Controlling the Diabetic Body? Managing Chronic Illness with Wearable Technology

I explore the experience of managing type 1 diabetes with wearable technology. Type 1 diabetes is a chronic illness which requires continuous maintenance to keep the blood glucose levels within range. Using autoethnography, I investigate both the practices of translating information from technology and from senses, and also from health authorities, into practices. I conclude that the management of type 1 diabetes is informed by an urge to control the body, but this situation can be understood otherwise from a logic of care.

Psychometric Evaluation of the Modes of Health Information Acquisition, Sharing, and Use Questionnaire: Prospective Cross-Sectional Observational Study

BACKGROUND

Health information is a critical resource for individuals with health concerns and conditions, such as hypertension. Enhancing health information behaviors may help individuals to better manage chronic illness. The Modes of Health Information Acquisition, Sharing, and Use (MHIASU) is a 23-item questionnaire that measures how individuals with health risks or chronic illness acquire, share, and use health information. Yet this measure has not been psychometrically evaluated in a large national sample.

OBJECTIVE

The objective of this study was to evaluate the psychometric properties of the self-administered MHIASU in a large, diverse cohort of individuals living with a chronic illness.

METHODS

Sharing Information, a prospective, observational study, was launched in August 2018 and used social media campaigns to advertise to Black women. Individuals who were interested in participating clicked on the advertisements and were redirected to a Qualtrics eligibility screener. To meet eligibility criteria individuals had to self-identify as a Black woman, be diagnosed with hypertension by a health care provider, and live in the United States. A total of 320 Black women with hypertension successfully completed the eligibility screener and then completed a web-based version of the MHIASU questionnaire. We conducted a psychometric evaluation of the MHIASU using exploratory factor analysis. The evaluation included item review, construct validity, and reliability.

RESULTS

Construct validity was established using exploratory factor analysis with principal axis factoring. The analysis was constricted to the expected domains. Interitem correlations were examined for possible item extraction. There were no improvements in factor structure with the removal of items with high interitem correlation (n=3), so all items of the MHIASU were retained. As anticipated, the instrument was found to have 3 subscales: acquisition, sharing, and use. Reliability was high for all 3 subscales, as evidenced by Cronbach α scores of .81 (acquisition), .81 (sharing), and .93 (use). Factor 3 (use of health information) explained the maximum variance (74%).

CONCLUSIONS

Construct validity and reliability of the web-based, self-administered MHIASU was demonstrated in a large national cohort of Black women with hypertension. Although this sample was highly educated and may have had higher digital literacy compared to other samples not recruited via social media, the population captured (Black women living with hypertension) are often underrepresented in research and are particularly vulnerable to this chronic condition. Future studies can use the MHIASU to examine health information behavior in other diverse populations managing health concerns and conditions.

Stress and coping amongst cisgender male partners of transgender women

The cisgender male partners of transgender women have received little attention beyond their sexual behaviour. This is an issue, as marginalisation and social environments determine sexual behaviour and subsequent health outcomes. This article assesses in-depth interviews with cisgender male partners of transgender women in Atlanta and Baltimore, USA. Analysis suggests men experience minority stress that may lead to ameliorative coping processes such as coming out and LGBTQ group affiliation. Specifically, the interviews identify stressful, marginalising reactions from family and friends concerning men's relationships with transgender women. In turn, men described uniquely supportive ties to LGBTQ communities, which included ongoing relationships with transgender women, having close sexual and gender minority friends, and occupying notably LGBTQ spaces such as Pride events. The LGBTQ social connectivity of the cisgender male partners of transgender women could prove critical to future targeted HIV prevention efforts.

Uptake of and Engagement With an Online Sexual Health Intervention (HOPE eIntervention) Among African American Young Adults: Mixed Methods Study

Background

Regarding health technologies, African American young adults have low rates of uptake, ongoing usage, and engagement, which may widen sexual health inequalities.

Objective

We aimed to examine rates of uptake and ongoing usage, and factors influencing uptake, ongoing usage, and engagement for a consumer health informatics (CHI) intervention for HIV/sexually transmitted infection (STI) prevention among African American young adults, using the diffusion of innovation theory, trust-centered design framework, and O’Brien and Toms’ model of engagement.

