Cancer information scanning and seeking behavior is associated with knowledge, lifestyle choices, and screening

Previous research on cancer information focused on active seeking, neglecting information gathered through routine media use or conversation ("scanning"). It is hypothesized that both scanning and active seeking influence knowledge, prevention, and screening decisions. This study uses Health Information National Trends Survey (HINTS, 2003) data to describe cancer-related scanning and seeking behavior (SSB) and assess its relationship with knowledge, lifestyle behavior, and screening. Scanning was operationalized as the amount of attention paid to health topics, and seeking was defined as looking for cancer information in the past year. The resulting typology included 41% low-scan/no-seekers; 30% high-scan/no-seekers; 10% low-scan/seekers, and 19% high-scan/seekers. Both scanning and seeking were significantly associated with knowledge about cancer (B=.36; B=.34) and lifestyle choices that may prevent cancer (B=.15; B=.16) in multivariate analyses. Both scanning and seeking were associated with colonoscopy (OR = 1.38, for scanning and OR=1.44, for seeking) and with prostate cancer screening (OR=4.53, scanning; OR=10.01, seeking). Scanning was significantly associated with recent mammography (OR=1.46), but seeking was not. Individuals who scan or seek cancer information are those who acquire knowledge, adopt healthy lifestyle behaviors, and get screened for cancer. Causal claims about these associations await further research.     

Cancer Information Seeking and Cancer-Related Health Outcomes: A Scoping Review of the Health Information National Trends Survey Literature

Cancer is a leading cause of death among adults in the United States. Only 54% of U.S. adults reported seeking cancer information in 2014. Cancer information seeking has been positively associated with cancer-related health outcomes such as screening adherence. We conducted a scoping review of studies that used data from the Health Information National Trends Survey (HINTS) in order to examine cancer information seeking in depth and the relationship between cancer information seeking and cancer-related health outcomes. We searched five databases and the HINTS website. The search yielded a total of 274 article titles. After review of 114 de-duplicated titles, 66 abstracts, and 50 articles, 22 studies met inclusion criteria. Cancer information seeking was the outcome in only four studies. The other 18 studies focused on a cancer-related health outcome. Cancer beliefs, health knowledge, and information seeking experience were positive predictors of cancer information seeking. Cancer-related awareness, knowledge, beliefs, preventive behaviors, and screening adherence were higher among cancer information seekers. Results from this review can inform other research study designs and primary data collection focused on specific cancer sites or aimed at populations not represented or underrepresented in the HINTS data (e.g., minority populations, those with lower socioeconomic status).     

Information Seeking From Media and Family/Friends Increases the Likelihood of Engaging in Healthy Lifestyle Behaviors

The amount of cancer-related information available to the general population continues to grow; yet, its effects are unclear. This study extends previous cross-sectional research establishing that cancer information seeking across a variety of sources is extensive and positively associated with engaging in health-related behaviors. The authors studied how active information seeking about cancer prevention influenced three healthy lifestyle behaviors using a 2-round nationally representative sample of adults ages 40–70 years (n = 1,795), using propensity scoring to control for potential confounders including baseline behavior. The adjusted odds of dieting at follow-up were 1.51 (95% CI: 1.05, 2.19) times higher for those who reported baseline seeking from media and interpersonal sources relative to nonseekers. Baseline seekers ate 0.59 (95% CI: 0.28, 0.91) more fruits and vegetable servings per day and exercised 0.36 (95% CI: 0.12, 0.60) more days per week at 1-year follow-up compared with nonseekers. The effects of seeking from media and friends/family on eating fruits and vegetables and exercising were independent of seeking from physicians. The authors offer several explanations for why information seeking predicts healthy lifestyle behaviors: information obtained motivates these behaviors; information sought teaches specific techniques; and the act of information seeking may reinforce a psychological commitment to dieting, eating fruits and vegetables, and exercising.     

Health and cancer information seeking practices and preferences in Puerto Rico: creating an evidence base for cancer communication efforts

