Document Type

Doctoral Project

Publication Date



Health literacy is vitally important for African-Americans (AA), with higher incidence and mortality rates of colon cancer compared to Caucasians nationally and in Ohio. Larrabee's Model for Change to EBP and Self -Efficacy Middle range nursing theory guided this DNP project. A retrospective chart review of AA patients with colon cancer was completed to determine types of teaching methods used by nurses during the clinical encounter. A convenience sample (8%) of AA patients received colon cancer care in the ambulatory setting at the healthcare facility in the Midwest. More than half were female and the remainder were male (65% vs. 35%); with a median age of 52 years. The duration of diagnosis with colon cancer was six months to 1 year (65%); 23% was greater than a year, and 12% was less than one year. Nurses documented patient education in 97% of the encounters. The types of hea_lth literacy teaching methods were: explanation (53%), blended (41 %) and the use of audiovisual aids (3%). The findings supported the EBP literature of "Teach-Back", Audiovisual, Written or picture material, and Blended supporting the delivery of health literate education. No associations were made regarding types of health literacy education or patient's adherence to chemotherapy treatment plans of care due to the small sample of AA patients during the review period. It is possible that this health care system may not be the preferred choice for some AA patients seeking colon cancer treatment. Further EBP projects are needed to examine system barriers or internal factors influencing colon cancer treatment affecting AA with colon cancer. Documentation of patient education in the electronic medical record (EMR) offered nurses the opportunity to select one or more teaching methods during the patient encounter, but unfortunately does not define how patients apply health literate education promoting health care decisions. This DNP project identified an opportunity for nursing practice to develop tools that measure or examine health literacy teaching methods linked to colon cancer in AA patients.