Cancer information seekers in china: a preliminary profile

Medication safety perceptions in China: Media exposure, healthcare experiences, and trusted information sources

OBJECTIVE

Amid ongoing medication safety concerns in China and limited research on public perceptions, this study investigates the correlations between media exposure, healthcare experiences, and individuals' perceptions of medication safety. It also examines individuals' reliance on information sources during safety crises.

METHODS

A multistage stratified random sampling was employed with the gross sample containing 3090 Chinese adults aged 18-60 years. Data were analyzed using multiple linear regression.

RESULTS

Social media exposure was found to negatively correlate with perceptions of current medication safety and its perceived improvement, while exposure to television and print media showed positive correlations. Positive healthcare experiences were associated with improved medication safety perceptions. Among various information sources, healthcare professionals were deemed most trustworthy during medication safety incidents.

CONCLUSIONS

Media exposure and personal healthcare experiences significantly shape individuals' perceptions of medication safety in China, with healthcare professionals playing a crucial role in this context. Practiceimplications: Effective health crisis communication in China needs to be multifaceted, integrating traditional media and social media platforms to disseminate accurate information broadly. Additionally, healthcare professionals should be actively involved in crisis communication. Their role as trusted sources can be leveraged to clarify misconceptions, and reassure the public during medication safety incidents.

Examining the Role of Information Behavior in Linking Cancer Risk Perception and Cancer Worry to Cancer Fatalism in China: Cross-Sectional Survey Study

BACKGROUND

Reducing cancer fatalism is essential because of its detrimental impact on cancer-related preventive behaviors. However, little is known about factors influencing individuals' cancer fatalism in China.

OBJECTIVE

With a general basis of the extended parallel process model, this study aims to examine how distinct cancer-related mental conditions (risk perception and worry) and different information behaviors (information seeking vs avoidance) become associated with cancer fatalism, with an additional assessment of the moderating effect of information usefulness.

METHODS

Data were drawn from the Health Information National Trends Survey in China, which was conducted in 2017 (N=2358). Structural equation modeling and bootstrapping methods were performed to test a moderated mediation model and hypothesized relationships.

RESULTS

The results showed that cancer risk perception and cancer worry were positively associated with online health information seeking. In addition, cancer worry was positively related to cancer information avoidance. Moreover, online health information seeking was found to reduce cancer fatalism, while cancer information avoidance was positively associated with cancer fatalism. The results also indicated that the perceived usefulness of cancer information moderated this dual-mediation pathway.

CONCLUSIONS

The national survey data indicate that cancer mental conditions should not be treated as homogeneous entities, given their varying functions and effects. Apart from disseminating useful cancer information to encourage individuals to adaptively cope with cancer threats, we advocate for health communication programs to reduce cancer information avoidance to alleviate fatalistic beliefs about cancer prevention.

Trust in and Use of COVID-19 Information Sources Differs by Health Literacy among College Students

People’s health information-seeking behaviors differ by their health literacy levels. This study assessed the relationship between health literacy and college students’ levels of trust in and use of a range of health information sources of COVID-19. We collected data from August to December 2020 among college students (n = 763) through an online survey. We used a health literacy measure containing three self-reported survey questions, developed by the CDC. We assessed the extent to which participants trusted and used any of the sixteen different sources of information about COVID-19. Respondents reported high levels of trusting and using COVID-19 information from the CDC, health care providers, the WHO, state/county/city health departments, and official government websites when compared to other sources. After controlling for demographic characteristics (i.e., gender, age, race, ethnicity, and income), those who reported having lower health literacy were significantly less likely to trust and use COVID-19 information from these health authorities when compared to participants who reported having higher health literacy. Students with lower self-reported health literacy indicated not trusting or using official health authority sources for COVID-19 information. Relying on low-quality information sources could create and reinforce people’s misperceptions regarding the virus, leading to low compliance with COVID-19-related public health measures and poor health outcomes.

