Unmet Information Needs Among Hispanic Women with Thyroid Cancer

Abstract

Context: Thyroid cancer is the second most common cancer in Hispanic women.

Objective: To determine the relationship between acculturation level and unmet information needs among Hispanic women with thyroid cancer.

Design: Population-based survey study.

Participants: Hispanic women from Los Angeles Surveillance Epidemiology and End Results registry with thyroid cancer diagnosed in 2014-2015 who had previously completed our thyroid cancer survey in 2017-2018 (N = 273; 80% response rate).

Main outcome measures: Patients were asked about 3 outcome measures of unmet information needs: (1) internet access, (2) thyroid cancer information resources used, and (3) ability to access information. Acculturation was assessed with the Short Acculturation Scale for Hispanics (SASH). Health literacy was measured with a validated single-item question.

Results: Participants' median age at diagnosis was 47 years (range 20-79) and 48.7% were low-acculturated. Hispanic women were more likely to report the ability to access information "all of the time" if they preferred thyroid cancer information in mostly English compared to mostly Spanish (88.5% vs 37.0%, P < 0.001). Low-acculturated (vs high-acculturated) Hispanic women were more likely to have low health literacy (47.2% vs 5.0%, P < 0.001) and report use of in-person support groups (42.0% vs 23.1%, P = 0.006). Depending on their level of acculturation, Hispanic women accessed the internet differently (P < 0.001) such that low-acculturated women were more likely to report use of only a smartphone (34.0% vs 14.3%) or no internet access (26.2% vs 1.4%).

Conclusions: Low-acculturated (vs high-acculturated) Hispanic women with thyroid cancer have greater unmet information needs, emphasizing the importance of patient-focused approaches to providing medical information.

Keywords: Hispanic women; health literacy; information needs; information seeking behavior; thyroid cancer.

Figure 1.

Flow diagram of survey respondents (N = 273, 80% response rate). SEER indicates Surveillance, Epidemiology, and End Results program.

Figure 2.

Patient-reported access to the internet by level of acculturation. Rao-Scott adjusted chi-square P-value was < 0.001.

Figure 3.

Patient-reported use of thyroid cancer information resources by level of acculturation and preferred language. Low-acculturated (vs high-acculturated) Hispanic women were more likely to report use of in-person support groups (P = 0.006) and less likely to report use of search engines or medical websites/journals (both P < 0.001).

Figure 4.

Patient-reported ability to access information in preferred language. Hispanic women were more likely to report the ability to access information “all of the time” if they preferred thyroid cancer information in mostly English compared with if they preferred it in mostly Spanish (P < 0.001).