Celebrity Health Announcements and Online Health Information Seeking: An Analysis of Angelina Jolie's Preventative Health Decision

Media exposure, trustworthiness of sources and the health information literacy knowledge gap: a study in China

Health information literacy (HIL), as an essential part of the wellbeing of citizens, is a crucial indicator used to measure a country's primary public health level. The present study collected 1051 samples in southern China to examine the factors predicting HIL. The results showed that males, those less educated, and older adults had lower HIL. Television exposure, unofficial Internet exposure, trust in government and trust in doctors and medical institutions were positively associated with HIL. In contrast, newspapers, radio exposure and trust in web celebrities were negatively associated with HIL. Official Internet media exposure helps to bridge the HIL knowledge gap generated by differences in education level, while trust in celebrities-especially web celebrities-could widen the HIL knowledge gap. This study extends the knowledge gap theory in health communication in the Chinese context and provides pathways for future health interventions.

The Boseman Effect: A Missed Opportunity?

Introduction

Public figures, namely celebrities, are highly influential people whose actions and thoughts are often emulated, especially regarding healthcare. Understanding trends in public interest may provide an opportunity for further patient education. Given the changes of the COVID-19 pandemic along with the highly publicized death of actor Chadwick Boseman, who died from complications of colon cancer, we analyzed trends in colon cancer searches over a 15-month period.

Methods

Google Trends (Google, Mountain View, California) was used to access search histories in the United States from January 1, 2020, through April 30, 2021. Four search terms were analyzed: “colon cancer”, “colonoscopy”, “Cologuard”, and “virtual colonoscopy”. Google Trends reports data as relative search volume (RSV), a scaled number from 0-100 reflecting interest in a particular search term over a set time. Search terms were analyzed on the same RSV scale with one-way ANOVAs comparing search volumes during four eight-week blocks.

Results

Google Trends data was reported weekly. Search volume for colon cancer was higher (17.3, p=0.00) over the eight weeks following Boseman’s death, while search volume for colonoscopy returned to normal (21.5, p=0.95) when compared to pre-pandemic levels.

Conclusion

The peak in colon cancer searches in late August of 2020 corresponds to the death of Chadwick Boseman on 8/28/2020. Colonoscopy interest decreased during the COVID-19 pandemic before returning to previous levels around the time of Boseman’s death without experiencing the same spike in interest. This discrepancy represents a missed opportunity for patient education on this preventable disease.

Out-of-pocket and private pay in clinical genetic testing: A scoping review

Full coverage of the cost of clinical genetic testing is not always available through public or private insurance programs, or a public healthcare system. Consequently, some patients may be faced with the decision of whether to finance testing out-of-pocket (OOP), meet OOP expenses required by their insurer, or not proceed with testing. A scoping review was conducted to identify literature associated with patient OOP and private pay in clinical genetic testing. Seven databases (EMBASE, MEDLINE, CINAHL, PsychINFO, PAIS, the Cochrane Database of Systematic Reviews, and the JBI Evidence-Based Practice database) were searched, resulting in 83 unique publications included in the review. The presented evidence includes a descriptive analysis, followed by a narrative account of the extracted data. Results were divided into four groups according to clinical indication: (1) hereditary breast and ovarian cancer, (2) other hereditary cancers, (3) prenatal testing, (4) other clinical indications. The majority of studies focused on hereditary cancer and prenatal genetic testing. Overall trends indicated that OOP costs have fallen and payer coverage has improved, but OOP expenses continue to present a barrier to patients who do not qualify for full coverage.

A scoping review of social and behavioral science research to translate genomic discoveries into population health impact

