"I Know News Will Find Me": Examining the Relationship Between the "News-Finds-Me" Perception and COVID-19 Misperceptions.

In the current media environment, some individuals have shifted from actively monitoring news toward passively waiting for the media to alert them about news to a certain extent, forming a "news-finds-me" (NFM) perception. Drawing on a cross-sectional survey (N = 906) of adults from the United States, this study investigates the relationship between the NFM perception and COVID-19 misperceptions. Findings demonstrated a positive association between NFM perception and misperceptions. Moreover, information avoidance mediated the relationship between NFM and misperception. Finally, need for cognition (NFC) was a significant moderator, such that among those with greater NFC, the indirect effect of NFM perception on misperceptions became weaker. Findings of this study can contribute to the literature of NFM perception in health contexts and provide useful guidelines for combating misinformation and misperceptions in the algorithm-generated information environment.

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

BACKGROUND: Reducing cancer fatalism is essential because of its detrimental impact on cancer-related preventive behaviors. However, little is known about factors influencing individuals' cancer fatalism in China. OBJECTIVE: With a general basis of the extended parallel process model, this study aims to examine how distinct cancer-related mental conditions (risk perception and worry) and different information behaviors (information seeking vs avoidance) become associated with cancer fatalism, with an additional assessment of the moderating effect of information usefulness. METHODS: Data were drawn from the Health Information National Trends Survey in China, which was conducted in 2017 (N=2358). Structural equation modeling and bootstrapping methods were performed to test a moderated mediation model and hypothesized relationships. RESULTS: The results showed that cancer risk perception and cancer worry were positively associated with online health information seeking. In addition, cancer worry was positively related to cancer information avoidance. Moreover, online health information seeking was found to reduce cancer fatalism, while cancer information avoidance was positively associated with cancer fatalism. The results also indicated that the perceived usefulness of cancer information moderated this dual-mediation pathway. CONCLUSIONS: The national survey data indicate that cancer mental conditions should not be treated as homogeneous entities, given their varying functions and effects. Apart from disseminating useful cancer information to encourage individuals to adaptively cope with cancer threats, we advocate for health communication programs to reduce cancer information avoidance to alleviate fatalistic beliefs about cancer prevention.

The Effects of Patient-Centered Communication on Emotional Health: Examining the Roles of Self-Efficacy, Information Seeking Frustration, and Social Media Use.

The existing literature on the direct association between patient-centered communication (PCC) and emotional well-being often demonstrates inconsistent results. To explain such inconsistency, it is important to explore the mediating and moderating mechanisms underlying this relationship. Built upon the communication pathways model, this study empirically analyzed the Health Information National Trends Survey 5 Cycle 3 dataset (N = 4,709) and tested a moderated mediation model that links PCC to emotional health via information-seeking self-efficacy, with an additional assessment of the moderating effects of information-seeking frustration and social media use. The findings showed that PCC was positively related to emotional health. Also, PCC was indirectly associated with emotional health through information-seeking self-efficacy. In addition, information-seeking frustration and social media use weakened the association between PCC and information-seeking self-efficacy. Furthermore, the indirect path from PCC to emotional health through information-seeking self-efficacy was conditional on both information-seeking frustration and social media use. Important theoretical and practical implications are also discussed.

Linking Nonverbal Rapport to Health Outcome: Testing an Organizational Pathway Model.

A growing body of research on medical communication indicates that nonverbal rapport (e.g., smiling, eye contact, closer proximity) is central to productive health care delivery. However, mechanisms integral to the process by which nonverbal rapport influences health improvement remain under-researched. This study breaks new grounds in proposing and testing mediation pathways that take into account organizational factors. We conducted a cross-sectional survey in a private hospital in Singapore among 417 patients to examine their communication with physicians and nurses. Results indicated that nonverbal rapport did not have a significant direct relationship with perceived health outcome in both the patient-physician dyad and the patient-nurse dyad. Instead, communication satisfaction and organizational identity completely mediated this relationship. In addition, respect positively moderated the relationship between nonverbal rapport and communication satisfaction in both dyads, while health literacy was not a significant moderator. The findings suggest that the organizational context should be considered in pathways research.

