Information-seeking in cancer survivors: application of the Comprehensive Model of Information Seeking to HINTS 2007 data

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.

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.

The Media-Mediated Model of Information Seeking Behavior: A Proposed Framework in the Chinese Culture During the COVID Pandemic

This study aims to unravel the key determinants of individuals' information seeking behavior during health crises. It challenges conventional perspectives that solely emphasize individual experiences. It also undermines frameworks that draw direct parallels between individual experiences and media factors, disregarding the mediating role of media. Models like the Comprehensive Model of Information Seeking (CMIS) also have limitations as they prioritize media mediation over recognizing the direct impacts of individual experiences on information seeking behaviors. We hereby propose a framework, the Media-Mediated Model of Information Seeking Behavior, that sheds light on the interplay between individual and media experiences. Analysis of survey data involving 5,469 participants in three Chinese societies, including mainland China (n = 2,067), Hong Kong (n = 1,913), and Taiwan (n = 1,489), reveals that individual experiences have both direct and indirect effects on information seeking, mediated by media utility. Experience of symptoms and risk perception depend on people's perceptions of the utility of media, while efficacy and media trust directly influence information seeking behaviors. These findings contribute to theoretical understanding and offer practical guidelines. Public institutions and health promoters can leverage media platforms to shape people's perceptions of health issues and encourage active information behaviors. It is also crucial to prioritize cultivating public trust in media and efficacy during crises.

Public Interest in Shoulder Platelet-Rich Plasma Injections Is Increasing: A 10-Year Google Trends Analysis

Purpose

To quantify and analyze public interest trends in platelet-rich plasma (PRP) therapy for shoulder pathology between 2011 and 2020 using Google Trends data.

Methods

Google Trends data were queried for online search data ranging from January 2011 to December 2020. Various combinations of terms related to PRP and shoulder pathology were queried. Terms related to corticosteroid therapy in association with shoulder pathology were also generated for comparative analysis. Analyses were performed regarding trends in online search volumes.

Results

Linear models were generated to evaluated trends in the volume of online searches for PRP and corticosteroid therapy for shoulder pathology. For both the PRP and steroid groups, linear models showed a statistically significant increase in search volume for the period studied (P < .001). The PRP group showed a significantly greater growth rate than the steroid group (P < .001). There were no statistically significant differences in online search volume when compared between different geographic and socioeconomic locations.

Conclusions

This study indicates consistently increasing public interest in PRP injections in the shoulder. The rate of online search volume growth of PRP is significantly greater than that of corticosteroid injections for the period studied.

Clinical Relevance

Awareness of patient perceptions has value in informing shared decision making, aligning patient expectations, and guiding areas of future research. Each of these has an impact on patient care. Being aware of patient interest and expectations is particularly important in areas with controversial or emerging research.

Cancer-related information behavior among black and hispanics in an NCI-designated comprehensive cancer center catchment

OBJECTIVE

This study aims to better understand health behaviors, particularly health information seeking, and how this impacts cancer care within underserved minority populations in a specific catchment area in Florida.

METHODS

We conducted an analysis of survey data from a 2019 community health survey conducted by the Moffit Cancer Center (MCC). We utilized the Comprehensive Model of Information Seeking (CMIS) as a framework and performed structural equation modeling (SEM) and related statistical analyses.

RESULTS

Our findings confirm that characteristics and demographics present a positive relationship to Online Health Information Seeking (OHIS). We also found that Utility had a negative significant relationship to OHIS.

CONCLUSIONS

We concluded that the CMIS is a useful framework for studying cancer-related information seeking, and that when properly executed in the confines of a study, can lend itself to in-depth statistical analyses as found in SEM.

IMPLICATIONS

The SEM revealed the CMIS to be promising with results in our analysis worthy of further investigation of cancer care and healthcare information access considering undeserved and minority populations.

PRACTICE IMPLICATIONS

Models such as the CMIS can be useful for understanding information seeking behaviors and to design information and communication interventions to improve access and health outcomes.

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.

A Comparison of Women's and Men's Online Information Seeking Behaviors about Gender-Related Health Information: A German Stratified Online Survey (Preprint)

BACKGROUND

Gender-sensitive approaches to health communication aim to integrate gender perspectives at all levels of communication, as an individual's biological sex and socially assigned gender identity have an impact on whether and how one acquires what type of health information. Due to the fast and low-cost opportunity to search for a wide range of information, the internet seems to be a particularly suitable place for gender-related health information about diseases of sex-specific organs and diseases where biological differences are associated with different health risks.

