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Schuster AM, Ghaiumy Anaraky R, Cotten SR. Online health information seeking and the association with anxiety among older adults. Front Public Health 2023; 11:1076571. [PMID: 36844827 PMCID: PMC9950410 DOI: 10.3389/fpubh.2023.1076571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 01/24/2023] [Indexed: 02/12/2023] Open
Abstract
Introduction The Internet supplies users with endless access to a wealth of information and is generally the first source searched by U.S. adults (18 years and older) when seeking health information. Age and anxiety are associated with online health information seeking (OHIS). Older adults (65 years and older) are increasing their OHIS. Importantly, OHIS can potentially lead to improved health outcomes for older adults. The relationship between OHIS and anxiety is less clear. Studies report those with more symptoms of anxiety are more likely to be OHIS, while other studies find the reverse pattern or no association. Generalized anxiety disorder affects up to 11% of older adults and is oftentimes unrecognized and untreated. Methods To address the mixed findings in the literature, we analyzed six waves (2015-2020) of data from the National Health and Aging Trends Study to assess the causal relationship between anxiety and OHIS using a Random Intercept Cross-lagged Panel Model framework. Results We found that while anxiety symptoms lead to OHIS in the next wave, OHIS was not associated with anxiety symptoms in the next wave. Discussion This suggests that for this sample of older adults, OHIS does not reduce or exacerbate older adults' symptoms of anxiety.
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Affiliation(s)
- Amy M. Schuster
- Department of Sociology, Anthropology and Criminal Justice, Clemson University, Clemson, SC, United States,*Correspondence: Amy M. Schuster ✉
| | - Reza Ghaiumy Anaraky
- Department of Technology Management and Innovation, Tandon School of Engineering, New York University, New York City, NY, United States
| | - Shelia R. Cotten
- Department of Sociology, Anthropology and Criminal Justice, Clemson University, Clemson, SC, United States,Department of Communication, Clemson University, Clemson, SC, United States
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Baxter K, Czarnecka B, Schivinski B, Massaro MR. Masculine men do not like feminine wording: The effectiveness of gendered wording in health promotion leaflets in the UK. PLoS One 2022; 17:e0273927. [PMID: 36301843 PMCID: PMC9612536 DOI: 10.1371/journal.pone.0273927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 08/17/2022] [Indexed: 11/07/2022] Open
Abstract
Following mixed-methods sequential design and drawing on the message-audience congruence concept and homophily theory, across three studies in the UK, we examined the effect of gendered wording and endorser’s gender on the effectiveness of leaflets promoting walking. In Study 1, a mall-intercept study achieved 247 completed questionnaires. Results demonstrated that men and women indicated the highest behavioural intentions for communal wording presented by a male endorser. However, pairwise comparisons revealed that when the wording of the advert was agentic and the endorser was male, males indicated significantly higher scores of behavioural intentions compared with females. Attitude towards the ad for women was highest for communal wording/female endorser; for men it was for agentic wording/male endorser. In Study 2, consumers’ views towards the gendered content were explored in 20 semi-structured interviews. In study 3 we examined the impact of the respondent’s gender role identity on gendered content effectiveness. Overall, when controlled for level of gender role identity, only masculine males evaluated leaflets featuring communal wording negatively which suggests that wording matters only for masculine males, but not for other men and women. Theoretically, we identified that gender-based message-respondent congruence is not a necessary aspect of communications to be effective, except for one group: masculine males. Our study identified dominant gender role identity as a factor that explained respondents’ preferences for presented stimuli. Specifically, males who display masculine gender role identity differ in evaluations of communal wording from all other groups. Social and commercial marketers who target men and women with exercise-related services should consider the use of agentic wording endorsed by a male endorser when targeting masculine men to increase the likelihood of eliciting positive attitudes towards the communication. However, such distinctions should not be associated with differences in women’s evaluations or men who do not report masculine gender role identity.
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Affiliation(s)
- Katherine Baxter
- Department of Business Management and Marketing, Liverpool Hope University, Liverpool, United Kingdom
| | - Barbara Czarnecka
- Division of Management, Marketing and People, London South Bank University, London, United Kingdom
- * E-mail:
| | - Bruno Schivinski
- School of Media and Communication, RMIT University, Melbourne, Australia
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Online Health Information-Seeking Behavior Among Korean American Immigrants in Rural Alabama: Dose Discrimination Matter? J Immigr Minor Health 2021; 24:996-1004. [PMID: 34837591 DOI: 10.1007/s10903-021-01317-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2021] [Indexed: 10/19/2022]
Abstract
Little attention has been paid to online health information seeking (OHIS) among immigrants residing in rural areas. This study examines the intensity of OHIS among Korean American (KA) immigrants living in rural Alabama. A total number of 261 KA immigrants aged 23 to 75 participated in the study. Multiple linear regression analyses were conducted. Age (B = - 0.044, p < 0.05), marital status (B = 1.132, p < 0.05), race/ethnic discrimination (B = 0.821, p < 0.05), having computer or tablet (B = 1.286, p < 0.05), and access to internet (B = 1.778, p < 0.01) were associated with the intensity of OHIS. Substantial efforts should be devoted to narrowing the access gap by providing offline health information services for those without internet access and with limited health literacy. Moreover, culturally competent healthcare services and information should be provided to serve racial/ethnic minority populations better.
