Examining the dimensions of cancer-related information seeking and scanning behavior

HPV Vaccination Information Access, Needs, and Preferences Among Black and Hispanic Mothers

HPV-associated cancer disparities disproportionately affect Black/African American and Hispanic individuals in the U.S. HPV vaccination, which can prevent many HPV-associated cancers, should be clearly recommended by pediatricians to parents of adolescents aged 9-12, yet uptake and completion remain lower than other adolescent vaccinations. We used the Structural Influence Model of Health Communication to explore communication inequalities from interviews with 19 Black and Hispanic mothers of adolescents. We identified HPV vaccination information seeking behaviors, media use, and preferred channels to address information needs. This study provides insights into how mothers' nativity and ethno-racial identity influenced how they accessed and processed information from various sources. Preferences for digital and community-based strategies to address information gaps and hesitancy concerns are also presented. Findings suggest future prevention strategies must increase access to accurate information that resonates with NH-Black and Hispanic communities' needs and is disseminated via preferred communication channels to maximize the effects of multi-level interventions promoting HPV vaccination among communities experiencing disparities.

Explaining Seeking, Scanning, and Avoidance of Information About the Mammography-Screening: Results of a Two-Wave Online Survey with a Stratified Sample of Women

Whether individuals engage with or avoid health information and which sources are used is crucial for informed decision-making about mammography. Therefore, we aim to develop a typology of mammography-related information behaviors and explore their determinants, which were derived from the Theory of Motivated Information Management (TMIM). Based on a two-wave online survey of a sample of German women aged 40 to 69 years (N = 1,138), a cluster analysis resulted in five person-centric types of information behavior that cover respondents' variety of engagement with mammography-related information: The seekers, the scanners, the avoiders, the involved, and the inactive. The types indicated that most individuals possess a high preference for one strategy of information behavior. Looking at the determinants of belonging to a particular type of information behavior, it becomes apparent that the factors of the TMIM have only limited explanatory power. The most relevant factors in distinguishing the types of information behaviors are benefit perceptions, worry, interest, avoidance efficacy, seeking, and avoidance-related outcome expectancies. Scanners and seekers had higher benefit perceptions. Seekers were further motivated by greater worries, while involved ones felt more interested and held stronger expectancies. Avoiders were more anxious and had a higher avoidance efficacy. The study suggests that inactive individuals and avoiders are highly prevalent and relevant target groups for health interventions that support informed decision-making. To facilitate informed decision-making, women should be encouraged to weigh benefits and harms of their options and to address negative emotions, such as anxiety, that may exist or arise during decision-making.

Associations between news coverage, social media discussions, and search trends about celebrity deaths, screening, and other colorectal cancer-related events

OBJECTIVE

Colorectal cancer (CRC) is the third leading cause of cancer death among both men and women in the United States. CRC-related events may increase media coverage and public attention, boosting awareness and prevention. This study examined associations between several types of CRC events (including unplanned celebrity cancer deaths and planned events like national CRC awareness months, celebrity screening behavior, and screening guideline changes) and news coverage, Twitter discussions, and Google search trends about CRC and CRC screening.

METHODS

We analyzed data from U.S. national news media outlets, posts scraped from Twitter, and Google Trends on CRC and CRC screening during a three-year period from 2020 to 2022. We used burst detection methods to identify temporal spikes in the volume of news, tweets, and search after each CRC-related event.

RESULTS

There is a high level of heterogeneity in the impact of celebrity CRC events. Celebrity CRC deaths were more likely to precede spikes in news and tweets about CRC overall than CRC screening. Celebrity screening preceded spikes in news and tweets about screening but not searches. Awareness months and screening guideline changes did precede spikes in news, tweets, and searches about screening, but these spikes were inconsistent, not simultaneous, and not as large as those events concerning most prominent public figures.

CONCLUSIONS

CRC events provide opportunities to increase attention to CRC. Media and public health professionals should actively intervene during CRC events to increase emphasis on CRC screening and evidence-based recommendations.

Breathing on the job: investigating predictors of air quality protective actions and information seeking among outdoor workers

BACKGROUND

Air quality issues, exacerbated by wildfire smoke and excessive ozone that is worsened by climate change, pose significant health risks to outdoor workers, who are often overlooked in regulatory protection and communication efforts. This study examined how outdoor worker demographics, risk perceptions, and efficacy beliefs predict air quality protective actions and information seeking. Additionally, it investigates the sources of information that this population relies on for understanding air quality.

METHOD

A survey was conducted with 256 outdoor workers in Colorado, a state regularly affected by wildfire smoke and ozone. Measures included demographics, perceived risk, efficacy beliefs, air quality actions, and information seeking behavior.

RESULTS

Both perceived risk and efficacy beliefs influenced health-protective actions during poor air quality events. Interestingly, efficacy beliefs were found to be a more reliable predictor of air quality information seeking than perceived risk. The top sources of air quality information among outdoor workers were local news media, The Weather Channel, mobile apps, state public health authorities, and the National Weather Service.

CONCLUSIONS

These findings enhance our understanding of how perceived risk and efficacy beliefs promote health-protective behaviors among outdoor workers. They lay the groundwork for future research and initiatives to improve air quality communication and promote health-protective actions for this population group. Promoting the efficacy of health-protective actions and seeking information are important components of air quality communication.

Search Engine Use for Health-Related Purposes: Behavioral Data on Online Health Information-Seeking in Germany

Internet searches for health-related purposes are common, with search engines like Google being the most popular starting point. However, results on the popularity of health information-seeking behaviors are based on self-report data, often criticized for suffering from incomplete recall, overreporting, and low reliability. Therefore, the current study builds on user-centric tracking of Internet use to reveal how individuals actually behave online. We conducted a secondary analysis of passively recorded Internet use logs to examine the prevalence of health-related search engine use, the types of health information searched for, and the sources visited after the searches. The analysis revealed two key findings. 1) We largely support earlier survey-based findings on the prevalence of online health information seeking with search engines and the relatively minor differences in information-seeking behaviors between socio-demographic groups. 2) We provide a more granular picture of the process of HISB using search engines by identifying different selection patterns depending on the scope of the searches.

Revisiting the symptom iceberg based on the Danish symptom cohort - Symptom experiences and healthcare-seeking behaviour in the general Danish population in 2022

Introduction

Healthcare-seeking behaviour may change over time, and some groups are more likely to avoid relevant help seeking, which possibly contributes to social inequity in health. Thus, we developed an expansion of and follow-up to the Danish Symptom Cohort (DaSC) from 2012 and formed the DaSC II, which encompassed a population-based questionnaire study investigating symptoms and healthcare-seeking behaviour. In this paper, we describe the conceptual framework, development and content validity of the questionnaire and a responder analysis of the participants in the DaSC II. We present the symptom iceberg in the Danish general population by estimating the prevalence of symptoms and proportion of contacts to general practitioners (GPs) in 2022. Moreover, we discuss differences in healthcare-seeking behaviour with reference to the 2012 DaSC.