Effective communication around cancer control requires understanding of population information seeking practices and their cancer-relevant risk behaviors, attitudes, and knowledge. The Health Information National Trends Survey (HINTS) developed by the U.S. National Cancer Institute (NCI) provides surveillance of the nation's investment in cancer communication tracking the effects of the changing communication environment on cancer-related knowledge, attitudes, and behaviors. The University of Puerto Rico Comprehensive Cancer Center (UPRCCC), the Puerto Rico Behavioral Risk Factors Surveillance System (PRBRFSS), and the NCI implemented HINTS in Puerto Rico in 2009. In this article we describe the health and cancer information seeking behaviors, sources of information, trust in information sources, and experiences seeking information among the population of Puerto Rico. A total of 639 (603 complete and 36 partially complete) interviews were conducted. Nearly one-third of respondents had ever looked for information about health (32.9%) or about cancer (28.1%). The Internet was the most frequently reported source of information. College educated (odds ratio [OR]?=?7.6) and females (OR?=?2.8) were more likely to seek health information. Similarly, college educated (OR?=?5.4) and females (OR?=?2.0) were more likely to seek cancer information. Only 32.7% of respondents had ever accessed the Internet, and college educated were more likely to use it (OR?=?12.2). Results provide insights into the health and cancer information seeking behaviors and experiences of the population in Puerto Rico and contribute to the evidence base for cancer control planning on the island.     

Health and the information nonseeker: a profile

Despite increased information-seeking by the public, a significant percentage of those diagnosed with a serious disease such as cancer report that they do not seek or receive health information beyond that given by health care providers. This study attempts to profile these nonseekers and study possible determinants of nonseeking behaviors. Data come from the 2003 Health Information National Trends Survey, a national survey of American adults conducted by the National Cancer Institute ( N = 6,133; Nelson et al., 2004). Individuals were categorized as nonseekers or seekers and then further classified based on cancer history to yield 4 groups: nonseeker patients, the nonseeker public, seeker patients, and the seeker public. Compared to other groups, nonseeker patients came from the lowest income and education groups, and scored lower on attention to health in the media and trust in mass media health information. Nonseekers also scored lower on preventative health behaviors.     

Cancer information disparities between U.S.- and foreign-born populations

Immigrant health is an important component of American public health. But relatively little is known about immigrants' cancer information use. Using the 2005 Health Information National Trends Survey (HINTS) data, this study examined potential disparities between foreign-born (n?=?563) and U.S.-born (n?=?4,830) populations in their access to and experience with cancer information. Logistic regressions showed that foreign-born Hispanics were less likely than the U.S.-born to have ever sought cancer information (adjusted odds ratio [OR]?=?.51). Foreign-born individuals overall were also less likely to have had somebody else look for cancer information for them (OR?=?.66). Compared with the U.S.-born, foreign-born individuals in general faced greater obstacles during the process of cancer information seeking (ORs?=?1.98-2.27). They were also less trusting of some important sources of health information (ORs?=?.50-.64), a pattern that was particularly pronounced among Hispanics (ORs?=?.20-.43). Implications of these disparities were explored through multiple linear regressions that revealed negative associations between cancer information use and undesirable cancer beliefs.     

Seeking cancer-related information from media and family/friends increases fruit and vegetable consumption among cancer patients

Previous research suggests positive effects of health information seeking on prevention behaviors such as diet, exercise, and fruit and vegetable consumption among the general population. The current study builds upon this research by examining the effect of cancer patients' active information seeking from media and (nonmedical) interpersonal sources on fruit and vegetable consumption. The results of this longitudinal study are based on data collected from a randomly drawn sample from the Pennsylvania Cancer Registry, comprising breast, prostate, and colorectal cancer patients who completed mail surveys in the fall of 2006 and 2007. There was a 65% response rate for baseline subjects (resulting n = 2013); of those, 1,293 were interviewed one year later and 845 were available for final analyses. We used multiple imputation to replace missing data and propensity scoring to adjust for effects of possible confounders. There is a positive effect of information seeking at baseline on fruit and vegetable servings at follow-up; seekers consumed 0.43 (95% CI: 0.28 to 0.58) daily servings more than nonseekers adjusting for baseline consumption and other confounders. Active information seeking from media and interpersonal sources may lead to improved nutrition among the cancer patient population.     

Cancer information seeking preferences and experiences: disparities between Asian Americans and Whites in the Health Information National Trends Survey (HINTS)

Little is known about cancer information needs and seeking patterns in the rapidly growing Asian American population. The purpose of this study is to characterize cancer information seeking behaviors and preferences in Asian Americans and to examine their cancer-related knowledge and risk perceptions. Data from the nationally representative Health Information National Trends Survey (HINTS) database were analyzed to compare non-Hispanic Asians and Whites. Asians had lower awareness of the National Institutes of Health and American Cancer Society, were less likely to think that not smoking or quitting smoking would reduce cancer risk, were less knowledgeable about colon cancer screening, and considered their personal cancer risk to be low. Asians and Whites had similar media usage rates. They also had similar rates of preference for cancer information from various sources, although Asians were significantly more likely to prefer print materials. The level of trust of cancer information from doctors was high overall. This study is limited by under-representation of some demographic subpopulations, future surveys should oversample Asians and strive to include higher-risk Asians (e.g., elderly, poorly educated, immigrants, and those with limited English proficiency).     

