Information seeking during the COVID-19 pandemic: Application of the risk information seeking and processing model.

BACKGROUND: To limit the risk of contracting the coronavirus, it is crucial for individuals to attain accurate COVID-19 related information. Once equipped with such information, they can engage in risk preventive behaviors. OBJECTIVE: Applying the risk information seeking and processing (RISP) model, this study examined the sociopsychological factors predisposing individuals' information-seeking intentions. METHODS: This study employed a cross-sectional survey design. Using an online survey platform, study participants were recruited from US adults. A total of 510 valid responses were included in the analyses. Multivariate regression analyses were conducted in a hierarchical fashion while controlling for numerous covariates to determine the relationships between the sociopsychological variables and information-seeking intentions. RESULTS: Sociodemographic disparities were found in perceptions of COVID-19 risk. Perceived risk of coronavirus infection was higher among females, individuals with a history of COVID-19 symptoms, and those in a lower health status. Individuals' perceived risk provoked affective responses (e.g., worry and fear), which then increased self-perceived information insufficiency. This finding indicated individuals experienced worry and fear after perceiving the risk of coronavirus. Such affective responses made them realize that their current COVID-19 related knowledge was insufficient. Subjective norms were also found to increase information insufficiency. In other words, individuals who desired to comply with others' expectations to acquire knowledge about the risk recognized that their current knowledge about coronavirus was insufficient. Finally, individuals who acknowledged information insufficiency were motivated to seek information about the coronavirus. The relation between information insufficiency and information-seeking intentions was moderated by perceived information gathering capacity, but not by relevant channel beliefs. CONCLUSIONS: The findings suggest that policy makers and clinicians assist the public in obtaining accurate information from reliable sources.

Harnessing an Integrated Health Communication (IHC) Framework for Campaigns: A Case of Prescription Drug Decision Making.

Drawing on a multiplicity of mass media and health behavior theories, we propose an integrated health communication (IHC) framework to understand and leverage the ways in which mass mediated and interpersonal sources of health information influence the public's health behavior in the context of their prescription drug decisions. Building on the agenda setting theory, two-step flow theory, and the Health Belief Model, we dig into the interrelationships between mass media and interpersonal information sources and information seeking engagement. Employing survey methodology, our framework was tested using a sample of U.S. adults (N = 628). The major results include (a) information gained through interpersonal sources and perceived benefits of the prescription drugs positively and sequentially mediate the association between mass media exposure and intent to seek prescription drug information, (b) interpersonal health information positively moderate the mediation of mass media exposure - perceived benefits - intent to seek prescription drug information, and (c) the inexpert interpersonal information's positive interaction effect with mass media exposure on intent to seek prescription drug information mediated through perceived benefits was greater with high expert interpersonal communication. These results impart valuable theoretical contributions and have the potential to guide integrated health communication (IHC) campaigns.

Interpersonal Communication Influence on Health-Protective Behaviors amid the COVID-19 Crisis.

The 2019 novel coronavirus (COVID-19) has posed substantial threats to global public health. Individuals are extensively exposed to interpersonal sources of health information (e.g., family, friends, colleagues, physicians, and pharmacists). Interpersonal connections often encourage people to question or reinforce other sources of health information, which can affect their perceptions and behaviors. This study integrates research on how exposure to interpersonal health communication affects people's risk perception and affective responses to influence health-protective behaviors such as health information seeking and adherence to protective measures. Findings from an online survey of U.S. adults (n = 488) demonstrated that risk perception and affective responses serve as behavioral motivation factors. The influences of cognitive and affective responses were greater to the extent that individuals believed the health-protective behaviors are beneficial. Our study illuminates how people engage in preventive health behaviors to protect themselves in the COVID-19 context and demonstrates the influence of interpersonal social networks in motivating such behaviors. The theoretical and practical implications of these findings are discussed.

Narrative Medicine for Healthcare Providers: Improving Practices of Advance Care Planning.

Advance care planning (ACP) conversations about treatment preferences and end-of-life goals relate to positive outcomes for patients and families, though ongoing barriers exist. Additionally, providers personal discomfort and personal experiences may influence how they engage (or avoid) ACP conversations. Narrative medicine (NM) offers one approach to help practitioners develop ability to hear and understand the story of others in ways that may overcome barriers to quality conversations. This study investigated the effectiveness of a 3-hour NM workshop to develop communication skills around ACP and facilitate reflection on the relationship between personal experiences and professional practices in ACP and end-of-life care. Twenty-five participants completed post-assessments of the workshop. Key themes included increased awareness, improved skills for active listening and eliciting stories, and improved understanding of how personal experiences shape professional practice. Results indicate practitioners value the NM approach to ACP suggesting this approach may provide impactful change in practice.

Examining the Theory of Motivated Information Management (TMIM) in the COVID-19 Pandemic.

