Associations between patient-level health literacy and diagnostic time intervals for head and neck cancer: A prospective cohort study

• Published in: Head & neck 2024-04, Vol.46 (4), p.857-870
• Main Authors: Venchiarutti, Rebecca L, Clark, AM, Jonathan R, Palme, Carsten E, Dwyer, Patrick, Tahir, Abdul Rahim Mohd, Hill, Jacques, Ch'ng, Sydney, Elliott, Michael S, Young, Jane M
• Format: Article
• Language: English
• Subjects: Cohort analysis; Comorbidity; Diagnosis; Education; Head & neck cancer; Health education; Health literacy; Patients; Primary care
• ISSN: 1043-3074; 1097-0347; 1097-0347
• DOI: 10.1002/hed.27633

Health literacy (HL) comprises skills and knowledge required to understand, access, and make decisions about healthcare. Our aim was to examine associations between patient HL and time intervals (defined in the Aarhus statement) along the pathway to treatment of head and neck cancer (HNC). A prospective cohort study was conducted from October 2018 to March 2020. Participants completed the Health Literacy Questionnaire (HLQ®) and described key events and dates along the pathway to treatment using validated questionnaires. Correlations between six diagnostic time intervals and domains of HL were explored, and factors predicting exceeding maximum acceptable timeframes were assessed using logistic regression. One hundred patients with a diagnosis of HNC within the preceding 6 months were recruited. HLQ® Domain 2 (sufficient information to manage health) was significantly negatively associated with four intervals: the patient interval (first symptom to first presentation), primary care interval (first presentation to referral to secondary care), diagnostic interval (first presentation to diagnosis), and total interval (first symptom to treatment onset); correlation coefficients -0.25 to -0.27 (P