"Don't Leave Us Out" Civic Literacy: Older Mexican-American Women and Cervical Cancer Screening

Friday, 25 July 2014: 1:50 PM

Bertha Eloisa Flores, MSN, RN, WHNP-BC
Department of Family & Community Nursing, University of Texas at Austin & University of Texas Health Science Center at San Antonio, San Antonio, TX
Lyda Arevalo-Flechas, PhD, MSN, BSN
St. David's School of Nursing, Texas State University- Round Rock Campus, Round Rock, TX
Sara Gill, PhD, RN
The University of Texas Health Science Center at San Antonio, San Antonio, TX
Sharon Brown, PhD, RN, FAAN
School of Nursing, University of Texas at Austin, Austin, TX
Michael Mackert, PhD, RN
The University of Texas at Austin, Austin, TX


Describe the health literacy knowledge and experiences of English and/or Spanish speaking older women of Mexican American ancestry as they relate to cervical cancer screening following Zarcadoolas et al. (2005) model of health literacy which descries four domains; fundamental literacy, science literacy, cultural literacy and civic literacy.


A qualitative study design was conducted using focus group and individual interviews in English and Spanish.  A moderator guide was developed following Zarcadoolas et al. (2005) health literacy framework. Participants were presented with two brochures one from the Texas Department of State and health Services and one from the Centers for disease Control (CDC). A purposeful convenience and snowball sample of thirty women 50 and older were recruited to participate. Interviews were audio taped and transcribed in its original language. Content analysis was used to analyze data and matrices were developed. Codes and themes in Spanish were translated to the target language for meaning. Bilingual researchers concurred with translations from Spanish to English.


Participants reported receiving health information from different sources including, doctor’s offices, TV, women’s magazines. Participants were not aware of government programs available such as the Breast and Cervical Cancer Services (BCCS) or educational government websites through the Centers for Disease Control (CDC) or the Texas Department of State Health Services. All participants preferred simple and easy to read text and graphics from the Texas Department of State Health Services. However participants did not like the brochure from the CDC, it was “too busy” and presented too much information.

            Participants said that the brochures did not apply to women of their age and lacked of age representation. Participants recommended adding pictures of older women. The following statements best describe the overall sentiments “We need another viejita” [little old lady] and “Don’t leave us out”.


Further efforts are needed to develop national health polices and educational campaigns which are inclusive of all populations including older Mexican American women. Global communication efforts through different mediums aimed at improving health promotion practices which are cultural, linguistic and age appropriate will aide in decreasing this health disparity gap.