Cancer Health Literacy and Willingness to Participate in Cancer Research and Donate Bio-Specimens

Abstract

Although it has been well documented that poor health literacy is associated with limited participation in cancer clinical trials, studies assessing the relationships between cancer health literacy (CHL) and participation in research among diverse populations are lacking. In this study, we examined the relationship between CHL and willingness to participate in cancer research and/or donate bio-specimens (WPRDB) among African Americans, Latinos, and Whites. Participants completed the Cancer Health Literacy Test and the Multidimensional Cancer Literacy Questionnaire. Total-scale and subscale scores, frequencies, means, and distributions were computed. Analyses of variance, the Bonferroni procedure, and the Holm method were used to examine significant differences among groups. Cronbach's alphas estimated scales' internal consistency reliability. Significant interactions were found between race/ethnicity, gender, and CHL on WPRDB scales and subscale scores, even after education and age were taken into account. Our study confirms that CHL plays an important role that should be considered and researched further. The majority of participants were more willing to participate in non-invasive research studies (surveys, interviews, and training) or collection of bio-specimens (saliva, check cells, urine, and blood) and in studies led by their own healthcare providers, and local hospitals and universities. However, participants were less willing to participate in more-invasive studies requiring them to take medications, undergo medical procedures or donate skin/tissues. We conclude that addressing low levels of CHL and using community-based participatory approaches to address the lack of knowledge and trust about cancer research among diverse populations may increase not only their willingness to participate in research and donate bio-specimens, but may also have a positive effect on actual participation rates.

Keywords: African Americans; Blacks; Hispanics; Latinos; Whites; cancer health literacy; cancer research; community-based participatory research; minorities.

Figure 1

Conceptual framework of the effects of cancer health literacy on cancer-related behaviors and outcomes.

Figure 2

Cancer health literacy total scores.

Figure 3

Cancer health literacy levels by race/ethnicity.

Figure 4

Cancer Health Literacy (CHL) mean scores by race/ethnicity, gender, and education. Note: the group with an education lower than primary school (n = 126) and the group with some high school education (n = 179) in Table 1 were combined because of their small sample size when compared to the other three educational groups.

Figure 5

Item-level differences on willingness to participate in research and donate bio-specimens scale by race/ethnicity.

Figure 6

Item-level differences on willingness to participate in research and donate bio-specimens scale by cancer health literacy level.

Figure 7

Item-level differences on willingness to participate in research by institution type scale and race/ethnicity.

Figure 8

Item-level differences on willingness to participate in research by Institution Type scale and Cancer Health Literacy level.

Figure 9

Interaction between cancer health literacy, race/ethnicity, and gender on WPRDB total scale.

Figure 10

Interaction between cancer health literacy and race/ethnicity on Will:Donate subscale mean score.

Figure 11

Interaction between cancer health literacy, race/ethnicity, and gender on Will:Institution subscale mean scores.