Cancer Research, Statistics, and Treatment (Jan 2023)
Optimizing cancer screening rates in populations with low literacy in France: Results of a mixed-methods cancer educational intervention study
Abstract
Background: Vulnerable populations, including those with low income and literacy, are less likely than the general population to participate in cancer education programs and screenings. It is therefore crucial to examine the role of a cancer educational intervention in increasing the suboptimal cancer screening rates in France. Objectives: We aimed to evaluate the effect of an eight-week cancer educational intervention on self-efficacy, cancer, and cancer prevention knowledge. We also aimed to study the uptake of colorectal, breast, and cervical cancer screenings among low-income immigrant women with low levels of literacy in France. Materials and Methods: Between January 2019 and March 2020, we implemented a cancer educational intervention and followed up with a mixed-methods study in the Ain Department in the east of France, triangulating quantitative survey data with qualitative interview data. Participants completed a survey assessing their knowledge and self-efficacy of cancer and cancer screenings before and after an eight-week in-person cancer educational program. Semi-structured qualitative interviews were also conducted with each participant. Screening outcomes were obtained two years after the interviews. Appropriate quantitative and qualitative analyses were performed. Results: Study outcomes in our cohort (n = 164 women) improved following the cancer educational intervention as shown in pre- versus post-survey results: self-efficacy (8 [9.4%] to 48 [56.5%]), cancer knowledge (14 [16.5%] to 72 [84.7%]), screening knowledge (4 [4.7%] to 54 [63.5%]), and screening outcome (25 [30.6%] to 61 [73.6%], P < 0.0001 for at least one screening). The interview data were consistent with the quantitative results. Conclusions: Developing specific cancer educational initiatives for vulnerable low-income and low-literate populations can significantly improve knowledge about cancer and cancer prevention, and increase cancer screening rates. The provision of audience-tailored cancer educational interventions is an effective strategy to eradicate cancer inequities in France.
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