A Time Series Analysis of Cancer-Related Information Seeking: Hints From the Health Information National Trends Survey (HINTS) 2003–2014

Recent technological changes, such as the growth of the Internet, have made cancer information widely available. However, it remains unknown whether changes in access have resulted in concomitant changes in information seeking behavior. Previous work explored the cancer information seeking behaviors of the general population using the 2003 Health Information National Trends Survey (HINTS). This article aims to reproduce, replicate, and extend that existing analysis using the original dataset and five additional iterations of HINTS (2007, 2011, 2012, 2013, 2014). This approach builds on the earlier work by quantifying the magnitude of change in information seeking behaviors. Bivariate comparison of the 2003 and 2014 data revealed very similar results; however, the multivariate model including all years of data indicated differences between the original and extended models: individuals age 65 and older were no longer less likely to seek cancer information than the 18–35 reference population, and Hispanics were also no longer less likely to be cancer information seekers. The results of our analysis indicate an overall shift in cancer information seeking behaviors and also illuminate the impact of increased Internet usage over the past decade, suggesting specific demographic groups that may benefit from cancer information seeking encouragement.     

The Internet as a health information source: findings from the 2007 Health Information National Trends Survey and implications for health communication

A wealth of health information is available online, but we do not fully understand the implications for health communication. This study examined whether health information seekers who turn to the Internet first differ from those who turn elsewhere. Data from the 2,338 respondents to the mail portion of the National Cancer Institute's Health Information National Trends Survey (HINTS) 2007 who reported looking for health information for themselves were analyzed. Logistic regression was used to examine whether health information seekers turning to the Internet first differed in terms of demographics, information preferences and seeking confidence, and communication with providers from those using other sources. In the final model, Internet users were younger, more educated, higher income, preferred numbers rather than words to describe chance, and think it is very important to get personal medical information electronically. There were no differences in terms of gender, health status, confidence seeking health information, or communication with providers. Health information seekers who turn to the Internet first are different, both in terms of demographics and information preferences. As the use of communication technologies increases, health communicators need to be attentive to the potential for communication inequalities.     

Factors associated with men's use of prostate-specific antigen screening: evidence from Health Information National Trends Survey

BACKGROUND: Rapid uptake of prostate-specific antigen (PSA) testing has occurred in the United States despite inconclusive evidence regarding mortality benefit. METHODS: We examined data (n=927) from the 2003 Health Information National Trends Survey to assess prevalence of self-reported PSA use and its association with patients' decision making. RESULTS: Over half (55.2%) the sample reported ever having had a PSA test. Men aged 65-74 (OR=2.53, 1.49-4.31), with some college (OR=2.41, 1.22-4.77) or college degrees (OR=5.01, 2.53-9.90) were more likely to have had PSA tests, while men without health insurance (OR=0.32, 0.12-0.88) or a usual source of care (OR=0.35, 0.22-0.54) were less likely. In a model including healthcare provider communication and information seeking, men who reported that providers involved them in decisions (OR=1.76, 1.02-3.03) and recommended PSA (OR=236.3, 70.5-791.4) were more likely to have had the tests. Men aged 65-74 (OR=2.30, 1.33-4.00), with college degrees (OR=2.91, 1.45-5.82), and greater information attention/seeking (OR=1.23, 1.07-1.40) were more likely to report PSA recommendations, while those without usual care were less likely (OR=0.37, 0.22-0.64). Men without usual care (OR=0.38, 0.20-0.71) and Hispanic men (OR=0.40, 0.19-0.85) were less likely to report that healthcare providers involved them in healthcare decisions. CONCLUSIONS: Results emphasize the relevance of patient decision making and the importance of healthcare providers in PSA testing.     

The Health Information National Trends Survey (HINTS): development, design, and dissemination

Little is known about access, sources, and trust of cancer-related information, or factors that facilitate or hinder communication on a population-wide basis. Through a careful developmental process involving extensive input from many individuals and organizations, the National Cancer Institute (NCI) developed the Health Information National Trends Survey (HINTS) to help fill this gap. This nationally representative telephone survey of 6,369 persons aged > or = 18 years among the general population was first conducted in 2002-2003, and will be repeated biennially depending on availability of funding. The purpose of creating a population survey to be repeated on a cyclical basis is to track trends in the public's rapidly changing use of new communication technologies while charting progress in meeting health communication goals in terms of the public's knowledge, attitudes, and behaviors. The HINTS survey instrument was built upon extant models of health communication and behavior change, taking into account the rapidly changing communication environment. Questions in the survey were drawn from an overall theoretical framework that juxtaposed the"push" aspects of traditional broadcast media against the"pull" aspects of new media. HINTS data will be made widely available for researchers and practitioners; it will help further research in health communication and health promotion and provide useful information for programs, policies, and practices in a variety of settings.     