In order to inform understanding of the public's health information management during the COVID-19 pandemic, we applied a modification of TMIM from a serial mediation model to a conditional process model (moderated mediation). In doing so, the current study attempted to refine some of the relational propositions of the original TMIM with a focus on efficacy while addressing the distinction between a mediator and a moderator in a behavioral decision model. Findings from an online survey of U.S. adults (n = 488) demonstrated that anxiety can positively motivate evaluation of information seeking during the COVID-19 pandemic context, a unique context of application for TMIM. Efficacy was found to be qualified as an individual difference variable that moderates the relationships of uncertainty perception and health decision. Our newly proposed conditional process framework of the TMIM opens research directions in health information-seeking and encourages researchers to continuously incorporate updated methodological thought and approach in applying and building communication theory.

Optimistic Bias and Consumer Prescription Drug Decisions: Influences of Direct to Consumer Advertising and Perceived Susceptibility.

This study examines how optimistic bias moderates the association of direct-to-consumer prescription drug advertising (DTCA) exposure with consumers' responses to DTCA. We propose and test a model that addresses how exposure to DTCA plays a role in health risk assessment and prescription drug decision engagement. Findings from an online survey of U.S. adults (n = 628) demonstrated that exposure to DTCA is positively associated with consumers' perceived susceptibility and negatively associated with optimistic bias about health risk. The relationship between DTCA exposure and prescription decision engagement was mediated through perceived susceptibility, and this process was moderated by optimistic bias. The study's theoretical implications are discussed along with its consumer and public health implications.

Interpersonal Communication Influence on Health-Protective Behaviors Amid the COVID-19 Crisis.

Drawing on a multiplicity of mass media and health behavior theories, we propose an integrated health communication (IHC) framework to understand and leverage the ways in which mass mediated and interpersonal sources of health information influence the public's health behavior in the context of their prescription drug decisions. Building on the agenda setting theory, two-step flow theory, and the Health Belief Model, we dig into the interrelationships between mass media and interpersonal information sources and information seeking engagement. Employing survey methodology, our framework was tested using a sample of U.S. adults (N=628). The major results include (a) information gained through interpersonal sources and perceived benefits of the prescription drugs positively and sequentially mediate the association between mass media exposure and intent to seek prescription drug information, (b) interpersonal health information positively moderate the mediation of mass media exposure-perceived benefits-intent to seek prescription drug information, and (c) the inexpert interpersonal information's positive interaction effect with mass media exposure on intent to seek prescription drug information mediated through perceived benefits was greater with high expert interpersonal communication. These results impart valuable theoretical contributions and have the potential to guide integrated health communication (IHC) campaigns.

Optimistic bias and preventive behavioral engagement in the context of COVID-19.

BACKGROUND: The coronavirus (COVID-19) pandemic presents a global crisis. To remain safe, individuals must take preventive measures. Health behavior theories suggest that perceived risk is a key determinant of engagement in preventive behavior. People often underestimate their risk for disease compared with similar others', a phenomenon known as optimistic bias (OB). OBJECTIVE: This study aimed to explore how OB affected individuals' engagement in COVID-19 preventive behavior/intentions. Based on health behavior theories, this study considered risk perception and risk response as mediators of the relationship between OB and individuals' preventive health behaviors and intentions. METHODS: This study used a cross-sectional survey design. Online survey platforms were used to recruit U.S. adults. A total of 293 valid responses were included in the analyses. Multivariate regression analyses were conducted to determine the relationship of OB to the respondents' health information seeking intention and related behavioral outcomes. RESULTS: Results from the first regression model showed that OB was negatively related to risk perception. In other words, optimistically biased respondents perceived their risk of COVID-19 to be low. The second model demonstrated that perceived risk was related positively to affective responses to risk (e.g., worry and fear). That is, the lower their perceived risk of COVID-19, the less likely respondents were to feel anxiety and fear about this disease. Models 3 and 4 revealed positive relationships between risk response and respondents' intentions and behaviors. Finally, the results supported a fully mediated pathway: OB → risk perception → risk response → information seeking intention and behavioral outcomes. CONCLUSIONS: The study findings suggest that by decreasing their perceived risk and subsequent responses, optimistic bias can undermine individuals' motivation to take precautions. To reduce this bias, the actual risk of COVID-19 should be reinforced.

Consumer Engagement with Prescription Medicine Decisions: Influences of Health Beliefs and Health Communication Sources.

Consumers' prescription drug decisions are affected by a number of structural, psychological, and health communication source variables. To provide a theoretically sound and comprehensive prescription medication decision engagement framework, this study integrated Andersen's Health Service Use Model to address contextual and structural factors, the Health Belief Model (HBM) to examine psychological factors, and extant research on the influence of various health communication sources to explain the prescription drug decision engagement mechanisms of health information-seeking intention, prescription drug-seeking intent, and prescription-seeking behavior. Employing survey methodology, the framework was tested using a sample of U.S. adult consumers (N = 370). Results demonstrated the utility of the integrated model for explaining consumers' participation in their prescription decisions. Specifically, consumers' assessment of target health behaviors and the use of various health communication sources significantly improved the explanatory power of the decision engagement model beyond structural factors. The results impart valuable theoretical contributions and have the potential to guide public health interventions related to consumers' prescription drug decisions.

Consumer's Regulatory Knowledge of Prescription Drug Advertising and Health Risk Awareness: The Moderating Role of Risk Information Prominence.

