Health information seeking, receipt, and use in diabetes self-management

Information behaviours of people with type 2 diabetes in Kuwait: a grounded theory study

BACKGROUND

Relative to country-specific epidemiological trends, Kuwait experiences a far greater burden of type 2 diabetes among its population. Information behaviours form a significant component of self-care management for patients diagnosed with type 2 diabetes, however this remains an understudied aspect of disease management. This study aims to investigate the information behaviours of patients with type 2 diabetes in Kuwait, and characterise the methods employed to manage their disease.

METHODS

This qualitative study employed a grounded theory method. Semi-structured interviews were conducted with twenty-seven participants over three phases of data collection in primary, secondary and tertiary healthcare settings across Kuwait. These were complemented by in-depth interviews to detail the information behaviours of these participants. The interviews were translated where appropriate, transcripts, and analysed through qualitative coding to synthesise the information behaviour patterns.

RESULTS

The findings demonstrated that living with type 2 diabetes involved a range of developmental and transformative stages, including changes to the patients' emotional state, reconstruction of their lifestyle and identity, and changes in the ways they find and use information. Living with the chronic condition was viewed as a dynamic and transitional process, where patients' information behaviours continually changed throughout the process across various identifiable stages. This dynamic pattern was reflected most prominently across the participants' behavioural needs, sources and information-seeking patterns.

CONCLUSION

Patients with type 2 diabetes continuously adapted their information behaviours to optimise the self-management of their condition across a relatively predictable pattern. Greater understanding of these behaviours across a wider population would improve the provision of clinical care for patients with diabetes.

Information-seeking Behavior of Iranian Young Adults (18-28 Years Old) Regarding HPV on Social Media: A Preventive Approach to HPV

Background

Health information-seeking behavior refers to individuals' targeted actions to satisfy their health information needs and search for relevant disease-related information. Nowadays, social media platforms provide a great opportunity for meeting health information needs and delivering preventive education regarding human papillomavirus (HPV). The purpose of this study is the information-seeking behavior of Iranian young adults (18-28 years old) regarding HPV on social media, a preventive approach to HPV.

Methods

The present descriptive-analytical study was conducted in 2023 among Iranian boys and girls aged 18-28 years. A multistage cluster sampling method was used to select 3840 participants. The data collection tool was Longo's Health Information-Seeking Behavior Questionnaire. The collected data were analyzed using the SPSS software.

Results

The results showed that Iranian youth aged 18-28 were more inclined to seek information on social media about the transmission routes and preventive measures for HPV. The primary informational need regarding transmission was "I want to know the main route of HPV transmission is through vaginal and anal intercourse?", and regarding prevention, it was "Can condoms prevent HPV infection?" Additionally, the findings indicated that young individuals sought information about HPV after their first sexual encounter. Most of the information needs of the youth were fulfilled through YouTube, Instagram, and WhatsApp, mainly in video format. Approximately 85.10% of the youth were satisfied with the information obtained from social media. The results revealed a significant and positive relationship between the health information needs of young adults (18-28 years old) in the area of HPV and personal factors. Gender, age, marital status, education level, history of HPV infection, and engaging is unprotected extramarital sex were identified as significant influential factors on the level of information needs of young individuals, especially regarding HPV preventive measures (P < 0.05).

Conclusion

Health authorities and disease control and prevention centers need to harness the potential of social media in meeting the informational needs of youth and providing education and awareness, especially concerning the transmission and prevention of HPV.

Rethinking Health Recommender Systems for Active Aging: An Autonomy-Based Ethical Analysis

Health Recommender Systems are promising Articial-Intelligence-based tools endowing healthy lifestyles and therapy adherence in healthcare and medicine. Among the most supported areas, it is worth mentioning active aging. However, current HRS supporting AA raise ethical challenges that still need to be properly formalized and explored. This study proposes to rethink HRS for AA through an autonomy-based ethical analysis. In particular, a brief overview of the HRS' technical aspects allows us to shed light on the ethical risks and challenges they might raise on individuals' well-being as they age. Moreover, the study proposes a categorization, understanding, and possible preventive/mitigation actions for the elicited risks and challenges through rethinking the AI ethics core principle of autonomy. Finally, elaborating on autonomy-related ethical theories, the paper proposes an autonomy-based ethical framework and how it can foster the development of autonomy-enabling HRS for AA.

"I Saw it Incidentally but Frequently": Exploring the Effects of Online Health Information Scanning on Lung Cancer Screening Behaviors Among Chinese Smokers

In China, lung cancer is the most common cancer with high mortality. While prior research suggests that health information scanning influences cancer screening within the general population, a deeper exploration of the underlying mechanisms is imperative. This study specifically targets smokers, aiming to investigate whether online health information scanning can effectively encourage lung cancer screening and elucidate the mechanisms driving this association. Data were extracted from a Chinese national survey conducted between January and September 2023, exclusively involving current smokers (N = 992). A moderated mediation model was employed to examine a cognitive-affective sequential chain of mediation through risk perceptions and cancer worry. Results showed that 99.1% of Chinese smokers reported online health information scanning, which possessed significant influence. Online health information scanning was positively associated with effective lung cancer screening among smokers directly (OR = 1.927, p < .01) and indirectly (OR = .065, p < .001). The perceived threat of smoking and cancer worry served as the cognitive and affective mediating mechanisms. Furthermore, a moderating effect of eHealth literacy was observed (OR = 6.292, p < .05). Smokers with higher eHealth literacy are more inclined to undergo effective lung cancer screening. Based on these findings, public health sectors should leverage online platforms to disseminate tailored cancer screening education and implement initiatives to enhance public eHealth literacy.

Social support via Internet communication technology for diabetes self-management: a scoping review

Background

The global prevalence of diabetes has been increasing over the past 30 years, leading to a rise in complications; diabetes is the leading cause of amputations, blindness, and kidney failure in developed countries. Diabetes self-management is challenging due to the complex lifestyle changes required. Social support from family and friends plays a crucial role in overcoming barriers to healthy behavior choices. Integrating Internet and communication technologies with social support interventions has the potential to improve diabetes self-management.

Methods

A scoping review was conducted by searching PubMed, Ovid, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Association for Computing Machinery (ACM) Digital Library databases for studies combining diabetes, Internet and communication technologies, and social support interventions. Inclusion criteria focused on adult patients with diabetes and primarily Internet and communication technologies-based strategies to initiate and enhance social support. Data abstraction included study population, design, outcomes, social support domains emphasized, support relationship intervention strategy, and Internet and communication technologies modality.

Results

The review identified 39 articles and 33 unique studies representing 27 unique interventions utilizing peer web forums, interactive voice recordings, messaging-based interventions (including Short Message Service and instant messaging), and email as Internet and communication technologies modalities. Various outcomes were reported, including improvements in perception of social support, psychosocial well-being, behavior changes, and clinical outcomes. Existing support relationships may be more effective in promoting behavior change and clinical outcomes compared to developing new relationships. Studies that explicitly measured patients' perception of support consistently showed improvements in psycho-social, behavioral, and clinical outcomes.

Conclusions

This scoping review highlights the pivotal role of social support in diabetes self-management. By integrating Internet and communication technologies into interventions, diverse modalities such as web forums and text messaging have shown promise in enhancing patients' perception of support and improving psychosocial well-being, behavior changes, and clinical outcomes. The emphasis on leveraging existing support relationships, rather than establishing new ones, underscores the effectiveness of personalized, patient-centered approaches. These findings provide essential insights for healthcare strategies, emphasizing the need to harness technology and existing social networks to empower individuals in managing diabetes effectively.

The Association of eHealth Literacy Skills and mHealth Application Use Among US Adults With Obesity: Analysis of Health Information National Trends Survey Data

BACKGROUND

Physical inactivity and a poor diet are modifiable behaviors that contribute to obesity. Obesity is a well-recognized risk factor for chronic diseases, including diabetes. Mobile health (mHealth) apps can play an important adjuvant role in preventing and treating chronic diseases and promoting positive health behavior change among people with obesity, and eHealth literacy skills have the potential to impact mHealth app use.

