Age-related digital disparities, functional limitations, and social isolation: unraveling the grey digital divide between baby boomers and the silent generation in senior living facilities.

OBJECTIVES: The onset of the digital age has sparked a significant age-related digital divide, detrimentally affecting older adults. The age-related digital disparities and the gray digital divide between the Baby Boomers and the Silent Generation in senior living facilities remains an exigent issue. This study explored the lived experiences of older adults as they confront the challenges posed by age-related digital disparities inherent in the gray digital divide in senior living facilities. METHODS: In-depth, semi-structured interviews and observations were conducted with 28 older adults living in six senior living facilities in three urban locations. Moustakas's transcendental phenomenology was employed, and the Modified Stevick-Colaizzi-Keen method was used to analyze the data. RESULTS: This study identified six main themes: barriers to connectivity, digital literacy, generational-rooted perceptions, navigating technology with functional limitations, social isolation, and end-of-life planning. CONCLUSION: The gray digital divide disproportionately affects older adults in senior living facilities. The study emphasizes the need for tailored interventions and targeted support to address the specific needs of each cohort and reduce age-related disparities. Addressing these disparities has significant implications for academics, policy-makers, senior living accommodations, and technology developers.

Aesthetic Medicine Across Generations: Evolving Trends and Influences.

Aesthetic medicine has grown exponentially in recent decades, becoming a key part of healthcare and wellness, with distinct generational demands shaping its landscape. Baby Boomers seek youthful rejuvenation, preferring noninvasive treatments like botulinum toxin injections and dermal fillers. Generation X favors natural, minimally invasive enhancements, often influenced by authentic testimonials. Millennials, driven by social media and self-care trends, prioritize preventive and enhancement procedures, sharing their experiences online. Generation Z, influenced by social media and digital beauty standards, focuses on prejuvenation and temporary enhancements. For industry professionals, understanding these generational dynamics and leveraging social media is essential to meet diverse patient expectations and enhance engagement.Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Did Gender Egalitarianism Weaken Religiosity in Baby Boom Women? A Developmental-Historical Approach.

This investigation used long-term longitudinal survey data from baby boomer women to identify whether strengthening gender role egalitarianism in early adulthood predicted declines in religious service attendance and religious intensity in later life. The aging of this cohort coincided with dramatic societal shifts in gender values and religiosity. The data were derived from 350 women participating in the Longitudinal Study of Generations, a study originally fielded in 1971 of families living in Southern California. Respondents were initially assessed in their late teens and early 20s and followed up to their early-to-mid 60s. Using growth curve modeling, we linked the change in egalitarian gender attitudes from 1971 to 1988 to a change in religiosity from 1994 to 2016. Women who became more egalitarian in their gender attitudes experienced sharper declines in religious intensity, but not in religious attendance in the period studied. Controlling for life-course transitions did not alter these results. The findings are discussed in terms of the connection between two asynchronous social changes occurring over the lives of women in a uniquely positioned birth cohort.

Patient Navigation Increases Linkage to Care and Receipt of Direct-acting Antiviral Therapy in Patients with Hepatitis C.

BACKGROUND & AIMS: Patient navigation interventions can improve health outcomes in underserved, low-income, and racial and ethnic minority groups, who often experience health disparities. We examined the effectiveness of patient navigation to improve linkage to hepatitis C virus (HCV) treatment receipt in a socioeconomically disadvantaged, racially diverse patient population. METHODS: We performed a pre-post analysis evaluating the effectiveness of a patient navigation program among baby boomers who tested positive for HCV in a safety-net health system. The usual care group (June 2013 to May 2015) and patient navigation group (January 2016 to December 2017) were balanced using a stabilized inverse probability of treatment weighting approach. We used logistic regression analyses to evaluate associations between patient navigation and linkage to care for HCV treatment evaluation, treatment initiation, and sustained virologic response. RESULTS: Among 1353 patients (62% black, 61% uninsured, 16% homeless), 769 were in the usual care group, and 584 were in the patient navigation group. The patient navigation group had significantly higher odds of linkage to care (odds ratio [OR], 3.7; 95% confidence interval [CI], 2.9-4.8) and treatment initiation (OR, 3.2; 95% CI, 2.3-4.2) within 6 months. The patient navigation group continued to have increased linkage to care (OR, 3.4; 95% CI, 2.7-4.3) and treatment initiation (OR 2.3; 95% CI, 1.7-3.0) at 12 months. However, there was no significant difference in sustained virologic response between the groups (86.9% vs 86.1%; P = .78). CONCLUSIONS: Patient navigation was associated with significantly increased linkage to care and treatment initiation among patients with HCV infection. Patient navigation programs can be used to promote HCV elimination among traditionally difficult-to-reach patient populations.

