Original Article
Association between Comprehensive Health Literacy and Participation in Mammography Screening
2026 Volume 53 Issue 2 Pages 320-329
Details
2026 Volume 53 Issue 2 Pages 320-329
Purpose: The association between comprehensive health literacy (HL) and participation in mammography (MMG) screening remains unclear. This study aimed to explore the relationship between comprehensive HL and MMG screening participation.
Methods: An online survey targeting women in their 40s without a history of breast cancer was conducted, and data were collected from 1,068 respondents. The survey included items on HL, the number of MMG screenings, demographic characteristics, self-rated health (SRH), and breast cancer risk factors. Multivariate logistic regression was conducted to analyze the association between HL and MMG screening. The dependent variables were 1) MMG screening history (0 times vs. one or more times) and 2) repeated MMG screenings (1 time vs. two or more times), and the independent variables included HL and other factors. Participants were also categorized into two groups based on their HL level, allowing for an examination of differences in screening-related factors.
Results: The number of valid responses was 612, with HL levels of "insufficient" at 36%, "problematic" at 30%, and "adequate" at 35%. The adjusted odds ratios (aORs) for HL and screening attendance, with "adequate" as the reference category, were 1.28 (95% confidence interval [CI]: 0.82–2.00) for "inadequate" and 0.87 (95% CI: 0.55–1.36) for "problematic". For repeated screenings, the aORs were 0.72 (95% CI: 0.43–1.20) for "insufficient" and 1.04 (95% CI: 0.59–1.82) for "problematic". No significant association was found between HL and screening. When comparing HL levels, significant associations were observed between SRH and HL in the low HL group for screening participation, and between education and HL in the same group for participation in repeated screenings.
Conclusions: Comprehensive HL did not directly affect MMG screening participation. However, different factors influenced participation based on HL levels, so tailored interventions targeting the characteristics of each HL level may enhance screening participation rates.