OBJECTIVE

The purpose of this study was to explore the associations between the 2 dimensions, access and application, of eHealth literacy skills and mHealth app use among US adults (≥18 years of age) with obesity (BMI ≥30 kg/m2).

METHODS

Data were obtained from February to June 2020 using the Health Information National Trends Survey 5. A total of 1079 respondents met the inclusion criteria of adults with obesity and owners of smartphones. Individual associations between mHealth app use and sociodemographic variables were explored using weighted chi-square and 2-tailed t tests. A multivariable weighted logistic regression model was fitted, and adjusted odds ratios (ORs) of using mHealth apps with corresponding 95% CIs were reported across multiple sociodemographic variables. An Ising model-weighted network visualization was produced. A receiver operating characteristic curve was calculated, and the area under the curve was reported with the corresponding Delong 95% CI.

RESULTS

A majority of respondents were female (550/923, 59.6%) or non-Hispanic White (543/923, 58.8%). Individuals in households earning less than US $50,000 comprised 41.4% (382/923) of the sample. All sociodemographic variables were found to be univariately significant at the 5% level, except employment and region. Results from the multivariable weighted logistic regression model showed that the adjusted odds of using an mHealth app are 3.13 (95% CI 1.69-5.80) and 2.99 (95% CI 1.67-5.37) times higher among those with an access eHealth literacy skill of using an electronic device to look for health or medical information for themselves and an application eHealth literacy skill of using electronic communications with a doctor or doctor's office, respectively. Several sociodemographic variables were found to be significant, such as education, where adjusted ORs comparing subgroups to the lowest educational attainment were substantial (ORs ≥7.77). The network visualization demonstrated that all eHealth literacy skills and the mHealth app use variable were positively associated to varying degrees.

CONCLUSIONS

This work provides an initial understanding of mHealth app use and eHealth literacy skills among people with obesity, identifying people with obesity subpopulations who are at risk of a digital health divide. Future studies should identify equitable solutions for people with obesity (as well as other groups) and their use of mHealth apps.

Profiling Cancer Patients Based on Their Motives for Seeking Informational and Emotional Support Online

Understanding why patients seek informational and/or emotional support online is fundamental to providing patients with accurate and reliable support that is tailored to their needs, preferences, and personal situation. Based on the stress and coping theory and uses and gratifications theory (UGT), this study aimed to identify theoretically-founded profiles of cancer patients differing in their motives for seeking informational and/or emotional support online, and to compare the profiles in terms of patients' psychological and background characteristics, and perception of health care services. Hierarchical cluster analysis was conducted, using questionnaire data from patients visiting a large Dutch health website (N = 181). This revealed three distinctive profiles, i.e., overall seekers (n = 83, 46.0%), occasional information seekers (n = 83, 46.0%), and contact exchangers (n = 15, 8.0%). Patients across these profiles differed in their eHealth literacy, with the contact exchangers being more eHealth literate than the overall seekers and occasional information seekers. The results can be used to create awareness among health care providers, web designers, and patient organizations on different types of cancer patients with different motives for seeking informational and/or emotional support online, and help them to tailor recommendations to and development of (online) sources that fit patients' needs. Future research could further investigate the integration of stress and coping theory with UGT by acknowledging the interplay of different coping strategies and different gratifications.

Understanding the Process of Family Cancer History Collection and Health Information Seeking

PROBLEM ADDRESSED

To better understand the factors associated with family cancer history (FCH) information and cancer information seeking, we model the process an individual undergoes when assessing whether to gather FCH and seek cancer information and compare models by sociodemographics and family history of cancer. We used cross-sectional data from the Health Information National Trends Survey (HINTS 5, Cycle 2) and variables (e.g., emotion and self-efficacy) associated with the Theory of Motivated Information Management to assess the process of FCH gathering and information seeking. We completed path analysis to assess the process of FCH gathering and stratified path models.

RESULTS

Those who felt they could lower their chances of getting cancer (emotion) were more confident in their ability to complete FCH on a medical form (self-efficacy; B = 0.11, p < .0001) and more likely to have discussed FCH with family members (B = 0.07, p < .0001). Those who were more confident in their ability to complete a summary of their family history on a medical form were more likely to have discussed FCH with family members (B = 0.34, p < .0001) and seek other health information (B = 0.24, p < .0001). Stratified models showed differences in this process by age, race/ethnicity, and family history of cancer.

IMPLICATIONS FOR PUBLIC HEALTH RESEARCH AND PRACTICE

Tailoring outreach and education strategies to address differences in perceived ability to lower chances of getting cancer (emotion) and confidence in the ability to complete FCH (self-efficacy) could help encourage less engaged individuals to learn about their FCH and gather cancer information.

Does fear drive health app adoption? The role of threat perception in diabetes app usage

BACKGROUND AND AIM

This study explores the interplay between fear or threat perception and adoption of health apps among individuals with diabetes. It draws on the concept of "fear" as an emotional response stemming from perceived threat, raising the question of whether threat perception drives the uptake of health apps.

METHODS

This study investigates the influence of diabetes threat perception on app adoption, akin to the role of fear appeal in behavior change communication. This study employed both a handout questionnaire and an online survey tool, Survey Monkey, for data collection. Using purposive sampling, data were collected from 222 individuals aged 35 years and above with diabetes in Chennai.

RESULTS

The results indicate that threat perception can trigger health app usage among people with high diabetic conditions, supporting the broader literature on fear appeal. Additionally, the perceived threat of diabetes is elevated among app users. Notably, a significant positive correlation exists between perceived threat of diabetes, daily app usage, and consistent app use.

CONCLUSION

This study underscores that the extent of perceived harm or vulnerability to threats influences individuals' behavioral changes. It introduces new avenues for encouraging health app usage among high-risk groups.

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.

Who can help me? Understanding the antecedent and consequence of medical information seeking behavior in the era of bigdata

Introduction

The advent of bigdata era fundamentally transformed the nature of medical information seeking and the traditional binary medical relationship. Weaving stress coping theory and information processing theory, we developed an integrative perspective on information seeking behavior and explored the antecedent and consequence of such behavior.

Methods

Data were collected from 573 women suffering from infertility who was seeking assisted reproductive technology treatment in China. We used AMOS 22.0 and the PROCESS macro in SPSS 25.0 software to test our model.

Results

Our findings demonstrated that patients' satisfaction with information received from the physicians negatively predicted their behavior involvement in information seeking, such behavior positively related to their perceived information overload, and the latter negatively related to patient-physician relationship quality. Further findings showed that medical information seeking behavior and perceived information overload would serially mediate the impacts of satisfaction with information received from physicians on patient-physician relationship quality.

Discussion

This study extends knowledge of information seeking behavior by proposing an integrative model and expands the application of stress coping theory and information processing theory. Additionally, it provides valuable implications for patients, physicians and public health information service providers.

Self-Care Practices and Their Role in the Control of Diabetes: A Narrative Review

Diabetes mellitus (DM) is a long-standing, continuously growing metabolic ailment in which levels of glucose in the blood increase due to a total (DM of type 1) or incomplete (DM of type 2) decrease in the level of the hormone insulin. Diabetes mellitus affects a large number of individuals worldwide, and as more people develop the disease, the burden will double from what it is now. The requirements of people suffering from diabetes are not only confined to the control of blood glucose; there is also a need to prevent disabilities, side effects, and difficulties in rehabilitation. Studies suggest that seven self-care practices for individuals suffering from this disease have shown good outcomes. Those practices include assessment of sugar levels in the blood, consuming healthy foods, remaining physically active, taking medications regularly and on time, maintaining healthy behavior, and decreasing risk factors. All of these practices collectively have shown good results in maintaining blood glucose levels, decreasing side effects, and increasing life expectancy in people with diabetes mellitus. Those who have DM and practice self-care have shown positive results by reducing the complications of DM, decreasing its progression, and leading to a huge reduction in the burden due to DM. Despite these positive changes, people sticking to these self-care practices are very few, specifically when we see broad and chronic changes. There are many positive contributing factors, such as social factors, demographic factors, and various socio-economic factors, but the role of physicians in increasing the practices associated with personal care for people with this disease is crucial and most important for the desired outcome. Keeping in mind the burden and multidimensional nature of the disorder, proper systematic and combined efforts are needed to increase these self-care practices in patients with diabetes to reduce any chronic side effects and complications.

