Cancer-Related Information Seeking Among Cancer Survivors: Trends Over a Decade (2003-2013).

The demonstrated benefits of information seeking for cancer patients, coupled with increases in information availability, underscore the importance of monitoring patient information seeking experiences over time. We compared information seeking among cancer survivors to those with a family history of cancer and those with no history of cancer. We identified characteristics associated with greater information seeking among cancer survivors, key sources of cancer-related information, and changes in information source use over time. Data from five iterations of the Health Information National Trends Survey (HINTS) spanning 2003 to 2013 were merged and analyzed. Frequencies, cross-tabulations, multivariate logistic regression, and multinomial regression analyses were conducted. All data were weighted to provide representative estimates of the adult US population. Cancer information seeking was reported most frequently by cancer survivors (69.8 %). The percentage of cancer survivors who reported information seeking increased from 66.8 % in 2003 to 80.8 % in 2013. Cancer information seeking was independently associated with age, education, and income; seeking was less likely among older adults, those with less education, and those with lower incomes. Compared to respondents in 2003, those in 2005 (odds ratio (OR) = 0.40, 95 % confidence interval (CI) = 0.24-0.65) and 2008 (OR = .43, 95 % CI = 0.26-0.70) were about half as likely to use the Internet as the first source of cancer information compared to a healthcare provider. Despite overall increases in cancer information seeking and access to health information from a variety of sources, healthcare providers remain a key source of health information for cancer survivors.

Is Online Health Activity Alive and Well or Flatlining? Findings From 10 Years of the Health Information National Trends Survey.

The Internet increasingly enables diverse health communication activities, from information seeking to social media interaction. Up-to-date reporting is needed to document the national prevalence, trends, and user profiles of online health activities so that these technologies can be best used in health communication efforts. This study identifies prevalence, trend, and factors associated with seeking health information, e-mailing health care providers, and using social media for health purposes. Four iterations of HINTS survey data, collected in 2003, 2005, 2008, and 2012, were analyzed to assess population-level trends over the last decade, and current prevalence of Internet-based health communication activities. Sociodemographic and health correlates were explored through weighted logistic regression modeling. Findings demonstrated that Internet use has steadily increased, with 78% of U.S. adults online in 2012; however several digital divide factors--among them education, age, and race/ethnicity--still predict access. Once online, 70% of adults use the Internet as their first source for health information, and while 19% have e-mailed health care providers, engagement in health communication on social media is still relatively low. Distinct user profiles characterize each type of communication, with age, population density, and gender emerging as important predictors across online health activities. These findings have important implications for health communication research and practice.

Health information-seeking on behalf of others: characteristics of "surrogate seekers".

Understanding the behaviors of surrogate seekers (those who seek health information for others) may guide efforts to improve health information transmission. We used 2011-2012 data from the Health Information National Trends Survey to describe behaviors of online surrogate seekers. Respondents were asked about use of the Internet for surrogate-seeking over the prior 12 months. Data were weighted to calculate population estimates. Two thirds (66.6%) reported surrogate-seeking. Compared to those who sought health information online for only themselves, surrogate seekers were more likely to live in households with others (weighted percent 89.4 vs. 82.5% of self-seekers; p < 0.05); no significant differences in sex, race, income or education were observed. Surrogate seekers were more likely to report activities requiring user-generated content: email communication with healthcare providers; visits to social networking sites to read and share about medical topics and participation in online health support groups. On multivariate analysis, those who had looked online for healthcare providers were more likely to be surrogate seekers (OR 1.67, 95% CI 1.08-2.59). In addition to seeking health information, surrogate seekers create and pass along communications that may influence medical care decisions. Research is needed to identify ways to facilitate transmission of accurate health information.

Meeting the healthy people 2020 goals: using the Health Information National Trends Survey to monitor progress on health communication objectives.

The Healthy People initiative outlines a comprehensive set of goals aimed at improving the nation's health and reducing health disparities. Health communication has been included as an explicit goal since the launch of Healthy People 2010. The Health Information National Trends Survey (HINTS) was established as a means of exploring how the changing information environment was affecting the public's health, and is therefore an ideal tool for monitoring key health communication objectives included in the Healthy People agenda. In this article, the authors apply an integrative data analysis strategy to more than 10 years of HINTS data to demonstrate how public health surveillance can be used to evaluate broad national health goals, like those set forth under the Healthy People initiative. The authors analyzed just one item from the HINTS survey regarding Internet access in order to illustrate what public health surveillance tools, like HINTS, can reveal about important indicators that are of interest to all those who work to improve the health of the public. Results show that reported Internet penetration has exceeded the Healthy People 2020 target of 75.4%. HINTS data also allowed modeling of the effects of various sociodemographic factors, which revealed persistent differences on the basis of age and education, with the oldest age groups and those with less than a college education falling short of the Healthy People 2020 target as of 2013. Furthermore, although differences by race/ethnicity were observed, the analyses suggest that race in itself accounts for very little of the variance in Internet access.

It takes a (virtual) village: crowdsourcing measurement consensus to advance survivorship care planning.

We report results from the use of an innovative tool (the Grid-Enabled Measures (GEM) database) to drive consensus on the use of measures evaluating the efficacy and implementation of survivorship care plans. The goal of this initiative was to increase the use of publicly available shared measures to enable comparability across studies. Between February and August 2012, research and practice communities populated the GEM platform with constructs and measures relevant to survivorship care planning, rated the measures, and provided qualitative feedback on the quality of the measures. Fifty-one constructs and 124 measures were entered into the GEM-Care Planning workspace by participants. The greatest number of measures appeared in the domains of Health and Psychosocial Outcomes, Health Behaviors, and Coordination of Care/Transitional Care. Using technology-mediated social participation, GEM presents a novel approach to how we measure and improve the quality of survivorship care.

Patient perceptions of electronic medical records use and ratings of care quality.

PURPOSE: Despite considerable potential for improving health care quality, adoption of new technologies, such as electronic medical records (EMRs), requires prudence, to ensure that such tools are designed, implemented, and used meaningfully to facilitate patient-centered communication and care processes, and better health outcomes. The association between patients' perceptions of health care provider use of EMRs and health care quality ratings was assessed. METHOD: Data from two iterations of the Health Information National Trends Survey, fielded in 2011 and 2012, were pooled for these analyses. The data were collected via mailed questionnaire, using a nationally representative listing of home addresses as the sampling frame (n=7,390). All data were weighted to provide representative estimates of quality of care ratings and physician use of EMR, in the adult US population. Descriptive statistics, t-tests, and multivariable linear regression analyses were conducted. RESULTS: EMR use was reported significantly more frequently by females, younger age groups, non-Hispanic whites, and those with higher education, higher incomes, health insurance, and a usual source of health care. Respondents who reported physician use of EMRs had significantly higher ratings of care quality (Beta=4.83, standard error [SE]=1.7, P<0.01), controlling for sociodemographic characteristics, usual source of health care, and health insurance status. CONCLUSION: Nationally representative data suggest that patients' perceptions of EMR use are associated with their perceptions of the quality of the health care they receive.