Generational effect on nurses' work values, engagement, and satisfaction in an acute hospital.

BACKGROUND: The present nursing workforce comprises four generational of nurses working side-by-side. While such a generation blend adds invaluable diversity to the workforce, it also brings added complexity. The study aimed to describe and summarise work values and attitudes of four nursing generations, namely Baby boomers, Generation X, Y and Z. METHOD: A cross-sectional questionnaire study was adopted. A total of 778 nurses from an acute hospital in Singapore completed the online questionnaire. The Work Value and Attitude scale measuring seven constructs (Work Centrality, Non-compliance, Technology Challenge, Work life balance, leadership, Power, and Recognition) was employed for data collection. RESULTS: The Cronbach's alpha was 0.714 for the overall instrument. Statistically significant differences amongst the four generations of nurses emerged in the Work Value and Attitude scale in the construct of non-compliance (p = 0.007), technology challenge (p = 0.027), work-life balance (p < 0.001), and recognition (p < 0.001). No statistically significant differences were noted for the rest of the constructs. DISCUSSION AND CONCLUSION: The findings of this study highlight that differences in work values and attitudes exist among nurses of different generations. Generation X are less likely to challenge the conventional norm and supervisors. Generation Y and Z are the most tech-savvy generations and can adapt quickly to new technology. There is also a greater emphasis on work-life balance as the generation gets younger. Generation Y and Z nurses perceived that younger nurses do not get due respect and recognition from their colleagues. Acknowledging the generational differences in work values and attitudes can facilitate nursing management to tailor strategies to improve individual and organisation performance while creating a work environment that enhances intergeneration harmony and teamwork.

Integrating hepatitis C virus screening of baby boomers at a community hospital emergency department.

Approximately 2.4 million Americans are infected with hepatitis C virus (HCV), and persons born from 1945 through 1965 (i.e. baby boomers) account for nearly three-fourths of all HCV infections. The purpose of this study was to implement HCV screening for baby boomers presenting to a community hospital emergency department (ED) and to facilitate linkage to care. We developed a process within our electronic medical record system to screen patients for HCV testing eligibility, link eligible patients to laboratory orders, notify patients of HCV test results (via patient navigator) and track follow-up care. We tracked performance from February 2016 to December 2018. Sociodemographic compositions and linkage to care rates of all participants were evaluated. A total of 14,927 patients from the birth cohort of 1945-1965 were screened for HCV. Of those tested, 555 (3.7%) had a positive HCV antibody test and 147 were HCV RNA-positive patients (1.0%) demonstrating that only 27% of HCV antibody-positive individuals were chronically infected. Males, black race and USA-born baby boomers had a higher prevalence of HCV antibody and viral load positivity (p < 0.05). Initially, only 17.6% of patients were ultimately linked to care, which improved to over 94% after the implementation of patient navigation support. There is a need for HCV screening protocol in the community. The cost of implementing an HCV screening programme must include information technology and a team of care coordinators to improve screening rates and facilitate linkage to continual care using the four pillars framework.

"It's impossible for them to understand me 'cause I haven't said a word": how women baby boomers shape social participation spaces in old age.

The baby boom generation's retirement will change the conceptualization of participation in old age due to their particularities from having experienced a specific socio-historical context. Likewise, the feminization of old age underscores the importance of developing research from the perspectives of gender and critical feminist gerontology. The objective of the present study is to identify and analyze women baby-boomers' conceptualizations about social participation regarding the configuration of social participation spaces. Five discussion groups and five individual interviews were conducted with 56 baby boomers residing in Andalusia (Spain). Here we focus on a separate analysis of the 27 women participating in these settings. The results were organized around four factors: desirability of social participation spaces, adaptation of spaces to preferences, facilitators and barriers in the adaptation of spaces, and the importance of agency in the social participation spaces. Through the analyzed discourse it was observed that participants in this study gave special importance to promoting spaces that involve social contribution, self-management, and self-determination of the spaces, adaptation of access, as well as exercising agency.

Older Caregivers: Who They Are and How to Support Them.