Methods

100,000 randomly selected Danish citizens aged ≥20 years, along with the 44,713 respondents from the 2012 cohort, were invited to participate in a survey. The questionnaire was pilot and field tested prior to distribution. Descriptive statistics were used to estimate symptom prevalence and proportion of GP contacts, and to execute the respondent analysis.

Results

Nine out of ten respondents reported at least one symptom within the preceding four weeks and reported an average of 4.6 symptoms. One in four symptoms were presented to a GP. The highest proportion of GP contacts was found for haematuria (63.3 %) and shortness of breath (51.8 %). For several symptoms, differences between the sexes were found in relation to both prevalence and GP contacts. The proportion of GP contacts was higher in 2022 than in 2012 and was most pronounced for general, frequently experienced symptoms and to a lesser extent for cancer alarm symptoms.

Conclusion

Many symptoms go unreported, which may delay relevant diagnosis; more research on certain symptom categories and population subgroups is needed. Future studies based on the DaSC II form a basis for interventions targeting symptom awareness, healthcare-seeking behaviour and social equity in society and health.

Health information and resources in hospital outpatient waiting areas may not meet the needs of older adults from culturally and linguistically diverse backgrounds: A cross-cultural qualitative study

BACKGROUND

Health information and resources are often provided in hospital outpatient waiting areas but may not meet the cultural and health literacy needs of older adults from culturally and linguistically diverse (CALD) backgrounds.

OBJECTIVES

To explore the perspectives and experiences of Cantonese- and Vietnamese-speaking patients and carers in this setting.

METHODS

This qualitative interview-based study was conducted from December 2019 to March 2020 at a single outpatient rehabilitation service located at a tertiary public hospital. Four adult consumers (two older adult patients, two caregivers) from CALD backgrounds participated in semi-structured interviews with bilingual researchers. Data were transcribed, translated and analysed using reflexive thematic analysis.

RESULTS

Five themes were developed which highlighted that older adults' language profiles shaped their health information needs and ability to access resources in waiting areas. Cultural factors such as filial responsibility may also influence health information preferences.

DISCUSSION

Older consumers from CALD backgrounds did not have equitable access to health information and resources in the waiting area compared with English-literate older adults.

CONCLUSION

Health information and resources in waiting areas warrant improving to better meet the needs of older patients from CALD backgrounds and their caregivers.

Effects of Exposure to Conflicting Health Information on Topic-Specific Information Sharing and Seeking Intentions

Despite considerable evidence that exposure to conflicting health information can have undesirable effects on outcomes including public understanding about and trust in health recommendations, comparatively little is known about whether such exposure influences intentions to engage in two communication behaviors central to public health promotion: information sharing and information seeking. The purpose of the current study is to test whether exposure to conflicting information influences intentions to share and seek information about six health topics. We analyzed data from two waves of a longitudinal survey experiment with a nationally representative sample of U.S. adults (N = 3,920). Participants were randomly assigned to either a conflict or no-conflict message condition, in which they read news stories and social media posts about three (of six) randomly selected health topics at Time 1 and the remaining three at Time 2. The dependent variables, which were measured at Time 2, asked participants whether they intended to share or seek information about the three topics they had just viewed. Linear mixed effects models showed that exposure to conflict reduced intentions to share and seek information, regardless of health topic. These findings suggest that exposure to conflicting health information discourages two important types of health information engagement, thus adding to the growing evidence base documenting the adverse consequences of conflicting information for public health.

Engaging and (the Illusion of) Learning? Examining the Relationship Between Different Social Media Activities and Reproductive Health Knowledge

Social media have become fundamental platforms for learning about health, including reproductive health knowledge. However, little is known about what specific user activity is conducive to learning about reproductive health and by what means. Drawing upon the cognitive mediation model, this study examines how different social media activities function in terms of elaboration and knowledge gain. Our hypothesized model was largely supported by a nationwide online survey with 1,000 Chinese women residing in both rural and urban areas. The results revealed the crucial role of information elaboration in bridging different social media activities with both subjective and factual reproductive health knowledge. Interestingly, public reposting of reproductive health information was found to be positively related to subjective knowledge but negatively related to factual knowledge, suggesting the emergence of an illusion of knowing among our participants. Multigroup SEM analyses revealed that the positive roles of scanning and private sharing in encouraging elaboration were more pronounced among users with lower levels of need for cognition. The findings are expected to contribute to a more nuanced understanding of health learning based on users' social media activities and intrinsic motivations for learning.

Clarifying the Relationship Between Information Seeking and Avoidance: Longitudinal Analyses of Information Behaviors and Their Normative Influences

Information seeking and avoidance are relevant behaviors to cope with health crises. While there are various assumptions about their relationship, past research has not yet analyzed their interplay. The present study aims to clarify the relationship between information seeking and avoidance in the course of the COVID-19 pandemic and shed light on whether both behaviors are impacted by seeking- and avoidance-related norms, which are known factors in individuals' health- and risk-related behaviors. Based on a four-wave panel study conducted among German residents (n = 492), we investigated information seeking and avoidance and their normative influences from a longitudinal perspective. Results of random intercept cross-lagged panel models suggest that information seeking and avoidance are distinct, not causally related but correlated concepts. This understanding is supported by the findings that seeking- and avoidance-related norms operate differently for seeking and avoidance. The results add to construct clarification and theory development, but more research is needed to understand the relations between information behaviors.

Correlates of COVID-19 Information Overload and Information Seeking: Evidence from a Community Survey

PURPOSE

To examine the relationships among health literacy, risk perceptions, COVID-19 information overload, health information seeking, and race/ethnicity.

DESIGN

A cross-sectional non-probability community survey conducted between December 2020 and January 2021. A questionnaire was developed in collaboration with a local minority health task force.

SETTING

Albany, New York, USA.

SAMPLE

331 adults residing in Albany, NY and neighboring areas (80.3% completion rate).

MEASURES

Multi-item scales were used to measure health literacy, perceived severity, perceived susceptibility, information overload, and health information seeking frequency and types.

ANALYSIS

We conducted multivariate regression analysis.

RESULTS

Health literacy (standardized β = -.33, P < .001) and perceived severity (β = -.23, P < .001) were negatively associated with information overload. Information overload was negatively associated with health information seeking frequency (β = -.16, P < .05) and types (β = -.19, P < .01). A further analysis shows several factors, including information overload and race (African Americans), were negatively related to seeking specific types of information.

CONCLUSION

We find that low health literacy and perceived severity contribute to information overload and that information overload adversely affects health information seeking. Black individuals are less likely to search for certain types of information. The cross-sectional study design limits our ability to determine causality. Future research should employ panel data to determine the directionality of the observed relationships.