Methods

This community-based participatory mixed methods study included surveys at four time points (n=315; 280 African American participants) among young adults aged 18 to 24 years involved in a blended offline/online HIV/STI prevention intervention (HIV Outreach, Prevention, and Education [HOPE] eIntervention), which was described as a “HOPE party.” Qualitative interviews were conducted with a subset of participants (n=19) after initial surveys and website server logs indicated low uptake and ongoing usage. A generalized linear mixed-effects model identified predictors of eIntervention uptake, server logs were summarized to describe use over time, and interview transcripts were coded and thematically analyzed to identify factors affecting uptake and engagement.

Results

Participants’ initial self-reported eIntervention uptake was low, but increased significantly over time, although uptake never reached expectations. The most frequent activity was visiting the website. Demographic factors and HOPE party social network characteristics were not significantly correlated with uptake, although participant education and party network gender homophily approached significance. According to interviews, one factor driving uptake was the desire to share HIV/STI prevention information with others. Survey and interview results showed that technology access, perceived time, and institutional and technological trust were necessary conditions for uptake. Interviews revealed that factors undermining uptake were insufficient promotion and awareness building, and the platform of the intervention, with social media being less appealing due to previous negative experiences concerning discussion of sexuality on social media. During the interaction with the eIntervention, interview data showed that factors driving initial engagement were audience-targeted website esthetics and appealing visuals. Ongoing usage was impeded by insufficiently frequent updates. Similarly, lack of novelty drove disengagement, although a social media contest for sharing intervention content resulted in some re-engagement.

Conclusions

To encourage uptake, CHI interventions for African American young adults can better leverage users’ desires to share information about HIV/STI prevention with others. Ensuring implementation through trusted organizations is also important, though vigorous promotion is needed. Visual appeal and targeted content foster engagement at first, but ongoing usage may require continual content changes. A thorough analysis of CHI intervention use can inform the development of future interventions to promote uptake and engagement. To guide future analyses, we present an expanded uptake and engagement model for CHI interventions targeting African American young adults based on our empirical results.

HIV Information Acquisition and Use Among Young Black Men Who Have Sex With Men Who Use the Internet: Mixed Methods Study

Background

HIV disproportionately affects young Black men who have sex with men (YBMSM) in the United States. eHealth holds potential for supporting linkage and engagement in HIV prevention and care and the delivery of HIV information to YBMSM.

Objective

This study aims to investigate HIV information acquisition and use among YBMSM who use the internet.

Methods

A web-based self-administered survey and semistructured interviews were conducted. The survey findings informed the development of the interview guide. Descriptive statistics were used to characterize the survey sample, and interview data were analyzed thematically using modified grounded theory methodologies.

Results

Among the internet sample (N=83), the average age was 29.2 (SD 3.5) years, 41% (n=34) of participants self-reported living with HIV, 43% (n=36) were HIV-negative, and 15% (n=13) were unsure of their HIV status. Most participants (n=79, 95%) acquired HIV information through the internet while using a mobile phone. Web-based HIV information was intentionally sought from consumer health information websites (n=31, 37%), government health information websites (n=25, 30%), and social media (n=14, 17%). Most men incidentally acquired HIV information via advertisements on social media sites and geospatial dating apps (n=54, 65%), posts on social media sites from their web-based social ties (n=44, 53%), and advertisements while browsing the internet (n=40, 48%). Although the internet is the top source of HIV information, health care providers were the most preferred (n=42, 50%) and trusted (n=80, 96%) source of HIV information. HIV information was used to facilitate the use of HIV prevention and care services. The qualitative sample included YBMSM across a range of ages and at different points of engagement in HIV prevention and care. Qualitative findings included the importance of the internet as a primary source of HIV information. The internet was used because of its ease of accessibility, because of its ability to maintain anonymity while searching for sensitive information, and to mitigate intersecting stigmas in health care settings. Participants used HIV information to assess their risk for HIV and AIDS, support their skill building for HIV prevention, inform patient–doctor communication, and learn about HIV prevention and treatment options. Men expressed concerns about their diminishing access to online spaces for HIV information exchange among YBMSM because of censorship policies on social media sites and the stigmatizing framing and tone of mass media HIV-prevention advertisements encountered while using the internet.

