Social exclusion, self-affirmation, and health information avoidance

Linking patient-centered communication with cancer information avoidance: The mediating roles of patient trust and literacy

OBJECTIVES

This study, drawing on the pathway mediation model developed by Street and his colleagues (2009) that links communication to health outcomes, explores how patient-centered communication affects cancer information avoidance.

METHODS

Data was gathered through online access panel surveys, utilizing stratified sampling across Germany, Switzerland, the Netherlands, and Austria. The final sample included 4910 non-cancer and 414 cancer patients, all receiving healthcare from clinicians within the past year.

RESULTS

The results demonstrated that patient-centered communication is directly associated with reduced cancer information avoidance, especially among cancer patients. Additionally, this association is indirectly mediated through patient trust and healthcare literacy.

CONCLUSION

The findings provide empirical evidence that reveals the underlying mechanism linking clinician-patient communication to patient health information behavior.

PRACTICE IMPLICATIONS

The potential of clinician-patient communication in addressing health information avoidance is highlighted by these findings. Future interventions in healthcare settings should consider adopting patient-centered communication strategies. Additionally, improving patient trust and literacy levels could be effective in reducing cancer information avoidance.

What motivates information (non-)seeking behaviors about a healthy diet?

Previous research on health information seeking has primarily focused on individuals'intentions to seek or avoid information. However, limited empirical evidence exists regarding the actual behavioral patterns of information-seeking and non-seeking. To address this, we conducted a survey experiment manipulating cognitive load with mostly Belgian participants (N = 359). By integrating self-report and behavioral data, we investigated motivations and conditions associated with information (non)-seeking behaviors on a healthy diet. Guided by the risk information seeking and processing (RISP) model, we examined the roles of informational subjective norms and information insufficiency, as well as the moderating role of cognitive capacity. Neither informational subjective norms nor information insufficiency significantly correlated with information-seeking behaviors. However, a significant interaction between the predictors and cognitive capacity in predicting non-seeking behaviors was observed. These findings underscore the intricate nature of individuals' behavioral patterns in seeking or not seeking information about healthy eating.

Reasons people avoid colorectal cancer information: a mixed-methods study

OBJECTIVE

With screening, colorectal cancer can be detected when treatable, or even prevented. However, approximately one in five people tend to avoid colorectal cancer information, and avoidance is associated with being less likely to have been screened for the disease. Crucial to developing strategies to reduce information avoidance, we sought a comprehensive understanding of reasons people avoid colorectal cancer information.

METHODS AND MEASURES

In a mixed methods study, we surveyed 200 participants who varied with respect to avoidance and interviewed 15 people who tended to avoid colorectal cancer information (all aged 40-75) about reasons for avoiding.

RESULTS

In both survey and interviews, primary reasons for information avoidance were: (1) shielding from anxiety and other aversive emotion, (2) perceived information sufficiency and (3) feelings of information overload. Trait anxiety, fear of diagnosis, anticipating negative interactions with healthcare, and negative associations with screening procedures exacerbated avoidance. Participants justified information non-relevance by attributing risk to other people's characteristics such as family history, gastrointestinal symptoms, being male, or living an unhealthy lifestyle.

CONCLUSION

Novel findings include the triggering influence of trait anxiety and financial constraints on information avoidance. Also, information overload and incorrect understanding of risk factors may exacerbate perceptions of information sufficiency and avoidance.

Information Avoidance: Past Perspectives and Future Directions

In the present age of unprecedented access to information, it is important to understand how and why people avoid information. Multiple definitions of "information avoidance" exist, and key aspects of these definitions deserve attention, such as distinguishing information avoidance from (lack of) information seeking, considering the intentionality and temporal nature of information avoidance, and considering the personal relevance of the information. In this review, we provide a cross-disciplinary historical account of theories and empirical research on information avoidance and seeking, drawing from research in multiple fields. We provide a framework of antecedents of information avoidance, categorized into beliefs about the information (e.g., risk perceptions), beliefs about oneself (e.g., coping resources), and social and situational factors (e.g., social norms), noting that constructs across categories overlap and are intertwined. We suggest that research is needed on both positive and negative consequences of information avoidance and on interventions to reduce information avoidance (when appropriate). Research is also needed to better understand temporal dynamics of information avoidance and how it manifests in everyday life. Finally, comprehensive theoretical models are needed that differentiate avoidance from seeking. Research on information avoidance is quickly expanding, and the topic will only grow in importance.