Topic Modeling Analysis of Diabetes-Related Health Information during the Coronavirus Disease Pandemic

This study aimed to provide diabetes-related health information by analyzing queries posted in the diabetes-related online community required during the COVID-19 pandemic. A total of 9156 queries from the diabetes-related online community, dated between 1 December 2019 and 3 May 2022, were used in the study. The collected data were preprocessed for bidirectional encoder representation from transformer topic modeling analysis. Topics were extracted using the class-based term frequency-inverse document frequency for nouns and verbs. From the extracted verbs, words with common definitions were subject to substitution and unification processes, which enabled the identification of multifrequent verb categories by noun topics. The following nine noun topics were extracted, in this order: dietary management, drug management, gestational and childhood diabetes, management of diabetic complications, use and cost of medical treatment, blood glucose management, exercise treatment, COVID-19 vaccine and complications, and diabetes in older adults. The top three verb categories by noun topics were permission, method, and possibility. This study provided baseline data that can be used by clinical nurses to deliver diabetes-related education and management based on information sought by patients.

Utility and usability evaluation of an information diary tool to measure health information access and exposure among patients with high cardiovascular risk

Background

Online health misinformation about statins potentially affects health decision-making on statin use and adherence. We developed an information diary platform (IDP) to measure topic-specific health information exposure where participants record what information they encounter. We evaluated the utility and usability of the smartphone diary from the participants' perspective.

Methods

We used a mixed-method design to evaluate how participants used the smartphone diary tool and their perspectives on usability. Participants were high cardiovascular-risk patients recruited from a primary care clinic and used the tool for a week. We measured usability with the System Usability Scale (SUS) questionnaire and interviewed participants to explore utility and usability issues.

Results

The information diary was available in three languages and tested with 24 participants. The mean SUS score was 69.8 ± 12.9. Five themes related to utility were: IDP functions as a health information diary; supporting discussion of health information with doctors; wanting a feedback function about credible information; increasing awareness of the need to appraise information; and wanting to compare levels of trust with other participants or experts. Four themes related to usability were: ease of learning and use; confusion about selecting the category of information source; capturing offline information by uploading photos; and recording their level of trust.

Conclusion

We found that the smartphone diary can be used as a research instrument to record relevant examples of information exposure. It potentially modifies how people seek and appraise topic-specific health information.

Understanding Contexts and Challenges of Information Management for Epilepsy Care

Epilepsy is a common chronic neurological disease. People with epilepsy (PWE) and their caregivers face several challenges related to their epilepsy management, including quality of care, care coordination, side effects, and stigma management. The sociotechnical issues of the information management contexts and challenges for epilepsy care may be mitigated through effective information management. We conducted 4 focus groups with 5 PWE and 7 caregivers to explore how they manage epilepsy-related information and the challenges they encountered. Primary issues include challenges of finding the right information, complexities of tracking and monitoring data, and limited information sharing. We provide a framework that encompasses three attributes - individual epilepsy symptoms and health conditions, information complexity, and circumstantial constraints. We suggest future design implications to mitigate these challenges and improve epilepsy information management and care coordination.

The Impact of Individual Factors on Health Information-Seeking Behavior of Infertile Couples Undergoing Assisted Reproductive Technologies: Longo Model

Background

This study investigated the impact of individual factors on the Health information-seeking behavior (HISB) of infertile couples undergoing Assisted Reproductive Technologies (ART).

Materials and Methods

This applied study was done using the descriptive-analytical method. The population of the study remains to be infertile couples undergoing ART referred to a public Infertility Center and a private one in Bandar Abbas (capital of Hormozgan province, Southern Iran) in the summer of 2020. Using simple random sampling, 168 people were selected. The data collection tool was a questionnaire extracted from Longo HISB Model, used after validation and reliability. Data were analyzed by SPSS software using descriptive and inferential tests.

Results

The results showed that individual factors (gender, education, income, age, and cause of infertility) affect the HISB of infertile couples. Based on the analysis of variance, there was a significant difference between infertile couples concerning Passive Information Receipt (F = 2.688 and P = 0.048) so the couples with a male cause used Passive Information Receipt more.

Conclusions

Considering the results, it is necessary for the country's health system to take appropriate measures to provide an appropriate situation for better decision-making for infertile couples and improve the chances of fertility by reducing the existing inequalities to Active Information Receipt and quality health information.

European national health plans and the monitoring of online searches for information on diabetes mellitus in different European healthcare systems

Diabetes mellitus (DM) is a serious non-communicable disease (NCD) and relies on the patient being aware of their condition, proactive, and having adequate medical care. European countries healthcare models are aware of the impact of these variables. This study evaluates the impact of online health information seeking behavior (OHISB) during World Diabetes Mellitus Day (WDMD) in European countries from 2014 to 2019 by grouping countries according to the changes in citizens' search behavior, diabetes mellitus prevalence, the existence of National Health Plans (NHP), and their respective healthcare systems. We extracted data from Global Burden of Disease, Google Trends (GT), Public Health European Commission, European Coalition for Diabetes, and the Spanish Ministry of Health. First, we used the broken-line models to analyze significant changes in search trends (GT) in European Union member countries in the 30-day intervals before and after the WDMD (November 14) from 2014 to 2019. Then the results obtained were used in the second phase to group these countries by factor analysis of mixed data (FAMD) using the prevalence of DM, the existence of NHP, and health models in each country. The calculations were processed using R software (gtrendsR, segmented, Factoextra, and FactoMineR). We established changes in search trends before and after WDMD, highlighting unevenness among European countries. However, significant changes were mostly observed among countries with NHP. These changes in search trends, in addition to being significant, were reiterated over time and occurred especially in countries belonging to the Beveridge Model (Portugal, Spain, and Sweden) and with NHPs in place. Greater awareness of diabetes mellitus among the population and continuous improvements in NHP can improve the patients' quality of life, thus impacting in disease management and healthcare expenditure.

An online intervention for 18-25-year-old youth whose parents have a mental illness and/or substance use disorder: A pilot randomized controlled trial

AIM

Young adults aged 18-25 whose parents have a mental illness or substance use problem can be vulnerable to multiple difficulties in adulthood. There are, however, few available interventions designed for this group. This study evaluated a 6 week online intervention (mi. spot; mental illness: supported, preventative, online, targeted) specifically designed for this population. The intervention aims to improve mental health and wellbeing.

METHODS

Forty-one young people, recruited from the community, participated in a two-arm parallel randomized controlled trial where participants were randomized to mi. spot (n = 22) or a wait list control group (n = 19). They were assessed at baseline, immediately post intervention and at six weeks post intervention with measures covering depression, anxiety and stress, wellbeing, coping, general self-efficacy, help seeking and social connectedness.

RESULTS

Intervention participants reported significantly improved psychological wellbeing, coping, general self-efficacy, and a reduction in anxiety. Participants in the control group reported significant improvements in emotional wellbeing and help seeking and a reduction in self-blame.

CONCLUSION

This pilot controlled trial supported previous findings and shows preliminary evidence that mi.spot is effective for young adults who grew up with parents who have a mental illness or substance use problem. A large-scale, randomized controlled trial with a diverse group of young people is needed.

