Health literacy and beliefs about cancer causation and prevention in a Haitian immigrant population

Introduction: Cancer prevention efforts are influenced by individuals' beliefs about disease causation and their ability to access, understand, and use health information. This descriptive study presents interim findings on health literacy, cancer causal beliefs, and cancer prevention attitudes among Haitian immigrants. The data come from a subsample in the Florida Cancer Health Disparity Registry. Methods: We conducted a cross-sectional survey among 75 Haitian adults residing in South FL. Health literacy was assessed using the HLS19-Q12 and the BRIEF HL Screening Tool. Additional items evaluated beliefs about the causes and preventability of cancer. Descriptive statistics summarized sociodemographic data, literacy levels, and thematic patterns in belief systems. No inferential testing was performed at this stage. Results: Mean age of participants was 43.45 years (+/-13.47). Over half (52.7%) had never been married. Educational attainment varied, 44.0% having intermediate education, 32.0% low, and 24.0% high. Two-third reported earning less than $10,000 annually, and 56.8% were unemployed. Family history of cancer was reported by 19.7% of respondents. On the HL, 44.1% of participants had inadequate HL, and 33.9% had problematic HL, totaling 78% with suboptimal skills. On the BRIEF, 82.0% had trouble learning from written health materials, 80.3% struggled to understand spoken explanations, and 77.1% required help reading hospital materials. Only 53.2% felt confident completing forms, while 46.8% lacked confidence. Overall, 60.7% demonstrated “not sufficient” health literacy. Regarding cancer causation, participants listed 188 beliefs, the most frequent being diet and nutrition (35.1%), referencing processed foods, sugar, red meat, and chemical additives. Other belief categories included environmental exposures (14.4%), genetic/biological factors (12.8%), behavioral factors (11.7%), infections (10.6%), physical causes (8.0%), and cosmetic products (4.3%). When analyzed by controllability, 47% listed three controllable causes, and 36% listed two, suggesting widespread belief in individual agency over cancer risk. In terms of prevention beliefs, 76.6% disagreed with the statement "Everything causes cancer," and 65.6% disagreed with "Not much you can do to prevent cancer," reflecting positive attitudes toward preventability. However, 40.6% agreed that cancer means death, and 54.8% found cancer prevention recommendations confusing. Conclusions: Our results highlight limited health literacy alongside strong beliefs in cancer preventability and personal control over risk among Haitian immigrants. Findings support the need for tailored education addressing literacy gaps and cancer-related misconceptions. Further analyses will examine associations between literacy, beliefs, and sociodemographic factors to guide targeted intervention development.