Cancer-related information sought by the general public: evidence from the National Cancer Institute's Cancer Information Service, 2002-2003

Contributions to Research and Practice Made by the National Cancer Institute's Health Communication and Informatics Research Branch

The Health Communication and Informatics Research Branch at the U.S. National Cancer Institute was founded in 1999 in response to increasing evidence demonstrating a link between effective health communication and improved cancer-related outcomes and in recognition of the rapid and dramatic technological changes that were transforming health communication at the turn of the 21st century. For the past 25 years, the Health Communication and Informatics Research Branch has been conducting and supporting research at the forefront of emerging cancer communication trends and technologies, making numerous contributions to health communication science, public health, and cancer control practice. In this essay, we provide a brief history of the branch and the context that led to its establishment, discuss contributions made by the branch to health communication research and practice through key projects and initiatives, and conclude by highlighting health communication and informatics research priorities that offer opportunities for significant impact going forward in light of the challenges posed by the current communication environment.

Are cancer helplines effective in supporting caregivers? A systematic review

PURPOSE

The aims of this systematic review were to summarize the profile of caregivers accessing cancer helplines, to evaluate caregiver satisfaction with the helpline service, and to review the evidence base of intervention studies testing the efficacy of community-based cancer helplines in improving caregiver health and well-being.

METHODS

Four electronic databases (Medline, CINAHL, PsychINFO, and EMBASE) were systematically searched to identify relevant literature, including all articles published in English until May 2018. Reference lists of accepted papers were reviewed for the inclusion of additional potentially relevant articles, gray literature was excluded.

RESULTS

Forty-five publications met the inclusion criteria for this review. Forty-one papers reported on the proportion of caregivers accessing cancer helplines. Twenty-six studies described demographic and clinical characteristics of caregivers and eight reported on call characteristics. Reasons for contacting the service were stated in 21 studies and caregiver satisfaction with the helpline service was assessed in 12 articles. Fourteen studies investigated specific topics of interest (e.g., prevalence of sleep problems, distress screening, or clinical trial participation). Two randomized controlled trials examined the efficacy of cancer helplines in improving caregiver outcomes, with findings showing interventions to be effective in reducing distress and unmet needs, and in increasing positive adjustment.

CONCLUSIONS

There is limited scientific evidence regarding the efficacy of cancer helplines to improve caregivers' health and well-being. More intervention studies are needed to examine the benefits of cancer helplines to this study population to ensure structured referral pathways can be established.

Who Seeks Cita Con El Doctor? Twelve Years of Spanish-Language Radio Program Targeting U.S. Latinos

Purpose. Spanish-dominant Latinos make up 13% of the U.S. population, and this group is poorer and faces multiple threats to health compared with the general population. Additionally, Spanish speakers face challenges accessing health information that is often not available in Spanish. This study provides a descriptive epidemiology of a unique, low-cost health information source: the longest-running U.S.-based Spanish-language call-in radio health education program. Method. From the universe of all calls 1999 to 2011, stratified random sampling yielded 1,237 analyzed calls, which were manually coded for caller sex, age, proxy status, and health concern. Descriptive statistics were used to examine basic demographics of callers and call topics overall and by sex and proxy caller status. Results. Among all calls, the top three call-generating health topics were specific symptoms/conditions, sexual/reproductive health, and gastrointestinal concerns. The top nine topics were consistent among women, men, and proxy callers; however, relative frequency of topics varied across groups. Nearly one quarter of calls were initiated on behalf of someone, generally a child, spouse or sibling, or parent. Sixty percent of callers were women; women made 70% of proxy calls. Conclusion. Understanding the differences in information seeking behaviors, information needs, and source preferences is important for determining where and how to disseminate health information and may help explain disparities in knowledge and health outcomes. The radio talk show format provides a uniquely personal, culturally sensitive channel for meeting health information needs of a vulnerable population while leveraging the cost-effectiveness and wide reach of a mass medium.

Internet use and cancer-preventive behaviors in older adults: findings from a longitudinal cohort study

BACKGROUND

The Internet is a key provider of health information, but little is known about its associations with cancer-preventive behaviors. This study investigated the associations between Internet use and cancer-preventive behaviors among older adults.