Qualitative Research Studies Addressing Patient-Practitioner Communication about Online Health Information

Modern healthcare is becoming increasingly technologized, knowledge-intensive, and specialized, which has consequences for communication between patients and practitioners in clinical encounters. Health information is increasingly accessible to patients through online resources. The objective of this paper is to provide an overview of existing studies that address how patients communicate with practitioners about online health information and to identify the key topics raised in these studies. With the concept of eHealth literacy as its point of departure, this paper specifically highlights the eHealth literacy topic of how patients comprehend, appraise and communicate online health information before and during the encounter with the healthcare professionals. In the literature search, we focus on qualitative studies that consider patients' and/or practitioners' reflections on online health information. We searched PUBMED, SCOPUS and Web of Science to capture research from various fields. Sixteen studies were included that met the following criteria: Qualitative study, focus on patient-practitioner communication, eHealth literacy and online information. The results show that the vast majority of studies were based on qualitative interviews, addressing patients' and practitioners' perspectives. Key topics in studies addressing patient perspectives were: reasons for seeking online information; calibrating understanding of online information with the practitioner; and barriers to discussing online information with practitioners. Key topics raised in studies focusing on practitioners were: trust in the patient and the online health information he/she presented as well as strategies to respond to patients who referred to online health information. The review highlights the need for further qualitative studies, preferably observational studies from authentic clinical communication situations, in order to capture how patients and practitioners communicate about online health information.

Structured diabetes self-management education and its association with perceived diabetes knowledge, information, and disease distress: Results of a nationwide population-based study

OBJECTIVE

To evaluate, how participation in structured diabetes self-management education (DSME) programs is associated with perceived level of knowledge about diabetes, information needs, information sources and disease distress.

METHODS

We included 796 ever- and 277 never-DSME participants of the population-based survey "Disease knowledge and information needs - Diabetes mellitus (2017)" from Germany. Data on perceived level of diabetes knowledge (12 items), information needs (11 items), information sources (13 items) and disease distress (2 indices) were collected. Multiple logistic regression analyses were used to examine the association of DSME-participation with these outcomes.

RESULTS

DSME-participants showed a higher level of diabetes knowledge compared to never-DSME participants, particularly in aspects concerning diabetes in general (odds ratio 2.53; 95% confidence intervals 1.48-4.33), treatment (2.41; 1.36-4.26), acute complications (1.91; 1.07-3.41) and diabetes in everyday life (1.83; 1.04-3.22). DSME-participants showed higher information needs regarding late complications (1.51; 1.04-2.18) and acute complications (1.71; 1.71-2.48) than DSME never participants. DSME-participants more frequently consulted diabetologists (5.54; 3.56-8.60) and diabetes care specialists (5.62; 3.61-8.75) as information sources. DSME participation was not associated with disease distress.

CONCLUSION

DSME is a valuable tool for improving individual knowledge about diabetes. However, DSME should focus more on psychosocial aspects to reduce the disease burden.

Disparity and Factors Associated With Internet Health Information Seeking Among US Adults Living With Diabetes Mellitus: Cross-sectional Study

Background

Many patients with chronic medical conditions search the internet to obtain medical advice and health information to improve their health condition and quality of life. Diabetes is a common chronic disease that disproportionately affects different race and ethnicity groups in the United States. In the existing literature on the popularity of internet health information seeking among persons with a chronic medical condition, there are limited data on US adults living with diabetes.

Objective

This study aims to examine the factors associated with internet health information seeking among US adults living with diabetes and whether there is a disparity in internet health information seeking stratified by race and ethnicity.

Methods

We conducted a cross-sectional study using the Health Information National Trends Survey data from 2017 to 2020. We selected our study sample based on respondents’ reports on whether they were told they had diabetes, and our primary outcome was internet health information–seeking behavior. We used 2 multivariable logistic regression models to examine the effects of sociodemographic factors and other covariates on the internet health information–seeking behavior of adults with diabetes. Jackknife replicate weights were used to provide bias-corrected variance estimates.

Results

Our study sample included 2903 adults who self-reported that they had diabetes. In total, 60.08% (1744/2903) were non-Hispanic White individuals, 46.88% (1336/2850) were men, and 64% (1812/2831) had some college or graduate education. The prevalence of internet health information seeking in this population was 64.49% (1872/2903), and the main factors associated with internet health information seeking included education level (some college vs less than high school: odds ratio [OR] 1.42, 95% CI 1.44-1.88; and college graduate or higher vs less than high school: OR 2.50, 95% CI 1.79-3.50), age (age group ≥65 years vs age group 18-44 years: OR 0.46, 95% CI 0.34-0.63), and household income level (P<.001). In addition, we found significant differences in the effects of predictors stratified by race.

Conclusions

The findings from this study suggest that internet health information seeking is common among US adults living with diabetes. Internet health information could influence the relationship between health care providers and adults living with diabetes and improve their self-management and quality of life.

Leveraging information literacy: Mapping the conceptual influence and appropriation of information literacy in other disciplinary landscapes

Information literacy forms a key concept within Library and Information Science, where it forms the focus of scholarship, conferences, journals and teaching librarian practice, alike. However, little is known about how other fields and disciplines have employed these outputs within their own research and practice. This paper examines how the concept of information literacy has been leveraged into the discourses of non-Library and Information Science disciplinary landscapes. This is achieved through a qualitative mapping of five different fields and disciplines, including Higher Education, Management and Business, Public Health, Nursing and Psychology, to identify how information literacy terminology, definitions, theories and frameworks have travelled across scholarly and practice boundaries to become appropriated into other disciplinary landscapes. The aim of this collaborative work is to develop an indicative rather than an exhaustive understanding of what travels within information literacy research and practice and to strengthen the Library and Information Science narrative on the impact of information literacy activities.

Contextual Health Information Behavior in the Daily Lives of People with Type 2 Diabetes: A Diary Study in Scotland

Changes in lifestyle can have positive effects on treating type 2 diabetes (T2D), like sporting or healthy eating. Therefore, a person diagnosed with T2D is often advised to make healthy choices throughout the day, in addition to other interventions such as medication. To do this, he or she needs health information to support decision-making. Literature describes ample categorizations of types of (health) information behavior and theoretical models that explain the factors that drive people to search for, encounter or avoid information. However, there are few longitudinal studies about triggers and factors in daily life that affect health information behavior (HIB). This study was set up to identify triggers, actions and outcomes for active, passive and avoidant HIB situations in daily life among Scots with Type 2 diabetes (T2D) to identify points of attention for communication strategies. Twelve participants took part in a four-week diary study. Every day, participants received an online diary form to describe active, passive or avoidant HIB situations. Data collection resulted in 53 active, 120 passive and 25 avoidant diary entries. Seven active HIB contexts (e.g., experiencing symptoms, cooking dinner, sports training) and five passive HIB contexts (e.g., home, work, medical facility) were identified. Four motivations for avoidance were found (e.g., time constraints, no health trigger). These results can be used to supplement the theoretical models of health information behavior. Furthermore, health professionals can use these results to support their clients with T2D in the self-management of their health, by guiding them to trustworthy sources of health information and lowering barriers for searching health information.

Application of theory of planned behavior in identifying factors affecting online health information seeking intention and behavior of women

Purpose

Today, the Internet has become an attractive source for obtaining health information. Since women play an important role in maintaining the health of the family and community and since they are active seekers of health information through the Internet, it is essential to examine their online health information seeking behavior. Therefore, the main purpose of this article is to identify the factors affecting the online health information seeking intention and behavior of women.

Design/methodology/approach

The theoretical framework of this quantitative study was based on the theory of planned behavior. A total of five hypothesized relationships were formulated to develop a conceptual model. The study approach was quantitative. Using simple random sampling, 400 women referred to specialized and sub-specialized clinics of Hamadan University of Medical Sciences, Iran participated in the study and responded to the survey. Descriptive and inferential data analysis was performed using SPSS 21 and Smart PLS 3 software.

Findings

The results showed that the intention to find health information online is a function of psychological variables. These variables include attitude, subjective norms and perceived behavioral control. Findings showed that attitude is the most important factor affecting online health information seeking intention. It was also found that online health information seeking intention has a positive and significant effect on women's information seeking behavior.

Originality/value

This study is the first attempt to use an important and universally accepted theory to identify the factors affecting the online health information seeking behavior of women referring to specialized and sub-specialized clinics and provides important practical concepts for health officials and managers to improve and develop online health information seeking behavior.

