Information-seeking behaviour and sources of health information: associations with risk factor status in an analysis of three Queensland electorates

Abstract: Making a special effort to gain health information has been associated with healthy behaviour. This paper identifies the information-seeking dimension and the sources of information people use and examines whether there is an association between these and individual health status. In November 1989 a randomly selected sample of 2134 adults in the electorates of Maryborough, Toowoomba and Port Curtis (Gladstone) completed a self-administered questionnaire which aimed to measure health-related knowledge, attitudes and behaviour. Factor analysis identified clusters of items representing different dimensions of risky health behaviour as well as different perceived barriers to seeking preventive health care. Multiple regression analysis was then used to determine sociodemographic, attitudinal and behavioural variables related to a tendency not to seek health information and to be at risk for preventable diseases The findings have implications for the development of future health promotion programs in provincial Australian cities. Both age and sex were significant in predicting where people obtain information on health. Women were more likely than men to seek health information and their sources of information reflected this proactive attitude to health. While there was no significant difference between the perceived health status of males and females, reported behavioural risk factors were much more prevalent in males. Most respondents had consulted a general practitioner in the previous twelve months and stated that they would change their behaviour on the advice of a medical practitioner. However, few nominated medical practitioners as their main source of health information.     

Curative medicine, preventive medicine and health status: the influence of politics on health status in a rural Mexican village

This paper examines a recent program which purports to address the health concerns of millions of poor rural Mexicans whose constitutional guarantees of health have been largely ignored. This new program asserts the importance of preventive medicine, but makes little effort to implement preventive measures. The curative medicine it does emphasize in practice may alleviate pain and suffering for a time, but ignores critical factors that contribute to the persistence of disease. This paper examines why underdeveloped countries are more likely to implement curative than preventive services for poor people, even while proclaiming the importance of preventive measures. In dependent capitalist economies, the rural penetration of state-directed health services perpetuates the privileged position of the political and economic elite. Based on research conducted in a highland Chinantec village in Oaxaca, this paper concludes that the recent health services program addresses symptoms rather than causes of disease and is not likely to significantly improve the health status of the people who are most in need of such assistance.     

Relationship of Household Food Insecurity to Health-Related Quality of Life in a Large Sample of Rural and Urban Women

The authors examined the associations of household food insecurity and other characteristics with fair-to-poor general health, poor physical health, and frequent mental distress among 1,367 rural and urban women in Texas. The 2006 Brazos Valley Community Health Assessment provided data on demographic characteristics, economic risk factors, health-related quality of life, household food insecurity, and geographic residence. Multivariable logistic regression models were estimated for the three health-related quality of life measures: fair-to-poor health, poor physical health, and frequent mental distress, adjusting for confounding variables. Having less than 12 years of education, not being employed full-time, and being household food insecure were independently significantly associated with increased odds for all health-related quality of life outcomes. Rural residence and being nonwhite were associated with fair-to-poor general health, but not physical or mental health. Results from the separate urban and rural models indicated that household food insecurity was associated with fair-to-poor general health among rural women, not among urban women. Poverty and being nonwhite were also associated with increased odds of reporting fair-to-poor general health, but were significant only among urban women. These results emphasize the need for health promotion and policy efforts to consider household food access and availability as part of promoting healthful food choices and good physical and mental health among women, especially rural women.     

Relationship of household food insecurity to health-related quality of life in a large sample of rural and urban women

The authors examined the associations of household food insecurity and other characteristics with fair-to-poor general health, poor physical health, and frequent mental distress among 1,367 rural and urban women in Texas. The 2006 Brazos Valley Community Health Assessment provided data on demographic characteristics, economic risk factors, health-related quality of life, household food insecurity, and geographic residence. Multivariable logistic regression models were estimated for the three health-related quality of life measures: fair-to-poor health, poor physical health, and frequent mental distress, adjusting for confounding variables. Having less than 12 years of education, not being employed full-time, and being household food insecure were independently significantly associated with increased odds for all health-related quality of life outcomes. Rural residence and being nonwhite were associated with fair-to-poor general health, but not physical or mental health. Results from the separate urban and rural models indicated that household food insecurity was associated with fair-to-poor general health among rural women, not among urban women. Poverty and being nonwhite were also associated with increased odds of reporting fair-to-poor general health, but were significant only among urban women. These results emphasize the need for health promotion and policy efforts to consider household food access and availability as part of promoting healthful food choices and good physical and mental health among women, especially rural women.     

