Problem-solving tools to encourage cancer screening among low health literacy populations in Western New York

This study evaluated pre-post changes in readiness to engage in cancer screening among populations with low screening rates after using mobile problem-solving tools. Disseminating strategies for tool scale-up were examined.

The study was conducted among low-resourced communities in Western New York (2023-2024) across two cohorts; women eligible for breast cancer screening (BCS) and adults eligible for lung cancer screening (LCS). Tools utilized literacy-adjusted, culturally-tailored visual content, guided by focus groups and a community advisory board (CAB). Participants used the tools and completed pre-post (REDCap) surveys. Primary outcome was readiness-to-screen; secondary outcomes included screening-related knowledge, self-efficacy, and concerns. Two dissemination strategies were evaluated - targeted social media ads and printed flyers distributed in CAB-engaged areas.

After reviewing the problem-solving tools, low knowledge, low self-efficacy, and high concerns decreased across cohorts, with significant improvements in the LCS group (p < 0.05). Increased readiness-to-screen was associated with current or past employment (OR: 13.95, 95% CI: 1.23, 157.84). Social media outreach generated 770,000 ad views and 1640 website visits but no participation while community engagement with 400 flyers yielded 100 inquiries and 59 participants.

Literacy-adjusted, culturally-tailored tools may reduce barriers and enhance cancer screening engagement in low-resource communities, supported by trusted community partnerships.