Social capital and health information seeking in China

Background

People’s potentials to seek health information can be affected by their social context, such as their social networks and the resources provided through those social networks. In the past decades, the concept of social capital has been widely used in the health realm to indicate people’s social context. However, not many such studies were conducted in China. Chinese society has its special quality that many Western societies lack: people traditionally render strong value to family relations and rely heavily on strong social ties in their social life. Therefore, the purpose of this study was to examine the association between different types of social capital and health information-seeking behavior (HISB) in the Chinese context. The different types of social capital were primarily bonding and bridging, as well as cognitive and structural ones.

Methods

Our analysis is based on a total of 3090 cases taken from the Health Information National Trends Survey (HINTS) – China, 2017. Dataset was weighted due to the overrepresentation of female respondents and hierarchical multiple regression analyses as well as binary logistic regression tests were operated to examine the associations between people’s social capital and their HISB.

Results

Some aspects of social capital emerged as positive predictors of HISB: information support (standing in for the cognitive component of social capital) promoted health information seeking, organization memberships (standing in for the structural component) encouraged cancer information seeking, and both the use of the internet and of traditional media for gaining health information were positively linked with bridging networks and organization memberships. Bonding networks (structural component) were not correlated with any other of the key variables and emotional support (cognitive social capital) was consistently associated with all health information-seeking indicators negatively.

Conclusions

Social capital demonstrated significant and complex relationships with HISB in China. Structural social capital generally encouraged HISB in China, especially the bridging aspects including bridging networks and organization memberships. On the other hand, emotional support as cognitive social capital damaged people’s initiatives in seeking health-related information.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13895-2.

Unfolding Media Source Characteristics Regarding Food Fraud Misinformation: A Comparative Study of the Health Information National Trends Survey (HINTS) in China

BACKGROUND

The ongoing rumors and fake news regarding food fraud, adulteration, and contamination are highly visible. Health risk information circulating through media and interpersonal communication channels has made health crisis an important research agenda.

OBJECTIVE

This study explores the issue of food fraud and the effect of rumors, incidents, and misinformation. Further, it studies whether and how these issues have provided evidence-based interventions for food handlers and regulators to mitigate food fraud misinformation.

METHODS

The Health Information National Trends Survey (HINTS) was adopted for collaborative study in China, after which a cross-sectional survey with door-to-door interviews was performed. Participants from Beijing and Hefei were selected using multistage sampling of adults during May, 2017. Based on four government surveillance reports on food rumors and safety incidents, a descriptive, correlation, and multivariate variance analysis was applied to the data.

RESULTS

A total of 3,090 results were gathered and analyzed. An average of 83.6% (n = 2,584) respondents heard at least one food rumor. Learning about food fraud is correlated with interpersonal connections (e.g., doctors or health specialists) for accessing food health information. Overall, Chinese citizens with a higher level of interpersonal connection were more likely to be concerned about food incidents with the statistical difference (P< .001). The Interpersonal connection was the highest frequency of communication sources (n = 698, 55.7%), followed by traditional media (n = 325, 25.9%) and Internet portal (n = 144, 11.5%). There was a significant relationship between media use and media category in Beijing (P<.001) and in Hefei (P<.001). Overall, Beijing's responses to the food fraud and incidents risks were lower than in Hefei (P < .01). The respondents in Beijing were confronted more frequently by food rumors (range 346-1253) than those in Hefei (range 155-946). The urban dwellers in Beijing and their rural counterparts in Hefei also differ in terms of perceiving different levels of food risk from different media sources. The food rumor narratives examined the conspiracy belie finds that social media play a more important role in influencing attitude against misinformation for users in Hefei, rather than in Beijing.

CONCLUSIONS

A media complementarity and food fraud information acquisition examined food fraud rumors and incidents with intent to harm, mainly done for economic gain. The HINTS China reports that around 73.6% out of 2,584 Chinese respondents prefer to go to their physicians for quarrying food health information first; however, when asked where they actually went and got access to food rumors, up to 36.6% of out of 1,462 Beijing respondents and 55.6% out of 1,122 Hefei respondents reported going online first. This study extends beyond local food products to foreign countries that import conspiracy beliefs with fake food. Nonetheless, consumers have to be on guard not just against fake food, but also spreading fake information and rumors about food. The aim of this study is to focus on characterizing media sources, types of food fraud misinformation, and risk perception of food safety, which mixes urgency and suspicions, and to provide evidence-based interventions for risk management guidance, with the hypotheses of the significant correlations between media types and sources and consumers' exposing and perceiving levels of food rumors and risks.

