Grant: Doctoral Award - Frederick Banting and Charles Best Canada Graduate Scholarships

Having the ability to access and understand health information, termed health literacy, is vital to the management of breast cancer. Unfortunately, approximately 45% of patients' health literacy is below the level necessary to process and understand basic health information (Paasche-Orlow et al., 2005). However, health literacy can be greatly improved when health care professionals devote the necessary time to guide the patient through the information and present it in a personally relevant context (Flory, 2004). Time demands often prohibit lengthy patient-doctor contact; however, patient navigator programs (wherein nurse-practitioners provide patients with cancer-related information, prepare them for procedures, help them to cope emotionally with cancer, and increase access to services and resources), may serve to fill this need. To examine if health literacy impacts the effectiveness of patient navigation interventions, 60 newly diagnosed breast cancer patients' health literacy will be assessed and their progress in a patient navigator intervention will be monitored. The patient navigation intervention will consist of three telephone-administered sessions focused on improving patient understanding of breast cancer and its treatments, teaching self-management through enhanced problem-solving skills, improving the management of psychological distress, and facilitating continuity of care. It is predicted that the lower health literacy patients will report greater improvements in psychological distress, satisfaction with care, self-efficacy, preparedness for treatment, and quality of life than the higher health literacy patients. Findings from this study will serve to promote program development and improve health care delivery for the large percentage of low health literate patients seen in clinics across Canada.