"I Saw it Incidentally but Frequently": Exploring the Effects of Online Health Information Scanning on Lung Cancer Screening Behaviors Among Chinese Smokers

In China, lung cancer is the most common cancer with high mortality. While prior research suggests that health information scanning influences cancer screening within the general population, a deeper exploration of the underlying mechanisms is imperative. This study specifically targets smokers, aiming to investigate whether online health information scanning can effectively encourage lung cancer screening and elucidate the mechanisms driving this association. Data were extracted from a Chinese national survey conducted between January and September 2023, exclusively involving current smokers (N = 992). A moderated mediation model was employed to examine a cognitive-affective sequential chain of mediation through risk perceptions and cancer worry. Results showed that 99.1% of Chinese smokers reported online health information scanning, which possessed significant influence. Online health information scanning was positively associated with effective lung cancer screening among smokers directly (OR = 1.927, p < .01) and indirectly (OR = .065, p < .001). The perceived threat of smoking and cancer worry served as the cognitive and affective mediating mechanisms. Furthermore, a moderating effect of eHealth literacy was observed (OR = 6.292, p < .05). Smokers with higher eHealth literacy are more inclined to undergo effective lung cancer screening. Based on these findings, public health sectors should leverage online platforms to disseminate tailored cancer screening education and implement initiatives to enhance public eHealth literacy.

From Information Seeking and Scanning to the Practice of Healthy Habits: A Longitudinal Test of the Integrative Model of Behavioral Prediction in the Context of Fruit and Vegetable Consumption

Fruit and vegetable intake is essential for health, but global adherence to recommended levels remains insufficient. Health information exposure positively influences consumption, yet the underlying mechanisms are not fully understood. This study aims to explore the relationships between information seeking and scanning, attitudes, norms, perceived behavioral control (PBC), intentions, and fruit and vegetable intake, following the main tenets of the Integrative Model of Behavioral Prediction (IM). Data were collected through face-to-face surveys in Santiago, Chile, with a representative sample of individuals aged 25 and older in two waves. Findings revealed that intentions in Wave 1 predicted fruit and vegetable consumption in Wave 2, with positive associations between attitudes, norms, PBC, and intentions. Information seeking was positively associated with attitudes, norms, and PBC, and it had indirect effects on fruit and vegetable consumption through attitudes, norms, PBC, and intentions. Information scanning did not show significant indirect effects on fruit and vegetable consumption, even though the path between scanning and attitudes was significant. The study provides support for the IM and highlights the importance of information seeking in promoting fruit and vegetable consumption through its influence on attitudes, norms, and PBC. The findings have practical implications for health campaigns, educational programs, healthcare interactions, and public policies targeting healthier dietary habits.

Collective Information Seeking During a Health Crisis : Predictors of Google Trends During COVID-19

This article approaches collective health information seeking from computational method by investigating patterns of Google Trends data in the United States during the early stages of the COVID-19 pandemic. We analyzed factors that prompted a community's curiosity, and information that communities were most curious about. The results of our cross-sectional and time-series-based analyses reveal a few salient findings: (1) Republican leaning states searched less frequently, and while states with more cases searched more, partisan lean is a more significant predictor; (2) States with greater level of poverty searched less frequently; (3) Leadership on the national level significantly influenced people's searching behavior; (4) Communities were most interested in "local risk" information as well as quantifiable information. We show in this work that established individual information seeking theoretical predictors (risk) can predict online collective information demand and information seeking subcategories with important contributions from collective conditions (leadership). Health communication practitioners can design health messages and choose media channels more purposefully according to what people are most interested in searching.

Understanding the Effects of News-Finds-Me Perception on Health Knowledge and Information Seeking During Public Health Crises

News-finds-me (NFM) perception is a belief that, in the era of social media, individuals can remain adequately well-informed about current events even if they do not actively seek news. While it has been examined in the context of general and political news, NFM perception has not been explored in the context of other genres of news. Through an online survey involving 1,001 Singaporeans, with the Planned Risk Information Seeking Model, this study examines how NFM perception is related to information seeking and COVID-19 knowledge. An issue-specific NFM perception was also proposed and tested in order to determine whether NFM perception and its associated effects differ when operationalized as general news exposure or issue-specific news relating to COVID-19. The negative relationship between general NFM perception and knowledge and the mediating role of information seeking on social media in this relationship are detected. It is also found that when the NFM perception is issue-specific (i.e. COVID-NFM perception), information insufficiency and intentions of information seeking on social media fully mediated the relationship between NFM perception and knowledge. Theoretical and practical implications are discussed.

Understanding the Associations Between Adolescents' Exposure to E-Cigarette Information and Vaping Behavior Through the Theory of Planned Behavior

Adolescents have actively looked for and passively scanned information about electronic cigarettes (e-cigarettes) from a variety of media and interpersonal sources. Despite the evidence that exposure to e-cigarette information is associated with youth's increased vaping intention, there is a paucity of scholarship that differentiates the sources where adolescents obtain e-cigarette information in their investigation, which limits our understanding of the unique association between vaping intention and e-cigarette information acquisition from specific sources. In addition, few studies have systematically examined the mechanism of the aforementioned associations. To fill the gap, an online national survey on a panel of adolescents between 13 to 17 years old was conducted. After controlling for potential confounders, several significant indirect effects were observed. Specifically, adolescents' vaping intention was negatively associated with e-cigarette information seeking from health professionals but positively with e-cigarette information exposure from family and friends, outdoors advertisements, social media, and other online channels, with the theory of planned behavior (TPB) constructs mediating these relationships. The findings not only contribute to the body of scholarship on TPB but also provide important suggestions for regulating outdoor and online e-cigarette information and designing persuasive interventions and campaigns.

An Elicitation Study to Understand Young Adults' Beliefs About Seeking Health Information From Social Media Influencers

Social media influencers increasingly make health recommendations on social media. Research on influencer health messaging is mixed in that some studies show it can result in misleading or harmful health information, and others demonstrate it can lead to beneficial behavioral outcomes. However, there is little research on young adults' beliefs about following health guidance from influencers. Guided by the reasoned action approach, this study examined young adults' attitudes, normative beliefs, and control in seeking health information from social media influencers using focus groups (n = 31). Results suggest that young adults obtain health information from influencers and perceive them as a source of health education. Several barriers to getting health information from influencers were mentioned, including sponsorship, lack of credibility, and perceived normative pressure to critically analyze influencer content from peers and family. Practical and theoretical implications for future research are discussed.

Overcoming Black Americans' Psychological and Cognitive Barriers to Clinical Trial Participation: Effects of News Framing and Exemplars

This study examines how news features (framing and the use of exemplars) can help overcome two common barriers (psychological and cognitive) impeding Black American participation in clinical trials. In an online experiment, Black participants (N = 390) viewed social media news posts varying in framing (focus on psychological vs. cognitive barriers) and use of an exemplar (present vs. absent and White vs. Black) and then responded to outcome measures including perceived message effectiveness, message attitudes, and intention to participate in clinical trials. The findings illustrate that including a racially matched (i.e. Black) exemplar improves attitudes toward clinical trial messages. Most notably, featuring a race-matched exemplar increases intention to participate in a trial when the messages discuss psychological barriers. These findings enhance our understanding of how messages can be better designed to increase Black American participation in clinical trials, thereby contributing to reducing health inequities and improving health outcomes.