OBJECTIVE

This study aims to inform gender-related information provision and acquisition in 2 ways. The first objective was to provide a theory-driven analysis of web-based health information-seeking behavior (HISB) regarding gender-related issues. Therefore, the Planned Risk Information Seeking Model (PRISM), which is one of the most integrative models of HISB, was adapted and applied. Second, we asked for gender-specific motivational determinants of gender-related web-based HISB comparing the predictors in the groups of women and men.

METHODS

Data from a stratified web-based survey of the German population (N=3000) explained gender-related web-based HISB and influencing patterns comparing women and men. The applicability of PRISM to gender-related web-based HISB was tested using structural equation modeling and a multigroup comparison.

RESULTS

The results revealed PRISM as an effective framework for explaining gender-related web-based HISB. The model accounted for 28.8% of the variance in gender-related web-based HISB. Gender-related subjective norms provided the most crucial explanatory power, followed by perceived seeking control. The multigroup comparison revealed differences in the model's explanatory power and the relevance of predictors of gender-related web-based HISB. The share of explained variances of web-based HISB is higher in men than in women. For men, norms were a more relevant promoting factor, whereas web-based HISB of women was more strongly associated with perceived seeking control.

CONCLUSIONS

The results are crucial for gender-sensitive targeting strategies and suggest gender-related health information interventions that address gender-related subjective norms. Furthermore, programs (eg, web-based learning units) should be developed and offered to improve individuals' (perceived) abilities to perform web-based searches for health information, as those with higher control beliefs are more likely to access web-based information.

To know or not to know? Exploring COVID-19 information seeking with the risk information seeking and processing model

To cope with the COVID-19 pandemic and reduce uncertainty, the public needs accurate and timely information. Inspired by the risk information seeking and processing (RISP) model, this article discovers the significant predictors of individuals’ COVID-19 information-seeking intention and behaviour. Overall, 394 adult participants from 47 states completed this study’s online survey. The hierarchical regression analysis reveals that risk experience and informational subjective norms are the most substantial predictors of individuals’ online information-seeking behaviour about COVID-19. Information insufficiency did not predict information seeking, and participants tend to overestimate their knowledge about COVID-19. RISP variables tend to share power in explaining the variances of information-seeking behaviour. Moreover, both channel beliefs and perceived information gathering capacity moderate information insufficiency’s prediction of information-seeking intention. These findings will assist researchers in discovering the fundamental motivation of information seeking. This article can guide pragmatic interventions to reduce the public’s uncertainty and mitigate the risk.

Explaining Online Information Seeking Behaviors in People With Different Health Statuses: German Representative Cross-sectional Survey

Background

Worldwide, the internet is an increasingly important channel for health information. Many theories have been applied in research on online health information seeking behaviors (HISBs), with each model integrating a different set of predictors; thus, a common understanding of the predictors of (online) HISB is still missing. Another shortcoming of the theories explaining (online) HISB is that most existing models, so far, focus on very specific health contexts such as cancer. Therefore, the assumptions of the Planned Risk Information Seeking Model (PRISM) as the latest integrative model are applied to study online HISB, because this model identifies the general cognitive and sociopsychological factors that explain health information seeking intention. We shift away from single diseases and explore cross-thematic patterns of online HISB intention and compare predictors concerning different health statuses as it can be assumed that groups of people perceiving themselves as ill or healthy will differ concerning their drivers of online HISB. Considering the specifics of online HISB and variation in individual context factors is key for the development of generalizable theories.

Objective

The objective of our study was to contribute to the development of the concept of online HISB in 2 areas. First, this study aimed to explore individual-level predictors of individuals’ online HISB intention by applying the postulates of PRISM. Second, we compared relevant predictors of online HISB in groups of people with different health statuses to identify cross-thematic central patterns of online HISB.

Methods

Data from a representative sample of German internet users (n=822) served to explain online HISB intentions and influencing patterns in different groups of people. The applicability of the PRISM to online HISB intention was tested by structural equation modeling and multigroup comparison.