Deliberate ignorance-a barrier for information interventions targeting reduced meat consumption?

OBJECTIVE

Despite abundant information about negative consequences of consuming meat, consumption in many Western countries is many times higher than recommended. One possible explanation for this discrepancy is that people consciously decide to ignore such information-a phenomenon called deliberate ignorance. We investigated this potential barrier for information interventions aiming to reduce meat consumption.

METHODS

In three studies, a total of 1133 participants had the opportunity to see 18 information chunks on negative consequences of meat consumption or to ignore part of the information. Deliberate ignorance was measured as the number of ignored information chunks. We assessed potential predictors and outcomes of deliberate ignorance. Interventions to reduce deliberate ignorance (i.e., self-affirmation, contemplation, and self-efficacy) were experimentally tested.

RESULTS

The more information participants ignored, the less they changed their intention to reduce their meat consumption (r = -.124). This effect was partially explained by cognitive dissonance induced by the presented information. While neither self-affirmation nor contemplation exercises reduced deliberate ignorance, self-efficacy exercises did.

CONCLUSION

Deliberate ignorance is a potential barrier for information interventions aiming to reduce meat consumption and needs to be considered in future interventions and research. Self-efficacy exercises are a promising approach to reduce deliberate ignorance and should be further explored.

Research on hotspots and evolution paths in the field of health information behavior: a comparison study of bibliometrics based on CNKI and WoS data

Purpose

This study aimed to examine the research hotspots and evolution paths in the field of health information behavior (HIB) in China and abroad, and conduct comparative analysis to better understand its development trajectory globally.

Design/methodology/approach

A keyword search of the relevant literature included in the China National Knowledge Infrastructure (CNKI) database and Web of Science (WoS) core collection database was conducted, using the visualized analysis tool CiteSpace V for bibliometric analyses.

Findings

The common research hotspots in China and abroad can be divided into related research on HIB, research on its influencing factors and health information research. Among these, health information-seeking behavior has been the focus of domestic and foreign scholars. From the subdivision perspective, the focus of Chinese and foreign research hotspots differs. In terms of evolutionary path, the initial stage of HIB research in China and abroad revolves around health information and health information-seeking behavior, followed by the influencing factors of HIB; however, the research breakthrough point is the reverse. Then, domestic and foreign research was conducted on different types of HIBs. Regarding the selection of research objects, Chinese and foreign research objects were increasingly diversified.

Research limitations/implications

This study also has several limitations. First, the literature sample only selected the literature in the WoS and CNKI databases, and there may be many HIB-related works published in other databases. Therefore, future research should include other databases. Second, in terms of language, this study selected only Chinese and English literature, but in many countries, important research results on certain topics are usually published in native language, and future research should expand the language selection. Third, this study only conducted national and institutional collaboration network analysis, keyword co-occurrence analysis, cluster analysis and timeline chart analysis.

Practical implications

The implication of practice can be divided into the following three points. (1) Analyzing the domestic and foreign literature on HIB and identifying highly cooperative institutions and countries in the field of HIB can reveal the research situation of HIB and help researchers establish new research networks in the future. (2) Analyzing the research hotspots and evolutionary paths of HIB at home and abroad is helpful for quickly understanding the development context of this field and grasping the emerging research directions such as HIB of people in close contact with patients, health information exchange behavior, health information avoidance behavior and health information discontinuation behavior, which can help researchers to explore the future research direction in this field, so as to determine the topic and fill the research gap. (3) Combining the analysis of HIB-related research at home and abroad is helpful for professionals to understand the characteristics and rules of HIB of users, consumers and other groups to further optimize and improve health information services.

Originality/value

Comparing and summarizing the research status of HIB in China and globally, and presenting the findings visually, will help researchers better grasp the research overview and hotspot changes in this field, as well as provide a follow-up reference.