Descriptive Norms and eHealth Use Among Older Adults: A Cross-Country Comparative Study.

eHealth use enables older adults to access and manage healthcare resources, and benefits their health; however, older adults' uptake of eHealth remains low across societies. Social influences such as descriptive norms may be of critical importance in promoting the elderly's usage of eHealth. Based on the Integrative Model of Behavioral Prediction, this study investigates how descriptive norms relate to eHealth use among the elderly in China and the United States. Analysis of the combined sample (N = 1,070) showed that descriptive norms were positively related to eHealth use. Also, descriptive norms were indirectly associated with eHealth use via injunctive norms, attitudes and self-efficacy. Moderated mediation analysis indicated that these direct and indirect relationships differed across the two countries. This study highlights the important role of descriptive norms in promoting older adults' eHealth use behavior and addresses potential country differences in how the elderly respond to descriptive norms. Several important theoretical and practical implications are also discussed.

Social Media Communication about HPV Vaccine in China: A Study Using Topic Modeling and Survey.

The human papillomavirus (HPV) vaccine is relatively novel to people in China. Social media is becoming an important channel for learning new health information. However, limited is known about what HPV vaccine information has been disseminated on social media, and how such online information is associated with health-related behaviors in China. Based on Longo et al.'s model of patient use of healthcare information for healthcare decision, and Longo's model of health information seeking behaviors, this study examined HPV vaccine-related information type and information acquisition pattern. Following the mixed-methods approach, we first crawled 67,773 postings about HPV vaccine on Weibo, the largest microblogging website in China, and performed topic modeling to identify HPV vaccine-related topics that are prevalent on Weibo. The results showed six major topics about HPV vaccine, namely policy, guidance information, advertising, scandals, personal experience sharing, and HPV risks. Second, we conducted an online survey (n = 1,982) to investigate how scanning, seeking, and discussing the six HPV vaccine topics identified from big data analytics can affect HPV vaccine knowledge, safety concern, and vaccination intention. We documented significant impacts of social media health communication on users' health knowledge, attitude and behavioral intention.

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

BACKGROUND: The increasing incidence of cancer among young adults (18-40 years old) is of concern in China. OBJECTIVES: This study aims to examine the influence of cancer information-seeking behaviours (CISB) on young adults' worries about cancer and participation in screening. METHODS: This study analysed data from two probability sample surveys conducted in 2012 and 2017 in China. The questions in the questionnaire remained the same for better comparison. The sample size was 1212 in the 2012 survey, and 2178 in the 2017 survey. RESULTS: From 2012 to 2017, among young adults, there was a decline in cancer information seeking, diversity of cancer information sought and cancer worry, while an improvement in cancer information-seeking experience was found. Also, CISB had significant associations with cancer worry and health screening over the 5 years. DISCUSSION: The level of young adults' cancer information seeking remains low in China, and this group is not fully aware of their potential risks of getting cancer. CONCLUSION: Although young adults find the experience of looking for cancer information easier in 2017, health campaigns may be necessary to encourage young adults to find out more about their cancer risks, and to participate more in health screening.

Complementary Media Use for Health Information Seeking and the Role of Health Orientation: A Survey Study in India.

Mass media are offering numerous ways to obtain health information. As people are facing with a plethora of media sources, it is important to investigate how they navigate and select multiple media sources in the process of searching for health information. With the basis of the channel complementarity theory, the current study aims to explore the patterns of media complementarity for health information seeking in the context of India. Our survey study among 1,005 participants in India showed that media complementarity did not occur within print media (e.g., newspaper, book, magazine) or within broadcast media (e.g., television and radio), but existed between these two categories of media. Also, the Internet had some complementary relationships with both print media and broadcast media. Besides, users' health orientation served as a moderating factor that strengthened the media complementarity. The theoretical and practical implications were also discussed.

The Effects of Social Media Information Discussion, Perceived Information Overload and Patient Empowerment in Influencing HPV Knowledge.

Social media is becoming a viable channel to seek health information. However, the effects of social media on health knowledge have been inconsistent in the existing literature. Drawn upon the cognitive mediation model, this study examined the motivations influencing social media use for human papillomavirus (HPV) information and explored the underlying pathways linking social media use to HPV knowledge. With two-wave online surveys conducted in China, we found that three motivations of social media use, namely surveillance, anticipated interaction, and guidance, were positively associated with information discussion on social media, which increased perceived information overload that was negatively related to knowledge. In addition, patient empowerment positively moderated the effects of motivations on information discussion.

The Effect of Social Media on Stress among Young Adults during COVID-19 Pandemic: Taking into Account Fatalism and Social Media Exhaustion.

