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

Health Information Repertoires of Implant Patients: Toward a Deeper Understanding of Multiple Source Use and the Role of Health-Related Motives

Health information-seeking behavior can be understood as an active and purposeful acquisition of information from selected information sources. It supports patients to cope with medical and health-related uncertainties and enables them to engage in informed decision-making. To obtain health information, patients can turn to a variety of sources, such as going to a physician, exchanging information with their family, or using different Internet sources. Research showed that patients typically use multiple sources to meet their health-related information needs. To attain a holistic and differentiated picture of patients' actual health information behavior, the current study draws on the repertoire approach. We conducted an online survey with 1,105 implant patients and performed a cluster analysis to explore their health information repertoires. To gain a deeper understanding of the practical meaning behind the repertoires, we also considered health-related information motives and socio-structural factors, as well as the implant type (dental, orthopedic, cochlear), to characterize the repertoires. The study revealed seven different health information repertoires of implant patients, varying in their combination of multiple sources used. In addition, group comparisons showed that the repertoires differ significantly regarding socio-structural factors, such as gender, age, and education, as well as implant type. Furthermore, information motives contribute significantly to the differentiation of the repertoires. The results are of high theoretical potential for communication science as well as practical use for strategic health communication.

Development of a Symptom Self-Management Guide for Older Chinese Americans Kidney Receiving Replacement Therapy

Aim

To assess the acceptability of a symptom self-management booklet among older Chinese Americans receiving kidney replacement therapy.

Background

In previous work, we identified commonly occurring, bothersome symptoms and strategies used in this population to ameliorate symptoms. We used these data to develop a symptom self-management booklet in English, traditional, and simplified Chinese.

Introduction

In the United States, the prevalence of kidney disease is 1.5 times higher in Asians compared to whites. With the many symptoms associated with this disease, self-management of symptoms would be particularly helpful.

Methods

Seven older Chinese Americans receiving kidney replacement therapy and their caregivers were interviewed to assess the acceptability of the booklets. We reviewed participant feedback on content, graphics, and design, reading experience, suggestions for improvement, and health information sources using the inductive thematic method.

Results

Overall, patients confirmed acceptability of these self-management booklets across all domains. Discussion. This study validated the booklet as a source of health information for older Chinese American patients with kidney disease, which some studies suggest are preferred to electronic materials or methods in this population. Health care providers can use the resultant booklets when caring for these patients to provide culturally sensitive information on self-management of symptoms. Conclusion and Implications for Nursing. These booklets provide a free resource tailored to an underserved population and may help nurses and nurse practitioners provide care with cultural humility. Implications for Health Policy. Embracing community-based participatory research, as was done in this study, can help create culturally appropriate patient education materials that empower patient symptom self-management and promote informative and culturally sensitive conversations between patients, families, and providers.

Patients' perceptions of patient-centered communication with healthcare providers and associated factors in Japan - The INFORM Study 2020

OBJECTIVE

To describe patients' perceptions of the patient-centeredness of their communication with healthcare providers in Japan, and to examine factors associated with these perceptions.

METHODS

We analyzed the cross-sectional data from the INFORM Study 2020, which is a nationwide survey on health information access in Japan. A total of 3605 respondents completed the survey. Our primary outcome was the nine elements of the patient-centered communication scale (PCCS), which was compiled from 2703 respondents (75.0%) reporting at least one provider visit within 12 months. It was rated on a four-point Likert scale: always, usually, sometimes, and never. We used binary logistic regression to examine the association between sociodemographic and health-related variables, and each element of the PCCS.

RESULTS

For all elements, the percentage of respondents who agreed that their healthcare providers always communicated in a patient-centered way was low (17-31%). Patients with higher age, higher education, poorer general health status and a larger number of visits to providers in the previous 12 months were more likely to have positive perception.

CONCLUSION

Patient-centered communication as reported in a national sample in Japan was low.

CLINICAL IMPLICATIONS

Efforts are needed to improve the patient-centeredness of patient-provider communication in Japan to optimize health outcomes.