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Zahnd WE, Askelson N, Vanderpool RC, Stradtman L, Edward J, Farris PE, Petermann V, Eberth JM. Challenges of using nationally representative, population-based surveys to assess rural cancer disparities. Prev Med 2019; 129S:105812. [PMID: 31422226 PMCID: PMC7289622 DOI: 10.1016/j.ypmed.2019.105812] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 08/08/2019] [Accepted: 08/14/2019] [Indexed: 12/16/2022]
Abstract
Population-based surveys provide important information about cancer-related health behaviors across the cancer care continuum, from prevention to survivorship, to inform cancer control efforts. These surveys can illuminate cancer disparities among specific populations, including rural communities. However, due to small rural sample sizes, varying sampling methods, and/or other study design or analytical concerns, there are challenges in using population-based surveys for rural cancer control research and practice. Our objective is three-fold. First, we examined the characterization of "rural" in four, population-based surveys commonly referenced in the literature: 1) Health Information National Trends Survey (HINTS); 2) National Health Interview Survey (NHIS); 3) Behavioral Risk Factor Surveillance System (BRFSS); and 4) Medical Expenditures Panel Survey (MEPS). Second, we identified and described the challenges of using these surveys in rural cancer studies. Third, we proposed solutions to address these challenges. We found that these surveys varied in use of rural-urban classifications, sampling methodology, and available cancer-related variables. Further, we found that accessibility of these data to non-federal researchers has changed over time. Survey data have become restricted based on small numbers (i.e., BRFSS) and have made rural-urban measures only available for analysis at Research Data Centers (i.e., NHIS and MEPS). Additionally, studies that used these surveys reported varying proportions of rural participants with noted limitations in sufficient representation of rural minorities and/or cancer survivors. In order to mitigate these challenges, we propose two solutions: 1) make rural-urban measures more accessible to non-federal researchers and 2) implement sampling approaches to oversample rural populations.
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Affiliation(s)
- Whitney E Zahnd
- Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, 220 Stoneridge Dr. Suite 204, Columbia, SC 29210, United States of America.
| | - Natoshia Askelson
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, 145 N. Riverside Drive, Iowa City, IA 52242, United States of America.
| | - Robin C Vanderpool
- Department of Health, Behavior & Society, College of Public Health, University of Kentucky, 111 Washington Avenue, Lexington, KY 40536, United States of America.
| | - Lindsay Stradtman
- Department of Health, Behavior & Society, College of Public Health, University of Kentucky, 111 Washington Avenue, Lexington, KY 40536, United States of America.
| | - Jean Edward
- College of Nursing, University of Kentucky, 751 Rose Street, Lexington, KY 40536, United States of America.
| | - Paige E Farris
- OHSU-PSU School of Public Health, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, United States of America.
| | - Victoria Petermann
- School of Nursing, University of North Carolina at Chapel Hill, Carrington Hall Campus Box #7460, Chapel Hill, NC 27599-7460, United States of America.
| | - Jan M Eberth
- Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, 220 Stoneridge Dr. Suite 204, Columbia, SC 29210, United States of America; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, United States of America; Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Columbia, SC 29208, United States of America.
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Hong YA, Cho J. Has the Digital Health Divide Widened? Trends of Health-Related Internet Use Among Older Adults From 2003 to 2011. J Gerontol B Psychol Sci Soc Sci 2017; 72:856-863. [PMID: 27558403 DOI: 10.1093/geronb/gbw100] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 07/21/2016] [Indexed: 11/12/2022] Open
Abstract
Objectives To examine the trend of health-related Internet use (HRIU) among older adults. Methods We analyzed data from the 2003, 2005, and 2011-2012 iterations of the National Cancer Institute (NCI)-sponsored Health Information National Trends Survey (HINTS). HRIU was measured by 4 online behaviors: seeking health information, buying medicine, connecting with people with similar health problems, and communicating with doctors. Results Internet use and HRIU among older adults increased substantially from 2003 to 2011 with more significant increases in seeking health information and communicating with doctors online. Overall, the digital health divide between different demographic groups has narrowed, especially in terms of gender, racial/ethnic group, rural/urban residence, and various health statuses; however, age, education, and household income remain persistent predictors of the digital divide. Those in the oldest group (75 or older), those with less than a high school education, and those with very low income (<$25,000/year) continuously lagged behind their counterparts in all aspects of HRIU. Conclusions Despite an overall increase in HRIU and a narrowed digital divide, significant variations in HRIU in different demographic groups persisted; therefore, we call for more senior-friendly online resources and culturally appropriate interventions to bridge the digital health divide for vulnerable older adults.
