Internet-based eHealth technology for emotional well-being among the older adults with a family cancer history: full mediation effects of health information self-efficacy and cancer fatalism.

BACKGROUND: Older adults with a family cancer history (FCH) face an increased cancer risk, which may adversely impact their emotional well-being. Internet-based eHealth technologies (IETs) provide a potential solution to this challenge. This study examines the influence of using IETs on the emotional well-being of older adults with FCH. It also delves into the mediating pathways through health information self-efficacy and cancer fatalism. METHODS: This study conducted a mediation analysis using data from the Health Information National Trends Survey (HINTS 6) collected from March 2022 to November 2022, focusing on older adults with FCH who had previously searched for cancer-related information (N = 1,280). RESULTS: In the mediation model, no positive direct associations between IETs usage and emotional well-being were found. Only health information self-efficacy and cancer fatalism were found to mediate the relationship between IETs usage and emotional well-being serially (ß = 0.007, 95% CI [0.003, 0.012]). CONCLUSIONS: The findings inform health information professionals and healthcare practitioners on enhancing the impact of IETs usage on individual health information self-efficacy, which mitigates cancer fatalism, contributing to better emotional well-being in the digital era.

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

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

Overcoming obstacles to mammography screening: Examining the role of offline healthcare barriers and online patient-provider communication.

Barriers to accessing offline healthcare may discourage patients from undergoing mammography screening. Online patient-provider communication (OPPC) offers a supplementary health resource that can complement traditional medical encounters and facilitate mammography screening. This study examines how offline healthcare barriers influence mammography screening, taking into account OPPC as an independent variable and cancer fatalism and patient activation as two mediators. Data from the 2017, 2018, and 2020 iterations of the Health Information National Trends Survey were used for this study. Results showed that OPPC was positively linked to mammography screening. Offline healthcare barriers had a negative association with patient activation and subsequent mammography behaviors. Moreover, offline healthcare barriers and OPPC were associated with mammography screening through serial mediation of cancer fatalism and patient activation. This study has important implications for encouraging mammography screening.

How does patient-centered communication work? Trend analysis of mediation through cancer worry and health self-efficacy, 2011-2020.

This study proposed and tested the cross-sectional effects of patient-centered communication (PCC) on cancer screening behaviors via an affective-cognitive sequential chain of mediation through cancer worry and health self-efficacy. Cross-sectional data were analyzed from four iterations of the Health Information National Trends Survey (2011, 2014, 2017, and 2020). The results found that lowered cancer worry following PCC does not show a cross-sectional positive effect in promoting cancer screening behaviors, while enhanced health self-efficacy as a subsequent state is a facilitator of screening behaviors. The findings further demonstrated increased PCC, a rise in cancer worry, and a sustained level of health self-efficacy. Also, our research has identified an upward trend in cancer screening behaviors from 2011 to 2017, followed by a notable decrease in 2020. These insights underscore the nuanced ways PCC can foster cancer screening behaviors, emphasizing the importance of emotional and cognitive aspects in clinical settings.

Examining the Intervening Roles of Patient-Centered Care and Patient Activation in the Health Impacts of Offline Healthcare Obstacles and Online Health Consultations Among Deaf and Hard-of-Hearing Patients.

Deaf and hard-of-hearing (DHH) patients often encounter difficulties in effective communication with healthcare professionals and are less likely to receive quality medical care. However, DHH populations are understudied in health communication research. This study examined how offline healthcare obstacles and online health consultation impact DHH patients' health, and the mediating roles of patient-centered care (PCC) and patient activation. Data from 323 DHH patients were analyzed using structural equation modeling to test the hypothesized mediation pathway model. Results indicate that offline healthcare obstacles negatively affect DHH patients' perception of patient-centeredness, which reduces their ability and confidence in self-care (conceptualized as patient activation in this study). This reduced patient activation may jeopardize DHH patients' physical and psychological health. Meanwhile, online health consultation is positively associated with PCC, and higher levels of PCC can increase patient activation, contributing to better physical and psychological health. Testing the same model with hearing-abled participants (n = 3542) revealed significant differences in these intervening relationships. Overall, this study provides valuable insights into the relationship between DHH patients' healthcare experience and their health outcomes. The findings support interventions that focus on enhancing PCC and patient activation to improve the physical and psychological health outcomes of DHH patients.

Effects of electronic personal health information technology on American women's cancer screening behaviors mediated through cancer worry: Differences and similarities between 2017 and 2020.