A Mobile Health Information Behavior Model: Theoretical Development and Mixed-Method Testing in the Context of Mobile Apps on Child Poisoning Prevention

While several studies have explored the use of mobile health applications, few have observed determinants of mobile health information behavior. To develop a model explaining parents' mobile information behavior on child poisoning prevention, we first explored relevant theories to suggest a theoretical model. In that, we combine existing models on risk and health information seeking, such as the Planned Risk Information Seeking Model, with models on the acceptance of mobile technologies, such as the Unified Theory of Acceptance and Use of Technologies. Thereafter, we employed a sequential mixed-method design with an initial qualitative study (four online focus groups with n = 25 parents in total) and a standardized online survey of n = 1,013 parents to evaluate our research model. Results confirm that both, determinants of information seeking and determinants of technology acceptance, contribute to the explanation of mobile information behavior. App use intention was mainly related to the performance expectancy of app use, the subjective information norm, and social influence on app use. To increase the usage of prevention apps and contribute to the reduction of child injuries, communication on poisoning apps should address subdimensions of the performance expectancy, such as their utility and peoples' trust in app providers. Moreover, physicians are important multipliers for these messages.

Information scanning in the COVID-19 pandemic: a test and expansion of the channel complementarity theory using latent class analysis

BACKGROUND

During health crisis, individuals need information to comprehend their circumstances. Channel complementarity theory posits that in meeting their informational needs, people will use different sources in a complementary fashion. This paper puts to test the main tenet of channel complementarity theory by focusing on information scanning (i.e. routine health information exposure) in the context of the COVID-19 pandemic in Chile.

METHOD

A survey was conducted among a sample of Chilean adults (N = 2,805). The questionnaire addressed information scanning across six sources (television, radio, internet, social media, family, and friends or coworkers) and explores how socioeconomic and demographic variables, as well as COVID-19 perceived risk related to scanning. Latent class analysis was employed to identify patterns of complementarity across channels.

RESULTS

The analysis yielded a solution of five classes, namely 'high complementarity and high frequency' (21%), 'high complementarity and low frequency' (34%), 'high frequency on television and digital media' (19%), 'mass media predominant' (11%), and 'no scanning' (15%). Educational attainment, age, and COVID-19 perceived risk were associated with scanning.

CONCLUSIONS

Television was a central channel for information scanning during the pandemic in Chile and more than half of participants scanned COVID-19 information complementarily. Our findings expand channel complementarity theory to information scanning in a non-US context and provide guidelines for designing communication interventions aiming at informing individuals during a global health crisis.

Usefulness of walkathon in improving knowledge on cancer: A cross-sectional study with the participants

AIM

Globally, walkathon, a type of community event involving walking a determined distance to raise awareness and/or collect donations for a social cause is gaining a lot of public attention. This study was conducted to understand the usefulness of walkathon in creating cancer awareness among the participants.

MATERIALS AND METHODS

This was a pre- and post-test study and was carried out on World Cancer Day on February 4, 2019 in Mangalore, Karnataka, India. The study subjects were the walkathon participants willing to be volunteers for the study. Differences in the answers were calculated by ascertaining the difference between the pretest and posttest using McNemar, Chi-square, or Fisher's exact test. A P < 0.05 was considered statistically significant.

RESULTS

Pretest scores indicated most volunteers were aware of the role of tobacco and alcohol in cancer, while most were unaware of the importance of fruits and consumption of vegetables and sedentary lifestyle in the development of cancer. Posttest showed a significant increase in knowledge gain (P = 0.003 to <0.001).

CONCLUSIONS

For the first time, this study shows Walkathon to be helpful in improving cancer knowledge in the participants. Walkathon is an inexpensive and joyful way to educate people and warrants further study on a range of medical and social themes affecting society to establish its usefulness in public health education.

Scanned information exposure and support for tobacco regulations among US youth and young adult tobacco product users and non-users

The influences of information exposure on youth and young adults' (YYA) support for smoking/vaping regulations have been understudied. This study examines (i) the relationships between routine exposure to (i.e. scanning) anti-smoking/pro-vaping information and YYA support for anti-smoking/vaping regulations and (ii) whether these relationships differ across YYA users and non-users of tobacco products. We analyzed the data from a nationally representative two-wave rolling cross-sectional survey of YYA in the United States, collected from 2014 to 2017 (baseline n = 10 642; follow-up n = 4001). Less than 5% of the participants ever scanned pro-smoking and anti-vaping information. Scanning anti-smoking information had significant positive relationships with support for all anti-smoking policies cross-sectionally, and this pattern was longitudinally significant in two anti-smoking policy contexts. Scanning pro-vaping information had significant negative associations with support for anti-vaping policies cross-sectionally, but not longitudinally. The lagged positive relationships between scanning anti-smoking information and support for anti-smoking regulations were stronger among YYA smokers than among YYA non-smokers, whereas evidence from adult data suggested the opposite pattern. The findings suggest that scanning information can affect YYA support for tobacco regulations. Future efforts are required to investigate mechanisms underlying the influences of scanned information on YYA support for tobacco regulations.

Behavior patterns and influencing factors: Health information acquisition behavior of Chinese senior adults on WeChat

Due to the gradual adoption of WeChat by older adults in China and their interest in health information, Chinese older people started to acquire health information through WeChat. We explored the specific patterns and influencing factors of the elderly's health information acquisition behavior senior adults. The cross-sectional study collected self-reported data with survey (N = 336) in the southeast of China, Zhejiang province. The findings of this study extend the previous research by suggesting that elderly adults' health information acquisition behavior has three patterns (actively seeking, passively browsing, and long-term collecting). These findings contribute to a better understanding of digital literacy, three dimensions of health literacy and their relationship with three specific patterns of health acquisition behavior. This study also provides practical insights related to narrow the technological gap of the older adults, improve their e-Health literacy of the elderly, and purify the health information environment in the network.

Utility and usability evaluation of an information diary tool to measure health information access and exposure among patients with high cardiovascular risk

Background

Online health misinformation about statins potentially affects health decision-making on statin use and adherence. We developed an information diary platform (IDP) to measure topic-specific health information exposure where participants record what information they encounter. We evaluated the utility and usability of the smartphone diary from the participants' perspective.

Methods

We used a mixed-method design to evaluate how participants used the smartphone diary tool and their perspectives on usability. Participants were high cardiovascular-risk patients recruited from a primary care clinic and used the tool for a week. We measured usability with the System Usability Scale (SUS) questionnaire and interviewed participants to explore utility and usability issues.

Results

The information diary was available in three languages and tested with 24 participants. The mean SUS score was 69.8 ± 12.9. Five themes related to utility were: IDP functions as a health information diary; supporting discussion of health information with doctors; wanting a feedback function about credible information; increasing awareness of the need to appraise information; and wanting to compare levels of trust with other participants or experts. Four themes related to usability were: ease of learning and use; confusion about selecting the category of information source; capturing offline information by uploading photos; and recording their level of trust.

Conclusion

We found that the smartphone diary can be used as a research instrument to record relevant examples of information exposure. It potentially modifies how people seek and appraise topic-specific health information.

