Patient attitudes and preferences regarding literacy screening in ambulatory cancer care clinics

OBJECTIVES To evaluate patient attitudes towards literacy screening, agreement between literacy tests, and associations between literacy, informed consent comprehension, and health-related quality of life (HRQL). METHODS Participants completed three literacy tests, read a sample consent form, and reported their HRQL, experiences, and attitudes. RESULTS We enrolled 97 cancer patients, of whom 66% were female, 67% were African American, and 65% were high school graduates. Sixty percent of patients with lower reading comprehension had trouble reading health information, and 31% had trouble reading everyday written material. Even patients with higher reading comprehension had trouble reading health information (29%) and everyday written material (10%). Low-literacy patients were more likely to feel anxious about literacy screening. However, the majority of patients (84%) would be willing to have literacy results given to providers. Comprehension of informed consent increased with higher literacy. There were no HRQL differences. CONCLUSIONS Patients report difficulty comprehending written health information. Literacy assessment is acceptable and it is considered important for providers to be aware of their patients' reading abilities. Patient preference data should be used to improve literacy testing strategies and measures. Enhancing detection of low literacy can facilitate interventions to reduce health disparities.