Examining information-seeking behavior in genetic testing for cancer predisposition: A qualitative interview study

Swiss residents' information behavior perceptions during the COVID-19 pandemic: A longitudinal qualitative study

People's information behavior during the COVID-19 pandemic was challenged through vast amounts of information, misinformation, and disinformation. This study sets out to address the research gap of longitudinal, qualitative inquiries about how people's information behavior changed during the COVID-19 pandemic. It aims to assess how residents of German-speaking Switzerland perceived and evaluated information gathering during a global health crisis. As part of the "Solidarity in Times of a Pandemic" (SolPan) Research Commons, 83 semi-structured interviews with residents of German-speaking Switzerland were conducted in April 2020 (T1), October 2020 (T2), and October 2021 (T3). People were asked about their lived experiences during the COVID-19 pandemic. Qualitative data analysis followed a reflexive thematic analysis approach, using Wilson's model of information behavior as a theoretical framework. Participants perceived high-quality journalistic news media, the Swiss national government, scientific experts, and their direct social environment as trustworthy information sources. They were motivated to gather information through the wish of gaining agency and certainty in the context of a major, global health crisis. Intervening variables that hindered information seeking included a perceived lack of agency, habituation effects in the later stages of the pandemic, information overload, inconsistent information, and conspiracy theories. While information needs were generally high in T1, participants expressed a growing extent of information fatigue in T2. In T3, the most prominent themes were conflicting information and differing interpretations, which led to an increased perception of societal polarization, which was perceived as a direct consequence of participants' information behavior. This finding is contextualized through established models of attitude formation: The study indicates how participants formed rather stable attitudes over time and how this led to a growing polarization and societal segmentation as the pandemic progressed. Practical implications regarding how to meet such societal polarization during crises are discussed.

Information-seeking preferences in diverse patients receiving a genetic testing result in the Clinical Sequencing Evidence-Generating Research (CSER) study

PURPOSE

Accurate and understandable information after genetic testing is critical for patients, family members, and professionals alike.

METHODS

As part of a cross-site study from the Clinical Sequencing Evidence-Generating Research consortium, we investigated the information-seeking practices among patients and family members at 5 to 7 months after genetic testing results disclosure, assessing the perceived utility of a variety of information sources, such as family and friends, health care providers, support groups, and the internet.

RESULTS

We found that individuals placed a high value on information obtained from genetics professionals and health care workers, independent of genetic testing result case classifications as positive, inconclusive, or negative. The internet was also highly utilized and ranked. Study participants rated some information sources as more useful for positive results compared with inconclusive or negative outcomes, emphasizing that it may be difficult to identify helpful information for individuals receiving an uncertain or negative result. There were few data from non-English speakers, highlighting the need to develop strategies to reach this population.

CONCLUSION

Our study emphasizes the need for clinicians to provide accurate and comprehensible information to individuals from diverse populations after genetic testing.

Psychosocial factors impacting barriers and motivators to cancer genetic testing

BACKGROUND

Only a small proportion of patients who qualify for clinical genetic testing for cancer susceptibility get testing. Many patient-level barriers contribute to low uptake. In this study, we examined self-reported patient barriers and motivators for cancer genetic testing.

METHODS

A survey comprised of both new and existing measures related to barriers and motivators to genetic testing was emailed to patients with a diagnosis of cancer at a large academic medical center. Patients who self-reported receiving a genetic test were included in these analyses (n = 376). Responses about emotions following testing as well as barriers and motivators prior to getting testing were examined. Group differences in barriers and motivators by patient demographic characteristics were examined.

RESULTS

Being assigned female at birth was associated with increased emotional, insurance, and family concerns as well as increased health benefits compared to patients assigned male at birth. Younger respondents had significantly higher emotional and family concerns compared to older respondents. Recently diagnosed respondents expressed fewer concerns about insurance implications and emotional concerns. Those with a BRCA-related cancer had higher scores on social and interpersonal concerns scale than those with other cancers. Participants with higher depression scores indicated increased emotional, social and interpersonal, and family concerns.

CONCLUSIONS

Self-reported depression emerged as the most consistent factor influencing report of barriers to genetic testing. By incorporating mental health resources into clinical practice, oncologists may better identify those patients who might need more assistance following through with a referral for genetic testing and the response afterwards.

