Socio-culturally mediated factors and lower level of education are the main influencers of functional cervical cancer literacy among women in Mayuge, Eastern Uganda
Socio-culturally mediated factors and lower level of education are the main influencers of functional cervical cancer literacy among women in Mayuge, Eastern Uganda
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DOI：
10.3332/ecancer.2020.1004
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发表时间：
2020-01-21
影响因子：
1.8
通讯作者：
Mugisha, Noleb Mugume
中科院分区：
文献类型：
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作者：
Jatho, Alfred;Bikaitwoha, Maniple Everd;Mugisha, Noleb Mugume
背景：健康素养（HL）是指个人寻求、理解和使用健康信息来做出健康决策的知识和能力的程度，但马尤格和乌干达整体上缺乏关于宫颈癌素养功能水平的信息。因此，我们在五个功能性 HL 领域评估了 Mayuge 地区 18-65 岁女性的功能性宫颈癌知识水平；先验知识、口语、印刷、算术和电子保健。了解与宫颈癌认知相关的因素也与宫颈健康传播规划有关，但是，在乌干达，特别是在马尤格，还没有研究记录这一点。 Mayuge 是一个以农村人口为基础的癌症登记处，也是乌干达癌症控制干预试点的地点之一。我们还评估了与宫颈癌知识和对当前可用宫颈癌预防服务的认识相关的因素。 方法：该研究方案得到了乌干达癌症研究所研究和伦理委员会 (UCI-REC) 的批准。 2017 年 8 月，我们评估了 5 个 HL 域；对 400 名家庭妇女进行了宫颈癌知识、纸质识字、使用音频剪辑的口语识字、数字识字和感知的电子HL。正确响应得分为 1，错误响应得分为 0，以生成每个域的平均百分比得分。根据知识、印刷、口腔和电子健康的 McCormack HL 截止量表以及计算能力的最新生命体征 (NVS) 的 Weiss 截止量表，将平均分分为有限、基础和熟练等级。我们使用宫颈癌认知评分来探讨所选研究变量对宫颈癌认知的影响。我们还根据 PEN-3 模型的理论构建进行了五次焦点小组讨论 (FGD)。 结果：大多数 (96.8%) 参与者的宫颈癌知识水平有限，平均得分为 42%。完成初等教育或更低水平的女性（OR = 3.91；p = 0.044）更有可能对宫颈癌的了解有限。定性数据表明，女性对宫颈癌的了解有限，而且男性伴侣的决策、社会和经济支持也有限，整体控制力较低。大多数（92.3%）女性不了解可用的宫颈癌服务，也无意进行筛查（52.5%）。结论：马于格女性除口腔HL领域外，总体宫颈癌知识知晓率有限。有限的宫颈癌识字率在教育水平较低的女性中最高，总体识字率似乎受到社会文化结构的影响，其特点是总体控制能力较低的女性决策、社会和个人资源有限。马尤格妇女进一步表现出对其所在地区可用的卫生服务知之甚少，并且筛查意愿较低。需要采取多策略宫颈健康赋权计划，通过口头传播信息来改善宫颈 HL。
Background: Health literacy (HL) is the degree of an individual's knowledge and capacity to seek, understand and use health information to make decisions on one's health, yet information on the functional level of cervical cancer literacy in Mayuge and Uganda as a whole is lacking. We, therefore, assessed the level of functional cervical cancer literacy among women aged 18-65 years in Mayuge district in five functional HL domains; prior knowledge, oral, print, numeracy and e-health. Understanding the factors associated with cervical cancer literacy is also pertinent to cervical health communication programming, however, no study has documented this in Uganda and particularly in Mayuge. Mayuge is a rural population based cancer registry and one of the sites for piloting cancer control interventions in Uganda. We also assessed the factors associated with cervical cancer literacy and awareness about currently available cervical cancer preventive services.Methods: The study protocol was approved by the Uganda Cancer Institute research and ethic committee (UCI-REC). In August 2017, we assessed five HL domains; cervical cancer knowledge, print literacy, oral literacy using audio-clip, numeral literacy and perceived e-HL among 400 women at household levels. Correct response was scored 1 and incorrect response was scored 0 to generate the mean percentage score for each domain. The mean scores were classified as limited, basic and proficient bands based on the McCormack HL cut-offs scale for knowledge, print, oral and e-health and Weiss cutoffs in the newest vital signs (NVS) for numeracy. We used the cervical cancer literacy scores to explore the effect of selected study variables on cervical cancer literacy. We also conducted five focus group discussions (FGDs) based on the theoretical constructs of the PEN-3 model.Results: The majority (96.8%) of the participants demonstrated a limited level of cervical cancer literacy with a mean score of 42%. Women who had completed a primary level of education or lower (OR = 3.91; p = 0.044) were more likely to have limited cervical cancer literacy. The qualitative data indicated that the women had limited cervical cancer literacy coupled with limited decisional, social and financial support from their male partners with overall low locus of control. Most (92.3%) of the women were not aware of the available cervical cancer services and had no intention to screen (52.5%).Conclusions: The women in Mayuge in general have limited cervical cancer literacy except oral HL domain. Limited cervical cancer literacy was highest among women with lower level of education and overall literacy seemed to be influenced on the higher side by socio-cultural constructs characterised by limited decisional, social and personal resources among the women with overall low locus of control. The Mayuge women further demonstrated scant knowledge about the available health services in their district and low intention to screen. Multi-strategy cervical health empowerment programme is needed to improve cervical HL using orally disseminated messages.