Conclusions

YBMSM in this sample had high utilization of eHealth for HIV information acquisition and use but diminished access to their preferred and most trusted source of HIV information: health care providers. Future eHealth-based HIV interventions culturally tailored for YBMSM should aim to reduce intersectional stigma at the point of care and support patient–provider communication. The findings demonstrate the need for community-informed, culturally tailored HIV messaging and online spaces for informational support exchange among YBMSM.

Subject structure of the research area on collaborative information behaviour

Purpose

The principal aim of the present study was to identify and model the subject structure of the research area on collaborative information behaviour (CIB).

Design/methodology/approach

A qualitative, inductive and exploratory approach was adopted, and the method of thematic analysis was used. This study was based on the analysis of 79 publications selected from the Library, Information Science and Technology Abstracts (LISTA) database in April 2019.

Findings

Collaborative and collective information behaviours were differentiated, and the subject structure of the CIB research area was identified to contain collaborative activities oriented to both information access and content, their various conditions, means of conducting, experiences of selected communities and metascientific research on the area itself.

Research limitations/implications

The limitations result primarily from relying on the research material selected from the database (LISTA) focussed mainly on the issues of library and information science.

Originality/value

This study contributes by proposing an original model of the CIB research area representing its subject structure and providing a coherent list of subjects of interest to CIB researchers. Hopefully, it will also contribute to the harmonisation of terminology related to this research area and thus facilitate communication between CIB researchers and accelerate the cumulative development of scientific knowledge on CIB.

Modeling the interplay of information seeking and information sharing

Purpose

The purpose of this paper is to contribute to the creation of a holistic picture of information behavior by examining the connections between information seeking and sharing.

Design/methodology/approach

Conceptual analysis is used to focus on the ways in which the researchers have modeled the interplay of information seeking and sharing. The study draws on conceptual analysis of 27 key studies examining the above issue, with a focus on the scrutiny of six major models for information behavior.

Findings

Researchers have employed three main approaches to model the relationships between information seeking and sharing. The indirect approach conceptualizes information seeking and sharing as discrete activities connected by an intermediating factor, for example, information need. The sequential approach assumes that information seeking precedes information sharing. From the viewpoint of the interactive approach, information seeking and sharing appear as mutually related activities shaping each other iteratively or in a cyclical manner. The interactive approach provides the most sophisticated research perspective on the relationships of information seeking and sharing and contributes to holistic understanding of human information behavior.

Research limitations/implications

As the study focuses on information seeking and sharing, no attention is devoted to other activities constitutive of information behavior, for example, information use.

Originality/value

The study pioneers by providing an in-depth analysis of the connections of information seeking and information sharing.

The relationships between health information behavior and neural processing in african americans with prehypertension

Information behavior may enhance hypertension self-management in African-Americans. The goal of this substudy was to examine relationships between measures of self-reported health information behavior and neural measures of health information processing in a sample of 19 prehypertensive African-Americans (mean age=52.5, 52.6% women). We measured 1) health information seeking, sharing, and use (surveys) and 2) neural activity using functional magnetic resonance imaging (fMRI) to assess response to health information videos. We hypothesized that differential activation (comparison of analytic vs. empathic brain activity when watching a specific type of video) would indicate better function in three, distinct cognitive domains: 1) Analytic Network, 2) Default Mode Network (DMN), and 3) ventromedial prefrontal cortex (vmPFC). Scores on the information sharing measure (but not seeking or use) were positively associated with differential activation in the vmPFC (rs=.53, p=.02) and the DMN (rs=.43, p=.06). Our findings correspond with previous work indicating that activation of the DMN and vmPFC is associated with sharing information to persuade others, and with behavior change. Although health information is commonly conveyed as detached and analytic in nature, our findings suggest that neural processing of socially and emotionally salient health information is more closely associated with health information sharing.