The health information national trends survey: research from the baseline

The decades surrounding the turn of the millennium will be remembered as a time of extraordinary opportunity in cancer communication. In 1990, the number of age-adjusted deaths due to cancer in the U.S. population began a slow steady decline after a century of disparaging increase. Reasons for this decline have been attributed to long-awaited successes in primary prevention, especially related to tobacco, and early detection for cervical, breast, prostate, and colorectal cancers, as well as advances in treatment. This was also a time of unparalleled change in the cancer communication environment. Scientific health discoveries escalated with the completion of the Human Genome project in 2003, and penetration of the Internet made health information available directly to consumers. To seize the opportunity afforded by these changes, the National Cancer Institute (NCI) launched the Health Information National Trends Survey (HINTS). Fielded for the first time in 2003, the HINTS is a nationally representative, general population survey of noninstitutionalized adults in the United States 18 years and older. This supplement contains a compilation of original research conducted using the data generated by the first administration of the HINTS telephone interviews. Covering topics in cancer knowledge, cancer cognition, risk perception, and information seeking, the articles represent an interdisciplinary view of cancer communication at the turn of the millennium and offer insight into the road ahead.     

结核病可疑症状者首诊选择结防机构医生的影响因素分析

[目的]探讨四川省若尔盖县结核病可疑症状者首诊选择结防机构医生的影响因素。为制定更适合人口分散、交通不便、以牧民为主的少数民族地区的结核病控制措施和策略提供依据。[方法]以若尔盖县为研究现场,对初次到县防疫站就诊的肺结核可疑症状者的社会经济学特征、结核病知识知晓状况、寻求结核病治疗过程状况等内容进行问卷调查。[结果]问卷调查了160例初次到县防疫站结防科就诊的肺结核可疑症状者,85.6%首次就诊于乡镇卫生院、私立诊所及综合医院等非结防专业机构。仅23.1%在此次患病前知道结核病的相关症状。多因素分析结果显示:结核可疑症状者首诊选择结防医生主要与住在县城(OR=6.483),是家庭主要劳动力(OR=4.548)及知道县防疫站是结防专业机构(OR=3.012)有关。[结论]加强结防知识的宣传,提供可及性较好的卫生服务是当地结核病控制的关键。     

A Nonresponse Bias Analysis of the Health Information National Trends Survey (HINTS)

We conducted a nonresponse bias analysis of the Health Information National Trends Survey (HINTS) 4, Cycles 1 and 3, collected in 2011 and 2013, respectively, using three analysis methods: comparison of response rates for subgroups, comparison of estimates with weighting adjustments and external benchmarks, and level-of-effort analysis. Areas with higher concentrations of low socioeconomic status, higher concentrations of young households, and higher concentrations of minority and Hispanic populations had lower response rates. Estimates of health information seeking behavior were higher in HINTS compared to the National Health Interview Survey (NHIS). The HINTS estimate of doctors always explaining things in a way that the patient understands was not significantly different from the same estimate from the Medical Expenditure Panel Survey (MEPS); however, the HINTS estimate of health professionals always spending enough time with the patient was significantly lower than the same estimate from MEPS. A level-of-effort analysis found that those who respond later in the survey field period were less likely to have looked for information about health in the past 12 months, but found only small differences between early and late respondents for the majority of estimates examined. There is some evidence that estimates from HINTS could be biased toward finding higher levels of health information seeking.     

Perceptions of traditional information sources and use of the world wide web to seek health information: findings from the health information national trends survey

As medical information becomes increasingly available and individuals take a more active role in managing their personal health, it is essential for scholars to better understand the general public's information-seeking behavior. The study reported here explores the use of the World Wide Web to seek health information in a contemporary information-media environment. Drawing from uses and gratifications theory and the comprehensive model of health information seeking, perceptions of traditional information sources (e.g., mass media, one's health care provider, etc.) are posited to predict use of the Web to seek health information and perceptions of information acquired from searches. Data from the Health Information National Trends Survey (HINTS; N = 3982) were analyzed to test study hypotheses. Trust in information-oriented media, entertainment-oriented media, and one's health care provider all predicted Web use behavior and perceptions. The implications of the findings for research on information seeking and the role of the Web in patient empowerment are discussed.     