Mapping the Health Information Landscape in a Rural,Culturally Diverse Region: Implications for Interventions to Reduce Information Inequality

The media is an important source of health information, especially critical in rural communities with geographically-dispersed populations that are harder to reach through other channels. Yet health information is unequally distributed; these information disparities are compounded in rural areas, which may contribute to health disparities. We identify and describe health-related news in a culturally-diverse rural California county characterized by high levels of poverty, unemployment, low educational attainment, and over half of Mexican-origin. We conducted a census of all available print news sources and then used content analysis to identify and characterize all health information printed in a 6-month study period. A total of 570 health-related articles were published. Five newspapers accounted for more than 80% of published health-related articles (n = 466); only one targeted the majority Latino population. The most common topic was access to health care/insurance/policy (33%), followed by diet/nutrition (13%), infectious disease (10%), and general prevention (9%). Just over one-quarter of health-related articles included useful information. Differences across newspaper types existed: independent newspapers reported more on health-related events compared with chain newspapers, and both ethnic-targeted newspapers and independently-published papers were more likely to include useful information compared with chain newspapers. While this region suffers from high rates of obesity and diabetes, there were relatively few articles on obesity and diabetes themselves, or linking behavioral risk factors with these conditions. One area we found absent from coverage pertained to the numerous environmental health threats prevalent in this heavily polluted, agricultural area (just 40 articles discussed environmental health threats). We also discovered that coverage of social determinants of health was lacking (just 24 of the 570 health articles), which was notable in a region that suffers extreme economic, educational, and health disparities. This analysis of a rural region’s local news coverage of health issues demonstrates significant opportunity to engage with rural local media, particularly ethnic media, to disseminate health information. Such a strategy holds considerable promise to advance public health goals using a multilevel approach: From an individual perspective, improving the amount and utility of the information can inform and educate publics in areas with otherwise low levels of health information access. From a policy perspective, improving coverage of the social determinants of health could shape public opinion to support policies that improve health.     

北京市顺义区农村居民健康知识知晓结果分析及健康需求调查

目的了解北京市顺义区农村居民健康知识掌握情况和健康教育需求现状,为改善健康教育与健康促进干预对策提供参考依据。方法按照分层随机整群抽样的原则,抽取570名农村居民进行问卷调查。结果顺义区农村居民对高血压8个主要危险因素全部认知的占22.5%,对糖尿病7个主要危因素全部认知的占25.0%,居民对流感的4个主要预防措施全部认知的占80.4%,对预防肠道传染病的4个主要措施全部认知的占81.1%。居民主要希望通过电视(60.9%)、医生咨询(59.8%)、健康大讲堂(41.8%)的方式来获取健康知识;而目前主要是通过电视(72.7%)、广播(50.1%)和报纸(40.09%)方式获取知识。不同年龄、文化程度的被调查对象健康需求情况有所不同,年龄越大健康知识需求越强烈。结论北京市农村居民需要掌握慢性病预防知识,今后开展健康教育与健康促进应以电视、健康大课堂和广播为主要传播方式。     

The goals of health work: Quality of life, health and welfare

Health-related quality of life is the ultimate general goal for medicine, health care and public health, including health promotion and health education. The other important general goal is health-related welfare. The aim of the paper is to explain what this means and what the consequences of these assumptions are for health work. This involves defining the central terms “health”, “quality of life” and “welfare” and showing what their conceptual relations are. Health-related quality of life has two central meanings: health-related well-being, which constitutes quality of life, and health as ability, which contributes causally to quality of life. Four meanings of health-related welfare are put forward: general well-being, health as ability, other inner properties of the individual, and external factors. States and processes covered by these categories contribute causally to health-related quality of life. Finally, using these distinctions, some more specific goals for medicine and health care, on the one hand, and for public health and health promotion, on the other, are outlined. In the former fields work is primarily directed towards changing the health-related quality of life of the individual through direct measures, “manipulating” the individual, whereas public health work and health promotion primarily use indirect measures and further health through various sorts of health-related welfare changes, e.g. through changing the environment.     