Online Information Sharing About Risks: The Case of Organic Food

Individuals have to make sense of an abundance of information to decide whether or not to purchase certain food products. One of the means to sense-making is information sharing. This article reports on a quantitative study examining online information sharing behavior regarding the risks of organic food products. An online survey among 535 respondents was conducted in the Netherlands to examine the determinants of information sharing behavior, and their relationships. Structural equation modeling was applied to test both the measurement model and the structural model. Results showed that the intention to share information online about the risks of organic food was low. Conversations and email were the preferred channels to share information; of the social media Facebook stood out. The developed model was found to provide an adequate description of the data. It explained 41% of the variance in information sharing. Injunctive norms and outcome expectancies were most important in predicting online information sharing, followed by information-related determinants. Risk-perception-related determinants showed a significant, but weak, positive relationship with online information sharing. Implications for authorities communicating on risks associated with food are addressed.

Tacit knowledge-sharing behavior among the academic staff

Purpose

The purpose of this paper is to examine the critical success factor of tacit knowledge-sharing behavior among the academic staff of higher learning institutions.

Design/methodology/approach

A total of 200 questionnaires were distributed among the academic staff of higher learning institutions in Bangladesh. Collectively, 150 usable responses were returned. Apart from descriptive statistics, this research applied confirmatory factor analysis (CFA) and structural equation modeling (SEM) to assess the measurement model and test the research hypotheses.

Findings

The findings from this empirical examination show that all the Big Five personality traits affect tacit knowledge-sharing behavior among the academic staff of higher learning institutions, except conscientiousness personality trait. However, the role of motivation, self-efficacy and mutual trust are also playing a significant role in tacit knowledge-sharing behavior. The CFA, SEM analysis confirmed the proposed conceptual model with a good model fit.

Research limitations/implications

The findings of this research contribute to the understanding of the role of personality traits and other antecedents which play a significant role for the academic staff tacit knowledge-sharing behavior which are interesting for policymakers and authorities of higher learning institutions. As there was no sampling frame, the researchers applied convenient sampling technique in choosing the respondents.

Originality/value

This research plays a pioneering role where it contributes to the growing literature on the relationships between personality traits and other factors to construct a model for the tacit knowledge behavior by considering academic staff of higher learning institutions from a developing country’s perspective.

Bringing out the everyday in everyday information behavior

Purpose

The purpose of this paper is to argue that scholars in the information behavior (IB) field should embrace the theoretical framework of the everyday to explore a more holistic view of IB.

Design/methodology/approach

The paper describes the theory of the everyday and delineates four opportunities offered by scholars of the everyday. The paper concludes with three examples that highlight what a more everyday-focused everyday information behavior might look like.

Findings

The theory of the everyday provides a useful theoretical framework to ground research addressing the everyday world as well as useful concepts for analysis and research methodology.

Originality/value

The theoretical framework of the everyday contributes to IB research by providing a theoretical justification for work addressing everyday life as well as useful concepts for analysis. The paper also outlines the benefits of integrating methods influenced by institutional ethnography, a methodology previously used to address the nuances of the everyday world.

"Take an opportunity whenever you get it": Information Sharing among African-American Women with Hypertension

Nearly half of African-American women have hypertension, which increases their risk for cardiovascular disease and stroke. A plethora of consumer health information products and services exist to inform people with hypertension and to promote self-management among them. Promotion of information sharing by African-American women represents a promising, culturally-applicable strategy for consumer health information services focused on hypertension self-management. Yet, how African-American women share hypertension information with others is unclear. The purpose of this qualitative, descriptive study was to examine practices of information sharing in African-American women with hypertension. Thirteen women (mean age = 73, SD = 9.87) participated in one of two focus groups held at an urban community health center. Thematic analysis revealed that the women shared information about how they self-managed their blood pressure 1) with female family members and friends, 2) about ways in which they adapted self-management strategies to work for them, 3) mostly in group settings, and 4) because they wanted to prevent others from suffering and reinforce their own knowledge about hypertension self-management. New findings emerged regarding assessing "readiness" for information. Study findings will be used to inform the design of an information sharing intervention to support self-management of hypertension in African-American women.

