Health Literacy Surrounding Anal Cancer Among Women and the Need for Policy Changes in Preventive Health Screenings

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When examining health literacy across ethnicities and communities, ethnic minority groups are known to be at a higher risk of being below the average health literacy threshold, and limited health literacy has been linked to poor health status and higher mortality rates (Giurca et al., 2018). This study examined health literacy surrounding anal cancer and HPV related preventative health screening behaviors. More specifically, the aim of the study was to bring awareness to low levels of anal cancer related health literacy for women and the need for policy changes regarding preventive health screenings. The following research questions were explored: (1) What are the common themes and/or beliefs when asked about anal cancer, HPV, and preventive screening? and (2) What are the common themes and beliefs surrounding the severity and susceptibility of contracting anal cancer?. This study utilized a cross-sectional design to survey 26 individuals regarding their knowledge level and perspectives regarding anal cancer and HPV related severity and susceptibility. The student researcher developed and administered an 8-question survey de novo. The survey included open-ended questions constructed based on an application of the Health Belief Model (HBM) elements of perceived susceptibility and perceived severity to anal cancer health literacy. This study employed thematic analysis and grounded theory to explore critical themes and construct a model to explain health literacy regarding anal cancer and intention to participate in preventive screenings. The fundamental attitudes and themes about health literacy related to anal cancer and the intention to participate in preventative screenings were elicited using a qualitative descriptive technique. The student researcher utilized the coded data to create open categories, axial codes, and finally selective codes based on higher level themes based on (1) knowledge and (2) perceived risk, both severity and susceptibility. A model for classifying responses, including knowledge levels and perceived severity, and perceived susceptibility, was created. While the axial and selective codes were created by grouping the themes discovered through open coding, application of the core constructs of the health belief model informed the creation of the groups into the evidence-based selective code categories of risk and knowledge. The results from this study may be used to inform practitioners, providers, and policymakers in developing interventions addressing low health literacy rates surrounding anal cancer in support of creating a standardized health screening procedure.
A thesis submitted in partial fulfillment of the requirements for the degree Master of Public Health
Public Health