CLINICALTRIAL

Explicating the health-related digital divide: A mediation mechanism between education level and online cancer information seeking frequency among Chinese adults

In China, highly educated adults seek online cancer information more frequently than less educated adults. This health-related digital divide may impede the less-educated from effectively preventing cancer. To explicate the divide, we introduce informational subjective norms (ISN) and information sufficiency threshold (IST) as two socio-psychological mediators between education level and online cancer information seeking (OCIS) frequency. ISN represents one's perceived social pressure about seeking cancer information, while IST manifests individual evaluation of the amount of information needed to prevent cancer. An online survey supported a serial mediation effect of ISN and IST. ISN and IST also independently mediated the relationship between education level and OCIS frequency. Besides, the mediation effect of ISN was stronger than that of IST. The findings suggest that increasing ISN among less educated Chinese adults could facilitate their OCIS and to narrow the health-related digital divide. These implications may also inform other developing countries.

Few changes shown in cancer information-seeking behaviour among young adults in China between 2012 and 2017

BACKGROUND

The increasing incidence of cancer among young adults (18-40 years old) is of concern in China.

OBJECTIVES

This study aims to examine the influence of cancer information-seeking behaviours (CISB) on young adults' worries about cancer and participation in screening.

METHODS

This study analysed data from two probability sample surveys conducted in 2012 and 2017 in China. The questions in the questionnaire remained the same for better comparison. The sample size was 1212 in the 2012 survey, and 2178 in the 2017 survey.

RESULTS

From 2012 to 2017, among young adults, there was a decline in cancer information seeking, diversity of cancer information sought and cancer worry, while an improvement in cancer information-seeking experience was found. Also, CISB had significant associations with cancer worry and health screening over the 5 years.

DISCUSSION

The level of young adults' cancer information seeking remains low in China, and this group is not fully aware of their potential risks of getting cancer.

CONCLUSION

Although young adults find the experience of looking for cancer information easier in 2017, health campaigns may be necessary to encourage young adults to find out more about their cancer risks, and to participate more in health screening.

Linking health information seeking to patient-centered communication and healthy lifestyles: an exploratory study in China

The existing research routinely measures the influence of health information-seeking behavior (HISB) as a whole, which does not capture the complexity and diversity of media channel usage in HISB. The influence of HISB on patient's lifestyle behaviors and the mediation process through patient-centered communication (PCC) in medical encounters has been understudied in previous literature. Drawing from Street's three-stage model, this study conducted a secondary analysis of the Health Information National Trends Survey in China to investigate the influences of HISB across five different media outlets (e.g. information-oriented media, entertainment-oriented media, search engines, social media and mobile health applications) on two types of healthy lifestyles (e.g. physical activity, fruit and vegetable consumption), by the mediation of PCC. PROCESS path-analysis with bootstrapping estimation was used to test the hypothesized relationships. The results revealed that HISB is positively related to PCC, and PCC positively predicts frequent engagement in healthy lifestyles. Moreover, PCC partially mediates the effect of information-oriented media HISB on healthy lifestyles and fully mediates the effect of HISB through the other four media sources. This study highlights the essential stage of PCC transferring HISB to engagement in healthy lifestyles and draws attention to the varying influences of media channels carrying different characteristics.