Caregivers play a crucial role in providing health and social supports to their family and friends. Older adults who take on caregiving roles are themselves uniquely vulnerable to negative health and financial effects due to their age and underlying health risks. Many caregivers do not receive adequate support - either formally or informally - exacerbating the strains of providing care. Racial and ethnic minority caregivers may be less likely to report receiving support in their role and face additional challenges. We describe these caregivers over 65 and the burdens they face. We recommend community health workers, direct compensation, and normalization of respite care to support these essential care workers in their role and as they age.

Comparing conceptions of gender, sexuality and lesbian identity between baby boomers and millennials.

To answer this special issue provocation, Is Lesbian Identity Obsolete? we analyzed interviews with people who had identified at some point in their lives as lesbians, or as women/femmes who were attracted to women - some of them part of the Baby Boomer generation and some part of the Millennial generation. Participants from both generations rejected the gender binary. Nevertheless, we found a shift away from understanding gender as an oppressive category to an understanding of gender as a proliferating identity in which one may play with gender in an intentional and creative manner. It appears that participants across generations articulated their sexual identities strategically to express not only a sexual orientation but more importantly political and community alliances. For Baby Boomer lesbians, lesbian identity connoted an alliance with feminism, and for Millennials their sexual identity indicated a political alliance with queer and trans* movements. In order to sustain solidarity between lesbians of different generations, we suggest that narratives about gender should include both intrinsic and extrinsic components. We further suggest that the political project of ending the oppression of all lesbians/women who love women is fraught, but essential in a world that hates women.

Older adults on involuntary hold status in the emergency department.

BACKGROUND: As the United States' population ages, the health care system will experience overall change. This study aims to identify factors in the older adult that may contribute to involuntary hold status in the ED. METHODS: This study is a retrospective review conducted at a suburban acute-care hospital ED of adult patients evaluated while on involuntary hold from January 1, 2014, through November 30, 2015. Older adults (patients born on or before 06/31/1964) were compared to younger adults (born on or after 07/01/1964) according to demographic and clinical variables including medical comorbidity, ED length of stay, reason for involuntary hold, psychiatric disorder, suicide attempt, substance use disorder, serum alcohol level, urine drug testing, medical comorbidity, violence in the ED, 30-day ED readmission, and 30-day mortality. RESULTS: Of 251 patients, 90 (35.9%) were older adults. The most common reason for involuntary hold in both cohorts was suicidal ideation. Medical comorbidities were more prevalent in older adults [60 (66.7%) vs. 64 (39.8%), P ≤.0001]. Older adults were less likely to report current drug abuse [31 (34.4%) vs. 77 (47.8%), P = .04]. The most commonly misused substance in both groups was alcohol; however, despite similar rates, blood alcohol levels (BAC) and urine drug screen (UDS) were performed less often in older adults. Cohorts were not significantly different with respect to sex, race, violence in the ED, psychiatric diagnosis, and ED LOS. CONCLUSIONS: Involuntary older adult patients present with medical comorbidities that impact mental health. In the ED, they are less likely report substance use, and drug screening may be underutilized. Medical needs make their care unique and may present challenges in transfer of care to inpatient psychiatric facilities.

Generation gaps in medical education: An exploratory qualitative study.

This qualitative study aimed to explore medical students' experience of generation gap in their interactions with senior teachers (aged >55) in Japan. Focus group interviews were conducted with 28 medical students (20 to 30 years, mean age 22 ±2 years, classified as millennials, with only one year of studies since starting specialised courses for medicine. The participants were interviewed in groups of four, with each interview lasting 60 minutes. Topics covered included generation gap experienced in daily life and during their studies, and work-life balance issues. The discussions were recorded and transcribed, and content analysis was applied. Four specific influential generation-gap categories were identified - distinctive sociocultural backgrounds, more recent educational media tools and faster information dissemination speed, new-era values, and challenges in communication - that were consistent with findings from previous studies. More senior personnel involved in medical education need to consider these categories to enhance effectiveness of teaching.

Impact of the COVID-19 pandemic on environmental awareness, sustainable consumption and social responsibility: Evidence from generations in Brazil and Portugal.