Defining a theoretical framework for information seeking and parenting

Purpose

Information seeking for child-rearing is an increasingly popular topic in the medical and social science literature, though a theoretical framework in which to understand this phenomenon is still missing. The paper aims to discuss this issue.

Design/methodology/approach

The authors present results from a qualitative research in which data were obtained from 21 interviews and the personal experience of one of the authors. Participants were all mothers supportive of attachment parenting, a parenting style inspired by attachment theory which advocates making parenting decisions on a strong basis of information. They were recruited in several Spanish autonomous communities and interviewed between April and July 2015.

Findings

Results were analyzed using grounded theory and allowed to define five major themes: becoming a mother implies a new perception of oneself in which it is common to feel more in need for information; the need to search for information originates in situations of “conflict” or crisis, or as a consequence of conflicting information; information is judged and weighed on the basis of affect and perceptions; scientific and experiential knowledge are valued as complementary; and finally, information seeking appears as one activity of identity work.

Originality/value

Placing conflict, instead of uncertainty, at the beginning of the search process allows to emphasize the role of information seeking in mediating relationships and interactions at a societal level. From this point of view, the authors understand that LIS should pay more attention to information seeking as an important factor in social change.

Building a Progressive-Situational Model of Post-Diagnosis Information Seeking for Parents of Individuals With Down Syndrome

This grounded theory study used in-depth, semi-structured interview to examine the information-seeking behaviors of 35 parents of children with Down syndrome. Emergent themes include a progressive pattern of behavior including information overload and avoidance, passive attention, and active information seeking; varying preferences between tacit and explicit information at different stages; and selection of information channels and sources that varied based on personal and situational constraints. Based on the findings, the author proposes a progressive model of health information seeking and a framework for using this model to collect data in practice. The author also discusses the practical and theoretical implications of a responsive, progressive approach to understanding parents’ health information–seeking behavior.

HIV Testing Behavior and Social Network Characteristics and Functions Among Young Men Who have Sex with Men (YMSM) in Metropolitan Detroit

HIV testing promotion is a critical HIV prevention strategy, especially among at-risk groups such as young men who have sex with men (YMSM). Based on a web survey of 194 YMSM (18-24), we examine the association of social network characteristics and functions, and of individual-level characteristics, with three HIV testing behaviors (ever, repeat, and recent testing). Network homophily was associated with recent testing in multivariable models. The network function of information acquisition was associated with ever testing and repeat testing. Perceived stigma regarding HIV-related help-seeking was negatively related to recent testing. Individual characteristics were associated with testing outcomes in all models; age, perceived behavioral control, and positive attitudes had the greatest influence. Individual characteristics had a stronger association with ever testing and repeat testing than network characteristics and functions; however, this relationship was reversed for recent testing. Findings support the value of multi-level and network-focused interventions for promoting HIV testing among YMSM.

Information Behavior and HIV Testing Intentions Among Young Men at Risk for HIV/AIDS

Health research shows that knowing about health risks may not translate into behavior change. However, such research typically operationalizes health information acquisition with knowledge tests. Information scientists who investigate socially embedded information behaviors could help improve understanding of potential associations between information behavior-as opposed to knowledge-and health behavior formation, thus providing new opportunities to investigate the effects of health information. We examine the associations between information behavior and HIV testing intentions among young men who have sex with men (YMSM), a group with high rates of unrecognized HIV infection. We used the theory of planned behavior (TPB) to predict intentions to seek HIV testing in an online sample of 163 YMSM. Multiple regression and recursive path analysis were used to test two models: (a) the basic TPB model and (b) an adapted model that added the direct effects of three information behaviors (information exposure, use of information to make HIV-testing decisions, prior experience obtaining an HIV test) plus self-rated HIV knowledge. As hypothesized, our adapted model improved predictions, explaining more than twice as much variance as the original TPB model. The results suggest that information behaviors may be more important predictors of health behavior intentions than previously acknowledged.

