Decisional balance and self-efficacy mediate the association among provider advice, health literacy and cervical cancer screening.
Kyounghae Kim, Qian-Li Xue, Benita Walton-Moss and 2 others
PMID 29353633WHAT IT FOUND
Health literacy was not directly associated with Pap test use in 560 Korean American women, but was associated through weighing Pap test pros and cons and confidence.
Provider advice had the strongest direct association.
Key findings
01Health literacy was not directly associated with Pap test use, but was associated through weighing Pap test pros and cons and confidence.
02A provider’s advice had the strongest direct association with Pap test use, although only 15.7% reported receiving advice.
03Provider advice was also associated with Pap test use through weighing Pap test pros and cons and confidence.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was cross-sectional, so it cannot show that health literacy, provider advice, pros and cons, or confidence caused Pap test use. Pap test use was self-reported at baseline, so screening rates may be over- or underestimated. Participants were recruited from Korean churches on the East Coast, so results may not apply to other Korean American women or other settings. The Pap test pros and cons and confidence scales were not validated specifically with Korean women, although they had good internal consistency in this sample. The analysis used baseline data, not outcomes from the parent community trial intervention.
The easy way to misread this
Do not conclude that provider advice or health literacy training causes Pap test use. The study measured associations at one time point, and the direct health literacy association was not significant.