Oral cancer awareness campaign in Northern Germany: successful steps to raise awareness for early detection

PURPOSE

Oral cancer is an underestimated health problem, and its existence and the relevant prevention measures are not sufficiently known by the general population. The project thus aimed to develop, implement and evaluate an oral cancer campaign in Northern Germany, and to increase problem awareness on various levels: draw public attention to the tumour by media coverage increase awareness of early detection opportunities for the target group, and raise awareness of carrying out early detection measures by the professional groups involved.

METHODS

For each level, a campaign concept was developed and documented in terms of content and timing. The identified target group was elderly educationally disadvantaged male citizens ≥ 50 years. The evaluation concept for each level included pre-, post- and process evaluations.

RESULTS

The campaign was carried out from April 2012 to December 2014. The issue of awareness within the target group was significantly increased. Media coverage showed that regional media adopted the topic of oral cancer and placed it on their published agenda. Furthermore, the continuous involvement of the professional groups over the course of the campaign led to an increased awareness of oral cancer.

CONCLUSION

The development of the campaign concept with a comprehensive evaluation showed that the target group was successfully reached. The campaign was adapted to the required target group and specific conditions, and was also designed to be context sensitive. It is, therefore, recommended that the development and implementation of an oral cancer campaign on a national level be discussed.

Social Media Communication about HPV Vaccine in China: A Study Using Topic Modeling and Survey

The human papillomavirus (HPV) vaccine is relatively novel to people in China. Social media is becoming an important channel for learning new health information. However, limited is known about what HPV vaccine information has been disseminated on social media, and how such online information is associated with health-related behaviors in China. Based on Longo et al.'s model of patient use of healthcare information for healthcare decision, and Longo's model of health information seeking behaviors, this study examined HPV vaccine-related information type and information acquisition pattern. Following the mixed-methods approach, we first crawled 67,773 postings about HPV vaccine on Weibo, the largest microblogging website in China, and performed topic modeling to identify HPV vaccine-related topics that are prevalent on Weibo. The results showed six major topics about HPV vaccine, namely policy, guidance information, advertising, scandals, personal experience sharing, and HPV risks. Second, we conducted an online survey (n = 1,982) to investigate how scanning, seeking, and discussing the six HPV vaccine topics identified from big data analytics can affect HPV vaccine knowledge, safety concern, and vaccination intention. We documented significant impacts of social media health communication on users' health knowledge, attitude and behavioral intention.

Health information behavior and related factors among Estonians aged ≥ 50 years during the COVID-19 pandemic

Purpose

The purpose of the article is to introduce the outcomes of a study analyzing the relationships between willingness to use technology for health purposes, health information behavior (HIB), health behavior (HB) choices, readiness for COVID-19 vaccination, socioeconomic indicators and self-reported health among older adults aged = 50 years living in Estonia.

Design/methodology/approach

A cross-sectional survey was conducted among 501 people aged = 50 in Estonia in 2020, a month after the end of lockdown.

Findings

The results of the study indicate that the more recurrent the need for HI was (rho = 0.11, p < 0.05) and the more regularly one searched for it (rho = 0.14, p < 0.01), the more willing a person was to get vaccinated. Also, interest in digital applications corresponded to vaccination readiness (rho = 0.25, p < 0.001). However, this relationship did not emerge in the case of other HBs such as healthy eating and exercise. Differences in HIB should be taken into account when developing effective means of health communication designed especially for crisis situations.

Originality/value

Estonia is known as one of the digital front runners in the world. However, social welfare and the well-being of disadvantaged groups among the population (e.g. older people) have not yet caught up with the more developed Western countries. Thus, learning more about the health-related information behavior of older adults, e.g. the kind of health information they are seeking and using in Estonia, allows policymakers, health information providers and libraries in Estonia to plan and carry out more effective interventions and help them to improve the existing systems so as to furnish older adults with relevant information.

Effect of information encounter on concerns over healthy eating- mediated through body comparison and moderated by body mass index or body satisfaction

BACKGROUND

Understanding factors that influence healthy or unhealthy eating can inform intervention strategies. This study ascertained whether and how unintentional exposure to food and nutrition information influenced healthy eating concerns. The study tested body comparison, body satisfaction, and body mass index as three mechanisms that potentially link food information encounter, commonly known as information scanning, to healthy eating concerns.

METHODS

A sample of 440 online participants (mean age = 29.15 years) was used to investigate: (1) how unintentional exposure to food and nutrition information, i.e., information encounter (IE), affects healthy eating concerns (HEC); (2) how the effect of IE on HEC is mediated by body comparison (BC); (3) how the paths of the mediation model are moderated by body satisfaction (BS) or body mass index (BMI).

RESULTS

The findings show a positive and sizable total effect of IE on HEC - a whole-scale increase in information encounter is associated with a substantial increase in healthy eating concerns by 15 percentage points (b_p = 0.150). BC is found to mediate the effect of IE on HEC in an all-positive complementary mediation. Both the indirect and the direct-and-remainder paths show sizable effects. The mediated path contributes about 20% of the total effect between IE and HEC (c_p = 20%), while the direct-and-remainder path contributes the rest (c_p = 80%). BS was found to moderate the relationship between IE and BC, the first leg of the mediation. The moderation effect is large - the effect of IE on BC is much smaller on the highly and the moderately satisfied than on the lowly satisfied (slope differential b_p = -.60). BMI was found to moderate the direct-and-remainder effect of IE on HEC, controlling BC. That is, the effect of IE on HEC, after filtering out the mediated effect through BC, is much larger for those with high or low BMI than those with healthy BMI (slope differential b_p = .32).

CONCLUSIONS

Exposure, even if unintentional, to food and nutrition information is an important predictor of HEC. BC, BS, and BMI are important factors that help to explain the process through which information affects behaviors.

[COVID-19 risk groups and their strategies for navigating information overload during the first year of the pandemic in Chile]

As a part of the EIS-COVID project on the access and use of information during the COVID-19 pandemic in Chile, the objective of this paper was to ascertain how people's informational environment was constructed during the first stage of the pandemic. It discusses the results of a qualitative study of people belonging to risk groups for COVID-19: people over 18 and under 65 with chronic diseases (hypertension and diabetes) and people 65 and over. Ninety semi-structured interviews were conducted in the Metropolitan and Valparaíso regions between September 2020 and January 2021. The results reveal the problematic nature of the information overload encountered by these groups and the strategies they used to navigate it: a) information avoidance; b) content corroboration and active search for reliable sources; and c) differentiated media use.

Self- and surrogate-seeking of information about mental health and illness in Germany

BACKGROUND

Seeking information on mental health issues - both for oneself and on behalf of others (so-called surrogate-seeking) - is a critical early step in dealing with mental illness and known to impede stigmatizing attitudes and foster help-seeking. Yet, knowledge about mental health tends to be insufficient worldwide. Therefore, it is necessary to better understand the search for mental health information and examine the factors that are positively associated with information-seeking.

METHOD

In a face-to-face survey in Germany (N = 1,522), we investigated the factors related to mental health information-seeking. The data was analyzed by means of a logistic regression model, in which we distinguished those searching information for themselves from so-called surrogate seekers, i.e., people who seek information on behalf of someone else.

