Cancer is one of the leading causes of death worldwide, and thus represents a priority for national public health programs. Prevention has been assumed as the best strategy to reduce cancer burden, however most cancer prevention programs are implemented by healthcare professionals, which constrain range and educational impacts. We developed an innovative approach for cancer prevention education focused on high-school biology teachers, considered privileged mediators in the socialization processes. A training program, “Cancer, Educate to Prevent” was applied, so that the teachers were able to independently develop and implement prevention campaigns focused on students and school-related communities. The program encompassed different educational modules, ranging from cancer biology to prevention campaigns design. Fifty-four teachers were empowered to develop and implement their own cancer prevention campaigns in a population up to five thousands students. The success of the training program was assessed through quantitative evaluation – questionnaires focused on teachers' cancer knowledge and perceptions, before the intervention (pre-test) and immediately after (post-test). The projects developed and implemented by teachers were also evaluated regarding the intervention design, educational contents and impact on the students' knowledge about cancer. This study presents and discusses the results concerning the training program “Cancer, Educate to Prevent” and clearly shows a significant increase in teacher's cancer literacy (knowledge and perceptions) and teachers' acquired proficiency to develop and deliver cancer prevention campaigns with direct impact on students' knowledge about cancer. This pilot study reinforces the potential of high-school teachers and schools as cancer prevention promoters and opens a new perspective for the development and validation of cancer prevention education strategies, based upon focused interventions in restricted targets (students) through non-health professionals (teachers).

Introduction: Health literacy evaluation is considered a priority issue in the health literacy research field. The complexity of the multiple definitions of health literacy and the diversity of instruments to evaluate health literacy has become a challenge to the establishment of comparisons across different studies. This work aimed to provide a systematic literature review of the existing measurement instruments adapted or developed for different groups of the Portuguese population. Methods: A comprehensive search of digital databases was conducted to systematize and understand the available knowledge about health literacy measurement in Portugal and to identify assessment tools and studies developed. The selection process was based on PRISMA guidelines. Results: A total of 17 publications were analysed regarding different aspects, which resulted in the identification of 11 different instruments, that were adapted or developed to measure health literacy in different groups of the Portuguese population, mainly adults, adolescents, and young adults. Seven instruments focusing on general health literacy (including e-health), 2 on mental health literacy, and the other 2 on oral health literacy were identified. Discussion/Conclusion: This study presents the first general overview of health literacy measurement in Portugal and clearly shows that to deepen our knowledge of health literacy in the Portuguese population it is essential to broaden the scope and the target of health literacy assessment to have a comprehensive understanding that will allow transforming our reality regarding health and disease.

Assuming the multidimensionality of health literacy, new complex and comprehensive approaches are more adequate to specific disease contexts, such as cancer. Assessing cancer literacy levels is a priority, since it entails potential serious implications for disease outcomes and patient’s quality of life. This article reports on the translation and cultural adaptation of the Cancer Health Literacy Test to measure cancer literacy in Portuguese cancer patients. A multidisciplinary team of experts ensured the translation and cultural adaptation of the CHLT-30. A pre-test was conducted in two stages to evaluate the Portuguese version (CHLT-30 PT) in a sample of cancer patients (n = 71). Descriptive statistics were used to characterize the sample. Reliability (test–retest and internal consistency) and construct validity of CHLT-30 PT were assessed. The results obtained show a good internal consistency of the tool, respectively (Cronbach’s alpha = 0.86 in the test and 0.80 in the retest). Patients’ raw score mean in both test (23.96) and retest (25.97) and the distribution of scores categories are not statistically different. A suggestive association between higher education level and better total score was found compared to the results reported in CHLT-30-DKspa. The results obtained in the pre-test are favorable, and the instrument is now suitable for the next steps of the validation process. A Portuguese version of this tool will allow outlining patients’ cancer literacy along the cancer care continuum, enabling the identification and implementation of adequate socio-educational strategies with highly positive impacts on health outcomes.