Acceptability of COVID-19 booster vaccine in malaysia: a cross-sectional study

Despite the high efficacy and safety demonstrated in clinical trials, COVID-19 booster vaccination rates in Malaysia remain below 50% among the general public. This study explores the factors influencing public acceptance of the COVID-19 booster vaccine among the Malaysian population. The questionnaire included variables on sociodemographics, knowledge, and the Health Belief Model (HBM) constructs. Based on the Chi-squared test of contingencies, a t-test and multivariate logistic regression analysis on 411 collected responses, the findings revealed that older participants, individuals of Chinese ethnicity, and those with higher education levels and incomes were more willing to accept booster vaccinations. The analysis further identified perceived susceptibility, perceived severity and perceived barriers as significant predictors influencing booster vaccination acceptance rates. Healthcare policymakers may consider targeting interventions to diminish the obstacles associated with booster vaccinations. These intervention strategies include implementing health intervention programmes, such as public health awareness initiatives, to raise awareness of the risks and severity of COVID-19, ultimately encouraging higher uptake of booster vaccines.

Why do Chinese Youth Seek Cancer Risk Information Online? Evidence from Four Cities

This study, inspired by the Risk Information Seeking and Processing (RISP) model, examines the mechanisms by which perceived hazard characteristics and the informational subjective norms of Chinese youth, aged from 14 to 44 years old, become associated with their intentions to seek cancer risk information online. A sample of 684 Chinese youths was collected from four cities in Mainland China with results revealing that perceived hazard characteristics and informational subjective norms motivate their online cancer risk information seeking intentions. Specifically, perceived probability, perceived severity, and institutional trust are positively related to negative affect, however the relationship between personal control and negative affect is not significant. Institutional trust and personal control are positively related to positive affect while perceived probability and perceived severity have no significant effect on positive affect. Negative affect and informational subjective norms are positively related to perceived information insufficiency, while the relationship between positive affect and perceived information insufficiency is not significant. Negative affect, positive affect, informational subjective norms, and perceived information insufficiency are all positively related to the online cancer risk information seeking intentions of Chinese youth.

Use of immunology in news and YouTube videos in the context of COVID-19: politicisation and information bubbles

Background

The COVID-19 pandemic propelled immunology into global news and social media, resulting in the potential for misinterpreting and misusing complex scientific concepts.

Objective

To study the extent to which immunology is discussed in news articles and YouTube videos in English and Italian, and if related scientific concepts are used to support specific political or ideological narratives in the context of COVID-19.

Methods

In English and Italian we searched the period 11/09/2019 to 11/09/2022 on YouTube, using the software Mozdeh, for videos mentioning COVID-19 and one of nine immunological concepts: antibody-dependent enhancement, anergy, cytokine storm, herd immunity, hygiene hypothesis, immunity debt, original antigenic sin, oxidative stress and viral interference. We repeated this using MediaCloud for news articles.Four samples of 200 articles/videos were obtained from the randomised data gathered and analysed for mentions of concepts, stance on vaccines, masks, lockdown, social distancing, and political signifiers.

Results

Vaccine-negative information was higher in videos than news (8-fold in English, 6-fold in Italian) and higher in Italian than English (4-fold in news, 3-fold in videos). We also observed the existence of information bubbles, where a negative stance towards one intervention was associated with a negative stance to other linked ideas. Some immunological concepts (immunity debt, viral interference, anergy and original antigenic sin) were associated with anti-vaccine or anti-NPI (non-pharmacological intervention) views. Videos in English mentioned politics more frequently than those in Italian and, in all media and languages, politics was more frequently mentioned in anti-guidelines and anti-vaccine media by a factor of 3 in video and of 3-5 in news.

Conclusion

There is evidence that some immunological concepts are used to provide credibility to specific narratives and ideological views. The existence of information bubbles supports the concept of the "rabbit hole" effect, where interest in unconventional views/media leads to ever more extreme algorithmic recommendations.