Social media has been widely used as an important source of health information, particularly during public health crises. However, findings regarding social media's impact on young adults' mental health are mixed. There is a need to identify social mechanisms underlying the effect of social media on mental health outcomes. Our study breaks new ground by proposing and testing a moderated mediation pathway from social media use to stress in young adults during the COVID-19 pandemic. We conducted a two-wave online panel survey in the context of China. With a general basis of the Street's three-stage model, our results indicated that social media failed to directly affect young adults' stress. Instead, fatalism completely mediated this relationship. Also, one's perceived social media exhaustion negatively moderated this mediation pathway. The findings have significant theoretical and practical implications for the use of social media to promote health, well-being, and quality of life among young people during public health crises.

Social Media Health Promotion and Audience Engagement: The Roles of Information Dissemination, Organization-Audience Interaction, and Action Confidence Building.

Social media have become an important platform for health promotion. Based on the Information-Community-Action Framework, we conducted a content analysis of 1,481 Facebook postings by Singapore's Health Promotion Board. Results showed that organizational information and health benefit information dissemination were positively associated with online audience engagement. Also, organization-audience interaction had a positive relationship with online audience engagement. In addition, messages that help build confidence for health behavior change increased online audience engagement. In addition to these main effects, organization-audience interaction also played a moderating role that strengthened the effects of information dissemination and action confidence building on online audience engagement. This study offers important theoretical contributions to the Information-Community-Action Framework and has practical implications for enhancing the effectiveness of health promotion in this digital era.

Media and social factors influencing stigma towards eczema patients: A survey study in Singapore.

ISSUE ADDRESSED: Eczema is a common skin health issue in Singapore. A salient challenge eczema patients are facing is the stigma towards them, which has been relatively unacknowledged. It is critical to reducing stigma towards eczema patients, and an essential step is to identify factors influencing stigmatising behaviour. METHODS: With a general basis of the Integrative Model of Behavioral Prediction, we conducted a cross-sectional online survey (N = 293) in the context of Singapore. The sample was recruited via the online panel of a survey company, Rakuten Insights. Our sample's age and education level generally fit with the population in Singapore. RESULTS: Media exposure to eczema content did not influence stigmatising behaviour either directly or indirectly. However, personal connection with eczema patients reduced stigma indirectly, completely mediated by stigmatising attitude towards eczema patients and health literacy. That is, personal connection with eczema patients had a negative relationship with stigmatising attitude, which was positively associated with the intention of and actual stigmatising behaviour. However, personal connection increased health literacy, which in turn reduced stigmatising intention and behaviour. CONCLUSIONS: We call for more future initiatives to fight against health stigma. Health promotion can take advantage of eczema patients' social network to educate the general public about the eczema issue to lower stigma. Public policy responses to prevent discrimination on the basis of skin health are also needed. Media organisations should use news media and social media to speak out against stigma towards eczema patients, and avoid using stigmatising language.

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

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

Intentions to Seek Information about E-Cigarettes: Perceived Risk, Efficacy, and Smoking Identity.

While e-cigarette use increases in the US., people's knowledge about e-cigarettes is limited. Information seeking may influence people's knowledge about e-cigarettes. Using the risk perception attitude framework and the identity theory, this study examined if U.S. adult current smokers (n = 1,841) differing in perceived efficacy of switching completely to e-cigarettes, perceived risk of cigarette smoking, and smoking identity report different levels of intentions to seek information about e-cigarettes. Results revealed that smokers with high perceived risk of smoking and perceived efficacy about switching completely to e-cigarettes (responsive group) reported strongest intentions to seek information about e-cigarettes (M = 5.41 on a 1-7 scale), followed by the group having low smoking risk perceptions and high e-cigarette efficacy beliefs (proactive group; M = 4.58), the group having high smoking risk perceptions and low e-cigarette efficacy beliefs (avoidance group; M = 3.18), and the group low on both factors (indifference group; M = 2.76). The differences between responsive group and proactive, avoidance, and indifference groups were greater among smokers with high (Mdiff = 6.14) vs. low (Mdiff = 5.27) smoking identity. Theoretical and practical implications of the findings are discussed.

Talk to Your Doctors Online: An Internet-based Intervention in China.

China has long faced the problem of having health care that is difficult to access. Online patient-provider communication (OPPC) may offer a new option for the delivery of affordable health services in a timely manner. However, OPPC is still novel in China, particularly among middle-aged and older adults. Thus, to promote effective use of OPPC for these population groups, the current study implemented a four-week Internet-based intervention program, with a general basis of Social Cognitive Theory. With analyses of three-wave panel data, the results offer the promise of this intervention program in increasing usage frequency, quality of users' experience, self-efficacy, behavioral capability, and awareness of OPPC. This Internet-based intervention program also provides important implications for future research, practice, and policy in promoting e-Health in China.