Media Exposure, Cancer Beliefs, and Cancer-Related Information-Seeking or Avoidance Behavior Patterns in China

This study explored the relationships between media exposure, cancer beliefs, and cancer information-seeking or information-avoidance behaviors. Based on the planned risk information-seeking model and its extended framework, two predictive models were constructed: one for cancer information seeking and the other for cancer information avoidance. A structural equation modeling strategy was applied to survey data from China HINTS 2017 (n = 3090) to compare the impact of traditional mass media and social media exposure to cancer-related information on cancer information-seeking and information-avoidance behaviors. The study findings suggest that health-related information exposure through different media channels may generate distinctive information-seeking or information-avoidance behaviors based on various cancer beliefs. Additionally, the findings indicate that social media exposure to health-related and cancer curability beliefs does not lead to cancer information avoidance; both mass media and social media exposure encourage people to seek cancer-related information. Cancer fatalism is positively associated with cancer information-seeking and avoiding intentions, suggesting that negative cancer beliefs predict seemingly contradictory yet psychologically coherent information intentions and behaviors.

Perceived Needs Versus Predisposing/Enabling Characteristics in Relation to Internet Cancer Information Seeking Among the US and Chinese Public: Comparative Survey Research

Background

Since the rise of the internet, online health information seeking has become a worldwide phenomenon. However, health and health communication are inherently culture bound. A data-driven cross-country comparison enables us to better understand how cultural factors moderate the association between individual-level determinants and online health information seeking.

Objective

The objective of the study was to examine similarities and differences in determinants of internet cancer information seeking between the US and Chinese general public (excluding cancer patients and survivors) under the framework of a behavioral model of health services use.

Methods

This study used Health Information National Trends Survey (HINTS) 2017 (US data) and HINTS-China 2017 data to answer the research question. It focused on people with no cancer history and with internet access. For the HINTS 2017, the sample size was 2153; for the HINTS-China 2017, the sample size was 2358. To compare China and the United States, the researchers selected the same set of study variables for each dataset. Under the framework of the behavioral model of health services use, these predictors were predisposing factors, enabling factors, and need factors.

Results

In terms of the predisposing factors, a higher age, college degree or above, being currently unemployed, and having a family history of cancer were associated with internet cancer information seeking for the Chinese respondents; none of these factors were related to information seeking for the US respondents, although a lower age was associated with information seeking. Regarding the enabling conditions, lower trust in family members and friends as reliable information sources was the only factor associated with information seeking for the Chinese respondents, while no enabling factor was related to information seeking for the US respondents. Regarding the need factors, perceived health status was not related to information seeking for the Chinese respondents, while perception of poorer health condition was related to information seeking for the US respondents. Higher cancer fear was related to information seeking for both groups, but the magnitude of association was smaller for the Chinese respondents than for the US respondents.

Conclusions

Overall, under the framework of the behavioral model of health services use, the results based on multivariate logistic regression reveal clear patterns of cross-country/cultural differences in the factors associated with internet cancer information seeking behaviors: predisposing characteristics and enabling conditions are more important in China, while perceived needs are more significant in the US. Such differences might reflect possible US-China differences in job environment (eg, job pressure) and culture (individualism vs collectivism and family structure).

Online Health Information Seeking Using "#COVID-19 Patient Seeking Help" on Weibo in Wuhan, China: Descriptive Study

Background

First detected in Wuhan, China in December 2019, the COVID-19 pandemic stretched the medical system in Wuhan and posed a challenge to the state’s risk communication efforts. Timely access to quality health care information during outbreaks of infectious diseases can be effective to curtail the spread of disease and feelings of anxiety. Although existing studies have extended our knowledge about online health information–seeking behavior, processes, and motivations, rarely have the findings been applied to an outbreak. Moreover, there is relatively little recent research on how people in China are using the internet for seeking health information during a pandemic.

Objective

The aim of this study is to explore how people in China are using the internet for seeking health information during a pandemic. Drawing on previous research of online health information seeking, this study asks the following research questions: how was the “#COVID-19 Patient Seeking Help” hashtag being used by patients in Wuhan seeking health information on Weibo at the peak of the outbreak? and what kinds of health information were patients in Wuhan seeking on Weibo at the peak of the outbreak?

Methods

Using entity identification and textual analysis on 10,908 posts on Weibo, we identified 1496 patients with COVID-19 using “#COVID-19 Patient Seeking Help” and explored their online health information–seeking behavior.