Borrowing insights from the consumer knowledge and the direct-to-consumer prescription drug advertising (DTCA) risk communication literature, the current study examined how consumers' regulatory knowledge regarding DTCA affects attention to and awareness of risk information in DTCA. The moderating role of risk information prominence and the mediating mechanism of attention were also explored. Taking an experimental design approach using a sample of US consumers (N = 264), risk information prominence was manipulated using various message attributes (e.g., font, color, size, box line, thickness, proximity). The study found that consumers' higher regulatory knowledge led to greater attention to risk information when the health risks of the advertised drug were presented less prominently, compared with when the risks were salient. The regulatory knowledge enhanced consumer recall and recognition of the drug's health risks through attention, but the indirect effects were dependent on the disclosure prominence level, such that the effects were more apparent when the prominence was low. This study manifests the value of consumers' regulatory literacy of DTCA to make informed prescription medication decisions and advises pharmaceutical marketers to present noticeable health risk information to encourage consumers to consider important health risks of promoted drugs in their decision making.

Connecting Personal Experiences of Loss and Professional Practices in Advance Care Planning and End-of-Life Care: A Survey of Providers.

BACKGROUND: Although practitioners overwhelmingly agree on the importance of advance care planning (ACP) and preparing for the end of life (EOL), the process is fraught with barriers. OBJECTIVE: The goal of this research was to explore potential connections between providers' own personal experiences and current professional practices in ACP and EOL care. DESIGN: A cross-sectional survey design, gathering voluntary, anonymous responses from participants between August and December 2016. The survey sought information from providers in 3 distinct areas: (1) personal experiences of loss, (2) personal ACP, and (3) professional practices related to ACP and EOL care. SETTING/PARTICIPANTS: One hundred and ninety health-care professionals (primarily physicians, nurses, and social workers) participated in the survey across a greater, Metropolitan area in the Midwest. MEASUREMENTS: Questions for professional practices were subscales from the End-of-Life Professional Caregiver Survey: Patient- and Family-Centered Communication (PFCC) and Effective Care Delivery (ECD). Questions developed by the research team were evaluated by judges chosen for clinical and/or research expertise. RESULTS: Numerous connections were found between professionals' histories of loss, personal ACP, and professional practices. For example, both clinicians with personal experience caring for someone who is dying and clinicians who had completed their own ACP scored higher in both PFCC and ECD and were more likely to refer patients to hospice and palliative care. CONCLUSIONS: Results support educational interventions involving opportunities for reflection and completion and communication about ACP. Additionally, educational opportunities for students in health care should focus on incorporating both ACP and greater exposure to hospice and palliative care.

Family Communication about End-of-Life Decisions and the Enactment of the Decision-Maker Role.

End-of-life (EOL) decisions in families are complex and emotional sites of family interaction necessitating family members coordinate roles in the EOL decision-making process. How family members in the United States enact the decision-maker role in EOL decision situations was examined through in-depth interviews with 22 individuals who participated in EOL decision-making for a family member. A number of themes emerged from the data with regard to the enactment of the decision-maker role. Families varied in how decision makers enacted the role in relation to collective family input, with consulting, informing and collaborating as different patterns of behavior. Formal family roles along with gender- and age-based roles shaped who took on the decision-maker role. Additionally, both family members and medical professionals facilitated or undermined the decision-maker's role enactment. Understanding the structure and enactment of the decision-maker role in family interaction provides insight into how individuals and/or family members perform the decision-making role within a cultural context that values autonomy and self-determination in combination with collective family action in EOL decision-making.

Challenges and Opportunities with Empowering Baby Boomers for Personal Health Information Management Using Consumer Health Information Technologies: an Ecological Perspective.

"Baby Boomers" (adults born between the years of 1946 and 1964) make up the largest segment of the population in many countries, including the United States (about 78 million Americans) [1]. As Baby Boomers reach retirement age and beyond, many will have increasing medical needs and thus demand more health care resources that will challenge the healthcare system. Baby Boomers will likely accelerate the movement toward patient self-management and prevention efforts. Consumer Health Information Technologies (CHIT) hold promise for empowering health consumers to take an active role in health maintenance and disease management, and thus, have the potential to address Baby Boomers' health needs. Such innovations require changes in health care practice and processes that take into account Baby Boomers' personal health needs, preferences, health culture, and abilities to use these technologies. Without foundational knowledge of barriers and opportunities, Baby Boomers may not realize the potential of these innovations for improving self-management of health and health outcomes. However, research to date has not adequately explored the degree to which Baby Boomers are ready to embrace consumer health information technology and how their unique subcultures affect adoption and diffusion. This position paper describes an ecological conceptual framework for understanding and studying CHIT aimed at satisfying the personal health needs of Baby Boomers. We explore existing literature to provide a detailed depiction of our proposed conceptual framework, which focuses characteristics influencing Baby Boomers and their Personal Health Information Management (PHIM) and potential information problems. Using our ecological framework as a backdrop, we provide insight and implications for future research based on literature and underlying theories represented in our model.