Higher levels of health literacy (HL) have been shown to be influential in improving health outcomes including survival. Hence it is important to explore the role of HL in the context of adolescents and young adults (AYAs) who have or have had cancer. While prior research has focussed on the consequences more than the causes of HL, a population based study found that lower family socio-economic status is associated with lower HL in AYAs1. The aim of this study was to examine the impact of individual factors on HL.
The HL of 101 AYA cancer patients (M=18.6 years, SD=3.2 years) was assessed using a self-report scale that measures three components of HL: functionality, communication and criticality. The impact of age, gender, psychological distress, education, and time since diagnosis on each HL component was assessed using stepwise linear regression.
The analysis indicated that psychological distress was a predictor for functional literacy (R2=.04, F[1,99]=4.55, p=.035; β=-.21, p=.035); while communicative literacy was predicted by age and psychological distress (R2=.11, F[2,99]=7.17, p=.001; distress: β=-.28, p=.005, age: β=.27, p=.007); and critical literacy was predicted by age only (R2=.09, F[1,99]=10.4, p=.002; β=.311, p=.002). Higher levels of psychological distress predicted poorer functional and communicative HL, while critical and communicative HL were predicted by increasing age. Overall; the other variables had minimal effect on the HL of AYAs with cancer.
The results suggest that psychological distress and age have an impact on HL. It is interesting that time since diagnosis did not contribute to HL, as it is often seen as a proxy for level of exposure to the health system. Clearly, individual factors contribute to the HL of AYAs with cancer.