Cancer/health communication and breast/cervical cancer screening among Asian Americans and five Asian ethnic groups

ABSTRACT

Objectives: This paper is an examination of cancer/health communication factors (i.e. cancer/health information seeking, patient-provider communication (PPC), cancer screening information from providers) and screening for breast and cervical cancer among Asian Americans and five Asian ethnic groups (Chinese, Filipinos, Japanese, Koreans, Vietnamese) in comparison to Whites. Additionally, the relationship between cancer/health communication disparity and cancer screening gaps between Asian Americans and Whites was investigated.

Design: Data comes from a nationally representative sample of 2011–2014 Health Information National Trends Surveys (HINTS).

Results: Asian Americans and most Asian ethnic-groups reported significantly lower rates of cancer/health information seeking and lower evaluations for PPC as compared to Whites, though differences within Asian ethnic groups were observed (Koreans’ greater cancer/health information seeking, Japanese’ higher PPC evaluation). When the cancer/health communication factors were controlled, Asian Americans’ odds of cancer screening were increased. Especially, Asian Americans’ odds of adhering to the breast cancer screening guideline became nearly 1.4 times greater than Whites.

Conclusion: This research demonstrates that health organizations, providers, and Asian American patients’ collaborative efforts to increase the access to quality cancer information, to make culturally competent but straightforward screening recommendations, and to practice effective communication in medical encounters will contribute to diminishing cancer disparities among Asian Americans.     

Relationship of communication and information measures to colorectal cancer screening utilization: results from HINTS

Utilization of colorectal cancer screening tests is suboptimal. Knowledge of colorectal cancer screening has been associated with completion of screening. Thus, increasing awareness of colorectal cancer screening may lead to significant improvements in screening rates. We assessed for the association among provider-patient interaction, information-seeking patterns, sources of information, trust in cancer information, and Internet usage on colorectal cancer screening behavior using data obtained by the Health Information National Trends Survey (HINTS). From a cohort of 2,670 respondents greater than 50 years of age, we found that they (1) desired cancer information from personalized reading materials, meeting in person with a health care professional, and published materials; and (2) had great trust of information from their provider. Having trust in cancer information from the doctor or other health care professional was most predictive (OR 2.08, 95% CI 1.49-2.94) of being up to date. Other predictive factors include having a desire for cancer information from personalized reading materials (OR 1.56, 95% CI 1.24-1.95) and using the Internet from home (OR 1.32, 95% CI 1.04-1.67). We conclude that personalized communications from a health care provider are desired and trusted. Another promising information delivery approach is the Internet. Dedicated efforts using these approaches for information exchange may be most beneficial toward increasing utilization of colorectal cancer screening.     

Cancer news coverage and information seeking

The shift toward viewing patients as active consumers of health information raises questions about whether individuals respond to health news by seeking additional information. This study examines the relationship between cancer news coverage and information seeking using a national survey of adults aged 18 years and older. A Lexis-Nexis database search term was used to identify Associated Press (AP) news articles about cancer released between October 21, 2002, and April 13, 2003. We merged these data to the Health Information National Trends Survey (HINTS), a telephone survey of 6,369 adults, by date of interview. Logistic regression models assessed the relationship between cancer news coverage and information seeking. Overall, we observed a marginally significant positive relationship between cancer news coverage and information seeking (p < 0.07). Interaction terms revealed that the relationship was apparent only among respondents who paid close attention to health news (p < 0.01) and among those with a family history of cancer (p < 0.05). Results suggest that a notable segment of the population actively responds to periods of elevated cancer news coverage by seeking additional information, but they raise concerns about the potential for widened gaps in cancer knowledge and behavior between large segments of the population in the future.     

The Health Information National Trends Survey (HINTS): Development,Design, and Dissemination

Little is known about access, sources, and trust of cancer-related information, or factors that facilitate or hinder communication on a populationwide basis. Through a careful developmental process involving extensive input from many individuals and organizations, the National Cancer Institute(NCI)developed the Health Information National Trends Survey(HINTS)to help fill this gap. This nationally representative telephone survey of 6,369 persons aged?≥?18 years among the general population was first conducted in 2002–2003, and will be repeated biennially depending on availability of funding. The purpose of creating a population survey to be repeated on a cyclical basis is to track trends in the public's rapidly changing use of newcommunication technologies while charting progress in meeting health communication goals in terms of the public's knowledge, attitudes, and behaviors. The HINTS survey instrument was built upon extant models of health communication and behavior change, taking into account the rapidly changing communication environment. Questions in the survey were drawn from an overall theoretical framework that juxtaposed the“push”aspects of traditional broadcast media against the“pull”aspects of new media. HINTS data will be made widely available for researchers and practitioners; it will help further research in health communication and health promotion and provide useful information for programs, policies, and practices in a variety of settings.