Since the completion of the Human Genome Project, progress toward translating genomic research discoveries to address population health issues has been limited. Several meetings of social and behavioral scientists have outlined priority research areas where advancement of translational research could increase population health benefits of genomic discoveries. In this review, we track the pace of progress, study size and design, and focus of genomics translational research from 2012 to 2018 and its concordance with five social and behavioral science recommended priorities. We conducted a review of the literature following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Guidelines for Scoping Reviews. Steps involved completing a search in five databases and a hand search of bibliographies of relevant literature. Our search (from 2012 to 2018) yielded 4,538 unique studies; 117 were included in the final analyses. Two coders extracted data including items from the PICOTS framework. Analysis included descriptive statistics to help identify trends in pace, study size and design, and translational priority area. Among the 117 studies included in our final sample, nearly half focused on genomics applications that have evidence to support translation or implementation into practice (Centers for Disease Control and Prevention Tier 1 applications). Common study designs were cross-sectional (40.2%) and qualitative (24.8%), with average sample sizes of 716 across all studies. Most often, studies addressed public understanding of genetics and genomics (33.3%), risk communication (29.1%), and intervention development and testing of interventions to promote behavior change (19.7%). The number of studies that address social and behavioral science priority areas is extremely limited and the pace of this research continues to lag behind basic science advances. Much of the research identified in this review is descriptive and related to public understanding, risk communication, and intervention development and testing of interventions to promote behavior change. The field has been slow to develop and evaluate public health-friendly interventions and test implementation approaches that could enable health benefits and equitable access to genomic discoveries. As the completion of the human genome approaches its 20th anniversary, full engagement of transdisciplinary efforts to address translation challenges will be required to close this gap.

Talking about Decisions: The Facilitating Effect of a Celebrity Health Announcement on the Communication of Online Personal Experiences around Decision-making

This study examines how posters on an online forum discussed their own current and past decision-making in response to a celebrity health announcement. We examined messages in response to a celebrity narrative, and extracted those explicitly related to decision-making around genetic testing and preventative surgery. Using deductive coding we identified different types of decision-making narratives, and with inductive coding we examined how users discussed decision-making activities. Guided by the literature on narrative content types in decision-making, and on celebrity health narratives, we found that the celebrity decision announcement facilitated social sharing in relation to two key decision-making activities. First, identifying with the celebrity allowed people to reflect and compare their own personal health circumstances. This empowered readers to appraise and select options about their current decision-making regarding preventative surgery. Second, the announcement allowed an extension of the discussion beyond the celebrity, and acted as a catalyst encouraging other people to share their own previous decision-making experiences. These experiences contained a mix of narratives content types, and provided an opportunity for posters to evaluate their decisions, and to contribute to a repository of decision-making examples for others. Health narratives act as communication devices in decision-making, and we discuss the findings in relation to the extension of the educational and persuasive function of celebrity health narratives.

Celebrity Politicians as Health-Promoting Role Models in the Media: the Cases of Vladimir Putin, Donald Trump, and Benjamin Netanyahu

In recent years, scholars have increasingly revealed the importance of celebrities in society, among them celebrity politicians. These celebrities not only influence political attitudes but also serve as role models for many individuals. Yet, little is known regarding what types of role models' politicians serve as in the context of health. To fill this gap, we examined three influential contemporary political leaders: Vladimir Putin, Donald Trump and Benjamin Netanyahu, and the type of mediated role models each possibly comprise in the context of healthy living. By conducting a qualitative content analysis, we analyzed 90 articles from 2018 to 2019 from two leading newspapers in each of the three politician's countries, namely Russia, the USA, and Israel as well as the respective politician's Facebook pages. Our findings point to three types of potential role models' as political leaders: a health-promoting model (Putin), a hybrid model (Trump), and a model of non-existence (Netanyahu), as the literature points to mediated role models influencing individuals' beliefs and behaviors. This study contributes to the understanding of mediated types of role models' politicians potentially serve as in the context of health vital to people's personal health.

Researching Experiences of Cancer Risk Through Online Blogs: A Reflexive Account of Working Toward Ethical Practice

By providing space to document personal narratives and hold virtual discussions, the Internet represents a fruitful resource for sociologists of health and illness. However, the use of social media content for research entails complex ethical considerations. Due to the fluidity of online material, existing ethical guidelines advise a deliberative approach. However, this has led to disparity in the use of social media resources within the social sciences. I share an account of "doing ethics" for qualitative research with blogs focused on hereditary cancer risk. Blogging emerged not only as cathartic for authors, but also a means of accessing support. Blogs may thus be construed as constitutive and not only representative of cancer (risk) experience. Ethical questions surround anonymity and the appropriation of authors' accounts beyond the context in which they are composed. By sharing reflections on working with hereditary cancer risk blogs, I contribute to the continued reflexivity of social media researchers.

