Self-reported Health Literacy, Digital Literacy, and Barriers to accessing care at a Safety Net Breast Surgical Oncology Clinic

Abstract

Background: Sociodemographic factors, including language, education, race, and insurance status, significantly influence patient outcomes following breast surgery, especially in safety-net hospitals (SNHs) that serve vulnerable populations. Objective: To assess the sociodemographic composition of a breast surgical oncology clinic at an urban SNH and evaluate how these factors impact digital literacy, health literacy, and access to care. Methods: English and Spanish-speaking adult female patients at an urban SNH breast surgical oncology clinic between August and October 2022 completed a survey assessing digital and health literacy, barriers to care, and sociodemographic information. Descriptive statistics and comparative analyses were performed using Chi-squared and Fisher's exact tests. Results: Of 127 invited patients, 95 (75%) completed the survey. The median age was 50 years. Fifty-six percent identified as Hispanic, 43% preferred Spanish, and 40% had less than a high school education. Health literacy was lower among Spanish-speaking, older, and less-educated patients. Digital literacy was also lower among these groups, with notable disparities in access to computers, the internet, and smartphones. Conclusion: Significant disparities in health and digital literacy exist among vulnerable breast cancer patients at SNHs, particularly among Spanish-speaking, older, and less-educated individuals. Targeted interventions to improve education, access to digital resources, and supportive services are essential to ensure equitable care and improve health outcomes for these populations.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

This study did not receive any funding

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

COLORADO MULTIPLE INSTITUTIONAL REVIEW BOARD gave ethical approval for this work.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Data Availability

All data produced in the present study are available upon reasonable request to the authors

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