Patient-Centered Communication Mediates the Relationship between Health Information Acquisition and Patient Trust in Physicians: A Five-Year Comparison in China.

Public trust in medical profession has declined in the past decades. The deluge of health information available in various sources may be one contributing factor. However, how the health information acquisition influences patient trust remains unclear. With a general basis of Longo's Health Information Model, we proposed and tested mediation pathways linking three types of health information acquisition behaviors (scanning, seeking, and discussing) to patient trust in physicians, mediated by patient-centered communication. By using two iterations of probability sample surveys conducted in 2012 (N = 2568) and 2017 (N = 3090), respectively, in China, this study found that from 2012 to 2017, health information scanning declined. Specifically, the scanning via traditional media (e.g., newspaper, tv) decreased, but increased in the new media (e.g., Web). Besides, both health information seeking and discussing slumped. Among the three dimensions of health information acquisition, health information scanning and discussing exerted direct effects on patient trust. However, patient-centered communication was found to be mediated the relationships between all three types of health information acquisition and patient trust in physicians over time.

Patient-centered communication and emotional well-being in the era of medical violence in China.

The past decade has witnessed an increasing number of patient assaults on doctors in China. Patient-centered communication (PCC) may be one way to mitigate this problem. This study examined the effects of PCC and patient trust on emotional health outcome, especially how patients' attitude toward medical violence affected this relationship. Data were drawn from the China Governance and Public Policy Survey administered in 2017 with a sample size of 3784. The results showed that PCC had no direct effect on emotional well-being. Instead, patient trust completely mediated this path. Also, patients' attitude toward medical violence increased the indirect effect of PCC on emotional well-being, suggesting a moderated mediation model. We call for education programs to promote PCC for both providers and patients, mass media campaigns to condemn violence against doctors and stricter law enforcement to stop medical violence.

Digital divide and Internet health information seeking among cancer survivors: A trend analysis from 2011 to 2017.

OBJECTIVE: The current study aims to explore the trend of Internet health information seeking (IHIS) in cancer survivors and the relationship between four dimensions of digital divide (eg, mental access, material access, skills access, and usage access) and IHIS. METHODS: Data from three iterations (2011, 2013, and 2017) of Health Information National Trends Survey were analyzed. Only cancer survivors (2011: n=563; 2013: n=459; 2017: n=504) were included. ANOVA and multivariate regressions were performed. RESULTS: The rate of IHIS among cancer survivors has increased from 53.5% in 2011 to 69.2% in 2017. Also, across the three survey years, material access (eg, physical Internet access), usage access (eg, eHealth activities), and mental access (eg, trust in online health information) have remained in a significant and positive relationship with IHIS. Skills access (eg, health information seeking skills) and the other mental access factor, self-efficacy in health information seeking, were not significantly associated with IHIS over time. CONCLUSIONS: This research revealed a rising trend of IHIS adoption in cancer survivors, and demonstrated significant relationships between digital divide and IHIS. We call for targeted interventions to reduce the digital divide barriers for cancer survivors.

The Relationship between Face-to-Face and Online Patient-Provider Communication: Examining the Moderating Roles of Patient Trust and Patient Satisfaction.

Patient-provider communication is an important factor influencing patients' health-related outcomes. This study examined how the quality of face-to-face communication with providers is associated with their subsequent Internet use for patient-provider communication. With an analysis of two-wave panel data collected in China, results showed that face-to-face patient-provider communication had a positive and direct effect on online patient-provider communication at a later time point. In addition, patient trust and patient satisfaction both positively moderated the relationship between face-to-face and online patient-provider communication. The results of this study emphasized the important roles of patient-centered communication and patient-provider relationship in the process of eHealth and mHealth movement, particularly in the Chinese health care system.

Pathways Linking Patient-Centered Communication to Health Improvement: A Longitudinal Study in China.

The Chinese health care system has suffered from severe tension between patients and doctors during the past decade. Patient-centered communication (PCC) may play a significant role in mitigating this problem. With a general basis of the pathway model linking communication to health, this paper illustrates social mechanisms that underlie how PCC improves health outcomes in China. Using three-wave panel data collected in China, the results showed that PCC failed to directly influence health. Instead, PCC at Wave 1 predicted patient satisfaction and patient trust at Wave 2, which in turn enhanced self-reported health outcomes at Wave 3. In addition, bonding social capital positively moderated the effect of PCC on patient trust.