The COVID-19 Pandemic has become a major public health concern worldwide, which can impact environmental sustainability and social responsibility, as well as people's quality of life. In this context, environmental awareness, sustainable consumption and social actions of people have been effectively changed, as a period of quarantine, social isolation and health crisis caused by Pandemic has been experienced. This study aims to analyze the impact of the COVID-19 Pandemic on environmental awareness, sustainable consumption and social responsibility, in the perception of Baby Boomers, X and Y generations, residents in Brazil and Portugal. The method used was quantitative research, of a descriptive character, through a survey applied to 3236 people, which was analyzed with the use of Structural Equation Modeling. The results indicate that COVID-19 Pandemic is an important vector in people's behavioral change, which reflects on environmental sustainability and social responsibility. It is noteworthy that the impact of the COVID-19 Pandemic had a greater influence on sustainable consumption, followed by environmental awareness, and to a lesser extent, on social responsibility. There was also greater relevance in Portugal, as well as the perception of the Baby Boomers generation. This study also provides a framework such as metrics to measure a transformational event, which is the COVID-19 Pandemic in socio-environmental aspects and conscious consumption.

Relationship between visceral adipose tissue and bone mineral density in Australian baby boomers.

Adiposity has a complex relationship with bone health. In 4865 Australian baby boomers (2642 females) aged 45-70 years, we found that higher visceral adipose tissue mass is associated with reduced bone density adjusting for body mass and lifestyle factors, suggesting that excess visceral fat may be deleterious to bone. INTRODUCTION: Increased body mass is associated with higher bone mineral density (BMD), but higher visceral adipose tissue (VAT) may have a negative impact on bone health. In the Busselton Healthy Ageing Study, we examined associations between VAT mass and BMD in 4865 participants (2642 females) aged 45-70 years. METHODS: VAT mass and BMD of whole body, total hip, femoral neck and lumbar spine were measured using DXA. VAT mass was examined as a continuous variable and in quartiles using sex-specific cut-offs. RESULTS: The mean age was 58.0 ± 5.8 years. Males had significantly higher BMI (28.3 ± 3.7 vs 27.5 ± 4.9 kg/m2) and VAT mass (1675 ± 878 vs 882 ± 600 g) than females (both P < 0.001). In males, after adjustment for age, body mass, height and lifestyle factors, VAT mass negatively associated with total body, total hip and femoral neck BMD (ß = - 0.153 to - 0.293, all P < 0.001). Males in the highest quartile of VAT mass (> 2200 g) had significantly lower BMD at all three sites than those in lower quartiles, with estimated BMD differences of 2.3-5.7% (all P < 0.05). In females, VAT mass negatively associated with total body, femoral neck and lumbar spine BMD (ß = - 0.067 to - 0.178, all P < 0.05) and those in the highest quartile (> 1250 g) had significantly lower total body BMD than other quartiles (by 1.7-3.7%, all P < 0.05). CONCLUSION: In middle-aged Australians, after covariate adjustment, higher DXA-derived VAT mass is associated with reduced bone density, suggesting that excess visceral fat may be deleterious to bone, especially in males.

Expressions of Individualization on the Internet and Social Media: Multigenerational Focus Group Study.

BACKGROUND: Growing individualization within the past decades has been described as a fundamental shift in society. Studies have reported how the digital age promotes new forms of individualism with self-tracking technologies and self-presentation in social networks. Potential harmful effects on the mental health of young adults have already been at the forefront of research. However, 2 questions that remain unanswered are how emotional experiences and expressions of self-relatedness differ among generations in their usage of the internet and social media, and if an increasing individualism can be observed by this. OBJECTIVE: The aim of this study is to examine whether the use of the internet and social media has led people to be more concerned about themselves than former generations. The potential consequences of mental and emotional distress among different age groups are analyzed. METHODS: A focus-group approach was chosen to study the following age groups: Baby Boomers (those born in 1950-1965), Generation X (those born in 1966-1980), and Digital Natives (those born in 1981-2000). We organized 6 focus groups with 36 participants who discussed their private usage of the internet and social media, different devices, platforms and functions, communication behavior, and self-tracking. We applied inductive category formation and followed the Standards for Reporting Qualitative Research (SRQR) checklist. RESULTS: We found differences in the 3 studied generations regarding the reasons for their use of the internet and social media, the effects of this use, personal feelings and experiences, expressions of self-relatedness, and social relationships. The Baby Boomers voiced a wish to stay autonomous while being in contact with their personal network. Generation X included enthusiastic members who appreciate self-tracking for curiosity and fascination, as well as people who felt fears about data surveillance. The Digital Natives reported a wish to optimize their own body by self-tracking while being faced with norms and expectations that were communicated via the internet and social media. CONCLUSIONS: All generations expressed self-relatedness, yet by different means. The Baby Boomers expressed less individualism than Generation X and the Digital Natives, who felt the highest strain due to social comparisons. However, all generations reported specific, potentially problematic consequences for their mental health. Age-specific coping strategies are necessary to promote a mentally healthy way of using the internet and social media.

