Improving cervical cancer health literacy in Arabic-speaking immigrant women in the United States through an online patient education tool.
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BACKGROUND: Low health literacy rates especially among the medically underserved have called for more understandable and actionable resources to involve patients in their health. The online audio-visual Reproductive Health Network (ReproNet) cervical cancer tool was shown to improve cervical cancer health literacy among marginalized English- and Spanish-speaking populations and Arab and Afghan immigrants in a group setting. OBJECTIVE: This study aimed to determine whether or not the cervical cancer tool positively impacts health literacy for Arabic-speaking Middle Eastern or North African first- and second-generation immigrant women in the United States when self-administered. DESIGN: In this single-group pre-post interventional study, a convenience sample of 95 Arabic-speaking immigrant women in the United States, ages 18 and over, reviewed an online cervical cancer patient education tool and completed pre- and post-tests. METHODS: Participants received links to the tool and to pre- and post-tests, using the cervical cancer literacy assessment tool. We conducted McNemar tests and paired t-tests to compare pre- and post-test results in health literacy per participants. A multivariate regression model was fitted to test the association between demographic variables and the change of cervical cancer literacy content domains, controlling for the baseline scores before administering the tool. RESULTS: Out of 118 participants, 95 participants had complete pre- and post-tests. Health literacy increased overall after self-administration of the tool, specifically in terms of cervical cancer prevention and control (p < 0.01). There were no significant differences in knowledge in U.S.-born versus foreign-born Arabic-speaking women (p = 0.6660). CONCLUSION: The self-administration of the ReproNet cervical cancer tool most significantly increases awareness and knowledge of cervical cancer prevention in Arabic-speaking first- and second-generation immigrant women, thus pointing to increased quality of the provider-patient relationship.