ASPO Abstracts
Association between health literacy and baseline breast density awareness in a health-system embedded intervention efficacy study
Category: Behavioral Science & Health Communication
Conference Year: 2019
Abstract Body:
Purpose: Health literacy is the ability to perform basic reading and numerical tasksrequired to function in the health care environment. We examined the association between health literacy and mammographic breast density awareness among women participating in a breast cancer prevention trial. Methods: Women were members of an integrated health system where density information was available within mammography reports in an online patient portal. We used baseline surveydata collected in 2017-18 to measure health literacy using a validated three-item scale. Outcomes included whether or not women had heard of breast density before the trial and, among women who had heard of breast density, correctly answered a question about its impact on mammography performance. We used logistic regression to calculate odds ratios (ORs) adjusted for age, breast density, numeric breast cancer risk, breast cancer family history, priorbreast biopsy, education, race/ethnicity, and household income.Results: Trial participants (n=995; M age = 61.9 years) primarily identified as White(95%) and were college educated (73%) with household incomes over $60,000 (67%). Health literacy scores were highly positively skewed (median score=15, range 6-15) and 91% of women had heard of breast density before the trial. Among these women, 87% correctly responded that densebreasts make it more difficult to see cancer on a mammogram. Health literacy scores were associated with prior density awareness (OR: 1.17; 95% CI: 1.01-1.36; p=0.032) in unadjusted, but not adjusted models. We found no association between health literacy and knowledge about density’s effect on mammography performance in women who had heard of breast density prior to the trial. Conclusions: Even in the absence of a formal notification program, density awareness was high among women participating in screening mammography in an integrated health system. Health literacy may facilitate density awareness, a prerequisite to density-specific knowledge,but not be its primary driver in highly educated, insured populations.
Keywords: breast density;health literacy; density awareness; density knowledge