Results

The curve of the hashtag posting provided a dynamic picture of public attention to the COVID-19 pandemic. Many patients faced difficulties accessing offline health care services. In general, our findings confirmed that the internet is used by the Chinese public as an important source of health information. The lockdown policy was found to cut off the patients’ social support network, preventing them from seeking help from family members. The ability to seek information and help online, especially for those with young children or older adult members during the pandemic. A high proportion of female users were seeking health information and help for their parents or for older adults at home. The most searched information included accessing medical treatment, managing self-quarantine, and offline to online support.

Conclusions

Overall, the findings contribute to our understanding of health information–seeking behaviors during an outbreak and highlight the importance of paying attention to the information needs of vulnerable groups and the role social media may play.

Barriers to Low-Dose CT Lung Cancer Screening among Middle-Aged Chinese

PURPOSE

The current study aims to explore the barriers for middle-aged Chinese to learn about and uptake low-dose computed tomography (LDCT) lung cancer screening.

METHODS

Data were collected via an online survey in December 2019. Final valid sample included 640 respondents, aged 40-60 years old, from 21 provinces of China. We performed multiple linear regressions to test the potential barriers to LDCT scan.

FINDINGS

Cost concerns, distrust in doctors, fears of disease, lack of knowledge, and optimistic bias are negatively associated with the intention to learn about and uptake LDCT scan.

IMPLICATIONS

Our study contributes to understanding the negative predictors of middle-aged Chinese to get LDCT lung cancer scans. Future campaign programs should help audiences to build comprehensive understandings about lung cancer and LDCT scan. To better promote LDCT scan in China, the government should fund more trial programs continuously and public efforts should be made to rebuild the patient-doctor trust.

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.

Health Information Seeking Behaviors and Source Preferences between Chinese and U.S. Populations

This study examined similarities and differences in health information-seeking behaviors between American and Chinese people using data from the 2017 U.S. Health Information National Trends Survey (HINTS) and the 2017 China HINTS. It is one of the first studies that use comparable samples and survey instruments to make direct comparisons of the two populations' health information-seeking behaviors. Results showed that Americans (including different racial/ethnic groups in the U.S.) were more likely to actively seek health information than Chinese people. Americans were also more likely to use mediated communication as their primary sources of health information while Chinese people favored interpersonal sources. Chinese people reported lower quality of doctor-patient communication than their American counterparts. These differences between the two countries highlight the importance of using different information sources to reach specific populations, and the need to develop tailored public health intervention programs in different cultures.

Media Complementarity and Health Information Acquisition: A Cross-sectional Analysis of the 2017 HINTS-China Survey

Given the myriad of media channels and available health information, it is important to investigate how health consumers navigate and choose from multiple media channels in seeking health information and their preferences among different media sources. Previous research has routinely measured health information-seeking behavior (HISB), especially online health information seeking as a whole, which does not capture the complexity and diversity of media channels used in HISB. On the basis of the channel complementarity theory, this study further classified new media into search engines, social media, and mobile health applications. The results of a secondary analysis of the Health Information National Trends Survey in China (HINTS-China) reinforced the occurrence of media complementary between information-oriented media (newspapers and magazines) and entertainment-oriented media (television). In addition, people used traditional media complementarily with new media, except information-oriented media and search engine use exhibited a displacement relationship. Moreover, the results indicated different profiles of health information seekers varied according to the diverse media channels, although media trust, perceived poor health status, chronic disease, and family cancer history consistently propelled HISB for both online and offline media channels. Implications for theory and practice for health communication were discussed.

Promoting patient comprehension of relevant health information

Patient understanding of health care recommendations provided by health care professionals is essential to enabling active and informed patient participation in care. Unfortunately, evidence suggests that patients often seriously misunderstand relevant health information provided to them, leading to errant patient decisions about their care. This commentary examines key communication factors that influence patient understanding and argues for a comprehensive approach to assessing and promoting patient comprehension.