Health promotion and older people: the role of the general practitioner in Australia in promoting healthy ageing

OBJECTIVE: The Commonwealth Government's Enhanced Primary Care initiative supports measures to enhance the role of general practitioners (GPs) in promoting healthy ageing as part of a population health approach. This paper comments on how the health assessments can be conducted to best effect, to strengthen the role of GPs in primary care and to promote autonomy and independence in older people. METHOD: The relevant literature was collated to produce a review of public health and health promotion approaches and to ascertain the effectiveness of health promotion interventions for older people. A broad definition of health promotion including primary, secondary and tertiary prevention was adopted. RESULTS: The evidence base suggests there is scope for greater targeting of health promotion activities towards older people. The rationale for the Australian GP to assume a major health promotion role with their older patients is provided. Associated barriers and enablers are discussed. CONCLUSIONS: Prevention of disability is a key public health issue. The new MBS items may enable systematic evaluation of function and assist healthy ageing for all older people, including the frail aged. An increase in the preventive advice given to older patients has the potential to increase healthy behaviours and alter health outcomes. IMPLICATIONS: The annual health assessment items on the Medicare Benefits Schedule, by enabling the GP to focus on prevention and coordination of care, have the potential to improve the health, physical, psychological and social function of older Australians.     

Physical fitness and health-related fitness as indicators of a positive health state

This article focuses on the concept of positive health and,in particular, recognizes the importance of physical fitness. It is argued that measures of physical fitness are indicatorsof positive health and such measures are identified under theirdiscrete headings of agility, flexibility, power, speed andreaction time, strength, cardiovascular capacity, body compositionand posture. The theme of health-related fitness is explored, with recognitionof its increasing importance for health promotion in schools,the community and commerce. Evidence is presented that highlights the general acceptanceof the importance of certain fitness components in the assessmentof the positive health of populations. In addition, an alternativemethod of assessing fitness is discussed, arising from the authors'recognition of its potential as an inexpensive, easily administeredindicator of one aspect of positive health. The case for usingsubjective indicators of positive health is also presented–theargument being that subjective health could be a possible mediatorin the attainment of positive health.     

Does Context Matter? Examining PRISM as a Guiding Framework for Context-Specific Health Risk Information Seeking Among Young Adults

Research indicates that when people seek health information, they typically look for information about a specific symptom, preventive measure, disease, or treatment. It is unclear, however, whether general or disease-specific theoretical models best predict how people search for health information. We surveyed undergraduates (N = 963) at a large public southeastern university to examine health information seeking in two incongruent health contexts (sexual health and cancer) to test whether a general model would hold for specific topics that differed in their immediate personal relevance for the target population. We found that the planned risk information seeking model was statistically a good fit for the data. Yet multiple predicted paths were not supported in either data set. Certain variables, such as attitudes, norms, and affect, appear to be strong predictors of intentions to seek information across health contexts. Implications for theory building, research methodology, and applied work in health-related risk information seeking are discussed.     

北京市延庆县农民健康状况及健康教育需求调查

目的为了准确掌握北京市延庆县农民健康状况和健康教育需求,为今后在农村开展有针对性的健康教育和健康促进工作提供可靠依据。方法采取分层随机抽样的方法,抽取3个乡镇作为调查乡镇,共调查540人。被调查者年龄≥13岁,在当地行政区域内连续居住达6个月以上且能清楚回答问题者。结果不同年龄阶段农民健康状况不同,60岁以上人群健康状况最差;农民慢性病患病病种主要以高血压、糖尿病、高脂血症为主;被调查者高血压知识知晓率为76.6%;糖尿病知识知晓率为57.8%;呼吸道传染病预防措施的知晓率为90.1%;肠道传染病预防措施知晓率为69.5%。调查显示农民认为获取健康知识渠道主要是电视、医生咨询和健康大课堂3种形式。结论今后应该在农村地区要进一步加强健康教育和健康促进,利用电视、健康咨询、健康大课堂等形式普及慢性病和传染病的相关知识,提高农村百姓的健康知识水平,预防和控制各种疾病的发生。     

