Diviani, N. (2013). Cancer and Health Literacy: Establishing a Concept of Cancer Literacy. In R. Moore & D. Perry (Eds.), Health Literacy: Developments, Issues and Outcomes (pp. 67-88). Hauppauge NY: Nova Science Publishers.

Health literacy is widely recognized as a very important factor in explaining health outcomes. The present chapter deals with one of the main limitations of research around health literacy, i.e. the fact that a clear and shared definition of the concept is still missing. Furthermore, the conceptual complexity of the concept is not reflected in the existing measures: only functional health literacy has been operationally defined and instruments are only able to measure basic reading and writing skills. As a result all the literature studying the relationship between health literacy and health outcomes has focused on ‘functional health literacy’, or people’s ability to read and write in the health context, leaving the role of dimensions of health literacy beyond basic reading and writing skills mostly unexplored.
The main objective of the work presented in this chapter is the operationalization of a usable concept of health literacy. The chapter will document the different steps of the process of establishing the concept of Cancer Literacy. After a review of the literature on health literacy, the operationalization and validation of the concept of Cancer Literacy will be presented. In a first step, a Delphi study among a panel of Swiss cancer experts led to the first operational definition of the concept of Cancer Literacy, i.e. a list of aspects of cancer that should be known by a layperson to be considered cancer literate. In a second phase, a measure of Cancer Literacy was developed and tested in a sample of Italian-speaking Swiss residents (N = 639) in order to have some first insights into the validity of the concept.
This chapter provides relevant theoretical and empirical evidence for the attempt to go in the direction of a context- and content-specific conceptualization of health literacy: not only functional health literacy, but other dimensions of health literacy as well (in this case Cancer Literacy) can play a fundamental role in explaining health outcomes. At the same time it confirms the crucial role of research around health literacy for the evolution of the field of health communication.

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