Kyounghae Kim|Xue Qin|Benita Walton?Moss|Marie T. Nolan|Hae Ra Han
Decisional balance and self-efficacy mediate the association among provider advice, health literacy and cervical cancer screening
Johns Hopkins University|Johns Hopkins Medicine|Johns Hopkins University|University of Southern California|Johns Hopkins University|Johns Hopkins University
purpose health literacy emerged potential determinant cancer screening yet limited literature investigated pathways health literacy influences pap tests among immigrant women experience higher incidence cervical cancer study aimed test health literacyfocused sociocognitive model proposes motivational knowledge decisional balance volitional selfefficacy factors mediating association health literacy triennial pap tests methods using structural equation modeling conducted secondary analysis baseline data obtained randomized controlled trial promote breast cervical cancer screenings among 560 korean american women 2165 years age interviewed demographics education english proficiency provider advice health literacy knowledge cervical cancer decisional balance pap tests selfefficacy pap test use results higher health literacy predicted high level knowledge high decisional balance score greater selfefficacy decisional balance selfefficacy affected pap tests high level knowledge predicted pap tests impact decisional balance score receiving provider advice directly indirectly predicted pap tests high level health literacy high level decisional balance greater selfefficacy conclusions findings study suggest possible pathways provider advice health literacy affect pap tests interventions targeting immigrant women limited english proficiency consider skillbased approaches health literacy training promoting patientprovider communications emphasizing decisional balance selfefficacy potentially sustainable ways promoting pap tests