Nutzung von Gesundheitsinformationen

Well-informed citizens and patients regard health policy innovations as a key element when it comes to reforms in the health service--both in health economics and with regard to prevention issues. We evaluated the data provided by the 2003 Telephone Health Survey (GSTel03) to examine demographic and social distinctions in the use of different information sources. At the same time we examined whether there are any population-related differences in people's interest in health information depending on their levels of health awareness, attitudes to prevention and related modes of behaviour. The data generated by the survey show that there is considerable interest in health-related topics. Only 2% of the people questioned used no information sources for this purpose. In addition to more traditional media (books, newspapers, information from pharmacies), information provided by health insurance companies and via the Internet is becoming increasingly important. With the exception of the Internet, all other sources of information are used more frequently by women than by men, and demand for most of the information media increases with age. The frequency of information use and the number of different media used increase from the lower to the upper strata of society. As far as selected variables of health-related behaviour are concerned (smoking, sport, alcohol), the results show a link between a more positive attitude to health and a greater interest in information.     

Factors Associated With Health-Related Quality of Life Among an Older Population in a Largely Rural Western Region

CONTEXT: As elderly people become a larger proportion of the rural population, it is important to identify those at risk for poor health. Predictors of health-related quality of life can be useful in designing interventions. PURPOSE: One objective of the present study was to profile the health-related quality of life of community-dwelling, elderly people in a southwestern region of the United States. A related objective was to identify the principal factors associated with health-related quality of life, thereby identifying population subgroups in greatest need of health or social services. METHODS: A telephone survey of approximately 5,000 individuals 65 years and older collected data on need for assistance with activities of daily living, physical and mental health-related quality of life, and worry about health status measures. A modified version of the Behavioral Model was used to more clearly distinguish the different groups at risk for poor health. FINDINGS: Those groups of community-dwelling, elderly people in the poorest health were older than 75 years, had less than a high school education, were retired or unemployed, and had low household income. No differences were found by urban, rural, and frontier residence. CONCLUSIONS: To maintain the physical, social, and psychological health of older people residing in rural and urban areas, social services, medical care, and supportive services are needed, particularly among the most socially and economically disadvantaged.     

Promoción de la salud y prevención en tiempos de crisis: el rol del sector sanitario. Informe SESPAS 2014

This article reviews trends in lifestyle factors and identifies priorities in the fields of prevention and health promotion in the current economic recession. Several information sources were used, including a survey of 30 public health and primary care experts. Between 2006 and 2012, no significant changes in lifestyle factors were detected except for a decrease in habitual alcohol drinking. There was a slight decrease in the use of illegal drugs and a significant increase in the use of psychoactive drugs. Most experts believe that decision-making about new mass screening programs and changes in vaccination schedules needs to be improved by including opportunity cost analysis and increasing the transparency and independence of the professionals involved. Preventive health services are contributing to medicalization, but experts’ opinions are divided on the need for some preventive activities.Priorities in preventive services are mental health and HIV infection in vulnerable populations. Most experts trust in the potential of health promotion to mitigate the health effects of the economic crisis. Priority groups are children, unemployed people and other vulnerable groups. Priority interventions are community health activities (working in partnership with local governments and other sectors), advocacy, and mental health promotion. Effective tools for health promotion that are currently underused are legislation and mass media. There is a need to clarify the role of the healthcare sector in intersectorial activities, as well as to acknowledge that social determinants of health depend on other sectors. Experts also warn of the consequences of austerity and of policies that negatively impact on living conditions.     

Use of focus groups to identify health promotion strategies for the early detection of diabetic retinopathy

Background: People with diabetes do not regularly utilise eye services for the early prevention of vision loss due to diabetic eye disease. A community-based screening program has been initiated in Victoria to address this issue. To encourage people to take preventive eye health care measures, the most effective health promotion strategies were identified. Methods: Thirty-three health professionals were invited to attend focus groups. A sample of 35 people with diabetes was approached by their GPs or diabetes educators because of their motivation to participate in diabetes activities. Each group consisted of 10 members. Discussion points included the type of education messages available to people with diabetes; use of eye services among the participants with diabetes; and strategies required promoting the screening service.
Results: Five focus groups were conducted. The discussions highlighted that a great deal could be achieved by using local community networks to promote the benefits of early detection of diabetic retinopathy and local screening program. The group members recommended that particular attention be directed to general practitioners and their distribution of materials to patients. Key issues for planning and implementing the program were highlighted. The groups urged development of strategies to encourage people with diabetes in rural Victoria to participate in a program for the early detection of diabetic retinopathy.     