Which educational messengers do medical students prefer for receiving healthinformation? Development and psychometrics of using health messengers questionnaire

INTRODUCTION

Individuals vary in their selection of health messengers. This research aimed to construct an instrument to measure the preferences of medical students in selecting health messengers and in the next step to validate the aforementioned questionnaire.

METHOD

This research is a descriptive survey with an approach to construct a questionnaire. The statistical population included all students studying at Shiraz University of Medical Sciences in March to June 2022 in the academic year 2021-2022. 500 participants were involved in the study. To determine the types of health messengers and review the texts, a group of 15 primary items consisting of the 6 components of academic sources (2-items), formal news sources (2-items), mass media (3-items), internet search (2-items), social networks and messenger applications (4-items), and informal conversation (2-items) were compiled. A 4-point scale was developed the content validity of which was confirmed using CVI and CVR method and the reliability index was calculated to be 0.818. Factor analysis was also used to determine the construct validity and factor loading of each item.

RESULTS

The research covers university students in different medical fields. Using factor analysis, together with KMO = 0.810 and Bartlett's sphericity index P < 0.0001, saturation and the suitability of the test were confirmed. Students' preferences based on factor load were social media (28.92%), official and unofficial health sources(10.76%), academic sources (9.08%), internet search (8.18%), and mass media (7.13%), respectively. Among social media, Telegram (0.85) had the highest factor load followed by Instagram (0.79), and WhatsApp (0.71).

CONCLUSION

Medical students are always on the move and naturally prioritize mobile-based methods. They prefer messengers that are free from time and space restrictions. The widespread availability of mobile devices and the ability to search for and access information make it easier to test health information. Therefore, in health policy, attention should be paid to the virtual capabilities, especially mobile-based approaches.

Online Health Information Seeking: An Italian Case Study for Analyzing Citizens' Behavior and Perception

This study aims to understand people's behavior when searching for online health information (and COVID-19 information) and their perception of the trustworthiness and credibility of the searched information, the actors, and sources used to obtain it. A questionnaire addressed to people who permanently live in Italy between ages 19 and 60 has been used to collect data. Data extracted from the analysis are reassuring from the point of view of trust and credibility both in the actors and in the sources used to obtain information on health and COVID-19. A correlation between the analyzed individual features, the online health information-seeking behavior, and perception resulted from the analysis. The study also underlined a positive correlation between the perception of the influence of information on the knowledge of health problems and the ability to identify false online health information, and between the experience in detecting false health online information and the ability to detect it. Finally, a positive correlation also resulted between the experience in finding online health information and the experience in finding false COVID-19 information.

Psychological antecedents of COVID-19 information sharing within strong-tie and weak-tie networks

OBJECTIVE

This study investigates the psychological mechanisms underlying people's sharing of COVID-19 information within their strong-tie networks and weak-tie networks.

METHODS

A cross-sectional online survey was conducted between March and April 2020 (N = 609 Chinese adults). Measures included emotions and behavioral beliefs about COVID-19 information sharing, risk perceptions, and COVID-19 information acquisition and sharing behaviors. Multiple linear regression was performed to examine the psychological predictors of COVID-19 information sharing.

RESULTS

People were more likely to share COVID-19 information within their strong-tie networks when they experienced more negative emotions (β = .09, p = .01) and had stronger beliefs that information sharing would promote disease prevention (β = .12, p = .004). By comparison, negative emotions were the only significant predictor of COVID-19 information sharing (β = .12, p = .002) within weak-tie networks (β = .04, p = .31 for beliefs about sharing).

CONCLUSION

People may share COVID-19 information within weak-tie networks to cope with negative emotions regardless of whether they perceive information sharing as beneficial to disease prevention.

INNOVATION

Health educators should raise people's awareness of the psychological motivators of COVID-19 information sharing to create a healthy information environment for disease prevention.