Understanding the Information Needs of Patients With Ovarian Cancer Regarding Genetic Testing to Inform Intervention Design: Interview Study

Background

Experts in gynecological cancer care recommend that all patients with invasive or high-grade ovarian cancer (OC) undergo genetic testing. However, even patients who intend to take or have taken genetic tests have many unaddressed information needs regarding genetic testing. Existing genetic counseling falls short of adequately addressing this challenge.

Objective

This study aims to investigate the genetic testing–related information needs of patients with OC to inform the design of interactive technology-based interventions that can enhance communication of genetic testing information to patients.

Methods

We interviewed 20 patients with OC who had taken genetic tests and gathered genetic testing–related messages from an active OC web-based community. The interview transcripts and web-based community messages were analyzed using the qualitative content analysis method.

Results

Data analyses produced a comprehensive taxonomy of the genetic testing–related information needs of patients with OC, which included five major topic clusters: knowledge of genetic testing as a medical test, genetic testing process, genetic testing implications for patients, implications for family members, and medical terminology. Findings indicated that patients wanted to receive information that was relevant, understandable, concise, usable, appropriate, sympathetic, and available when needed. They also preferred various channels to receive information, including internet-based technologies, print, and conversations with health care providers.

Conclusions

Patients with OC need a range of information to address the uncertainties and challenges that they encounter while taking genetic tests. Their preferences for channels to receive information vary widely. A multichannel information delivery solution that combines both provider-led and peer-to-peer education models is needed to supplement existing genetic counseling to effectively meet the genetic testing–related information needs of patients with OC.

YouTube as an information source on BRCA mutations: implications for patients and professionals

Genetic testing for BRCA1/2 mutations in early breast cancer has been shown to be beneficial, and an increase in surveillance using these genetic markers is recommended. Given this recommendation, it is likely that individuals gather information about such testing. Social media is increasingly becoming a common source of health information. One such platform known for sharing health information is YouTube. The purpose of this study was to describe content related to BRCA1/2 mutations on YouTube. The sample included 100 English language videos, which were coded for content related to BRCA1/2 mutations. The 100 videos evaluated in this study were viewed 5.5 million times. In general, the BRCA1 and BRCA2 gene mutations were mentioned simultaneously, with only 15% of videos explaining the difference in prevalence or implication of the variants individually. A great number of videos (85.0%) discussed having genetic testing to determine the presence of BRCA mutations, but only 16.0% discussed the potential harms of BRCA mutation testing and 42.0% mentioned seeking genetic counseling to determine the need for testing and interpretation of the test results. Comparing the characteristics and content of videos created by healthcare professionals (n = 71) to those created by consumers and the media (n = 29), we found that consumer/media videos were viewed twice as many times as professional videos (3,704,351 vs. 1,851,825, p = 0.04). Videos from medical professionals should include consistent information on the recommendations for individuals who test positive for a BRCA mutation. Such content should include education about BRCA mutations, testing, implications of those results and ways to reduce risk, and recommendations for increased surveillance and enhanced screening for individuals positive for BRCA mutations.

Information seeking for coping with cancer: a systematic review

Purpose

Information seeking can be used to make sense of a situation or solve a problem. Information seeking can be considered a coping strategy when facing illness, crisis or other life-changing events. Cancer is a globally occurring, life-threatening disease, and this review aims to provide an overview of the existing literature on the active information seeking behaviour of cancer patients specifically focussing on how active information seeking serves as a coping strategy.

Design/methodology/approach

This study adheres to current guidelines for conducting systematic reviews and consequently, thorough literature searches were conducted in four databases: Medline, Embase, CINAHL and Scopus which resulted in 7,179 publications. Following a careful screening process, this systematic review identifies 14 studies on the use of information seeking to cope with cancer.

Findings

The included studies consist of both qualitative and quantitative approaches to analysing the use of information seeking to cope with cancer. The included studies have focussed primarily on demographic factors, the impact of affect, information needs, sources and coping strategies.

Research limitations/implications

A number of research gaps within library and information science are identified. Bringing research in this field into information science could allow for a greater understanding of information literacy, the use of existing information and the process of information searching when using information seeking to cope with serious illness.

Originality/value

This systematic review focusses on how information seeking serves as a coping strategy for cancer patients and provides an overview of the recent literature.