The Role of Federally Funded Health Centers in Serving the Rural Population

CONTEXT: Federally funded health centers attempt to improve rural health by reducing and eliminating access barriers to primary care services. PURPOSE: This study compares rural health center patients with people in the general rural population for indicators of access to preventive services and health outcomes. METHODS: Data from the annual reporting system for federally funded health centers, the 1999 Uniform Data System, and published national census data were used to provide sociodemographic comparisons. Selected health status indicators, preventive services utilization, and health outcomes were obtained from a survey of health center patients, and the results were compared with the National Health Interview Survey and National Vital Statistics. FINDINGS: Unlike the nation's rural population, the majority of rural health center patients are of minority race/ethnicity, live at or below poverty, and are either uninsured or on Medicaid. Despite having higher prevalence of traditional access barriers than the general rural population, rural health center patients are significantly more likely to receive certain preventive services and also to experience lower rates of low birthweight, particularly for African American infants. However, rural health center patients are not more likely to have received influenza vaccination or up-to-date mammogram screening. CONCLUSIONS: Health centers provide access to essential preventive care for many of the most vulnerable rural residents. A national strategy to expand the rural health center network will likely help to ensure improved health for the considerable proportion of rural residents who still lack access to appropriate services.     

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

ObjectiveHow 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.MethodsCross-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.FindingsParticipants’ 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.ConclusionPolicy 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.     

农村居民健康教育与健康促进探索：宁夏经验

目的：运用可行干预措施,帮助农民群众掌握基本健康知识,提高健康水平和生活质量。方法：开展基线调查,了解农民基本健康知识和行为。结果：宁夏农民健康教育普及率、核心信息知晓率、健康行为形成率不断提高,传染病、慢性病、地方病等疾病发病率逐年下降。结论：开展农民健康教育与健康促进行动是一项投入少,产出高的社会工程,需要多部门合作,广大农民参与,建立长效的工作机制,不断提高农民群众的健康意识和健康水平。     

Adolescents' beliefs about preferred resources for help vary depending on the health issue.

BACKGROUND: Adolescents' health care use is less than ideal, especially for more sensitive services. We know little about adolescents' preferred resources for help for health-related issues, and whether these resources vary by problem type. This study examined whether adolescents' preferred resources for help differed depending on the health issue studied. METHODS: Two hundred ten high school students (54% females; 76.6% participation rate) completed a self-administered survey of four separate age- and gender-specific health case scenarios: an adolescent who has symptoms of pneumonia; smokes five cigarettes daily; plans to initiate sex; and has symptoms of depression. For each health scenario, participants rated the importance of getting help in general, how important it was to get help from specific resources (friends/siblings; significant adults; health care professionals; and mental health professionals), and highest rankings of specific resources. RESULTS: Most adolescents believed it somewhat or very important to get help in general for all scenarios (94% pneumonia; 81% cigarette; 88% depression) except the sex scenario (27%). Repeated measures analysis of variance revealed significant differences in participants' beliefs in the importance of getting help from each specific resource across the four scenarios (all p < .001). Participants' top ranked resources included a doctor (55%) and parents (40%) for the pneumonia scenario; a friend (31%), parents (20%), and doctor (20%) for the cigarette scenario; a partner (38%) and friend (35%) for the sex scenario; and a partner (33%), psychologist (23%), and friend (20%) for the depression scenario. Beliefs in the importance of getting help from specific resources also varied by age, gender, and beliefs in importance of getting help in general. CONCLUSIONS: Adolescents' preferred resources for help differ depending on the health issue in question, with adolescents preferring informal resources (friends and partners) and significant adults (parents) to go to for help for nonphysical health-related issues and physicians for physical health-related issues. Future preventive service efforts and research should also consider the importance of age and gender when examining adolescents' preferred resources for help.