The Effect of Media Coverage of Celebrities with Panic Disorder on the Health Behaviors of the Public

Although having a mental illness has become common, many people tend to hide their illness and avoid seeking treatment. One of the reasons for not seeking treatment is the stigma of mental illness. Celebrity confessions about their experiences of mental illness can reduce such stigma, because the public obtains more knowledge about the illness and becomes more familiar with it. However, little research has been conducted on the influence of a celebrity's confession about mental illness on the public's health behaviors related to the illness. The present study examined the effects of the media coverage of celebrities with panic disorder on information-seeking, providing information about the illness, and the number of people who visited a psychiatrist in South Korea. For this, we collected all the news articles on celebrities' confessions regarding their panic disorder, search frequency of panic disorder, the number of questions on a Questions & Answers (Q&A) Website, a number of blog posts about panic disorder, and the number of people that visited a psychiatrist for panic disorder between 2010 and 2015. We found that there were positive correlations between the media's coverage of celebrities with panic disorder with other variables. In addition, the search frequency and the number of questions on the Q&A Website were also positively associated with the number of people who visited a psychiatrist. Regression analysis showed that the search frequency was the most significant predictor of the increase in the number of people who visited a psychiatrist for panic disorder.

Mental Health-Related Outcomes of Robin Williams' Death: The Role of Parasocial Relations and Media Exposure in Stigma, Help-Seeking, and Outreach

This study explores responses to the death of actor/comedian Robin Williams, focusing on the role of celebrity attachment and exposure to media coverage following his suicide. A total of 350 respondents recruited on Mechanical Turk completed an online survey. Participants who had a stronger parasocial relationship with Williams reported lower social distance from people with depression, greater willingness to seek treatment for depression, and more frequent outreach to other people with depression or suicidal thoughts following his death. Exposure to media coverage of suicide/depression - both informational and stigmatizing - was associated with more frequent outreach to others, but only informational coverage was related to greater willingness to seek treatment. Stigmatizing media exposure was related to greater depression stereotypes. Seeing more media stories celebrating Williams' life and career was associated with reduced depression stigma but also with less willingness to seek treatment for depression and less outreach to others. Implications of the findings for media and mental health are discussed.

Trends in Use of Risk-Reducing Mastectomy in a Context of Celebrity Decisions and Media Coverage: An Observational Study in the United States and Australia

OBJECTIVE

To examine trends in risk-reducing mastectomy (RRM) and immediate breast reconstruction in New York State and New South Wales, especially before and after Angelina Jolie's announcement of her surgery in 2013.

DATA SOURCE

Hospital discharge data, 2004-2014.

STUDY DESIGN

Trends in procedures were assessed using Poisson regression and the Cochrane-Armitage test.

DATA EXTRACTION METHODS

Extracted using procedure codes.

PRINCIPAL FINDINGS

There was an increase in RRM procedures after May 2013 in both regions, with a peak during late 2013-early 2014. The average bimonthly RRM procedures were significantly higher after Jolie's announcement than before.

CONCLUSIONS

In both countries, we found a substantial increase of RRM after Jolie's announcement, highlighting the impact of celebrity health care coverage on preventive surgical choice and the need for decision aids to assist patients.

Identity, community and care in online accounts of hereditary colorectal cancer syndrome

Sociological literature has explored how shifts in the point at which individuals may be designated as diseased impact upon experiences of ill health. Research has shown that experiences of being genetically "at risk" are shaped by and shape familial relations, coping strategies, and new forms of biosociality. Less is known about how living with genetic risk is negotiated in the everyday and over time, and the wider forms of identity, communities and care this involves. This article explores these arrangements drawing on online bloggers' accounts of Familial Adenomatous Polyposis (FAP). We show how accounts of genetic risk co-exist with more palpable experiences of FAP in everyday life, notably the consequences of prophylactic surgeries. We consider how the act of blogging represents but also constitutes everyday experiences of hereditary cancer syndrome as simultaneously ordinary and exceptional, and reflect on the implications of our analysis for understanding experiences of genetic cancer risk.

Relationship Between State-Level Google Online Search Volume and Cancer Incidence in the United States: Retrospective Study

Background

In the United States, cancer is common, with high morbidity and mortality; cancer incidence varies between states. Online searches reflect public awareness, which could be driven by the underlying regional cancer epidemiology.

Objective

The objective of our study was to characterize the relationship between cancer incidence and online Google search volumes in the United States for 6 common cancers. A secondary objective was to evaluate the association of search activity with cancer-related public events and celebrity news coverage.