Baby boomers as gamblers: recognizing and preventing gambling harm with intersectional approach.

OBJECTIVES: This study aims to discuss and analyse the gambling habits and perceptions towards gambling cultures and problems among the large 'baby boomer' generation in Finland from an intersectional approach. These people born between 1945 and 1955 in their retirement or approaching retirement may face new risks regarding gambling. The results of this study support the designing of harm prevention among this ageing generation. STUDY DESIGN: Twenty-five people were interviewed in six focus groups. Participants' gambling experience varied from non-gambling to having experienced some problems. Three of the focus groups had participants with second degree education the highest, and three of the groups had participants with second degree education the lowest. Four interviews were conducted in the capital area and two in rural environments. METHODS: The group interview data were analysed with thematic content analysis. After initial coding in accordance with the research questions, subthemes and final themes were formed. Results are discussed through the final themes. RESULTS: The main results concern the gambling habits on the participants' life course: from shared, cultural experiences in their childhood to mostly minor gambling on the edge of retirement; the mutual understanding of the enormous growth in gambling supply during their lifetime, but emphasizing the importance of gambling monopoly for the society; and framing gambling problems as an individual tendency. CONCLUSIONS: The prevention of gambling harm within this generation needs to take into account the historical changes they have lived: from few, harmless gambling products framed as an instrument to support 'good causes' to the current world of commercial gambling. The deterministic understanding of gambling problems as an individual flaw may prevent recognizing problem gambling and seeking help to tackle the problems. Risks for gambling harm relate more to the gambling structures and cultures this ageing generation lives in, and the deterministic, individual understanding of gambling harm they share, than to marginalized positions they may have through gender or education.

Health Behavior Profiles of Korean Baby Boomers.

This study identified profiles of health behaviors among Korean baby boomers and examined a set of individual characteristics associated with these latent profiles. We analyzed a sample of 4,047 middle-aged adults (aged 53-61) from the Korean Baby Boomer Panel Study (2014). Latent profile analysis was used to uncover distinct health behavior profiles, and multinomial regression was performed to investigate the associations between health behavior profiles and predisposing, enabling, and need factors-following from the behavioral models of health behaviors and health services use. Five profiles of health behaviors were identified: (a) low-risk and high-preventive behaviors (50%), (b) low-risk and low-preventive behaviors (35%), (c) moderate-risk and moderate-preventive behaviors (7%), (d) moderate-risk and high-preventive behaviors (6%), and (e) high-risk and low-preventive behaviors (2%). Further, individuals with more enabling and need characteristics, indicated by higher socioeconomic status and greater health concerns, were more likely to engage in healthier profiles.

An "Army of Volunteers"? Engagement, Motivation, and Barriers to Volunteering among the Baby Boomers.

Aging baby boomers are expected to provide a large reservoir for the nonprofit sector. We find evidence which while broadly supportive of this idea also suggest limitations as to what can realistically be expected. Using data from the third (2017) wave of the Norwegian life-course, aging, and generation study (n = 2,993, age 53-71), we find that a sizable proportion is already engaged (65-68% in the past year) and around half of non-volunteers (from 58% among the youngest to 43% among the oldest) express interest in volunteering. However, most volunteering is sporadic and less than half of volunteers participate on a weekly basis. Furthermore, most of the non-volunteers who express interest seem unlikely to realize their interest as they simultaneously report important motivational and ability-related barriers to volunteering. A further challenge is that few boomers are willing to make a major commitment to volunteering. Findings suggest that to mobilize boomers, nonprofit organizations need to accommodate more self-interested and flexible forms of involvement.

Hepatocellular carcinoma is leading in cancer-related disease burden among hospitalized baby boomers.