RESULTS

Twenty-six percent of German adults in our sample have already searched for information on mental health, with the majority already having searched for information for others (73% of all seekers). Our findings indicate that individuals' proximity to people with mental health issues, including their own mental health treatment experience (Cramer's V = .429, p < .001), education (Cramer's V = .184, p < .001), and desire for social distance from the affected people (F [1, 1516] = 73.580, p < .001, η² = .046), play an important role in mental health information-seeking. The patterns of sociodemographic and proximity factors hereby differ between self-seekers and surrogate-seekers.

CONCLUSIONS

Our study provides insights into the public's mental health information orientation. The findings may particularly guide strategies to improve mental health awareness and fill knowledge gaps in supporting informed decision-making and reducing stigma. Surrogate seekers appear to be an important and distinctive target group for mental health information provision. Depending on whether one wants to promote surrogate- or self-seeking seekers, different target groups and determinants should be addressed.

How Does Social Media Exposure and Engagement Influence College Students' Use of ENDS Products? A Cross-lagged Longitudinal Study

Electronic nicotine delivery systems (ENDS) products have been marketed heavily on social media throughout the past years, which exerts great influence on young adults' ENDS use. Despite scholars' pioneering efforts in investigating the influence of tobacco and nicotine products marketing on young adults' vaping behavior, scholarly attention has been paid primarily to passive exposure to rather than active engagement with the information on social media. In addition, the majority of existing research has been cross-sectional or focused on the unidirectional path from marketing information to behavior. To extend previous research in tobacco regulatory science on new media, we examined the bidirectional associations between self-reported exposure to and engagement with tobacco and nicotine products messaging on social media, and subsequent use of ENDS products one year later among a large, diverse sample of young adults. Results from cross-lagged panel analyses indicated that pro-tobacco/ENDS engagement and advertising exposure elevated risk whereas anti-tobacco/ENDS engagement decreased risk for the subsequent use of ENDS products one year later. On the other hand, the use of ENDS products positively predicted both pro- and anti-tobacco/ENDS engagement one year later. Findings provide empirical support for the reasoned action approach and the confirmation bias rooted in cognitive dissonance theory through rigorous longitudinal examination. Our findings not only point to the imperativeness of and offer guidance for regulating marketing information on social media, but also suggest social media as a promising platform to prevent young adults from initiating ENDS product use.

Motivations for nutrition information-seeking behavior among Belgian adults: a qualitative study

BACKGROUND

Nutrition information-seeking behavior is highly prevalent even though it can be challenging to find reliable nutrition information in the current media landscape. Previous quantitative research has identified which population segments use which sources, yet little is known about motivations underpinning nutrition information-seeking behavior. Understanding motivations for seeking nutrition information can increase the efficacy of future nutrition education efforts. The present study aims to identify motivations for nutrition information-seeking behavior among Belgian adults.

METHODS

In-depth qualitative interviews were conducted with 20 adults (n women = 15, n men = 4, n other = 1). Audio-recorded interviews were transcribed verbatim and analyzed in NVivo 12 using inductive thematic analysis. The coding process involved open and axial coding combined with constant comparison to identify themes.

RESULTS

The interviews revealed a diverse spectrum of motivations for nutrition information-seeking behavior. Five categories of motivations centered on health management, cognitive needs, affective needs, social integrative needs, and personal identity. Participants indicated seeking nutrition information to regain a sense of control over their health and it also helped them express their autonomy. Additionally, participants sought nutrition information out of curiosity or out of a long-standing interest. Nutrition information-seeking was also used as a form of emotion regulation with participants actively engaging in seeking behavior to pursue enjoyment, diversion, confirmation, inspiration, and even relaxation. Furthermore, nutrition information-seeking enabled participants to meet social integrative needs by helping them connect to others, gather social support, help others, and sometimes convince others. Lastly, participants indicated a need for nutrition information to express or defend their identity.

CONCLUSIONS

Our results indicate that beneath the surface of a more apparent need for nutrition information lies a range of motivations demonstrating that nutrition information serves more complex needs than simply information needs. To improve the efficacy of future nutrition education efforts, communication strategies must be tailored to a diverse range of motivations.

Health Disparities in Online COVID-19 Information Seeking and Protective Behaviors: A Two-Wave Longitudinal Study

The COVID-19 outbreak was declared a pandemic by the World Health Organization and claimed hundreds of thousands of lives in the U.S. However, the adoption of protective behaviors in response to COVID-19 varies among sociodemographic groups. To better understand the disparities in U.S. adults' adoption of protective behaviors in relation to sociodemographic factors, we conducted a two-wave panel survey in the U.S. Although sociodemographic factors were not found to be significant predictors in lagged regression analysis, results from a cross-sectional analysis showed that the White, younger, and higher educated individuals were more likely to take protective behaviors. Furthermore, based on the structural equation modeling, indirect effects were observed. Specifically, online COVID-19 information seeking mediated the effects of age and education on performance of protective behaviors, and subjective norms and online COVID-19 information seeking were found to be significant serial mediators of these relationships. The study not only extends the health disparities and health information seeking literature, but also offers practical insights to health campaigns and interventions promoting protective behaviors during a pandemic and reducing health disparities.

Cultural Differences in Cancer Information Acquisition: Cancer Risk Perceptions, Fatalistic Beliefs, and Worry as Predictors of Cancer Information Seeking and Avoidance in the U.S. and China

Cancer is one of the most common causes of death in China and the United States. Past studies found that cancer risk perceptions, fatalistic beliefs, and worry were prominent predictors of health-related behaviors. Perceived cancer risks, fatalistic beliefs, and worry were associated with cancer information acquisition in the United States. However, little is known about whether these factors played comparable roles in China. This study investigates the psychological antecedents of cancer information acquisition using data from Health Information National Trends Surveys (HINTS) in both countries. Results showed that cancer worry was negatively related to cancer information avoidance in the U.S. but positively related to information avoidance in China. Also, whereas cancer fatalistic beliefs were negatively associated with cancer information seeking in the U.S., the relationships between fatalistic beliefs and cancer information seeking exhibited more complex patterns in China. Implications for cancer communication in different cultures are discussed.

Understanding Health Information Behaviors of Migrant Domestic Workers during the COVID-19 Pandemic

Migrant domestic workers (MDWs) in Hong Kong remain vulnerable during the COVID-19 pandemic. Obtaining accurate information is essential for MDWs as it helps them understand their predicament and protect themselves. Therefore, this study delves into the MDWs' health literacy by scrutinizing how they acquire, verify, and respond to pandemic-related information. Semi-structured interviews were conducted with 32 Indonesian MDWs, recruited through purposive and snowball sampling. The data were examined using a constant comparative approach in grounded theory. The findings reveal that the participants engaged in information seeking and scanning to obtain health crisis information, mainly through their friends, family members, and community organizations. The participants also verified the information using their judgment or by consulting other actors, such as local organizations and media outlets. The messages they obtained informed the means to protect themselves, which motivated them to adopt preventive measures. However, some also engaged in maladaptive coping, such as taking ineffective preventive actions. The participants also disseminated health crisis information throughout their social circle. This study concluded that MDWs performed four health information behaviors during the pandemic, namely information acquisition, authentication, sharing, and adoption of preventive measures. However, their information practices may change at different stages of the pandemic.