Methods

We performed a population-based, retrospective study of state-level cancer incidence from 2004 through 2013 reported by the Centers for Disease Control and Prevention for breast, prostate, colon, lung, and uterine cancers and leukemia compared to Google Trends (GT) relative search volume (RSV), a metric designed by Google to allow interest in search topics to be compared between regions. Participants included persons in the United States who searched for cancer terms on Google. The primary measures were the correlation between annual state-level cancer incidence and RSV as determined by Spearman correlation and linear regression with RSV and year as independent variables and cancer incidence as the dependent variable. Temporal associations between search activity and events raising public awareness such as cancer awareness months and cancer-related celebrity news were described.

Results

At the state level, RSV was significantly correlated to incidence for breast (r=.18, P=.001), prostate (r=–.27, P<.001), lung (r=.33, P<.001), and uterine cancers (r=.39, P<.001) and leukemia (r=.13, P=.003) but not colon cancer (r=–.02, P=.66). After adjusting for time, state-level RSV was positively correlated to cancer incidence for all cancers: breast (P<.001, 95% CI 0.06 to 0.19), prostate (P=.38, 95% CI –0.08 to 0.22), lung (P<.001, 95% CI 0.33 to 0.46), colon (P<.001, 95% CI 0.11 to 0.17), and uterine cancers (P<.001, 95% CI 0.07 to 0.12) and leukemia (P<.001, 95% CI 0.01 to 0.03). Temporal associations in GT were noted with breast cancer awareness month but not with other cancer awareness months and celebrity events.

Conclusions

Cancer incidence is correlated with online search volume at the state level. Search patterns were temporally associated with cancer awareness months and celebrity announcements. Online searches reflect public awareness. Advancing understanding of online search patterns could augment traditional epidemiologic surveillance, provide opportunities for targeted patient engagement, and allow public information campaigns to be evaluated in ways previously unable to be measured.

Twitter and Non-Elites: Interpreting Power Dynamics in the Life Story of the (#)BRCA Twitter Stream

In May 2013 and March 2015, actress Angelina Jolie wrote in the New York Times about her choice to undergo preventive surgery. In her two op-eds, she explained that - as a carrier of the BRCA1 gene mutation - preventive surgery was the best way to lower her heightened risk of developing breast and ovarian cancer. By applying a digital methods approach to BRCA-related tweets from 2013 and 2015, before, during, and after the exposure of Jolie's story, this study maps and interprets Twitter discursive dynamics at two time points of the BRCA Twitter stream. Findings show an evolution in curation and framing dynamics occurring between 2013 and 2015, with individual patient advocates replacing advocacy organizations as top curators of BRCA content and coming to prominence as providers of specialist illness narratives. These results suggest that between 2013 and 2015, Twitter went from functioning primarily as an organization-centered news reporting mechanism, to working as a crowdsourced specialist awareness system. This article advances a twofold contribution. First, it points at Twitter's fluid functionality for an issue public and suggests that by looking at the life story-rather than at a single time point-of an issue-based Twitter stream, we can track the evolution of power roles underlying discursive practices and better interpret the emergence of non-elite actors in the public arena. Second, the study provides evidence of the rise of activist cultures that rely on fluid, non-elite, collective, and individual social media engagement.

Ovarian Cancer and BRCA1/2 Testing: Opportunities to Improve Clinical Care and Disease Prevention

Without prevention or screening options available, ovarian cancer is the most lethal malignancy of the female reproductive tract. High-grade serous ovarian cancer (HGSOC) is the most common histologic subtype, and the role of germline BRCA1/2 mutation in predisposition and prognosis is established. Given the targeted treatment opportunities with PARP inhibitors, a predictive role for BRCA1/2 mutation has emerged. Despite recommendations to provide BRCA1/2 testing to all women with histologically confirmed HGSOC, uniform implementation remains challenging. The opportunity to review and revise genetic screening and testing practices will identify opportunities, where universal adoption of BRCA1/2 mutation testing will impact and improve treatment of women with ovarian cancer. Improving education and awareness of genetic testing for women with cancer, as well as the broader general community, will help focus much-needed attention on opportunities to advance prevention and screening programs in ovarian cancer. This is imperative not only for women with cancer and those at risk of developing cancer but also for their first-degree relatives. In addition, BRCA1/2 testing may have direct implications for patients with other types of cancers, many of which are now being found to have BRCA1/2 involvement.