**4. Information strategies and health behaviors related to levels of prostatecancer literacy**

In Section 3, we contextualized health literacy within the perspective of men's experiences with prostate cancer. In this section, we present the results of a qualitative study with 14 Francophone Canadian men. The study documented men's strategies for dealing with prostate cancer information and their self-rated levels of health literacy (Zanchetta, 2002). The study demonstrated that levels of health literacy were not influenced by older men's self-reported general literacy (Zanchetta et al., 2007) and that, despite differences in their levels of health literacy, older men reported similar strategies for dealing with prostate cancer information: comparison, deduction, and hypothesis formation (Zanchetta et al., 2007). These information strategies revealed the importance of communication through social, intimate, and interpersonal interactions in enhancing older men's health literacy.

### **4.1 Older men's construction of health literacy**

Older men's health literacy is influenced by several factors, such as seeking health-related information to promote and maintain health, leading to personal empowerment (World Health Organization, 1998), reading and numeracy skills, comprehension, and decision making (Oldfield & Dreher, 2010); opportunities to obtain health-related information; concepts of masculinity (Peerson & Saunders, 2010; Zanchetta et al., 2010); and congruency between health-related information and personal views of masculinity (Zanchetta, 2002).

To guide decision making in collaboration with physicians, men with prostate cancer face great challenges in learning about and understanding their disease (Barry, 2010). Two of these uncertainties relate to prostate cancer's trajectory and the complex information patients receive about their prognosis and treatment options (Nanton et al., 2009). These uncertainties influence men's ability to participate in decision making about their care. In Zanchetta et al.'s (2007) study, men's various information strategies allowed them to participate in making decisions about their complex care. Low health literacy rates are another prominent challenge. Low health literacy rates limit men's understanding of prostate cancer information (Easton et al., 2010). Another challenge to the health literacy of men with prostate cancer is the lack of consensus among health care professionals about the most effective decision aids and the safest methods for screening and monitoring (Gwede & McDermott, 2006). Nor does consensus exist among health professionals on whether prostate cancer screening improves health outcomes (Krist et al., 2007) or what harmful consequences prostate cancer treatment has for men's physical and sexual functioning (Barry, 2010).

All of the above challenges, added to contradictions in information from health care professionals, contribute to men's confusion in trying to understand scientific discourse about prostate cancer and the impact of treatment on men's sexual function. Men's goal for learning about prostate cancer becomes clear: They seek information they can use to

What are some principles of adult learning that can guide health professionals in

Identify strategies that could foster learning among older men about their health and

What teaching strategies should health professionals consider when promoting literacy

In Section 3, we contextualized health literacy within the perspective of men's experiences with prostate cancer. In this section, we present the results of a qualitative study with 14 Francophone Canadian men. The study documented men's strategies for dealing with prostate cancer information and their self-rated levels of health literacy (Zanchetta, 2002). The study demonstrated that levels of health literacy were not influenced by older men's self-reported general literacy (Zanchetta et al., 2007) and that, despite differences in their levels of health literacy, older men reported similar strategies for dealing with prostate cancer information: comparison, deduction, and hypothesis formation (Zanchetta et al., 2007). These information strategies revealed the importance of communication through social, intimate, and interpersonal interactions in enhancing older men's health literacy.

Older men's health literacy is influenced by several factors, such as seeking health-related information to promote and maintain health, leading to personal empowerment (World Health Organization, 1998), reading and numeracy skills, comprehension, and decision making (Oldfield & Dreher, 2010); opportunities to obtain health-related information; concepts of masculinity (Peerson & Saunders, 2010; Zanchetta et al., 2010); and congruency between

To guide decision making in collaboration with physicians, men with prostate cancer face great challenges in learning about and understanding their disease (Barry, 2010). Two of these uncertainties relate to prostate cancer's trajectory and the complex information patients receive about their prognosis and treatment options (Nanton et al., 2009). These uncertainties influence men's ability to participate in decision making about their care. In Zanchetta et al.'s (2007) study, men's various information strategies allowed them to participate in making decisions about their complex care. Low health literacy rates are another prominent challenge. Low health literacy rates limit men's understanding of prostate cancer information (Easton et al., 2010). Another challenge to the health literacy of men with prostate cancer is the lack of consensus among health care professionals about the most effective decision aids and the safest methods for screening and monitoring (Gwede & McDermott, 2006). Nor does consensus exist among health professionals on whether prostate cancer screening improves health outcomes (Krist et al., 2007) or what harmful consequences prostate cancer treatment

All of the above challenges, added to contradictions in information from health care professionals, contribute to men's confusion in trying to understand scientific discourse about prostate cancer and the impact of treatment on men's sexual function. Men's goal for learning about prostate cancer becomes clear: They seek information they can use to

health-related information and personal views of masculinity (Zanchetta, 2002).

**4. Information strategies and health behaviors related to levels of prostate-**

**3.5.2 Questions** 

their bodies.

**cancer literacy** 

teaching older men about prostate cancer?

**4.1 Older men's construction of health literacy** 

has for men's physical and sexual functioning (Barry, 2010).

about health and prostate cancer among older men?

survive the disease, not scientific understanding of the disease process (Zanchetta et al., 2007). Erectile dysfunction, one potential consequence of prostate cancer treatment, represents failed masculinity (Knight & Latini, 2009) for men who adopt traditional masculinities. This representation undermines their motivation to learn about prostate cancer and its treatment.
