PROJECT 4 - HEALTH LITERACY AND CANCER PREVENTION; DO PEOPLE UNDERSTAND WHAT THEY

本申请提出开发一种测试来评估口语的理解（即，关于（留言） 癌症预防和筛查，研究健康素养和癌症预防之间的关系， 并测试对口头信息的修改是否能提高理解力。调查结果将奠定 今后研究口腔卫生知识不足的普遍性的基础;确定群体 和个人的理解能力不足，识别风险因素和原因有限， 理解;以及制定和评估干预措施，以提高对口头表达的理解。 传递信息。。具体的目标是：1）开发和验证一个心理测量学上的声音测试， 口腔健康素养与癌症预防的关系 行为和3）制定和测试改善癌症口头交流的建议 预防和筛查。测试开发将包括识别以下方面的真实健康信息： 癌症和癌症预防。项目开发将是迭代的，项目由 心理测量学、医患沟通、健康沟通、语言方面的专家团队 理解与癌症一位获奖的医学作家/制片人将创作高质量的视频， 典型的预防癌症信息录音带，模拟媒体上的实际信息 和医疗机构。理解问题将使用句子验证来编写 法为了避免印刷品识字的潜在污染，绝对不需要阅读;所有文本 会有画外音经过广泛的预测试和试点，项目将管理到一个 来自美国3个健康计划的900名健康计划成员（来自 马萨诸塞州、格鲁吉亚和夏威夷）。经典和现代测试理论程序将被用来检查 项目和测试特性，并估计可靠性。有效性研究将包括评估 维度和差异项目功能，以及与外部措施的相关性。的关系 将通过预测癌症的模型来研究健康知识-口腔和癌症预防之间的关系 预防实践（自我报告）和参与癌症筛查利用（自我报告和 记录在健康计划记录中）。多变量模型将检验健康的相对贡献 Jiteracy-print、人口统计学变量、医生建议、感知风险/担忧和感知成本 和筛查的好处。将使用定量和定性方法来确定 影响有关癌症预防和筛查的口头信息的可理解性。建议 修改口头信息，使其易于理解，并将开发的影响， 将在随机实验中测试具体的增强。

This application proposes to develop a test to assess comprehension of oral (i.e., spoken) messages about cancer prevention and screening, to examine the relationship between health literacy and cancer prevention, and to test whether modifications to oral messages can improve comprehension. Findings will lay the foundation for future research into the prevalence of inadequate health literacy-oral; identification of groups and individuals with inadequate comprehension skills, identification of risk factors and causes of limited comprehension; and development and evaluation of interventions to improve comprehension of orally transmitted messages. .The specific aims are: 1) to develop and validate a psychometrically sound test of Health Literacy-Oral, 2) to investigate the relationship between health literacy-oral and cancer prevention behaviors and 3) to develop and test recommendations for improving oral communication about cancer prevention and screening. Test development will include identification of authentic health messages about cancer and cancer prevention. Item development will be iterative, with items generated and reviewed by a team of experts in psychometrics, physician-patient communication, health communication, language comprehension and cancer. An award-winning medical writer/producer will create high quality video- and audio-tapes of typical cancer prevention messages simulating actual messages encountered in the media and in health care settings. Comprehension questions will be written using the Sentence Verification Technique. To avoid potential contamination with print literacy, absolutely no reading will be required; all text will have accompanying voiceover. After extensive pretesting and piloting, items will be administered to a diverse sample of 900 health plan members, recruited from 3 health plans across the United States (from Massachusetts, Georgia, and Hawaii). Classical and modern test theory procedures will be used to examine item and test characteristics, and to estimate reliability. Validity studies will include assessment of dimensionality and differential item functioning, and correlations with external measures. The relationship between health literacy-oral and cancer prevention will be investigated through models predicting cancer prevention practices (self-reported) and participation in cancer screening utilization (self reported and documented in health plan records). Multivariate models will test for the relative contributions of health Jiteracy-print, demographic variables, physician recommendations, perceived risk/worry, and perceived costs and benefits of screening. Both quantitative and qualitative methods will be used to identify the factors that affect comprehensibility of oral messages about cancer prevention and screening. Recommendations for modifying oral messages so that they are easily comprehensible will be developed, and the impact of specific enhancements will be tested in a randomized experiment.