METHODS

Data were taken from Waves 1 to 5 (2002-2011) of the English Longitudinal Study of Aging, a cohort study of men and women 50 years or older in England, United Kingdom. Internet use was recorded at each wave. Breast and colorectal screening, fruit and vegetable consumption, physical activity, and smoking were recorded at Wave 5. Social, cognitive, and physical function variables recorded at Wave 1 were analyzed as predictors of Internet use and included as covariates in analyses linking Internet use to behavior.

RESULTS

Of 5,943 respondents, 41.4% did not report any Internet use, 38.3% reported using it in one to three waves ("intermittent users"), and 20.3% used it in all waves ("consistent users"). Internet use was higher in younger, male, White, wealthier, more educated respondents, and those without physical limitations. Multivariable analysis showed that consistent users were more likely than "never users" to report CRC screening, weekly moderate/vigorous physical activity, and five or more daily servings of fruit and vegetables, and less likely to report smoking. There was no significant association between Internet use and breast screening.

CONCLUSIONS

Internet use showed a quantitative association with cancer-preventive behaviors even after controlling for various social, cognitive, and physical correlates of Internet use.

IMPACT

Promoting Internet use among older adults from all backgrounds could contribute to improving cancer outcomes and reducing inequalities.

Patterns of information behavior and prostate cancer knowledge among African-American men

The purposes of this study are to explore cancer information acquisition patterns among African-American men and to evaluate relationships between information acquisition patterns and prostate cancer prevention and control knowledge. A random sample of 268 men participated in a statewide interviewer-administered, telephone survey. Men classified as non-seekers, non-medical source seekers, and medical source seekers of prostate cancer information differed on household income, level of education, and beliefs about personal risk for developing prostate cancer. Results from multiple regression analysis indicated that age, education, and information-seeking status were associated with overall levels of prostate cancer knowledge. Results from logistic regression analyses indicated that men who included physicians as one of many information resources (medical source seekers) had superior knowledge over non-seekers and non-medical source seekers on 33% of individual knowledge details. The findings emphasize the need to connect lower-income and lower-educated African-American men to physicians as a source of prostate cancer control information.

Requests for cancer prevention information: the cancer information service (2002-2006)

Prevention is crucial to reducing cancer burden. Awareness of prevention information is critical to engaging the public in prevention activities. We examined 106,610 information requests from the general public to the Cancer Information Service from 2002 to 2006. The percent of requests related to primary prevention decreased in 2003, but otherwise remained stable around 19%. The percent of requests related to secondary prevention decreased over time, from 38% (2003) to 14% (2006). Demographic characteristics were associated with patterns of change across time. Results suggest that efforts are needed to increase public awareness of cancer prevention, particularly among certain populations.

Information support for cancer survivors

Survivors' information-seeking behavior has traditionally been documented through analysis of inquiries to hotlines and cancer information services. Data from these self-selected inquiries tend to be restricted to a time around diagnosis, and to those populations possessing the wherewithal and motivation to seek information actively. The current study used data from a general population survey to assess 1) the prevalence of information-seeking behavior among survivors in the general population, 2) characteristics of seekers versus nonseekers, 3) ratings of information-seeking experience, and 4) actual versus preferred sources of information. Data were analyzed from the 2005 administration of the Health Information National Trends Survey (HINTS). HINTS is a cross-sectional, random digit dial telephone survey, weighted to provide estimates for the general population. Nearly half of all Americans (48.7%) indicated that they have looked for cancer information from 1 source or another. Percentages were highest for those who have been touched by cancer (63.1% of cancer survivors and 54.6% of those with family histories) and lowest for those with no cancer history (27.6% of those with no history). Quality concerns topped the list of information-seeking experiences for those recalling the last time they looked. Patterns of information-seeking revealed a discrepancy between preferred and actual source when tracked over years since diagnosis. Information-seeking is prevalent among cancer survivors and does not diminish over time. Prescriptions are given for reengineering the information environment to improve long-term outcomes for survivors.