Results

Our results revealed PRISM to be an effective framework for explaining online HISB intention. For online HISB, attitudes toward seeking health information online provided the most important explanatory power followed by risk perceptions and affective risk responses. The multigroup comparison revealed differences both regarding the explanatory power of the model and the relevance of predictors of online HISB. The online HISB intention could be better explained for people facing a health threat, suggesting that the predictors adopted from PRISM were more suitable to explain a problem-driven type of information-seeking behavior.

Conclusions

Our findings indicate that attitudes toward seeking health information online and risk perceptions are of central importance for online HISB across different health-conditional contexts. Predictors such as self-efficacy and perceived knowledge insufficiency play a context-dependent role—they are more influential when individuals are facing health threats and the search for health information is of higher personal relevance and urgency. These findings can be understood as the first step to develop a generalized theory of online HISB.

Cancer Survivors: What Are Their Information Seeking Behaviours?

This study aims to examine the information seeking behaviours and experiences of cancer survivors at various stages of the cancer survivorship trajectory in Singapore. Data was collected via a self-administered questionnaire from survivors diagnosed with the top 6 cancers in Singapore seen at the National Cancer Centre Singapore (NCCS). Cancer survivorship stages were categorized as newly diagnosed and on treatment (NT), completed treatment or cancer-free ≥ 5 years (CT) and had recurrence or second cancer (RS). Out of the 998 cancer survivors, 676 (68%) had searched for cancer information since their diagnosis. About 57% of the searchers did their most recent search in the past 6 months prior to the survey, with most of these survivors from the NT and RS groups. Around half of the searchers (55%) obtained cancer information from the internet. The most preferred source for cancer information was the internet (38%), followed by healthcare professionals (HCPs) (23%). About half (49%) obtained cancer information from their preferred source. Some information searchers (24%) did not do so, out of which about half used the internet to obtain information that they would have preferred to obtain from HCPs. The top 3 most commonly sought information was related to treatment, cancer and diet/nutrition. Half of the searchers were concerned with the quality of the information that they found. These information seeking behaviours and experiences were similar across cancer survivorship stages. Our study reveals that information seeking is prevalent across all survivorship stages. Patterns of information-seeking revealed a discrepancy between preferred and actual source.

The Influence of Online Health Information Seeking Before a Consultation on Anxiety, Satisfaction, and Information Recall, Mediated by Patient Participation: Field Study

BACKGROUND

Today, many cancer patients engage in online health information seeking (OHIS). However, little is known about how patients differ in their OHIS levels. In addition, OHIS might influence patient participation during a consultation with a physician, which might mediate the effects on patient outcomes.

OBJECTIVE

The aim of this study is twofold: first, to provide insight into which personal characteristics and psychosocial factors affect patients' OHIS levels and, second, to test the hypothesis that the effects of OHIS on patient outcomes are mediated by patient participation during the consultation.

METHODS

Patient participation was operationalized in terms of patients' absolute word count; the relative contribution of the patient, compared with the health care provider; and the number of questions and assertions expressed during the consultation. The patient outcomes measured were anxiety after the consultation, satisfaction with the consultation, and information recall. Participants in this study were patients recently diagnosed with colorectal cancer recruited from 6 hospitals in the Netherlands (n=90). Data were collected using questionnaires and audio-recorded consultations of patients with health care providers before their surgery.

RESULTS

The results showed that younger patients, higher educated patients, patients with a monitoring coping style, and patients who experienced more cancer-related stress engaged more in OHIS. In turn, OHIS was related to patient participation in terms of the patient's absolute word count but not to the relative contribution to the consultation or expressing questions and assertions. We did not find a relation between OHIS and anxiety and OHIS and recall mediated by patient participation. However, we found that patients' absolute word count significantly mediated the positive association between OHIS and patients' satisfaction with the consultation.

CONCLUSIONS

Results indicate positive implications of OHIS for patients' care experience and, therefore, the importance of helping patients engage in OHIS. However, the results also suggest that OHIS is only successful in increasing a single aspect of patient participation, which might explain the absence of relations with anxiety and recall. The results suggest that more beneficial effects on patient outcomes may be achieved when health care providers support patients in OHIS.