Experiences of Online COVID-19 Information Acquisition among Persons with Type 2 Diabetes and Varying eHealth Literacy

During the COVID-19 pandemic, the Internet has been a major source of information for people to keep updated with news and guidelines. However, concerns have been raised about the ‘infodemic’, which includes the overabundance of online information and the spread of misleading information. Adequate eHealth literacy skills among world citizens have therefore been emphasized as vital during the pandemic. Persons with type 2 diabetes have been at increased risk of severe outcomes of COVID-19 disease. This study aimed to explore online COVID-19 information acquisition experiences among persons with type 2 diabetes and varying eHealth literacy. Fifty-eight participants filled out the eHealth Literacy Scale (eHEALS), along with a qualitative questionnaire with free-text questions. Additionally, 10 participants were interviewed. Thematic analysis was applied to identify patterns in participants’ experiences. Two domains were identified: perceived challenges with online information about COVID-19, and coping strategies to manage challenges. The perceived challenges were: being exposed to information overload, dealing with conflicting information, and being strongly emotionally affected. The related coping strategies were: protecting oneself, trusting authorities, taking command, and using common sense. These strategies often involved triangulation of the information obtained, including participants consulting their common sense, various sources, or family and friends. This paper highlights the crucial role of authorities in delivering online information, that according to health literacy principles, is easy to access, understand, and use. Furthermore, our results reinforce the importance of diabetes nurses, as well as healthcare professionals in general, in encouraging patients to share their Internet findings, promote information from reliable sources, and deliver tailored information that suits individual needs. Because our results underline the importance of social support in eHealth literacy and the assessment of online health information, the inclusion of family and friends needs to be increasingly considered in diabetes care. Due to the small homogenous sample, the results of this study cannot be generalized. However, the reader can assess the transferability to other situations and settings based on our contextual descriptions.

The missing link: Towards an integrated health and information literacy research agenda

Information forms one of the main commonalities shared between definitions of health literacy. However, information literacy research, which centres how people become informed within a specific setting, has been almost completely sidelined from health literacy scholarship. This oversight risks limiting understanding of how health literacy is practised as well as narrowing research discourses. It also forms a missed opportunity as the recent sociocultural turn creates a valuable point of synergy between each field. This paper carries out a narrative literature review to identify key areas where information literacy research could help to extend understanding about how people interact with information within health contexts. Centred on exploring theoretical and empirical work, the paper uses examples from literature to suggest that assumptions related to how information, models of information use, social dynamics of information environments, the outcomes of information activity and critical approaches to information practice are understood impact the scope and the reach of health literacy research and practice. The goal of this paper is to establish an initial, shared research agenda that places health and information literacy in dialogue rather than in isolation from each other.

Healthy or not? The impact of conflicting health-related information on attentional resources

Despite its ubiquity, little is known about the impact of exposure to conflicting health information on cognitive efficiency. We hypothesized that it would reduce attentional capacity, as evidenced by (1) increased response errors during the Attention Network Test (ANT), (2) decreased efficiency of each ANT system (alerting, orienting, execute control), and (3) increased self-reported workload, (4) nutritional confusion and (5) nutritional backlash. A sample of 184 online participants were assigned randomly to read an article containing either congruent or conflicting health information. Subsequently, they completed the ANT and self-report measures of workload, nutritional confusion, and backlash at nutritional recommendations and research. Participants in the conflicting health information condition made more errors, had overall slower reaction times, and reported greater workload, nutritional confusion, and backlash. No differences were found for individual ANT systems. These findings suggest that exposure to conflicting health information can degrade attentional mechanisms responsible for accurate and prompt responding to incoming information.

Arab women feelings while seeking information during COVID-19 pandemic: applying PMT constructs

Purpose

This study investigates the effect of protection motivation theory (PMT) constructs on Arab women's feelings while seeking information during the COVID-19 pandemic.

Design/methodology/approach

The study has adopted a mixed-method approach using semi-structured interviews and a questionnaire to explore PMT constructs' impact on women's feelings while seeking information on COVID-19. Several tests, such as standard deviation, mean, skewness, kurtosis and persons, were used to check the reliability of data and inter-relationships between constructs.

Findings

The study results show a significant positive correlation between PMT constructs (perceived vulnerability, perceived severity, response efficacy, self-efficacy and response cost) with the feelings of Arab women during information seeking on COVID-19. However, the relationship between threat appraisal and feelings during information seeking was more substantial than coping appraisal and feelings during information seeking. The researchers hope that this study creates a baseline of cross-cultural studies on PMT constructs' effect on women's feelings while seeking health information.

Research limitations/implications

The current study was conducted on female participants only. While the study intended to examine Arab women's feelings during information seeking with PMT's application, the results may be affected by other factors that were not considered in the current study. Furthermore, the questionnaire was distributed in three Arab countries, which means that the results cannot be generalized in other geographical contexts. Therefore, similar studies need to be conducted in larger geographical areas as cultural factors may produce different results.

Originality/value

This study explores women's feelings while seeking COVID-19 information using the PMT constructs. As far as we know, this study is the first study to investigate Arab women's feelings while seeking health information during pandemics. PMT utilization is considered a new approach to discover and measure informational needs and feelings associated with it during pandemics.

Wikipedia: an unexplored resource for understanding consumer health information behaviour in library and information science scholarship

Purpose

To date, health information behaviour (HIB) models have not been applied to an exploration of Wikipedia as a consumer health information resource. Wikipedia has been situated and is well established as a valuable resource for the general layperson wishing to learn more about their health or the health of a loved one. This paper aims to identify an approach to exploring the role of Wikipedia in consumer health information behaviour (CHIB) that is grounded in a conceptual framework from the library and information science (LIS) discipline.

Design/methodology/approach

The author draws on current HIB models and relevant theories from existing LIS literature and applies them to propose a new definition of CHIB. The author uses this definition to frame Wikipedia as an unexplored consumer health information resource in the LIS scholarship and suggests future directions for placing such investigations within a conceptual framework from LIS.

Findings

The paper finds that Longo's expanded conceptual model of health information-seeking behaviour (ECMHISB) could be valuable and useful for the exploration of CHIB in relation to Wikipedia's health and medical content. Due to Wikipedia's online nature, research framed by these models must acknowledge and take under consideration the digital divide phenomenon and various factors that influence an individual's place within it.

Research limitations/implications

This work builds a foundation upon which future research into the role of Wikipedia's health and medical content in CHIB can be grounded. Using Longo's model, future research might provide insight into who Wikipedia is helping and who it has left behind. LIS scholars, practicing health librarians and perhaps health workers stand to gain a deeper understanding of the potential influence of Wikipedia's health information on its consumers.

Originality/value

For LIS scholars, this paper is novel in the fact that a HIB model has not yet been applied to the study of Wikipedia's health content. This paper provides a foundation for this research.

Information and information resources in COVID-19: Awareness, control, and prevention

This study was conducted with the aim of evaluating the role of information and information resources in the awareness, control, and prevention of COVID-19. This study was a descriptive-analytical survey in which 450 participants were selected for the study. The data collection instrument was a researcher-made questionnaire. Descriptive and inferential statistics were used to analyze the data through SPSS. The findings show that a wide range of mass media has become well known as information resources for COVID-19. Other findings indicate a significant statistical difference in the rate of using information resources during COVID-19 based on age and gender; however, this difference is not significant regarding the reliability of information resources with regard to age and gender. Health information has an undisputable role in the prevention and control of pandemic diseases such as COVID-19. Providing accurate, reliable, and evidence-based information in a timely manner for the use of resources and information channels related to COVID-19 can be a fast and low-cost strategic approach in confronting this disease.

Information-Seeking Behavior and Its Associated Factors Among Patients with Diabetes in a Resource-Limited Country: A Cross-Sectional Study

BACKGROUND

Diabetes mellitus is one of the most common chronic diseases in the world. The burden of diabetes mellitus is increasing rapidly in developing countries, including Ethiopia. Diabetes information seeking is essential for patients with diabetes to better manage and control their diabetes. However, information seeking about disease prevention and treatment is low in developing countries.

OBJECTIVE

This study aims to assess the diabetes information-seeking behavior and its associated factors among patients with diabetes in Debre Markos Referral Hospital, Amhara Region, Northwest Ethiopia.

