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

这项申请建议开发一种测试来评估对关于以下内容的口头(即，口头)消息的理解 癌症预防和筛查，以检查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可以提高理解能力。调查结果将为 为今后研究健康素养不足的流行率奠定基础--口述；群体识别 以及理解能力不足、识别危险因素和原因有限的个人 理解；以及开发和评估干预措施，以提高对口头的理解 发送的消息。具体目标是：1)开发和验证心理测量学测验 健康素养-口腔，2)调查健康素养-口腔与癌症预防的关系 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有关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 理解和癌症。一位屡获殊荣的医疗编剧/制片人将制作高质量的视频-以及 模拟在媒体中遇到的实际消息的典型癌症预防消息的录音 以及在医疗保健环境中。将使用句子验证来编写理解题 技术。为了避免潜在的印刷读写污染，绝对不需要阅读；所有文本 将有配音伴奏。在广泛的预测试和试点之后，项目将被管理到 900名健康计划成员的不同样本，从美国各地的3个健康计划中招募(来自 马萨诸塞州、佐治亚州和夏威夷)。将使用经典和现代测试理论程序来检验 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，以及与外部测量的相关性。两国关系 健康素养-口腔和癌症预防之间的关系将通过预测癌症的模型进行调查 预防做法(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、人口统计变量、医生推荐、感知风险/担忧和感知成本 以及筛查的好处。将使用定量和定性的方法来确定以下因素 影响有关癌症预防和筛查的口头信息的可理解性。针对以下方面的建议 将制定修改口头信息，使其易于理解，并将产生的影响 具体的增强功能将在随机实验中进行测试。

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.