Initial Stage of the COVID-19 Pandemic: A Perspective on Health Risk Communications in the Restaurant Industry

Restaurant online review websites have made changes to adapt to customers' shifting needs during the COVID-19 crisis. Based on information behavior theory and social penetration theory, the present study investigated the changes in customers' emotions and how the volume of online reviews as an indication of sales is impacted by the instructional (i.e., with quantitative variables) and emotional (i.e., with qualitative variables) information on review websites. By comparing the same month (January-April) during 2017-2020, positive sentiment experienced a plunge, while negative sentiment showed an upsurge in April 2020. The volume of reviews was impacted by five quantitative variables (i.e., confirmed COVID-19 case number, food delivery option, takeout option, delivery fee, and delivery time) and seven qualitative variables (i.e., anticipation, fear, trust, anger, disgust, joy, and sadness). This study provides new insight into understanding information content on review websites during the crisis (e.g., pandemic) from the perspective of health risk communication.

Pathway linking health information behaviors to mental health condition during the COVID-19 infodemic: A moderated mediation analysis

Background

The COVID-19 outbreak is no longer a pure epidemiological concern but a true digital infodemic. Numerous conflicting information and misinformation occupy online platforms and specifically social media. While we have lived in an infodemic environment for more than 2 years, we are more prone to feel overwhelmed by the information and suffer from long-term mental health problems. However, limited research has concentrated on the cause of these threats, particularly in terms of information processing and the context of infodemic.

Objective

This study proposed and tested moderated mediation pathways from two types of health information behaviors (social media engagement and interpersonal communication) on information overload and mental health symptoms-long-term stress.

Methods

We conducted a cross-sectional online survey between May and June of 2021 among the Malaysian public. The final sample size was 676 (N = 676). A conceptual model was built to guide the data analysis. We conducted structural equation modeling (SEM), moderation and mediation analyses to examine each direct pathway, moderating and mediating effects.

Results

According to the pathway analysis, we found that, during the infodemic period, engaging COVID-19 information on social media positively associated with information overload, but interpersonal communication was negatively related to it. As the proximal outcome, there was also a positive association between information overload and the final outcome, perceived stress. The moderation analysis only reported one significant interaction: risk perception weakened the association between social media engagement and information overload. A conditional indirect effect was demonstrated and the indirect associated between social media engagement and perceived stress mediated through information overload was further moderated by COVID-19 risk perception.

Conclusion

This research offers new grounds for understanding health information behaviors and their consequences in the COVID-19 infodemic. We particularly highlighted the distinct functions of health information behaviors in causing information overload, as well as the importance of personal health belief in this process. Our proposed model contributes to the strategies of developing health messaging strategies that may be utilized by public health researchers and health educators in the future.

When Engagement Leads to Action: Understanding the Impact of Cancer (Mis)information among Latino/a Facebook Users

Latinos/as - the largest minority group in the U.S. - are avid Facebook users, making this an opportune tool to educate on the uptake of cancer prevention and screening behaviors. However, there is a dearth in scholarship exploring how Latinos/as engage with and act upon health content encountered on social media, which may be influenced by cultural values. This qualitatively-driven, mixed-methods study explores how Latinos/as engage with and act upon cancer prevention and screening information (CPSI) on Facebook. During one-on-one, in-depth interviews, participants (n = 20) logged onto their Facebook account alongside the researcher and discussed cancer-related posts they engaged with during the past 12 months. Interview questions included the reasons for engagement, and whether engagement triggered further action. Interviews were analyzed thematically. In parallel, a content analysis of the CPSI posts identified during the interviews was conducted. The majority of CPSI posts participants engaged with contained food-related content and visual imagery. Engagement was most common when individuals had personal relationships to the poster, when posts included videos/images, and when posts contained content promoting the curative properties of popular Latin American foods. Engagement often led to information-seeking and sharing, discussing content with others, and/or changing health behaviors. Findings highlight the importance of adequately contextualizing how cultural values influence the ways in which Latinos/as engage with and act upon CPSI on Facebook, which may lead individuals to bypass evidence-based procedures. Multi-pronged efforts are necessary to adequately leverage social media to empower Latinos/as to partake in behaviors that effectively reduce cancer health disparities.

COVID-19 Vaccine-related Information Seeking and Scanning: A Test of Mediators between Information Acquisition and Vaccination Intention among Unvaccinated Black Americans

Health information seeking and scanning are two important information acquisition strategies that can influence subsequent health behaviors. This research was contextualized in COVID-19 vaccinations and examined the effects of information seeking and scanning on vaccination intention among unvaccinated Black Americans (N = 1,278). Moreover, this research conceptualized perceived risk and efficacy as the intervening factors for the relationship between information acquisition and behavioral intention. The results indicated that information seeking had a significant effect on vaccination intention, whereas information scanning had no effect. Perceived susceptibility and response efficacy mediated the relationship between information seeking and vaccination intention. The proposed mediators did not mediate the relationship between information scanning and vaccination intention. Theoretical and practical implications are offered.

Wear or Not to Wear a Mask? Recommendation Inconsistency, Government Trust and the Adoption of Protection Behaviors in Cross-Lagged TPB Models

This study examined how exposure to government health advisories on face mask-wearing and trust in government influenced people's compliance with the advisory overtime. We conducted a three-wave panel survey (N = 1,024; T1 in February, T2 in March, T3 in April 2020) in Singapore, where the government initially enforced wearing a face mask conditional on feeling sick, and then later revised its advisory to make mask-wearing mandatory regardless of sickness. Exposure to the initial advisory at T1 had cross-lagged effects on forming positive expectancy, normative, and self-efficacy beliefs on conditional face mask-wearing at T2. Government trust at T1 also had a cross-lagged effect on increasing supportive perceived norm for conditional mask-wearing, while reducing positive expectancy of nonconditional mask-wearing at T2. Exposure to the revised advisory and government trust at T3 were positively associated with outcome expectancy, perceived norm, and self-efficacy regardless of behavior type. Regarding nonconditional mask-wearing, the autoregressive links from T2 to T3 were insignificant for perceived norm and self-efficacy and even negatively significant for intention and behavior. This study offers theoretical and practical insights by documenting the complex and dynamic processes involved in health decision-making during a novel disease pandemic.

Pandemics and Politics: Analyzing the Politicization and Polarization of Pandemic-Related Reporting

The COVID-19 pandemic generated tremendous journalistic attention, and occurred during a period of increasing politicization and polarization in America’s news media. This study considers the intersection of both phenomena, and the extent of politicization in recent and historical pandemic-related reporting. Results suggest that political topics, actions and actors have frequently been the focus of COVID-19-related reporting, and that such political content has grown more substantial over time.