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Affiliation(s)
- Y Alicia Hong
- Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M University, College Station
| | - Jinmyoung Cho
- Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M University, College Station.,Center for Applied Health Research, Baylor Scott and White Health, Temple, Texas
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Thompson MJ, Reilly JD, Valdez RS. Work system barriers to patient, provider, and caregiver use of personal health records: A systematic review. APPLIED ERGONOMICS 2016; 54:218-242. [PMID: 26851482 DOI: 10.1016/j.apergo.2015.10.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 10/16/2015] [Accepted: 10/18/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVES This review applied a human factors/ergonomics (HF/E) paradigm to assess individual, work system/unit, organization, and external environment factors generating barriers to patient, provider, and informal caregiver personal health record (PHR) use. METHODS The literature search was conducted using five electronic databases for the timeframe January 2000 to October 2013, resulting in 4865 citations. Two authors independently coded included articles (n = 60). RESULTS Fifty-five, ten and five articles reported barriers to patient, provider and caregiver PHR use, respectively. Barriers centered around 20 subfactors. The most frequently noted were needs, biases, beliefs, and mood (n = 35) and technology functions and features (n = 32). CONCLUSIONS The HF/E paradigm was effective in framing the assessment of factors creating barriers to PHR use. Design efforts should address literacy, interoperability, access to health information, and secure messaging. A deeper understanding of the interactions between work systems and the role of organization and external environment factors is required.
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Affiliation(s)
- Morgan J Thompson
- Psychology Department, The College of William and Mary, Williamsburg, VA 23187, USA.
| | - Jeremiah D Reilly
- Department of Public Health Sciences, University of Virginia, P.O. Box 800717, Hospital West Complex, Charlottesville, VA 22908, USA.
| | - Rupa S Valdez
- Department of Public Health Sciences, University of Virginia, P.O. Box 800717, Hospital West Complex, Charlottesville, VA 22908, USA.
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Ford EW, Hesse BW, Huerta TR. Personal Health Record Use in the United States: Forecasting Future Adoption Levels. J Med Internet Res 2016; 18:e73. [PMID: 27030105 PMCID: PMC4830902 DOI: 10.2196/jmir.4973] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 10/11/2015] [Accepted: 02/04/2016] [Indexed: 11/13/2022] Open
Abstract
Background Personal health records (PHRs) offer a tremendous opportunity to generate consumer support in pursing the triple aim of reducing costs, increasing access, and improving care quality. Moreover, surveys in the United States indicate that consumers want Web-based access to their medical records. However, concerns that consumers’ low health information literacy levels and physicians’ resistance to sharing notes will limit PHRs’ utility to a relatively small portion of the population have reduced both the product innovation and policy imperatives. Objective The purpose of our study was 3-fold: first, to report on US consumers’ current level of PHR activity; second, to describe the roles of imitation and innovation influence factors in determining PHR adoption rates; and third, to forecast future PHR diffusion uptake among US consumers under 3 scenarios. Methods We used secondary data from the Health Information National Trends Survey (HINTS) of US citizens for the survey years 2008, 2011, and 2013. Applying technology diffusion theory and Bass modeling, we evaluated 3 future PHR adoption scenarios by varying the introduction dates. Results All models displayed the characteristic diffusion S-curve indicating that the PHR technology is likely to achieve significant market penetration ahead of meaningful use goals. The best-performing model indicates that PHR adoption will exceed 75% by 2020. Therefore, the meaningful use program targets for PHR adoption are below the rates likely to occur without an intervention. Conclusions The promise of improved care quality and cost savings through better consumer engagement prompted the US Institute of Medicine to call for universal PHR adoption in 1999. The PHR products available as of 2014 are likely to meet and exceed meaningful use stage 3 targets before 2020 without any incentive. Therefore, more ambitious uptake and functionality availability should be incorporated into future goals.
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Affiliation(s)
- Eric W Ford
- Department of Health Policy and Management, Johns Hopkins University, Baltimore, MD, United States.
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