What Causes Health Information Avoidance Behavior under Normalized COVID-19 Pandemic? A Research from Fuzzy Set Qualitative Comparative Analysis

Affected by the normalization of the COVID-19 pandemic, people’s lives are subject to many restrictions, and they are under enormous psychological and physical pressure. In this situation, health information may be a burden and cause of anxiety for people; thus, the refusal of health information occurs frequently. Health-information-avoidance behavior has produced potential impacts and harms on people’s lives. Based on more than 120,000 words of textual data obtained from semi-structured interviews, summarizing a case collection of 55 events, this paper explores the factors and how they combine to lead to avoidance of health information. First, the influencing factors are constructed according to the existing research, and then the fuzzy set qualitative comparative analysis (fsQCA) method is used to discover the configuration relationship of health-information-avoidance behavior. The results show that the occurrence of health-information avoidance is not the result of a single factor but the result of a configuration of health-information literacy, negative emotions, perceived information, health-information presentation, cross-platform distribution, and the network information environment. These findings provide inspiration for reducing the adverse consequences of avoiding health information and improving the construction of health-information service systems.

Developing a framework for understanding health information behavior change from avoidance to acquisition: a grounded theory exploration

BACKGROUND

Health information avoidance is common in real life, but because it is not always conducive to health promotion and maintenance, people often actively switch to health information acquisition. Understanding this process of active change can facilitate intervention in unreasonable avoidance behaviors. However, studies so far have mostly focused on why and how avoidance takes place, little is known about the process of active change from avoidance to acquisition. We thus use a grounded theory approach (GT) to explore how the active change takes place, and to generate a grounded theoretical framework capable of illustrating stages and influencing factors involved in the active change process.

METHODS

Straussian grounded theory (Corbin & Strauss, 2015) was used to analyze data collected through semi-structured interviews with 30 adults (14 in good health, 11 with disease, 5 in other health status) who had experienced health information behavior change from avoidance to acquisition. These interviews focused on how the change occurred and what effected the change.

RESULTS

The core category of Health Information Avoidance Change and 12 categories were identified and integrated to form a theoretical framework termed the Health Information Avoidance Change Model (HIACM). This model describes the process using five non-linear stage variables (initiation, preparation, action, maintenance, and abandonment) and seven moderating factor variables (cognitive change, social stimulus, beliefs and attitudes, intrapsychic literacy, social resources, information source, time and material resources).

CONCLUSIONS

HIACM can be used to explain the process of active change from health information avoidance to health information acquisition. HIAC is a non-linear and holistic process, and it is necessary to dynamically analyze the impact of relevant factors and take targeted intervention measures in stages. HIAC is usually not only an individual behavior, but also a socialized behavior requiring the collaboration of individuals, families, health information providers, healthcare providers, and governments.

Contextual Health Information Behavior in the Daily Lives of People with Type 2 Diabetes: A Diary Study in Scotland

Changes in lifestyle can have positive effects on treating type 2 diabetes (T2D), like sporting or healthy eating. Therefore, a person diagnosed with T2D is often advised to make healthy choices throughout the day, in addition to other interventions such as medication. To do this, he or she needs health information to support decision-making. Literature describes ample categorizations of types of (health) information behavior and theoretical models that explain the factors that drive people to search for, encounter or avoid information. However, there are few longitudinal studies about triggers and factors in daily life that affect health information behavior (HIB). This study was set up to identify triggers, actions and outcomes for active, passive and avoidant HIB situations in daily life among Scots with Type 2 diabetes (T2D) to identify points of attention for communication strategies. Twelve participants took part in a four-week diary study. Every day, participants received an online diary form to describe active, passive or avoidant HIB situations. Data collection resulted in 53 active, 120 passive and 25 avoidant diary entries. Seven active HIB contexts (e.g., experiencing symptoms, cooking dinner, sports training) and five passive HIB contexts (e.g., home, work, medical facility) were identified. Four motivations for avoidance were found (e.g., time constraints, no health trigger). These results can be used to supplement the theoretical models of health information behavior. Furthermore, health professionals can use these results to support their clients with T2D in the self-management of their health, by guiding them to trustworthy sources of health information and lowering barriers for searching health information.

