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.

How does patient-centered communication influence patient trust?: The roles of patient participation and patient preference.

OBJECTIVE: The aim of this study was to examine the effects of patient-centered communication, patient participation, and patient preference on patient trust in the context of China. METHODS: A cross-sectional survey was conducted involving 217 cancer patients in China. Mediation and moderation analyses were performed to examine the relationships among the study variables. RESULTS: First, patient-centered communication increased patient participation in decision-making, which, in turn, enhanced patient trust. Second, patient-centered communication did not have a direct effect on patient trust. Third, patient preference for a passive role in decision-making weakened the relationship between patient participation and patient trust. CONCLUSION: The results underscore the significant effect of facilitating patient participation in linking patient-centered communication to patient trust. However, medical communication should also respond to patients' preferred roles in the decision-making process. PRACTICE IMPLICATIONS: Doctors should provide patients with opportunities to ask questions and express their concerns. In addition, they should evaluate patients' preferred degree of involvement before inviting them to contribute so as to respect their preferences and values.

"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.

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.

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.

Can Online Patient-Provider Communication Improve Emotional Well-Being? Examining the Roles of Social Presence and Patient Empowerment.

China has long been suffering from the problem of having health care that is expensive and difficult to access. Online patient-provider communication (OPPC) can offer a viable channel to increase access to care. However, through what underlying mechanisms OPPC can be associated with better health outcome is under-researched. To fill this research gap, this study investigated OPPC usage in China and identified psychological processes linking OPPC to emotional well-being. With two-wave panel surveys conducted in China, we found that mobile health app, social media, and health information service website were three common platforms for OPPC, followed by patient portal, whereas e-mail was used least frequently. Overall, OPPC did not have any direct effect on emotional well-being. Instead, OPPC first increased users' perceived social presence of providers in OPPC, which in turn triggered sense of patient empowerment, which finally enhanced emotional well-being.

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.

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.

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.

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.

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.

Linking the Pathway from Exposure to Online Vaccine Information to Cyberchondria During the COVID-19 Pandemic: A Moderated Mediation Model.

Cyberchondria describes excessive health information seeking on the Internet is associated with escalating concerns and anxiety. Drawing upon the stimulus-organism-response model, this study proposes a moderated mediation model to explore how people develop cyberchondria when they search for COVID-19 vaccine-related information on the Internet. To test the proposed model, an online survey was conducted in China. Results showed that there was a direct and positive relationship between exposure to online vaccine information and cyberchondria. This relationship was also partially mediated by perceived information overload. Moreover, e-health literacy negatively moderated the indirect relationship between exposure to online vaccine information and cyberchondria through perceived information overload. The results from this study can advance our knowledge on the development of cyberchondria during public health crises, and inform health professionals and social media operators on developing evidence-based interventions to manage this issue.

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.

Frequent and diverse use of electronic health records in the United States: A trend analysis of national surveys.

Objective: Considering the increasing integration of electronic health records (EHRs) into medical practice by healthcare organizations, it is especially pertinent to understand its actual usage by the general public in recent years. This study aims to explore factors associated with the frequency and diversity of EHR usage in the United States over time. Methods: We analyzed three iterations (2017, 2018, and 2019) of the Health Information National Trends Survey (HINTS). HINTS is a national cross-sectional survey conducted by the National Cancer Institute to document attitudes and perceptions about health information access and use among American adults. Results: Both frequency and diversity of EHR usage have slightly increased across the years. However, its overall usage still remained low. Three technology-related enablers (access to digital devices, access to the Internet, and perceived usefulness of EHRs) were positively related to EHR usage in all three iterations. In addition, perceived health status was a constant and negative predictor of EHR usage over years. Doctor-patient communication was positively associated with the frequency of EHR usage in two survey waves. Conclusions: More initiatives to increase EHR usage in the United States are needed. We advocate for providing affordable Internet access and smartphone to underserved populations; in medical encounters, doctors should have more patient-centered communication, introduce the benefits of EHRs to patients, and promote EHR adoption in terms of frequency and diversity.

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.

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.

Factors influencing COVID-19 vaccination intention: The roles of vaccine knowledge, vaccine risk perception, and doctor-patient communication.

OBJECTIVE: This study aims to investigate factors influencing COVID-19 vaccination intention in the United States. METHODS: A cross-sectional survey was conducted with 800 respondents recruited from an online panel managed by a survey company. Path analysis was employed to examine the relationships between the study variables. RESULTS: First, perceived susceptibility to COVID-19 vaccine side effects was negatively associated with vaccination intention whereas perceived severity did not show any significant impact. Second, vaccine-related knowledge was not directly related to vaccination intention, but it had an indirect and positive effect on vaccination intention via decreasing perceived susceptibility. Third, doctor-patient communication strengthened the negative effect of vaccine knowledge on perceived susceptibility and severity. CONCLUSION: The results of this study offer insights on how to increase people's vaccination intention and reduce their psychological concerns when making COVID-19 vaccine-related decisions. PRACTICE IMPLICATIONS: Government agencies should actively promote the effectiveness and importance of vaccination, while addressing concerns about vaccine safety in the public; Health initiatives also need to enhance the level of knowledge about COVID-19 vaccines through various media channels; Doctors can start the conversations about COVID-19 vaccination with their patients at the point of care and/or via online communication platforms.

Clinical trial participation in America: The roles of eHealth engagement and patient-provider communication.

OBJECTIVE: Public participation in a clinical trial is the foundation of clinical research and the cornerstone for the discovery of new treatment and improving health outcomes. This study aims to examine how eHealth engagement, patient-provider communication, and clinical trial knowledge are associated with clinical trial participation in the United States. METHODS: Data were drawn from the Health Information National Trends Survey Iteration 5 Cycle 4 conducted in 2020. The sample included 3865 American adults aged 18 years and above. Path analysis using structural equation modeling and hierarchical linear regression was performed to examine the effects of eHealth engagement and patient-provider communication on clinical trial participation. RESULTS: About 5% of American adults have ever participated in a clinical trial. Younger adults, males, minorities, and people with lower education, less clinical trial knowledge, and less eHealth engagement were less likely to participate. After controlling for demographic variables, we found that more eHealth engagement led to a better knowledge of clinical trials, which was strongly associated with participation. Further, patient-centered communication did not directly lead to clinical trial participation; instead, it positively moderated the relationship between clinical trial knowledge and participation. CONCLUSIONS: The national survey data indicate that American participation in clinical trials remains low and a significant disparity exists. Within the context of the eHealth movement, it is critical to implement targeted interventions to improve clinical trial knowledge, address the digital divide, and enhance patient-centered communication.

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.

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.