Objective: To identify clearer, learner-preferred, educational approaches for aspects of cervical cancer education found to be difficult to understand for low-literacy, Mexican, immigrant women. Setting: Kansas City, Kansas; Garden City, Kansas; San Antonio, Texas. Participants: Forty-five Mexican immigrant women in the United States for 5 years or less, ninth grade education or less, and predominantly Spanish speaking. Methods: Interviews were conducted to evaluate preference and best comprehension among options for specific cervical cancer educational elements, including reproductive system terminology, the purpose of Pap tests and meaning of results, Human Papilloma Virus (HPV), and illustrations of anatomy and Pap procedure. Results: We identified terminology, translation, content, and illustrations preferred by participants and areas of inadequate existing knowledge needed for comprehension of concepts being taught. Analogies, illustrations, and introduction of medical terms in conjunction with equivalent common Spanish terms were effective ways of building bridges from existing knowledge to new knowledge. Participants desired detailed information and shared new information with others Conclusion: We learned the importance of assessing patients' existing body knowledge. The detail desired by participants challenged common simplification approaches to teaching low-literacy learners. Participant willingness to share information challenged ideas of cultural taboo. Results provide evidence for more effective delivery of women's health education and call for further research on best approaches to teaching low-literacy learners. © 2012 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

Cervical cancer Women's health Immigrant health Learner verification and revision Mexican culture Health literacy

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