Associations Between COVID-19 Information Acquisition and Vaccination Intention: The Roles of Anticipated Regret and Collective Responsibility

While public health communication has been suggested to be a key for improving acceptance of COVID-19 vaccination, this study tested mediation pathways through which three types of vaccine information acquisition, i.e. seeking, scanning, and discussing, affect COVID-19 vaccination intention. The pathways comprise two mediators, i.e. anticipated regret due to inaction and collective responsibility. Results suggest that information seeking and discussing may have encouraged the intention to get vaccinated, but mainly indirectly through the two mediators. Information seeking and discussing may have elicited anticipated regret and collective responsibility, which in turn increased vaccination intention. The paths from information scanning were smaller in effect sizes and statistically unacknowledged. Implications and limitations are discussed.

Information Scanning Impacts Nonmedical Drug Use Among College Students: A Longitudinal Study of Scanning Effects

Health information that is acquired through information scanning has been shown to play an important role in shaping individual beliefs and health behavior. This study examines the direct and indirect effects of the breadth of scanning from media and interpersonal sources about two risk behaviors (nonmedical use of amphetamines and marijuana) on subsequent drug use behavior through changes to perceived norms. We test effects of scanning using a longitudinal online survey design with data collected at six-month intervals over three time points among 800 Israeli undergraduate students in their freshman year. Of the 800 respondents who participated in the first wave, 62.4% completed the second wave (N = 499), among which 347 (69.5%) completed a follow-up 6 months later. Results of cross-lagged structural equation models find that scanning information about amphetamines from interpersonal sources at 6 months predicted an increased likelihood of nonmedical use of amphetamines at 12-months. In addition, young adults who scanned information about marijuana from media sources at 6 months reported greater nonmedical marijuana use at 12 months. Breadth of scanning about marijuana from media sources mediated the relationship between perceived norms and marijuana use at 12 months. Results also showed indirect effects of scanning at baseline on nonmedical drug use at 12 months through scanning from the same source at 6 months. These findings contribute to our understanding of the role of information scanning and perceived norms in shaping substance use behaviors, and suggest that scanning may serve as a potential early indicator of risk.

Consequences of Online Misinformation on COVID-19: Two Potential Pathways and Disparity by eHealth Literacy

The COVID-19 pandemic poses an unprecedented threat to global human wellbeing, and the proliferation of online misinformation during this critical period amplifies the challenge. This study examines consequences of exposure to online misinformation about COVID-19 preventions. Using a three-wave panel survey involving 1,023 residents in Singapore, the study found that exposure to online misinformation prompts engagement in self-reported misinformed behaviors such as eating more garlic and regularly rinsing nose with saline, while discouraging evidence-based prevention behaviors such as social distancing. This study further identifies information overload and misperception on prevention as important mechanisms that link exposure to online misinformation and these outcomes. The effects of misinformation exposure differ by individuals' eheath literacy level, suggesting the need for a health literacy education to minimize the counterproductive effects of misinformation online. This study contributes to theory-building in misinformation by addressing potential pathways of and disparity in its possible effects on behavior.

Beyond Dr. Google: Health information seeking from an intelligent online symptom checker: Cross-Sectional Questionnaire Study (Preprint)

Background

The ever-growing amount of health information available on the web is increasing the demand for tools providing personalized and actionable health information. Such tools include symptom checkers that provide users with a potential diagnosis after responding to a set of probes about their symptoms. Although the potential for their utility is great, little is known about such tools’ actual use and effects.

Objective

We aimed to understand who uses a web-based artificial intelligence–powered symptom checker and its purposes, how they evaluate the experience of the web-based interview and quality of the information, what they intend to do with the recommendation, and predictors of future use.

Methods

Cross-sectional survey of web-based health information seekers following the completion of a symptom checker visit (N=2437). Measures of comprehensibility, confidence, usefulness, health-related anxiety, empowerment, and intention to use in the future were assessed. ANOVAs and the Wilcoxon rank sum test examined mean outcome differences in racial, ethnic, and sex groups. The relationship between perceptions of the symptom checker and intention to follow recommended actions was assessed using multilevel logistic regression.

Results

Buoy users were well-educated (1384/1704, 81.22% college or higher), primarily White (1227/1693, 72.47%), and female (2069/2437, 84.89%). Most had insurance (1449/1630, 88.89%), a regular health care provider (1307/1709, 76.48%), and reported good health (1000/1703, 58.72%). Three types of symptoms—pain (855/2437, 35.08%), gynecological issues (293/2437, 12.02%), and masses or lumps (204/2437, 8.37%)—accounted for almost half (1352/2437, 55.48%) of site visits. Buoy’s top three primary recommendations split across less-serious triage categories: primary care physician in 2 weeks (754/2141, 35.22%), self-treatment (452/2141, 21.11%), and primary care in 1 to 2 days (373/2141, 17.42%). Common diagnoses were musculoskeletal (303/2437, 12.43%), gynecological (304/2437, 12.47%) and skin conditions (297/2437, 12.19%), and infectious diseases (300/2437, 12.31%). Users generally reported high confidence in Buoy, found it useful and easy to understand, and said that Buoy made them feel less anxious and more empowered to seek medical help. Users for whom Buoy recommended “Waiting/Watching” or “Self-Treatment” had strongest intentions to comply, whereas those advised to seek primary care had weaker intentions. Compared with White users, Latino and Black users had significantly more confidence in Buoy (P<.05), and the former also found it significantly more useful (P<.05). Latino (odds ratio 1.96, 95% CI 1.22-3.25) and Black (odds ratio 2.37, 95% CI 1.57-3.66) users also had stronger intentions to discuss recommendations with a provider than White users.

Conclusions

Results demonstrate the potential utility of a web-based health information tool to empower people to seek care and reduce health-related anxiety. However, despite encouraging results suggesting the tool may fulfill unmet health information needs among women and Black and Latino adults, analyses of the user base illustrate persistent second-level digital divide effects.

What users seek and share in online diabetes communities: examining similarities and differences in expressions and themes

Purpose

This paper aims to investigate user health information seeking and sharing patterns and content in an online diabetes community and explore the similarities and differences in the ways and themes they expressed.

Design/methodology/approach

Multiple methods are applied to analyze the expressions and themes that users seek and share based on large-scale text data in an online diabetes community. First, a text classifier using deep learning method is performed based on the expression category this study developed. Second, statistical and social network analyses are used to measure the popularity and compare differences between expressions. Third, topic modeling, manual coding and similarity analysis are used to mining topics and thematic similarity between seeking and sharing threads.

Findings

There are four different ways users seek and share in online health communities (OHCs) including informational seeking, situational seeking, objective information sharing and experiential information sharing. The results indicate that threads with self-disclosure could receive more replies and attract more users to contribute. This study also examines the 10 topics that were discussed for information seeking and 14 topics for information sharing. They shared three discussion themes: self-management, medication and symptoms. Information about symptoms can be largely matched between seeking and sharing threads while there is less overlap in self-management and medication categories.

Originality/value

Being different from previous studies that mainly describe one type of health information behavior, this paper analyzes user health information seeking and sharing behaviors in OHCs and investigates whether there is a correspondence or discrepancy between expressions and information users spontaneously seek and share in OHCs.