Racial/Ethnic Disparities in Patient-Provider Communication and the Role of E-Health Use

Although the health care industry has strived to address racial/ethnic disparities in health communication, several gaps remain. Previous findings suggest that communication technology might help narrow the gaps; however, they do not provide a comprehensive picture of how or why. To answer these questions, we examined the potential role of communication technology in mitigating the racial/ethnic disparities in patient-provider communication. Data analysis of the 2018 Health Information National Trends Survey (N= 3,504) revealed that the levels of perceived quality of communication with health care providers were lower among Asians and Hispanics than non-Hispanic Whites while no difference emerged between Blacks and non-Hispanic Whites. Although the adoption of communication technology was relatively high across minority groups, its use appeared to play different roles in different racial/ethnic populations. The Internet and patient portals showed no particular associations with patient-provider communication except for Black Internet users, who reported poorer experiences with patient-provider communication than non-users. Among Asians and Hispanics, social media and mobile communication appeared to play different roles in impacting communication experiences with health care providers. The findings suggest that communication technologies need to be strategically utilized and tailored to better meet the communication needs of racial/ethnic minorities.

Interpersonal influences on self-management in the eHealth era: Predicting the uses of eHealth tools for self-care in America

Drawing on the social cognitive theory and the comprehensive model of information seeking, this study proposes a theoretical framework that systematically examines the role of interpersonal factors in individuals' self-management in the eHealth context. The framework was tested with a sample of 965 eHealth users drawn from the National Cancer Institute's 2018 Health Information National Trends Survey. Structural equation modelling was performed to model the relationships among patient-centred communication, social support, self-efficacy, perceptions of eHealth tools and eHealth behaviours. The results established social support and patient-centred communication as two important sources of self-efficacy. Self-efficacy together with characteristics of eHealth tools were associated with higher utility of eHealth tools, which further predicted higher levels of eHealth behaviours. The results show that incorporating interpersonal factors in health interventions may enhance the targets' self-efficacy in self-management and indirectly motivates eHealth behaviours.

Irish cancer patients and survivors have a positive view of the role of nutritional care in cancer management from diagnosis through survivorship

BACKGROUND

Nutrition is an important aspect of care in the management of cancer at all stages from diagnosis to survivorship. There is currently little data available on the views of those with cancer regarding the importance of nutrition throughout the cancer journey.

AIM

To identify the views of those with cancer regarding the importance of nutrition in ten different situations or cancer stages.

METHODS

A questionnaire containing demographic information and one question utilising a 5-point Likert scale around the importance of nutrition in relation to ten different cancer stages or patient types was circulated through the oncology day wards and outpatient departments in two hospitals in the North West of Ireland. We received 197 complete responses.

RESULTS

Nutritional care was viewed positively with 88.8 to 98.5% agreeing or strongly agreeing that nutritional care is important for everyone independent of their weight or cancer treatment; when you are receiving any form of active treatment for cancer; when you require surgery for cancer; when you require chemotherapy for cancer; when you require radiotherapy for cancer; when you are in the advanced stages of cancer; when you are a cancer survivor; when you have a low body weight; when you have a normal body weight; and when you are overweight.

DISCUSSION

Irish cancer patients and survivors have a positive view of the role of nutritional care in cancer from diagnosis through cancer survivorship. It is important that services are put in place to provide this nutritional care at all stages of cancer.

Beliefs and Information Seeking in Patients With Cancer in Southwest China: Survey Study

Background

Although previous studies have reported the cancer information-seeking behaviors among patients in high-income countries, the cancer information-seeking practices of patients living in low- and middle-income areas are less known.

Objective

This study investigated the beliefs and information-seeking patterns of cancer patients in southwest China.

Methods

A questionnaire was designed, and data were collected in two hospitals (N=285) in southwest China. Statistical analyses included bivariate analyses and regressions.

Results

Patients’ attitudes towards cancer fatalism were significantly influenced by marital status (P<.001), education (P<.001), and household income (P<.001). Moreover, endorsing fatalistic belief was positively associated with age (r=0.35, P<.001). The regression model showed that younger patients (odds ratio [OR] 0.96, 95% CI 0.93-0.99) and those with higher education (OR 1.75, 95% CI 1.09-2.81) were more likely to seek information. Additionally, patients who were less confident in getting information were more likely to find information (OR 1.70, 95% CI 1.15-2.52), while fatalism belief was not significant in the regression (OR 0.65, 95% CI 0.22-1.95).

Conclusions

This study explored the information-seeking patterns of cancer patients in southwest China. It was found that many Chinese people endorsed cancer fatalism. These pessimistic beliefs about the potential to prevent and to cure cancer correlate with rather than cause cancer-related information seeking. However, self-efficacy about the confidence in finding needed cancer information was a significant predictor of information-seeking.