Do it for others! The role of family and national group social belongingness in engaging with COVID-19 preventive health behaviors

COVID-19 is an unprecedented threat and an effective response requires a collective effort: engagement in preventive health behaviors, even from people at low risk. Previous research demonstrates that belongingness to social groups can promote prosocial, preventive health behaviors. The current research tests the effects of belongingness to two types of groups, intimate (family) and social category (nation), on intentions to comply with preventive health behaviors and reasons for these behaviors. We conducted three studies using French participants at low risk of grave effects from COVID-19 (total N = 875). In Study 1, across three time periods, belongingness was correlated with greater intentions to comply with preventive behaviors when these behaviors were not enforced by law. In Study 2, we experimentally manipulated threat to belongingness (vs. no threat). When belongingness was threatened, participants were less concerned with protecting vulnerable people. Closeness to family predicted preventive behavior intentions and both self-centered and prosocial reasons for these behaviors, regardless of condition. National identification buffered the negative effects of the threat to belongingness condition on preventive behavior intentions. In Study 3, we experimentally primed thoughts of belongingness to family vs. nation vs. control condition. We found greater intentions to engage in preventive behaviors and greater concern with protecting oneself and close relatives in the family condition. In summary, belongingness to one's family promotes preventive behavior intentions and the reasons given are to protect both oneself and others. Self-reported (but not primed) national identification can be related to prevention behavior intentions under certain conditions.

Media Exposure, Cancer Beliefs, and Cancer-Related Information-Seeking or Avoidance Behavior Patterns in China

This study explored the relationships between media exposure, cancer beliefs, and cancer information-seeking or information-avoidance behaviors. Based on the planned risk information-seeking model and its extended framework, two predictive models were constructed: one for cancer information seeking and the other for cancer information avoidance. A structural equation modeling strategy was applied to survey data from China HINTS 2017 (n = 3090) to compare the impact of traditional mass media and social media exposure to cancer-related information on cancer information-seeking and information-avoidance behaviors. The study findings suggest that health-related information exposure through different media channels may generate distinctive information-seeking or information-avoidance behaviors based on various cancer beliefs. Additionally, the findings indicate that social media exposure to health-related and cancer curability beliefs does not lead to cancer information avoidance; both mass media and social media exposure encourage people to seek cancer-related information. Cancer fatalism is positively associated with cancer information-seeking and avoiding intentions, suggesting that negative cancer beliefs predict seemingly contradictory yet psychologically coherent information intentions and behaviors.

Coping self-efficacy influences health information avoidance

Avoiding information about one's health can have long-term implications for health and well-being. Two studies examined the relationship between health information avoidance and coping self-efficacy, or a sense that one can effectively cope. In Study 1, coping self-efficacy, but not general self-efficacy, was associated with information avoidance. In Study 2, participants who reflected on their positive coping strategies were less likely to avoid learning their risk for disease as compared to those who did not reflect on their coping strategies. These findings suggest that coping self-efficacy is a good target for future interventions aimed at reducing health information avoidance.

Reconceptualizing Self-Affirmation With the Trigger and Channel Framework: Lessons From the Health Domain

Self-affirmation—a theory-based technique to affirm the adaptive adequacy of the self—can promote positive behavior change and adaptive outcomes, although effects are variable. We extend a novel framework (Trigger and Channel), proposing three conditions that facilitate self-affirmation-induced behavior change: (a) presence of psychological threat, (b) presence of resources to foster change, and (c) timeliness of the self-affirmation with respect to threat and resources. Using health behavior as a focus, we present meta-analytic evidence demonstrating that when these conditions are met, self-affirmation acts as a psychological trigger into a positive channel of resources that facilitate behavior change. The presence of a timely threat and the availability of timely resources independently predicted larger self-affirmation effects on behavior change, and the two interacted synergistically to predict still larger effects. The results illustrate the conditionality of self-affirmation effects and offer guidelines for when, where, and for whom self-affirmation will be most effective.