METHODS

An institution-based cross-sectional quantitative study supplemented with a qualitative study was conducted among 423 subjects from March to April 2019. A structured questionnaire and in-depth interview were used to collect the required data from the study subjects. The data were entered using Epi Info version 7.2.2. Data processing and analysis were conducted using SPSS version 23. Descriptive statistics and a binary logistic regression model were used for the quantitative study, and thematic content analysis was used for the qualitative study. The significance test cut-off value for bivariate analysis was P<0.2 and the cut-off value for multivariate analysis was P<0.05. Adjusted odds ratios with 95% confidence intervals were used to interpret the results.

RESULTS

Out of 423 study participants, only 41.6% of patients with diabetes were diabetes information seekers. After adjusting all other factors in the final model, educational status, place of residence, comorbidity and health literacy were significantly associated with diabetes information seeking.

CONCLUSION

This study result indicates that the overall prevalence of information seeking among patients with diabetes toward diabetes was low. Having higher educational status, urban place of residence, the presence of comorbidity and adequate health literacy level increased the likelihood of diabetes information-seeking behavior among patients with diabetes.

Health information-seeking behavior and self-care in women with osteoporosis: a qualitative study

The main findings of this study on the self-care behaviors contain "identification of knowledge gaps," "established networking for seeking information," "information from trust-to-distrust," "information-seeking inhibiting factors," "information-seeking facilitating factors," and "self-care behaviors based on required knowledge."

PURPOSE

Health information-seeking behavior affects self-care and could promote quality of life and life expectancy. This study aimed at assessing health information-seeking and self-care behaviors of women with osteoporosis in Iran.

METHODS

This study was conducted using a content analysis approach. Data were collected through semi-structured interviews with 15 women with osteoporosis aged above 50 years. The participants were selected by purposeful sampling. The data were analyzed by the conventional content analysis method using MAXQdata software version 10.

RESULTS

From in-depth descriptions of the participants' experiences, 246 primary codes were extracted. Subsequently, constant comparison analysis was done and 35 sub-categories and 6 main categories have appeared from the data.

DISCUSSION

Based on the experiences of women with osteoporosis, they received limited information from the health care providers, so they were seeking reliable information sources to meet their information needs. They obtained most of their information from other patients, family members, and network of friends. In the process of seeking information, they face various barriers such as lack of time in the health care team that affect their ability to self-care.

CONCLUSION

The results can guide health policymakers, patient educators, health care providers, information specialists, and patients and their families.

Understanding information behavior of diabetic patients: a case of the diabetic's institute Pakistan

Purpose

Pakistan is a developing country where one of the rapidly growing diseases is diabetes. Well-informed diabetic patients are expected to improve the quality of life, self-care behaviors and better cooperation with the health care team. The present study is designed to investigate the information behavior of diabetic patients, and to investigate the role of one institution that is working for diabetes management, treatment, education and counseling in Pakistan i.e. Diabetic's Institute Pakistan (DIP).

Design/methodology/approach

The “Embedded Design” based on the mixed methods research approach was adopted to carry out the current research. The study was mainly based on quantitative research design, quantitative data were collected through an adapted questionnaire, the supportive/supplementary qualitative data was collected through an in-depth interview of the medical director, observation record sheets and analysis of the available relevant documents i.e. prescription (prescription notepad with information), brochure and the website was applied.

Findings

Diabetic patients want to know about how to control diabetes and mostly rely on humans particularly health professionals and interpersonal networks. The use of books, journals, seminars, libraries is comparatively low. It is an important finding that health-related information is mostly required in national language by Pakistani patients. Lack of computer literacy and information overload were among the barriers that were reported by diabetic patients.

Practical implications

Health information seeking channels, formats and language preferences should be considered to design patients' cantered information services. Health information service providers i.e. government, health practitioners, health-related institutions and libraries should work in a liaison for creating health awareness. Identified barriers faced by diabetic patients are important to consider for designing health-related information services.

Originality/value

Investigating health information behavior is crucial particularly of the patients from developing countries. The study is first of its kind that is reported from Pakistan. The results of the study may help libraries, health professionals and diabetes-related organizations to design patient's centered policies and information-based services. These institutions may work together to create awareness and to help patients in managing their disease. The study findings are maybe helpful for other developing countries also.

Explaining variation in health information seeking behaviour - Insights from a multilingual survey

OBJECTIVE

How best to provide an increasingly diverse population with health information has become a major concern for health policy makers in Europe and beyond. Our study aims to investigate factors explaining variation in people's health information seeking behaviour. Our findings can be used to identify target groups for policy interventions that aim to provide health information efficiently.

METHODS

Cross-sectional, paper-based, multilingual survey of a random sample of enrolees of two statutory health insurers in Hamburg, Germany. Data were collected from September to December 2017. Multivariable logistic regression was used to examine sociodemographic and health-related individual characteristics and their associations with participants' choice of ten sources of health information.

FINDINGS

Participants' choice of information sources differed significantly across the following sociodemographic and health-related characteristics: age, gender, immigration status, education, employment status, marital status and general state of health. Immigrants and individuals with low educational attainment were most likely to use emergency departments as sources of health information.

CONCLUSION

Policy interventions aiming to manage the use of health information sources should focus on immigrants and individuals with low educational attainment. Providing multilingual, low-threshold counselling and information services could be an efficient way to reduce short-term costs of health information seeking behaviour to health insurers or other payers of care while improving patient empowerment.

Integrating a Web-Based Self-Management Tool (Managing Joint Pain on the Web and Through Resources) for People With Osteoarthritis-Related Joint Pain With a Web-Based Social Network Support Tool (Generating Engagement in Network Involvement): Design, Development, and Early Evaluation

BACKGROUND

Joint pain caused by osteoarthritis (OA) is highly prevalent and can be extremely debilitating. Programs to support self-management of joint pain can be effective; however, most programs are designed to build self-efficacy and rarely engage social networks. Digital interventions are considered acceptable by people with joint pain. However, many existing resources are not accessible for or developed alongside people with lower health literacy, which disproportionately affects people with OA.

OBJECTIVE

This study aims to design and develop an accessible digital self-management tool for people with joint pain and integrate this with an existing social network activation tool (Generating Engagement in Network Involvement [GENIE]) and to explore the feasibility of these linked tools for supporting the management of joint pain.

METHODS

The study was conducted in 2 phases: a design and development stage and a small-scale evaluation. The first phase followed the person-based approach to establish guiding principles for the development of a new site (Managing joint Pain On the Web and through Resources [EMPOWER]) and its integration with GENIE. People with joint pain were recruited from libraries, a community café, and an exercise scheme to take part in 3 focus groups. EMPOWER was tested and refined using think-aloud interviews (n=6). In the second phase, participants were recruited through the web via libraries to participate in a small-scale evaluation using the LifeGuide platform to record use over a 1-month period. Participants (n=6) were asked to complete evaluation questionnaires on their experiences. The NASSS (nonadoption, abandonment, scale-up, spread, and sustainability) framework was used to explore the feasibility of the sites.

RESULTS

The focus groups established guiding principles for the development of the tool. These included ensuring accessibility and relevance for people with OA-related joint pain and recognizing that joint pain is the reason for seeking support, trust, social facilitation, and goal setting. Think-aloud interviews identified issues with user experience and site navigation and the need for professional input for referral and goal setting, confusion, and tensions over the role of GENIE and site connectivity. Participants expected the sites to be specific to their pain-related needs. EMPOWER was accessed 18 times; 6 users registered with the site during the evaluation study. Participants mostly explored information pages on being active and being a healthy weight. Only one participant undertook goal setting and 4 participants visited the GENIE website.

CONCLUSIONS

Using the NASSS framework, we identified the complexity associated with integrating EMPOWER and GENIE. The value proposition domain highlighted the technical and conceptual complexity associated with integrating approaches. Although identified as theoretically achievable, the integration of differing propositions may have caused cognitive and practical burdens for users. Nevertheless, we believe that both approaches have a distinct role in the self-management of joint pain.