[Use of health information on the internet: personal and motivational influencing factors]

Hintergrund und Ziele

Die Übernahme einer aktiven Patient*innen-Rolle kann nur auf einer entsprechenden Informationsgrundlage gelingen. Die eigene Suche nach Gesundheitsinformationen im Internet kann zu einer solchen adäquaten Wissensbasis beitragen. Daher erscheint es zentral zu fragen, was die derzeitige Nutzung von Onlineangeboten und Gesundheits-Apps in Deutschland auszeichnet und welche personenbezogenen und motivationalen Einflussfaktoren beeinflussen, ob und wie häufig die Bürger*innen online nach Gesundheitsinformationen suchen oder Gesundheits-Apps nutzen.

Methoden

Zur Beantwortung der Fragestellungen wurde eine an der deutschen Gesamtbevölkerung stratifizierte Onlinebefragung (N = 3000) durchgeführt. Der Fragebogen erfasste die gesundheitsbezogene Nutzung des Internets und von Apps sowie mögliche personenbezogene und motivationale Einflussfaktoren. Die Bedeutung dieser Faktoren für die Internetnutzung wurde mittels Regressionsanalysen ermittelt.

Ergebnisse

Die gesundheitsbezogene Informationssuche mittels Internet ist in Deutschland weitverbreitet, während Gesundheits-Apps noch deutlich seltener genutzt werden. Am häufigsten werden auf Gesundheitsportalen Informationen zu Krankheitssymptomen gesucht. Die Zuwendung zum Internet wird besonders durch motivationale Faktoren geprägt. Akute Betroffenheit von körperlichen Beschwerden und entsprechende Informationskompetenzen sind die einflussreichsten Faktoren für die Internetnutzung.

Diskussion

Um die mit der Informationssuche im Internet verbundenen Potenziale zu entfalten, ist es notwendig, dass sich Bürger*innen zur eigenen Suche motiviert und befähigt fühlen. Besonders entsprechende Fähigkeiten gilt es zu fördern, um das Risiko der Verstärkung informationaler, gesundheitlicher und sozialer Unterschiede zu reduzieren.

Information seeking in the context of cigarette smoking: predictors from the Comprehensive Model of Information Seeking (CMIS)

Background: The CMIS indicates that key variables in actively obtaining information on cigarette smoking are demographics, direct experience, salience, and beliefs, which affects subsequent evaluations and utility of information. Method: Cross-sectional data were drawn from the HINTS-FDA 2015 national survey in which a stratified random sample of the U.S. postal addresses (N = 3,738) self-administered a mailed paper questionnaire. Path analysis was conducted to test the CMIS. Results: Age, income, education, sexual orientation, beliefs about behavior change, and salience are significant predictors of perceived utility of information.Direct predictors of information seeking on health effects are comprehension of information (β = .06, 95% CI: .02-.09, p < .05), trust in information sources (β = .23, 95% CI: .18-.276, p < .01), and confidence in obtaining information (β = .10, 95% CI: .047-.160, p < .05). The final model produced fit indices of c² = 356.48, df = 24, CFI = .91, RMSEA = .061 (95% CI: .055-.067), R² = .098. Conclusions: The CMIS is a valid theoretical framework in predicting information seeking on cigarette smoking. This study closes a gap in the literature by addressing key factors simultaneously that influence information seeking on health effects and cessation of cigarette smoking.

Understanding Information Seeking about the Health of Others: Applying the Comprehensive Model of Information Seeking to Proxy Online Health Information Seeking

A significant proportion of online health information seeking is related to the health of others, such as the one of family members and friends, instead of an individual's own health. Understanding these behaviors of proxy seekers, i.e., individuals who seek information about the health of others, can improve the transmission of health information to and social support for others. The comprehensive model of information seeking (CMIS) is an established model that predicts information seeking for the individual seeker. The model was modified and extended with concepts of social network ties to predict proxy information seeking intentions and the resulting social support intentions. Hypothetical scenarios of persons from the social network suffering from depression were varied in severity of disease and the relationship closeness to test their influence on model variables. Structural equation modeling (N = 607) served to evaluate the associations between the health-related factors and proxy health information seeking intentions, as well as support intentions. The results confirmed the direct effects of beliefs on information-carrier utility. Contrary to expectations, demographics, experience, and salience had direct effects on proxy information seeking intentions. The results indicate that a modified CMIS helps to better meet surrogate seekers' needs for supporting patients.

