Abstract B055: Health literacy, health numeracy, and cancer screening patterns in the Zuni Pueblo: Insights from and limitations of “standard” questions

Abstract American Indians (AIs) experience disparities in cancer screening, stage at disease diagnoses, and 5-year cancer survival. This study investigates how health literacy and health numeracy may be linked to cancer screening behaviors of Zuni Pueblo members using a survey exploring cancer screening behaviors related to breast, cervical, and colorectal cancers. As part of a larger community-based cancer-prevention project, Zuni Health Initiative staff conducted surveys from October 2020 through April 2021 for a total of 280 participants (men ages 50-75 and women ages 21-75) from the Zuni community. The project is in collaboration with the Pueblo of Zuni and has received research approval from the Zuni Pueblo Tribal Council, the Southwest Tribal IRB, and UNM Health Sciences Center IRB. Bivariate and multivariable analyses investigated associations between health literacy/numeracy measures and cancer screening behaviors. Bivariate analyses showed some associations between distinct measures of health literacy/numeracy and colorectal cancer (CRC) screening, including both colonoscopy (health literacy) and fecal occult blood testing (FOBT) (health numeracy), as well as cervical cancer screening (health literacy). There were no statistically significant associations between health literacy/numeracy measures and mammogram screening for breast cancer. In multivariable analyses, there were no consistent patterns between health literacy/numeracy and screening for any cancer. There are some individual findings worth noting, such as statistically significant findings for health numeracy and FOBT (those reporting lower health numeracy were less likely to report FOBT). An important finding of this study is that questions used to assess health literacy/numeracy did not identify associations aligned with previous research. We reflect on the ways the “standard” questions may not be sufficiently tailored to the Zuni experience and may contribute to health equity barriers. Citation Format: Kate Cartwright, Samantha Leekity, Judith Sheche, Deborah Kanda, Mikaela Kosich, Madison Gonya, Nicholas Edwardson, V. Shane Pankratz, Shiraz I. Mishra. Health literacy, health numeracy, and cancer screening patterns in the Zuni Pueblo: Insights from and limitations of “standard” questions [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B055.