Zhongguo quanke yixue (Nov 2022)
Effect of Health Literacy on Colonoscopy Screening Compliance in an At-risk Population Identified by the First Colorectal Cancer Screening
Abstract
Background The prevention and treatment of colorectal cancer has become a societal concern. One key to colorectal cancer prevention and treatment is to improve the detection rate of colonoscopy screening, an essential tool for early diagnosis of colorectal cancer, in populations at high risk of colorectal cancer. Some research results show that the ability of individuals to make healthy choices and decisions is closely associated with their ability to acquire and understand information. Objective To investigate the association of health literacy level with colonoscopy screening compliance in an at-risk population identified by the first colorectal cancer screening. Methods Participants were individuals at risk of colorectal cancer selected from January to March 2020 who were identified by the general colorectal cancer screeningconducted by a community health center in Shanghai's Yangpu District during 2017—2018. General Demographic Information Questionnaire and the Chinese version of Health Literacy Management Scale (HeLMS-C) were used to conduct a questionnaire survey. Results Altogether, 337 cases attended the survey, and 329 of them (97.6%) who handed in responsive questionnaires were finally included. Among the respondents, 252 had never received a colonoscopy, and only 77 had received that, with a colonoscopy screening compliance of 23.4%. The total average HeLMS-C score for the respondents was (103.77±3.78) . And the average scores of four domains of the scale, namely accessing GP healthcare services, communication with health professionals, patient attitudes towards their health, and social support were (44.50±1.70) , (36.34±2.10) , (15.83±2.01) and (7.09±1.37) , respectively. The distribution of marital status, type of risk for colorectal cancer identified by the first colorectal cancer screening, total score of the HeLMS-C, scores of accessing GP healthcare services, communication with health professionals and patient attitudes towards their health differed significantly between respondents who received a colonoscopy and those who did not (P<0.05) . Logistic regression analysis results showed that the type of marriage status, patient attitudes towards their health and communication with health professionals were associated with colonoscopy screening compliance (P<0.05) . Conclusion Having a spouse, higher patient attitudes towards their health, and higher level of communication with health professionals were associated with higher colonoscopy screening compliance in individuals at risk of colorectal cancer identified by the first colorectal cancer screening. In view of this, to improve the colonoscopy screening compliance of these people, attention should be paid to the improvement of the level of their health literacy.
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