Nutrition guidance for cancer patients and survivors-A review of the websites of Irish healthcare and charitable organisations and cancer centres

OBJECTIVE

To determine availability of nutrition information for cancer patients and survivors from Irish healthcare organisations, cancer charity and support groups and assess its quality and readability.

DESIGN

Cross-sectional.

SETTING

The National Health Service Executive websites were searched, as were the sites of the ten largest cancer charities/support groups identified through the Benefacts website. An additional internet search was conducted to ensure no large organisations/support groups were missed (February 2019). Quality of nutrition content was assessed using an evidence-based checklist and readability assessed using two validated formulas.

RESULTS

Thirty-two websites were identified, five contained nutrition information for cancer patients (15.6%), and three for cancer survivors (9.3%). The quality of the nutrition content ranged from 19.5 to 29/40 (mean ± SD, 23.2 ± 3.2; median = 21, interquartile range (IQR) = 7). There was a lack of practical strategies for implementation. Only 40% of material had an acceptable readability level (sixth-seventh grade level). Readability scores (mean ± SD) were 68.5 ± 6.0 for Flesch Reading Ease Score and 7.8 ± 1.1 for Flesch-Kincaid Grade Level Score.

CONCLUSION

There is limited nutrition information on Irish health and cancer websites and in particular very few tailored to cancer survivors. Irish health and cancer organisations should consider providing nutrition information that is easily accessible to all.

A scoping review of consumer needs for cancer information

OBJECTIVE

This study was a scoping review of research on cancer-related health information seeking and needs of patients, survivor, non-patients, and caregivers.

METHODS

This study used the COSI model to search for articles published from 2007 to 2017.

RESULTS

In total, 117 articles with titles and abstracts including the following terms were selected: cancer, health, information, seeking. Non-patients obtained information from the Internet, doctors, and media, whereas patients obtained information from doctors, the Internet, and media. Information needs were the highest for treatment, prognosis, and psychosocial support. Patients had the highest need for information on prognosis and treatment, whereas non-patients had the highest need for general cancer information, prevention, and cancer examination. Caregivers sought information about treatment, psychosocial support, and prevention.

CONCLUSION

This study revealed an increase in the number of research articles identifying cancer patients' information needs. Cancer patients rely on health professionals for information; thus, relevant materials are needed. Furthermore, not only medical but also psychosocial support information is needed.

PRACTICE IMPLICATIONS

There is a need for cancer information from health professionals, and thus for patient-centered training materials. Furthermore, a survey system to evaluate consumers' cancer information needs should be developed.

Applying Situational Theory of Problem Solving in Cancer Information Seeking: A Cross-Sectional Analysis of 2014 HINTS Survey

Informed by the Situational Theory of Problem Solving (STOPS), this study used data from the Health Information National Trends Survey, a large and representative national sample, to examine predictors of information seeking and information accessing of health information, including cancer-related information. We found that the independent variables in STOPS-problem recognition, involvement recognition, and referent criterion- well predicted people's information seeking of cancer-related information and accessing of health information on line. However, the impact of trust in online health information was more complicated than anticipated. Our study demonstrated the utility of the STOPS in the health information context. Theoretical and practical implications are discussed.

Online Cancer Information Seeking: Applying and Extending the Comprehensive Model of Information Seeking

This study applied the comprehensive model of information seeking (CMIS) to online cancer information and extended the model by incorporating an exogenous variable: interest in online health information exchange with health providers. A nationally representative sample from the Health Information National Trends Survey 4 Cycle 4 was analyzed to examine the extended CMIS in predicting online cancer information seeking. Findings from a structural equation model supported most of the hypotheses derived from the CMIS, as well as the extension of the model related to interest in online health information exchange. In particular, socioeconomic status, beliefs, and interest in online health information exchange predicted utility. Utility, in turn, predicted online cancer information seeking, as did information-carrier characteristics. An unexpected but important finding from the study was the significant, direct relationship between cancer worry and online cancer information seeking. Theoretical and practical implications are discussed.