Backgrounds: Thanks to their accessibility and low cost, electronic personal health information (ePHI) technologies have been widely used to facilitate patient-physician communication and promote health prevention behaviors (e.g. cancer screening). Despite that empirical evidence has supported the association between ePHI technology use and cancer screening behaviors, the underlying mechanism through which ePHI technology use influences cancer screening behaviors remains a topic of discussion. Objective: This study investigates the relationship between ePHI technology uses and cancer screening behaviors of American women and examines the mediating role of cancer worry. Methods: Data for this study were from the Health Information National Trends Survey (HINTS) collected in 2017 (HINTS 5 Cycle 1) and 2020 (HINTS 5 Cycle 4). The final sample included 1914 female respondents in HINTS 5 Cycle 1 and 2204 in HINTS 5 Cycle 4. Mann-Whitney U test, two-sample t-test, and mediation analysis were performed. We also referred to the regression coefficients generated by min-max normalization as percentage coefficients (bp) for the comparison. Results: This study reports increased usage of ePHI technologies (from 1.41 in 2017 to 2.19 to 2020), increased cancer worry (from 2.60 in 2017 to 2.84 in 2020), and a stable level of cancer screening behaviors (from 1.44 in 2017 to 1.34 in 2020) among American women. Cancer worry was found to mediate the ePHI effect on cancer screening behaviors (bp = 0.005, 95% confidence interval [0.001, 0.010]) in a positive complementary mediation in 2020. Conclusions: The research findings support a positive association between ePHI technology use and cancer screening behaviors, and cancer worry has been identified as a salient mediator. An understanding of the mechanism that prompts US women's cancer screening practices provides practical implications for health campaign practitioners.

Effect of information encounter on concerns over healthy eating- mediated through body comparison and moderated by body mass index or body satisfaction.

BACKGROUND: Understanding factors that influence healthy or unhealthy eating can inform intervention strategies. This study ascertained whether and how unintentional exposure to food and nutrition information influenced healthy eating concerns. The study tested body comparison, body satisfaction, and body mass index as three mechanisms that potentially link food information encounter, commonly known as information scanning, to healthy eating concerns. METHODS: A sample of 440 online participants (mean age = 29.15 years) was used to investigate: (1) how unintentional exposure to food and nutrition information, i.e., information encounter (IE), affects healthy eating concerns (HEC); (2) how the effect of IE on HEC is mediated by body comparison (BC); (3) how the paths of the mediation model are moderated by body satisfaction (BS) or body mass index (BMI). RESULTS: The findings show a positive and sizable total effect of IE on HEC - a whole-scale increase in information encounter is associated with a substantial increase in healthy eating concerns by 15 percentage points (bp = 0.150). BC is found to mediate the effect of IE on HEC in an all-positive complementary mediation. Both the indirect and the direct-and-remainder paths show sizable effects. The mediated path contributes about 20% of the total effect between IE and HEC (cp = 20%), while the direct-and-remainder path contributes the rest (cp = 80%). BS was found to moderate the relationship between IE and BC, the first leg of the mediation. The moderation effect is large - the effect of IE on BC is much smaller on the highly and the moderately satisfied than on the lowly satisfied (slope differential bp = -.60). BMI was found to moderate the direct-and-remainder effect of IE on HEC, controlling BC. That is, the effect of IE on HEC, after filtering out the mediated effect through BC, is much larger for those with high or low BMI than those with healthy BMI (slope differential bp = .32). CONCLUSIONS: Exposure, even if unintentional, to food and nutrition information is an important predictor of HEC. BC, BS, and BMI are important factors that help to explain the process through which information affects behaviors.

The Effects of the Use of Patient-Accessible Electronic Health Record Portals on Cancer Survivors' Health Outcomes: Cross-sectional Survey Study.

BACKGROUND: In the past decade, patient-accessible electronic health record (PAEHR) systems have emerged as an important tool for health management both at the hospital level and individual level. However, little is known about the effects of PAEHR portals on the survivorship of patients with chronic health conditions (eg, cancer). OBJECTIVE: This study aims to investigate the effects of the use of PAEHR portals on cancer survivors' health outcomes and to examine the mediation pathways through patient-centered communication (PCC) and health self-efficacy. METHODS: Data for this study were derived from the Health Information National Trends Survey (HINTS 5, Cycle 4) collected from February 2020 to June 2020. This study only involved respondents who reported having been diagnosed with cancer (N=626). Descriptive analyses were performed, and the mediation models were tested using Model 6 from the SPSS macro PROCESS. Statistically significant relationships among PAEHR portal use, PCC, health self-efficacy, and physical and psychological health were examined using bootstrapping procedures. In this study, we referred to the regression coefficients generated by min-max normalization as percentage coefficients (bp). The 95% bootstrapped CIs were used with 10,000 resamplings. RESULTS: No positive direct associations between PAEHR portal use and cancer survivors' health outcomes were found. The results supported the indirect relationship between PAEHR portal use and cancer survivors' psychological health via (1) PCC (bp=0.029; ß=.023, 95% CI .009-.054), and (2) PCC and health self-efficacy in sequence (bp=0.006; ß=.005, 95% CI .002-.014). Besides, the indirect association between PAEHR portal use and cancer survivors' physical health (bp=0.006; ß=.004, 95% CI .002-.018) via sequential mediators of PCC and health self-efficacy was also statistically acknowledged. CONCLUSIONS: This study offers empirical evidence about the significant role of PAEHR portals in delivering PCC, improving health self-efficacy, and ultimately contributing to cancer survivors' physical and psychological health.