Mediating Effects of Attitudes, Risk Perceptions, and Negative Emotions on Coping Behaviors

Based on the perspectives of social risk amplification and the knowledge-attitudes-practice model, this study aimed to test how the level of knowledge about COVID-19 and information sources can predict people's behavioral changes and to examine the effect mechanisms through the mediating roles of attitude, risk perception, and negative emotions in a survey of 498 older Chinese adults. The results showed that (1) older people had a lower level of factual knowledge regarding the variant strains and vaccines; (2) in the information sources-behavior, information sources had a critical influence on elderly individuals' coping behaviors; and (3) in the knowledge-behavior, factual knowledge had a significant effect on elderly individuals' coping behaviors. Specifically, for prevention behaviors, both risk perception and negative emotions played full mediating roles. The findings have significant implications for the development of an effective COVID-19 prevention program to older adults coping with pandemic conditions.

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

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

Excavating the social representations and perceived barriers of organ donation in China over the past decade: A hybrid text analysis approach

Background

Organ donation has been claimed as a prosocial behavior to prolong the recipient's life and deliver great love. However, the supply-demand ratio of organs in China is highly unbalanced. Being entangled with multiple factors derived from individual and supra-individual levels, organ donation in China is important but sensitive. Previous scholars usually depended on obtrusive approaches to explore the facilitators and hindrances of organ donation, which is hard to discover genuine perceptions toward organ donation. Besides, relatively limited scholarly attention has been paid to what hampers organ donation in China.

Objective

We intended to excavate the diversified social representations and perceived barriers to organ donation in China over the past decade.

Method

Two kinds of text analysis methods-semantic network analysis and conventional content analysis, were applied to 120,172 posts from ordinary users on the Sina Weibo platform to address the research questions.

Results

Regarding social representations, the "hope, understanding, and acceptance" of organ donation was the most pronounced one (34% of the whole semantic network), followed by "family story" (26%), "the procedure of organ donation in NGOs" (15%), "the practical value of organ donation" (14%), and "organ donation in the medical context" (11%). Regarding perceived barriers, a four-layer framework was constructed, including (1) the individual level, mainly about the fear of death and postmortem autopsy; (2) the familial level, which refers to the opposition from family members; (3) the societal level, which alludes to distrust toward medical institutions and the general society; (4) the cultural level, which covers religious-cultural concerns about fatalism.

Conclusion

In concordance with prior works on social representations regarding organ donation, the current study also uncovered the coexistence of antithetical representations about organ donation-the longing for survival and the fear of death. This representation pair serves as the foundation of Chinese people's ambivalence. Besides, family-related narratives were dispersed over various representations, demonstrating the critical position of family support in organ donation. Moreover, the four-layer framework concerning donation barriers affords a reference for future empirical studies. The practical implications of this work are further discussed.

Medical information seeking behavior of urban patients in Zhejiang Province, China: a cross-sectional study

Background

Health information seeking behavior (HISB) is a prevalent research topic. However, little is known about sociodemographic factors of HISB in China. This study aimed to examine the HISB of urban patients in China and identify predictors of source preference, online information seeking, and the timing of online seeking.

Methods

Based on the Health Information National Trends Survey (HINTS), this study conducted a cross-sectional survey of 1653 participants in different types of hospitals in 3 cities of different income levels within Zhejiang Province, China. Binary logistic regression analysis and multinomial logistic regression analysis were used to identify predictors of source preference, online medical information seeking, and the timing of online seeking for urban patients.

Results

The offline was the primary source of medical information for 58.61% of adult urban patients, while 78.19% had ever sought medical information online. 36.81% of online medical information seekers sought information before the medical visit, 8.65% sought information after the visit, and 54.54% sought information before and after the visit. China’s urban patients with higher education levels, higher income levels, young, active in internet use, and living in high-income cities were more likely to be active online medical information seekers (using the internet as the primary source) and online medical information seekers (having ever sought medical information online). Except for gender and age, most sociodemographic characteristics were not significantly associated with the timing of online medical information seeking.

Conclusions

Significant predictors of active online medical information seekers and online medical information seekers in China were almost the same. Regional economic development had a significant direct impact on medical information seekers. Most sociodemographic characteristics were not significantly associated with the timing of online medical information seeking. The findings of this study imply that China’s health information technology industry has Chinese characteristics.

