providing a baseline measure for cancer literacy in three groups of women, Black, Latina and Arab, who are disproportionately affected by breast and cervical cancer mortality.
