Stacy Tessler Lindau|Anirban Basu|Sara A. Leitsch
Health literacy as a predictor of follow-up after an abnormal pap smear
University of Chicago|University of Chicago|University of Chicago
low literacy influences cervical cancer screening knowledge possible contributor racial disparities cervical cancerto examine hypothesis literacy predicts patient adherence followup recommendations abnormal pap smeara prospective continuity clinicbased studyfrom sample 538 women undergoing literacy testing time pap smear screening studied 68 women abnormal pap smear diagnosesliteracy assessed using rapid evaluation adult literacy medicine realm also measured proxies literacy including educational attainment physician estimates patients literacy level outcome measures included ontime 1year followup duration time followup abnormal pap smearonly onethird cohort adhered followup recommendations 1 year 25 women returned patients inadequate literacy assessed realm less likely follow within 1 year although result statistically significant adjusted odds ratio or38 95 confidence interval ci 08 174 patients subjectively assessed physician low literacy skills significantly less likely follow within 1 year adjusted or14 95 ci 3 65 less high school education hazard ratio hr 23 95 ci 12 46 low physicianestimated literacy level hr34 95 ci 14 82 objective literacy level significant predictors duration time followup adjusting recommended days followup factorsamong women abnormal pap smear perceived physician low literacy significantly likely fail present followup