Information sources and online information seeking behaviours of cancer patients in Singapore

The aim of this study was to investigate the prevalence of Internet usage among cancer patients in seeking health-related information and the type of information sought. Sources of information received from, preferences for information sources and the perceived usefulness of information from these sources were also examined in this study. A self-administered questionnaire was used to evaluate the information needs of patients undergoing cancer treatment. The questionnaire also evaluated the current source and preferred source of information as well as their online information seeking behaviours. A total of 411 patients with cancer were recruited from an ambulatory cancer centre. The patients' physicians and healthcare specialists comprised a large majority of the patients' information sources; they were also the most preferred source of information. 59.1% of the respondents used the Internet to search for cancer-related information, namely diagnosis and treatment options, side effects of treatment and complementary and alternative therapy; demonstrating the importance of the above information. Physicians (60.3%) and healthcare specialists (26.5%) were the largest and most preferred sources of information for cancer patients in our study. It was not uncommon for cancer patients to use the Internet to search for additional information demonstrating the need to integrate this tool more effectively for knowledge transfer for those patients who want it. It is important for healthcare professionals to help cancer patients by directing them to sources of quality information (including websites). In addition, the provision of guidelines on how to evaluate health information on the Internet would be helpful to cancer patients.

Applying the Modified Comprehensive Model of Information Seeking to Online Health Information Seeking in the Context of India

This study extends the Comprehensive Model of Information Seeking (CMIS) to online health information seeking in the context of India. This study considers the Internet (i.e., media) use an antecedent factor and the personal relevance factor salience is separated into two dimensions - susceptibility and severity. Structural equation modeling analysis (N = 990) tested the associations between health-related antecedents, information-carrier factors, and their direct effects on online information seeking. The results among online health information seekers in India showed significant relationships between length and frequency of media use and self-efficacy to engage in preventive behavior to the information carrier utility. As predicted, demographics have no significant relationship with utility of the Internet, and direct experience with illness resulted in negative relationship with the Internet utility. Contrary to expectations, susceptibility and severity produced negative relationships with the Internet utility. Result shows that both information-carrier factors - characteristics related to trust and utility related to perceived usefulness and relevance of information - directly affect online health-information-seeking behavior. Unlike the original CMIS that primarily focused on specific illnesses, the current modified CMIS can be adapted and tailored to general online health-information-seeking behavior.

Advice to patients undergoing stem cell transplant: Content analysis of survivor peer support narratives

Hematopoietic stem cell transplant survivors often share advice with patients undergoing this difficult treatment. We content analyzed narratives written by 59 transplant survivors given the opportunity to share advice with patients. Analyses described categories of advice they shared and evaluated their perceptions of the helpfulness of advice they had received. We found nine advice categories and evidence for variation in their perceived helpfulness, especially for advice to "be your own advocate," "have someone you can rely on," and "think positive." Findings suggest the need to investigate how seemingly innocuous advice can be unhelpful and potentially distressing to some patients.

Social Support, Trust in Health Information, and Health Information-Seeking Behaviors (HISBs): A Study Using the 2012 Annenberg National Health Communication Survey (ANHCS)

We proposed a conceptual model to predict health information-seeking behaviors (HISBs) from three different sources (family, the Internet, doctors). To test the model, a structural equation modeling (SEM) analysis was conducted using data from the 2012 Annenberg National Health Communication Survey (ANHCS) (N = 3,285). Findings suggest higher social support from family predicts higher trust in health information from family members (abbreviated as trust in this article). Trust is positively related to HISBs from all three sources, with the path linking trust to HISB from family being the strongest. The effect of social support on HISB from family is partially mediated by trust, while effect of social support on HISBs from the Internet/doctors is fully mediated by trust. Implications of the study are discussed.

Weight Loss and Mortality in Overweight and Obese Cancer Survivors: A Systematic Review

Background

Excess adiposity is a risk factor for poorer cancer survival, but there is uncertainty over whether losing weight reduces the risk. We conducted a critical review of the literature examining weight loss and mortality in overweight or obese cancer survivors.

Methods

We systematically searched PubMed and EMBASE for articles reporting associations between weight loss and mortality (cancer-specific or all-cause) in overweight/obese patients with obesity-related cancers. Where available, data from the same studies on non-overweight patients were compared.

Results

Five articles describing observational studies in breast cancer survivors were included. Four studies reported a positive association between weight loss and mortality in overweight/obese survivors, and the remaining study observed no significant association. Results were similar for non-overweight survivors. Quality assessment indicated high risk of bias across studies.