How "community" matters for how people interact with information: mixed methods study of young men who have sex with other men

BACKGROUND

We lack a systematic portrait of the relationship between community involvement and how people interact with information. Young men who have sex with men (YMSM) are a population for which these relationships are especially salient: their gay community involvement varies and their information technology use is high. YMSM under age 24 are also one of the US populations with the highest risk of HIV/AIDS.

OBJECTIVE

To develop, test, and refine a model of gay community involvement (GCI) factors in human-information interaction (HII) as applied to HIV/AIDS information among YMSM, specifically examining the role of Internet use in GCI and HII.

METHODS

Mixed methods included: 1) online questionnaire with 194 YMSM; and 2) qualitative interviews with 19 YMSM with high GCI levels. Recruitment utilized social media, dating websites, health clinics, bars/clubs, and public postings. The survey included questions regarding HIV/AIDS-related information acquisition and use patterns, gay community involvement, risk behaviors, and technology use. For survey data, we tested multiple linear regression models using a series of community- and information-related variables as dependent variables. Independent variables included community- and information-related variables and demographic covariates. We then conducted a recursive path analysis in order to estimate a final model, which we refined through a grounded theory analysis of qualitative interview data.

RESULTS

Four community-related variables significantly predicted how people interact with information (HII variables): 1) gay community involvement (GCI), 2) social costs of information seeking, 3) network expertise accessibility, and 4) community relevance. GCI was associated with significantly lower perceived social costs of HIV/AIDS information seeking (R(2)=0.07). GCI and social costs significantly predicted network expertise accessibility (R(2)=0.14). GCI predicted 14% of the variance in community relevance and 9% of the variance in information seeking frequency. Incidental HIV/AIDS information acquisition (IIA) was also significantly predicted by GCI (R(2)=0.16). 28% of the variance in HIV/AIDS information use was explained by community relevance, network expertise access, and both IIA and information seeking. The final path model showed good fit: the RSMEA was 0.054 (90% CI: .000-.101); the Chi-square was non-significant (χ(2)(11)=17.105; P=.105); and the CFI was 0.967. Qualitative findings suggest that the model may be enhanced by including information sharing: organizing events, disseminating messages, encouraging safety, and referring and recommending. Information sharing emerged under conditions of pro-social community value enactment and may have consequences for further HII. YMSM with greater GCI generally used the Internet more, although they chatted online less.

CONCLUSIONS

HIV/AIDS-related HII and associated technology uses are community-embedded processes. The model provides theoretical mediators that may serve as a focus for intervention: 1) valuing HIV/AIDS information, through believing it is relevant to one's group, and 2) supportive and knowledgeable network members with whom to talk about HIV/AIDS. Pro-social community value endorsement and information sharing may also be important theoretical mediators. Our model could open possibilities for considering how informatics interventions can also be designed as community-level interventions and vice versa.

Talking about, knowing about HIV/AIDS in Canada: a rural-urban comparison

PURPOSE

To explore information exchange about HIV/AIDS among people living in rural and urban communities and to assess the value of social capital theory, as well as demographic factors, in predicting community members' knowledge of HIV/AIDS and their likelihood of having talked about the disease.

METHOD

A random-digit dial telephone survey was conducted in 3 rural regions and matched urban communities in Canada during 2006 and 2007. A total of 1,919 respondents (response rate: 22.2%) answered questions about their knowledge of and attitudes toward HIV/AIDS, their social networks, whether they were personally acquainted with a person with HIV/AIDS (PHA), and whether they had ever talked to anyone about HIV/AIDS.

FINDINGS

Rurality was a significant predictor of HIV/AIDS knowledge and discussion. Even after controlling for factors such as age and level of education, respondents living in rural regions were less knowledgeable about HIV/AIDS and were less likely to have spoken with others about the disease. Social capital theory was not as strongly predictive as expected, although people with more bridging ties in their social networks were more likely to have discussed the disease, as were those who knew a PHA personally.

CONCLUSION

Rural-dwelling Canadians are less likely than their urban counterparts to be knowledgeable about HIV/AIDS or to talk about it, confirming reports by PHAs that rural communities tend to be silent about the disease. The findings support policy recommendations for HIV education programs in rural areas that encourage discussion about the disease and personal contact with PHAs.