Self-Care and Health-Information-Seeking Behaviours of Diabetic Patients in Singapore

Patients in Singapore with chronic conditions such as diabetes are encouraged to participate in patient-professional partnership activities because of rising health care costs and a shortage of infrastructure and human resources. This study explores the self-care and health information seeking behaviors of diabetic patients in Singapore, as well as factors related to health and information carriers that might influence those behaviors. A pilot-tested online survey was developed based on the Comprehensive Model of Information Seeking (CMIS) and notified to the members of the Diabetic Society of Singapore (DSS) through their newsletter in January 2016. In total, 60 usable responses from the DSS members were collected. The survey revealed that more than 30% of the patients did not strictly follow doctors' instructions to regularly exercise, self-monitor blood sugar, and pay attention to type of food prepared at home. However, it was found that the majority of them had consciously limited their sugar intake. It was also revealed that respondents' most frequently used sources of health information were authoritative sources such as doctors/nurses and pamphlets/leaflets from hospitals/clinics. Understandably, respondents experiencing less distress caused by diabetes tended to report better health status, less worries, and stronger beliefs in the efficacy of their methods for diabetes control.

A cross-sectional survey interconnecting health information seeking behavior with clinical data of type 2 diabetes mellitus patients

Purpose

The purpose of this paper is the investigation of type 2 diabetes patients' information seeking behavior in terms of their information needs, sources and barriers faced by patients when seeking information. The information seeking behavior is associated with clinical patient data.

Design/methodology/approach

The relevant literature is reviewed, and the results of a cross-sectional survey informed by Wilson's macro-model of information seeking behavior are reported. The survey includes 106 outpatients from the diabetes clinic of a Greek major university hospital and includes information seeking behaviors and patient's clinical evidence.

Findings

The most important health information needs are related to the complications, symptoms and causes of diabetes, to the proper diet for diabetics and the measures adopted to avoid foot complications. Furthermore, the most important information resources were physicians, ophthalmologists, books, broadcast media and family members. Obstacles encountered during information seeking include the complicated nature of health information, which involves scientific terms as well as psychological issues. The diabetes stage is correlated with information needs for diabetes medication, while the years from the first diagnosis are negatively correlated with the use of informal sources.

Research limitations/implications

The information needs and sources of diabetic patients, as well as the main obstacles to this pursuit, could potentially have important implications in designing a future information campaign and information services for diabetes patients.

Originality/value

The Wilson's macro-model of information seeking has been applied to the diabetic patients' information seeking behavior; while information needs, information sources and information obstacles are correlated with clinical evidence from patients’ hospital records.

The Impact of Internet Medical Information Overflow on Residents' Medical Expenditure Based on China's Observations

Background: The rapid rise of medical expenditure is a common problem in the field of public health around the world, but the challenges for the Chinese government are even greater. How to control the rapid rise in medical expenditure and reduce individuals' economic burden when receiving medical treatment has become one of the core issues that the Chinese government urgently needs to solve. The aim of this study was to evaluate the impact of Internet use on individuals' medical expenditure and further discuss the potential impact mechanism. Methods: The data used in this study were from the 2018 China Family Panel Studies (CFPS) conducted by Peking University. The Heckman sample selection model was used to analyse the impact of Internet use on individuals' medical expenditure. Results: Internet use reduced the medical expenditure of individuals by 6.19%; high frequency Internet use reduced the medical expenditure of individuals by 15.1%, while low frequency Internet use had no impact. In addition, Internet use had different impacts on individuals' medical expenditure at different levels of hospitals. Specifically, Internet use reduced the medical expenditure of individuals who received medical treatment at general hospitals by 9.63%, and high frequency Internet use reduced the medical expenditure of individuals by 22.2%. However, Internet use had no impact on the medical expenditure of individuals who received medical treatment at primary hospitals. Conclusions: Findings from this study underscore the importance of Internet use as an important role in reducing individuals' medical expenditure. The use of the Internet can significantly reduce the level of individuals' medical expenditure, and high frequency Internet use has a greater effect. However, Internet use has different impacts on individuals' medical expenditure among different levels of hospitals. The reduction effect of Internet use on individuals' medical expenditure is mainly concentrated in general hospitals but has no effect in primary hospitals.

Social Support and User Characteristics in Online Diabetes Communities: An In-Depth Survey of a Large-Scale Chinese Population

:Objective: To determine the characteristics of members of online diabetes communities as well as those factors affecting the provision and acceptance of social support. Methods: A cross-sectional STAR questionnaire survey was conducted among patients with diabetes who were members of online diabetes groups. Univariate and multivariate binary logistic regression analysis were adopted to explore the relative analysis of providing and accepting social support compared with the characteristics of members in virtual diabetics' groups. Results: A total of 1297 respondents were collected. The map distribution of patients in China was mainly located in the Guangdong, Jiangsu, Shandong, Henan, and Hebei provinces. As for their demographic characteristics, respondents had diabetes or prediabetes and were between the ages of 21 and 50 years (Median age was 35.0 (interquartile range from 28.0 to 44.0)). Most respondents were married and lived in cities. The education level of patients was mainly distributed throughout junior high, technical secondary, high school, junior college, and undergraduate levels. Age, marital status, and education level varied by gender, and the total score of the patients aged 41 to 50 for social support had a statistical significance between male and female. In addition, when group members were in junior high school or below, or were undergraduate students, their total social support scores varied by gender. Binary logistic regression showed that in 21 independent variables the total score and the total score grade of relationship intensity in the online group and reorganize of age were significant. The patients' social support acceptance of the map of respondents score grading of relationship intensity in the online group was 5.420 times higher than that of the lower score grading of relationship intensity in the group. At the same time, the patients' social support acceptance of the patients at the age of less than or equal to 31 years old was 19.608 times higher than that of group members aged more than 31 years old. Conclusion: Age and education background of the patients affects scores of social supports between males and females. The higher the total score and the score grade of relationship intensity in the online group, the higher the patients' social support acceptance. The younger patients had a better utilization of social support.

"They are talking from the Encyclopedia Britannica brain": diabetes patients' perceptions of barriers to communicating with physicians

Background

Understanding patients’ beliefs about their role communicating in medical visits is an important pre-requisite to encourage patients’ use of active participatory communication, and these beliefs may be particularly relevant for patients with diabetes.

Methods

Focus groups were conducted to examine patients with diabetes view of their role communicating in medical encounters. Patients had type 2 diabetes, A1C ≥ 8% (64 mmol/mol), and were from an inner-city VA hospital. Guiding questions for the focus groups were based on theoretical models of patient-physician communication. Focus group transcripts were analyzed with the constant comparative method.

Results

Four focus groups were conducted with a total of 20 male Veterans. Participants mean age was 61 years, 65% self-identified as black or African-American, 80% completed high school or higher education, and mean A1C was 10.3% (89 mmol/mol). Eight themes were identified as to why patients might have difficulty communicating with physicians. These themes were grouped into three overarching categories explaining reasons why patients might avoid participatory communication and included patients’ view about their condition; about physician’s communication behaviors; and about external influences on patient-physician communication. For example, patients described how use of the EHR may deter patients’ use of active participatory communication.

Conclusions

These results are important for understanding how patients’ use of active participatory communication is influenced by their beliefs and expectations, physicians’ behaviors, and structural factors. The results may be useful for educational efforts to increase patient, physician, and healthcare systems awareness of problems that patients perceive when communicating with physicians.

Health information seeking behaviour: a concept analysis

BACKGROUND

In 2007, Lambert and Loiselle conducted an extensive concept analysis of the term health information seeking behaviour (HISB) to examine the concept's level of maturity and critically analyse its characteristics. Since their groundbreaking work, HISB has evolved with the proliferation of ICTs. The Internet is now a common and often preferred medium for the pursuit of health information.

OBJECTIVES

The previous analysis spanned 42 years of literature; this article describes an analysis of the last 10 years of literature on HISB and how online seeking has caused the concept to evolve in the literature.

METHODS

This study used the concept analysis methodology employed by Lambert and Loiselle in the original analysis. It also included a systematic search conducted in five databases to identify studies from 2007 to 2017, using similar inclusion criteria from the original study.

RESULTS

Of the more than 500 articles retrieved, 85 journal articles met the inclusion criteria. Consistent with the original work, articles that included outcomes were identified as either behavioural or cognitive.