INTRODUCTION AND OBJECTIVES: Three fourths of chronic hepatitis C virus (HCV) infected adult patients in the United States (US) are born between 1945 and 1965, also known as baby boomers (BB). Prevalence of hepatocellular carcinoma (HCC) is raising in BB due to their advancing age and prolonged HCV infection. We evaluated inpatient hospitalization and mortality in BB associated with HCC. MATERIALS AND METHODS: It is a retrospective cohort study utilizing the Healthcare Utilization Project-National Inpatient Sample (HCUP-NIS) database. From 2003 to 2012, top five primary cancer related hospitalization and mortality among BB were studied. RESULTS: Among 48,733 hospitalizations related to HCC in HCUP-NIS database from 2003 to 2012, BB accounted for 49.6% (24,210) whereas non-BB 50.4% (24,523). Within BB cohort, the top five cancers with the highest proportion of hospitalizations were HCC (46%), prostate (43%), kidney (41%), pancreas (33%), and bladder (21%). From 2003 to 2012, the proportion of HCC related hospitalizations represented by BB almost doubled (33.5 to 57.8%) whereas there was one-third reduction (66.4 to 42.1%) among non-BB. Similarly, HCC-related inpatient mortality in BB decreased by 28% (6.1 to 2.7 per 100,000 hospitalization) but it remained unchanged in non-BB (11.1 to 10.6). HCC accounted for 2nd highest mortality (4960 total deaths) among hospitalized BB behind pancreatic cancer. HCC related to HCV was disproportionately higher in BB compared to non-BB (50.6% vs. 19%; P<0.001). CONCLUSION: HCC ranks number one among the top five cancers with highest proportion of inpatient burden. Future studies should focus on understanding the underlying reasons for this ominous trend.

Genetic counselor workforce generational diversity: Millennials to Baby Boomers.

There are currently three generations of individuals that make up the genetic counselor workforce: Baby-Boomers, Generation X, and Millennials. These generations are presumed to be shaped by the historical, cultural, and social events that occurred during critical developmental periods. Understanding the underlying perceptions and viewpoints of genetic counselors regarding the multigenerational workforce may facilitate successful working relationships as well as recognition of the perceived unique characteristics that each generation offers. An online survey was distributed to practicing genetics counselors (GC) and genetic counseling students through the National Society of Genetic Counselors and the American Board of Genetic Counseling to elicit opinions about the perceived characteristics or skills of genetic counselors in each generation. Respondents (n = 407, estimated 10% response) preferentially assigned certain traits or skills to specific generations including their own. Findings suggest GC Baby Boomers were least likely to be described as "comfortable with phone or skype counseling" (p < 0.0001), Millennial GC, were least often assigned the term "Strong respect for authority" (p < 0.0005) and Generation X GC were most likely to be described as "Does not ask for feedback" (p < 0.05). These research findings demonstrate that GC perceive that their colleagues from every generation have unique attributes to bring to the profession and these attributes match those typically described in the U.S. literature about non-GC cohorts.

A Typology of Patients Based on Decision-Making Styles: Cross-Sectional Survey Study.

BACKGROUND: Although previous research shows broad differences in the impact of online health information on patient-practitioner decision making, specific research is required to identify and conceptualize patient decision-making styles related to the use of online health information and to differentiate segments according to the influence of online information on patient decision making and interactions with health professionals. OBJECTIVE: This study aimed to investigate patients' decision making in relation to online health information and interactions with health care practitioners. We also aimed to present a typology of patients based on significant differences in their decision making. METHODS: We applied a large-scale cross-sectional research design using a survey. Data, generated using a questionnaire that was administered by companies specializing in providing online panels, were collected from random samples of baby boomers in the United Kingdom, the United States, and New Zealand. The total sample comprised 996 baby boomers born between 1946 and 1964, who had used the internet in the previous 6 months to search for and share health-related information. Data were analyzed using hierarchical cluster analysis and confirmatory factor analysis, as well as one-way analysis of variance, chi-square tests, and paired sample t tests. RESULTS: Analyses identified 3 key decision-making styles that served as the base for 4 unique and stable segments of patients with distinctive decision-making styles: the Collaborators (229/996, 23.0%), the Autonomous-Collaborators (385/996, 38.7%), the Assertive-Collaborators (111/996, 11.1%), and the Passives (271/996, 27.2%). Profiles were further developed for these segments according to key differences in the online health information behavior, demographics, and interactional behaviors of patients. The typology demonstrates that collaborative decision making is dominant among patients either in its pure form or in combination with autonomous or assertive decision making. In other words, most patients (725/996, 72.8%) show significant collaboration in their decision making with health care professionals. However, at times, patients in the combination Autonomous-Collaborative segment prefer to exercise individual autonomy in their decision making, and those in the combination Assertive-Collaborative segment prefer to be assertive with health professionals. Finally, this study shows that a substantial number of patients adopt a distinctly passive decision-making style (271/996, 27.2%). CONCLUSIONS: The patient typology provides a framework for distinguishing practice-relevant and addressable segments with important implications for health care practitioners, including better-targeted communication programs for patients and more successful outcomes for health care services in the long term.