Elucidating a Silent Illness: Hepatitis B Knowledge Among Asian Individuals in an Urban Center

BACKGROUND

Despite comprising less than 6% of the US population, Asian individuals make up more than half of the approximately 1.6 million chronic hepatitis B virus (HBV) infections in the United States. The purpose of this investigation was to identify characteristics associated with HBV knowledge in this disproportionately affected population.

METHODS

A cross-sectional, multilingual survey study using convenience sampling was conducted in a Midwestern urban city to collect information on respondents' demographics, health care access, and HBV knowledge. Hepatitis B virus knowledge was categorized into epidemiology, natural history, transmission, and vaccination. Data were analyzed using Kruskal-Wallis and Spearman correlation tests.

RESULTS

Of the 174 individuals who completed surveys, 139 (79.9%) were Asian. Characteristics of univariate analyses associated with higher knowledge scores included younger age (18-49 years), proficiency in reading English, college education, current employment status, physician using preferred language, last physician's visit in 2018 or prior, perceived lack of time to see a physician, use of emergency department, prior HBV vaccination, prior HBV testing, higher level of self-reported knowledge about HBV, and acquiring health information from the Internet, messaging applications, friends, and family (P < .05). In the multivariable analysis, shorter residency in the United States (0-10 years), current employment status, having heard of HBV, and confidence in their HBV knowledge were associated with higher knowledge scores.

CONCLUSION

Knowledge deficits existed in our study population regarding HBV transmission, vaccination, and epidemiology, while knowledge was higher regarding HBV natural history. Education efforts should be designed to improve knowledge deficits about HBV for individuals with risk factors using culturally sensitive Internet and social media platforms.

Online Health Information Seeking Behavior: A Systematic Review

The last five years have seen a leap in the development of information technology and social media. Seeking health information online has become popular. It has been widely accepted that online health information seeking behavior has a positive impact on health information consumers. Due to its importance, online health information seeking behavior has been investigated from different aspects. However, there is lacking a systematic review that can integrate the findings of the most recent research work in online health information seeking, and provide guidance to governments, health organizations, and social media platforms on how to support and promote this seeking behavior, and improve the services of online health information access and provision. We therefore conduct this systematic review. The Google Scholar database was searched for existing research on online health information seeking behavior between 2016 and 2021 to obtain the most recent findings. Within the 97 papers searched, 20 met our inclusion criteria. Through a systematic review, this paper identifies general behavioral patterns, and influencing factors such as age, gender, income, employment status, literacy (or education) level, country of origin and places of residence, and caregiving role. Facilitators (i.e., the existence of online communities, the privacy feature, real-time interaction, and archived health information format), and barriers (i.e., low health literacy, limited accessibility and information retrieval skills, low reliable, deficient and elusive health information, platform censorship, and lack of misinformation checks) to online health information seeking behavior are also discovered.

Exploring public perceptions of the COVID-19 vaccine online from a cultural perspective: Semantic network analysis of two social media platforms in the United States and China

The development and uptake of the COVID-19 (coronavirus disease 2019) vaccine is a top priority in stifling the COVID-19 pandemic. How the public perceives the COVID-19 vaccine is directly associated with vaccine compliance and vaccination coverage. This study takes a cultural sensitivity perspective and adopts two well-known social media platforms in the United States (Twitter) and China (Weibo) to conduct a public perception comparison around the COVID-19 vaccine. By implementing semantic network analysis, results demonstrate that the two countries' social media users overlapped in themes concerning domestic vaccination policies, priority groups, challenges from COVID-19 variants, and the global pandemic situation. However, Twitter users were prone to disclose individual vaccination experiences, express anti-vaccine attitudes. In comparison, Weibo users manifested evident deference to authorities and exhibited more positive feelings toward the COVID-19 vaccine. Those disparities were explained by the cultural characteristics' differences between the two countries. The findings provide insights into comprehending public health issues in cross-cultural contexts and illustrate the potential of utilizing social media to conduct health informatics studies and investigate public perceptions during public health crisis time.

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.