Virginia Commonwealth University (VCU) Massey Cancer Center researchers have developed the first and only tool that can accurately measure cancer health literacy (CHL) and quickly identify patients with limited CHL. This tool has the potential to improve communication and understanding between physicians and patients, which, in turn, could lead to better clinical outcomes.
Recently published in the Journal of Health Communications, the Cancer Health Literacy Study was conducted over four years and involved 1,306 African-American and Caucasian patients from Massey and surrounding oncology clinics. The researchers developed an evaluation tool called the Cancer Health Literacy Test (CHLT)-30 to measure cancer health literacy along a continuum. The test, which was administered to the patients via a touch-screen device, asked 30 questions about cancer treatment, medication side effects and more. Six of the 30 questions (CHLT-6) were specifically designed to quickly identify individuals with limited CHL. Together, the tests were found to accurately measure CHL and quickly identify patients with limited CHL. This study reported that 18 percent of cancer patients have limited CHL, with an overrepresentation of African-American, undereducated and low-income patients.
"Using this tool, it takes just 1-2 minutes in the doctor's office waiting room to identify patients with limited CHL. Then this information can be digitally communicated to the doctors prior to seeing the patients, so that they are prepared to talk with the patients in terms they can understand," said Levent Dumenci, Ph.D., the study's lead researcher, member of the Cancer Prevention and Control research program at Massey and professor in the Department of Social and Behavioral Health at the VCU School of Medicine. "This simple change could lead to big improvements in health outcomes."
Health literacy is the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions. "Before now, there were only instruments that measured a particular aspect of general health literacy. It is important to have a tool that is specific to cancer because of the complex treatment options that cancer patients face, along with the increased demand for self-care," says Dumenci.
The demand for increased self-care was emphasized in the Affordable Care Act, where federal and state policymakers embraced patient engagement as a key strategy in addressing health care costs and improving quality of care. Patients are expected to play an active role in their health care by successfully adhering to medication regimens; distinguishing between scientifically credible medical evidence and misconceptions or myths; and effectively communicating with their providers on treatment decisions, risks and survival rates. Patients with limited cancer health literacy can struggle with these responsibilities and potentially jeopardize their health outcomes by making uninformed decisions, mishandling medications and more.
In future studies, the researchers hope to evaluate the CHL of Hispanic patients because prior research has indicated disparities in that population's health literacy. To do so, the CHL test will need to be translated into Spanish in order to remove the language barrier.
Dumenci collaborated on this research with Robin K. Matsuyama, Ph.D., member of the Cancer Prevention and Control research program at Massey and associate professor for the VCU Department of Social and Behavioral Health; Daniel L. Riddle, P.T., Ph.D., F.A.P.T.A., assistant chair and department coordinator for the Department of Physical Therapy at the VCU School of Allied Health Professions; Laura Cartwright, M.P.H., Ph.D., student in the VCU Department of Social and Behavioral Health; Robert A. Perera, Ph.D., assistant professor in the VCU Department of Biostatistics; Harold Chung, M.D., medical hematologist-oncologist and bone marrow transplant specialist at Massey and professor in the Division of Hematology, Oncology and Palliative Care; and Laura A. Siminoff, Ph.D., dean at the College of Health Professions and Social Work and professor for the Department of Public Health at Temple University.
This research was supported by National Institutes of Health (NIH)-National Cancer Institute (NCI) Grant R01 CA140151 and, in part, by VCU Massey Cancer Center's NCI Cancer Center Support Grant P30 CA 016059.
The full manuscript of this study is available online at: http://www.
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About VCU Massey Cancer Center
VCU Massey Cancer Center is one of only 68 National Cancer Institute-designated institutions in the country that leads and shapes America's cancer research efforts. Working with all kinds of cancers, Massey conducts basic science, translational and clinical cancer research, provides state-of-the-art treatments and clinical trials, and promotes cancer prevention and education. Since 1974, Massey has served as an internationally recognized center of excellence. It offers one of the largest selections of cancer clinical trials in Virginia and serves patients at multiple sites throughout the state. Its 1,000-plus researchers, clinicians and staff members are dedicated to improving the quality of human life by developing and delivering effective means to prevent, control and ultimately cure cancer. Visit Massey online at massey.vcu.edu or call 877-4-MASSEY for more information.
About VCU and the VCU Medical Center
Virginia Commonwealth University is a major, urban public research university with national and international rankings in sponsored research. Located in downtown Richmond, VCU enrolls more than 31,000 students in 222 degree and certificate programs in the arts, sciences and humanities. Sixty-six of the programs are unique in Virginia, many of them crossing the disciplines of VCU's 13 schools and one college. MCV Hospitals and the health sciences schools of Virginia Commonwealth University compose the VCU Medical Center, one of the nation's leading academic medical centers. For more, see http://www.