CONCLUSION

Most of the attention of the works studied focused on individuals and their information source preferences. This HISB analysis can be incorporated with studies to understand how various communities seek information in online versus non-online contexts.

Development and Validation of a Uremic Pruritus Treatment Algorithm and Patient Information Toolkit in Patients With Chronic Kidney Disease and End Stage Kidney Disease

CONTEXT

Uremic pruritus (UP) affects up to half of all patients with kidney disease and has been independently associated with poor patient outcomes. UP is a challenging symptom for clinicians to manage as there are no validated guidelines for its treatment.

OBJECTIVES

The study aimed to develop and validate an algorithm and patient information toolkit for the treatment of UP in patients with kidney disease.

METHODS

The study involved a literature search and development of an initial draft algorithm, followed by content and face validation of this algorithm. Validation entailed three rounds of interviews with six nephrology clinicians per round. Participants assessed the relevance of each component of the algorithm and then rated a series of statements on a scale of 1-5 to assess face validity of the algorithm. After each round, the content validity index (CVI) of each algorithm component was calculated, and the algorithm was revised by the study team in response to findings. This process was followed by a second study that developed and validated a patient information pamphlet and video.

RESULTS

Algorithm validation participants were affiliated with three institutions and included seven physicians, four registered nurses, three nurse practitioners, three pharmacists, and a dietician. The average CVI of the algorithm components across all three rounds was 0.89, with 0.80 commonly cited as the lower acceptable limit for content validation. More than 78% of participants rated each face validity statement as "Agree" or "Strongly Agree". For the patient information tools, five clinicians and 15 patients were included in validation. The average CVI was 1.00 for both tools, and the average face validity was 92%.

CONCLUSION

A treatment algorithm and patient information toolkit for managing UP in patients with kidney disease were developed and validated through expert review. Further research will be conducted on implementation of the treatment algorithm and evaluating patient-reported outcomes.

Feasibility, Acceptability, and Impact of a Web-Based Structured Education Program for Type 2 Diabetes: Real-World Study

BACKGROUND

Structured education for people with type 2 diabetes improves outcomes, but uptake is low globally. In the United Kingdom in 2016, only 8.3% of people who were referred to education programs attended the program. We have developed a Web-based structured education program named Healthy Living for People with type 2 Diabetes (HeLP-Diabetes): Starting Out (HDSO), as an alternative to face-to-face courses. A Web-based program gives people more options for accessing structured education and may help improve overall uptake.

OBJECTIVE

The aim was to explore the feasibility and acceptability of delivering a Web-based structured education program (named HeLP-Diabetes: Starting Out) in routine primary health care and its potential impact on self-efficacy and diabetes-related distress.

METHODS

HDSO was delivered as part of routine diabetes services in primary health care in the United Kingdom, having been commissioned by local Clinical Commissioning Groups. Quantitative data were collected on uptake, use of the program, demographic characteristics, self-reported self-efficacy, and diabetes-related distress. A subsample of people with type 2 diabetes and health care professionals were interviewed about acceptability of the program.

RESULTS

It was feasible to deliver the program, but completion rates were low: of 791 people with type 2 diabetes registered, only 74 (9.0%) completed it. Completers improved their self-efficacy (change in median score 2.5, P=.001) and diabetes-related distress (change in median score 6.0, P=.001). Interview data suggested that the course was acceptable, and that uptake and completion may be related to nonprioritization of structured education.

CONCLUSIONS

The study provides evidence of the feasibility and acceptability of a Web-based structured education. However, uptake and completion rates were low, limiting potential population impact. Further research is needed to improve completion rates, and to determine the relative effectiveness of Web-based versus face-to-face education.

Health information overload among health consumers: A scoping review

OBJECTIVE

To examine and identify the scope of research addressing health information overload in consumers.

METHODS

In accordance with a published protocol, six electronic databases (PubMed, CINAHL, ERIC, PsycINFO, Embase, and Scopus), reference lists of included articles, and grey literature (Google Advanced Search and WorldCat) were searched. Articles in English were included, without any limit on the date of publication.

RESULTS

Of the 69 records included for final analysis, 22 studies specifically examined health information overload, whereas the remainder peripherally discussed the concept alongside other concepts. The 22 studies focused on one or more of the following: 1) ways to measure health information overload (multi-item/single-item scales); 2) predictors of health information overload - these included low education level, health literacy, and socioeconomic status; and 3) interventions to address information overload, such as videotaped consultations or written materials. Cancer information overload was a popular topic amongst studies that focused on information overload.

CONCLUSION

Based on the identified studies, there is a clear need for future studies that investigate health information overload in consumers with chronic medical conditions other than cancer.

PRACTICE IMPLICATIONS

This review is the initial step in facilitating future efforts to create health information that do not overload consumers.

Healthcare wearable devices: an analysis of key factors for continuous use intention

This study empirically examined the effects of internal and external factors on actual use behavior, health improvement expectancy, and continuous use intention of healthcare wearable devices. The study proposed a research model with its associated hypotheses that were tested using structural equation modeling. We also performed a comparative analysis of the two sample groups (medical personnel and general public), based on data collected from 288 healthcare wearable devices/apps users. The findings of the study indicated that internal and external factors have positive effects on actual use behavior, and health improvement expectancy and continuous use intention of healthcare wearable devices can be promoted through actual use behavior. The comparative analysis of the two groups showed that medical personnel had higher relationships among the study factors than general public. The study results shed theoretical and practical implications regarding how healthcare wearable devices or apps can be effectively used for disease prevention and health management for the users.

Can online social support be detrimental in stigmatized chronic diseases? A quadratic model of the effects of informational and emotional support on self-care behavior of HIV patients

Objective

We studied the impact of online social support on patient self-care behavior in an online health community for human immunodeficiency virus (HIV) patients. We conceptualized emotional and informational support provided by community members into nuanced sub-dimensions. We explored how the direct and interaction effects of these sub-dimensions impact the self-care behavior of a support seeker.

Methods

We used data from 330 255 posts in 30 050 threads from POZ, an online health community for HIV patients. Our key variables-self-care behaviori, objective informationj, experiential supportj, and emotional tonej-were operationalized using linguistic analysis with self-generated dictionaries and Python libraries. We tested our hypotheses using Tobit regression.

Results

Out of 6 null hypotheses, 5 were rejected. Objective information and emotional tone had an inverted-U relationship with self-care behavior. Experiential information and community involvement were positively related to self-care behavior. Community involvement amplified the inverted-U relationship between emotional tone and self-care behavior. No significant interaction effect was found between experiential support and objective information.

Conclusions

Beyond a threshold, both informational and emotional online social support had a deleterious impact on self-care behavior of HIV patients. Our results suggested that caution should be exercised in the use of online health community interventions for HIV patients, and perhaps patients with other stigmatized chronic diseases.

Associations between disease education, self-management support, and health literacy in psoriasis

BACKGROUND

Patients' ability to perform self-management may be compromised if they are unable to fully comprehend their diagnosis and treatments. Weaknesses in health literacy (HL) pose a considerable health concern and may negatively influence SM, as well as interactions with health care professionals (HCP) and peers.

OBJECTIVES

To investigate possible associations between comprehensive HL and psoriasis education from HCPs in a cohort of patients with psoriasis. Another aim was to examine essential sources for psoriasis information and how these are evaluated.

METHODS

Cross-sectional questionnaire data, including the comprehensive Health Literacy Questionnaire (HLQ) from 825 patients with psoriasis who had participated in Climate Helio Therapy (CHT).

RESULTS

Participants having received HCP education scored significantly better in all HLQ scales compared to participants who did not receive such education (Cohen's effect size: 0.24 to 0.44). The CHT program, peers, and dermatologists were the most important sources of psoriasis information. People having participated more than once in CHT presented better HL scores and also higher self-management (skill and technique acquisition) and more psoriasis knowledge (effect-size: 0.75).

CONCLUSIONS

Psoriasis education by HCP seems important for HL and psoriasis knowledge. Patients may need multiple approaches and repetitions over time to be health literate and effective self-managers.