Conclusions

There is currently a lack of observational evidence that weight loss improves survival for overweight and obese cancer survivors. However, the potential for bias in these studies is considerable and the results likely reflect the consequences of disease-related rather than intentional weight loss. There is a need for stronger study designs, incorporating measures of intentionality of weight loss, and extended to other cancers.

Predictors of Online Cancer Prevention Information Seeking Among Patients and Caregivers Across the Digital Divide: A Cross-Sectional, Correlational Study

Background

The digital divide is a recognized public health problem caused by social determinants that exacerbate health disparities. Despite the “tectonic shift” in how most of the public obtains cancer information, underserved communities are at increased risk of being digitally marginalized. However, research that examines factors underlying eHealth information seeking in diverse health contexts is lacking.

Objective

The aim of this paper is to explore preferences and use of eHealth cancer prevention information (CPI) among patients and caregivers attending a minority-serving oncology clinic using the comprehensive model of information seeking as a theoretical framework. Specifically, the study examined the role of social determinants and prevention orientation in differences in preference and use of the Internet for CPI seeking among this diverse sample.

Methods

Survey methodology was used to identify social determinants and behavioral factors, including prevention orientation as correlates and predictors of respondents’ (n=252) preferences and use of eHealth for CPI seeking.

Results

Less than half (112/252, 44.4%) of respondents said that if faced with the need to seek CPI, they would seek this information online. In the final logistic regression model, education, ethnicity, age, and prevention orientation made significant contributions to the model (P<.05). Specifically, for each year increase in age, participants were 3% less likely to use the Internet for CPI seeking (P=.011). Compared to college graduates, respondents who did not complete high school were 11.75 times less likely to cite the Internet as a CPI carrier (P<.001) and those with a high school education were 3 times (2.99, P=.015) less likely. In addition, the odds that a Spanish speaker would cite the Internet as a CPI carrier were one-fifth (22%) of non-Hispanic whites (P=.032) and about one-quarter (26%) of English-speaking Latinos (P=.036). Finally, with each one point increase on the prevention orientation scale, respondents were 1.83 times less likely to cite online CPI seeking (P=.05).

Conclusions

Social determinants to health have profound influence on eHealth CPI seeking. Providers and policy makers should focus on meeting patients and family members’ CPI needs following diagnosis and increase eHealth accessibility and availability of evidence-based CPI to diverse populations. Future research is needed to unravel further differences in eHealth CPI seeking, including those among Native Americans that emerged as an additional digitally underserved racial/ethnic group. Finally, additional factors underlying these differences should be explored to better tailor CPI eHealth information to diverse communities’ information needs.

Availability of Information About Lifestyle for Cancer Survivors in England: A Review of Statutory and Charitable Sector Organizations and Cancer Centers

Background

Health behavior change following a cancer diagnosis has the potential to improve long-term outcomes. However, many patients do not receive professional advice about lifestyle and are therefore increasingly using the Internet to seek further information. The statutory and charitable sectors and cancer centers all play an important role in the provision of information and have been found to be favored by cancer survivors searching for information. However, to date there has been no systematic evaluation of the lifestyle information available online for cancer survivors.

Objective

The purpose of this review was to identify the lifestyle information provided for cancer survivors by statutory and charitable sector organizations and cancer centers in the United Kingdom. We aimed to identify information on tobacco, physical activity, diet, weight, and alcohol designed for people who have been diagnosed with breast, prostate, or colorectal cancer.

Methods

The National Health Service (NHS) website was the focus of the search for information provided by the statutory sector. Cancer centers were identified from the Organization of European Cancer Institutes and an Internet search, and charitable sector organizations were identified by searching the Charity Commission database. The three largest generic, breast, prostate, and colorectal cancer charitable organizations were included. A systematic search of the organizations was conducted to identify lifestyle information for cancer survivors.

Results

Ten organizations had some lifestyle information for cancer survivors on their websites. The Christie NHS Foundation Trust, Macmillan Cancer Support, and Prostate Cancer UK had the most comprehensive guides, covering physical activity, diet, weight management, smoking, and alcohol. The NHS website did not provide any information but had a link to Cancer Research UK’s information about diet. Eight organizations suggested talking to a health professional before making any changes.

Conclusions

The majority of organizations included in this review would benefit from updating their websites to include adequate information and advice about lifestyle for cancer survivors, or they risk cancer survivors turning to less reliable sources of information. Health professionals should be appropriately trained to deal with questions about lifestyle and to advise cancer survivors about lifestyle changes following their diagnosis.