What message features influence the intention to share misinformation about COVID-19 on social media? The role of efficacy and novelty.

Given the amount of misinformation being circulated on social media during the COVID-19 pandemic and its potential threat to public health, it is imperative to investigate ways to hinder its transmission. To this end, this study aimed to identify message features that may contribute to misinformation sharing on social media. Based on the theory of social sharing of emotion and the extant research on message credibility, this study examined if emotions and message credibility serve as mechanisms through which novelty and efficacy of misinformation influence sharing intention. An online experiment concerning COVID-19 misinformation was conducted by employing a 2 (novelty conditions: high vs. low) × 2 (efficacy conditions: high vs. low) between-subjects design using a national quota sample in South Korea (N = 1,012). The findings suggested that, contrary to the expectation, the overall effects of novelty on sharing intention were negative. The specific mechanisms played significant and unique roles in different directions: novelty increased sharing intention by evoking surprise, while also exerting a negative influence on sharing intention through an increase in negative emotions and a decrease in positive emotions and message credibility. Consistent with the expectation, efficacy exhibited positive total effects on sharing intention, which was explained by higher levels of (self- and response-) efficacy of protective action increasing positive emotions and message credibility but decreasing negative emotions. The implications and limitations of the study are discussed.

What quality factors matter in enhancing the perceived benefits of online health information sites? Application of the updated DeLone and McLean Information Systems Success Model.

BACKGROUND: Despite a growing need for designing and monitoring health information sites through comprehensive examination of the various elements of website quality, there is little research that systematically models and presents such examinations. OBJECTIVES: Applying the updated DeLone and McLean Model of Information Systems Success, this research aimed to examine how health information sites' information quality, system quality, and service quality lead to user satisfaction and perceived benefits. METHODS: This research was conducted in a specific context of the National Health Information Portal (NHIP), a governmental health information site in South Korea. We conducted online survey in 2017, with 506 adults from the NHIP consumer panel. Data were analyzed using a confirmatory factor analysis, hierarchical ordinary least squares regression, and bootstrapping approach for a mediation test. RESULTS: Of the three quality factors, information quality had significant associations with all outcome variables: user satisfaction, intention to reuse the site, and perceived benefits of site use in health settings. There were also indirect paths from information quality to perceived benefits, one mediated through intention and the other mediated through satisfaction and then intention. Service quality had a significant association with user satisfaction, and its impact on perceived benefits occurred indirectly through user satisfaction and intention in serial. By contrast, the role of system quality received no empirical support. IMPLICATIONS: The results offer theoretical and practical implications for how to enhance the effectiveness of online health information sites.

What Factors Impact Consumer Perception of the Effectiveness of Health Information Sites? An Investigation of the Korean National Health Information Portal.

Lay public's concerns around health and health information are increasing. In response, governments and government agencies are establishing websites to address such concerns and improve health literacy by providing better access to validated health information. Since 2011, the Korean government has constructed the National Health Information Portal (NHIP) website run in collaboration with the Korean Academy of Medical Sciences (KAMS). This study therefore aimed to 1) examine consumer use of NHIP, with respect to the usage patterns, evaluation on health information provided, and perceived effectiveness of the site; and 2) identify factors that may impact perceived effectiveness of the site. An online survey was conducted with 164 NHIP users, recruited through a popup window on the main screen of the portal website from October to November 2015. The significant predicting factors supported by the data include the relevance of health information on the site, the usefulness of information in making health decisions, and the effective visualization of information. These factors can inform future efforts to design more effective health information websites, possibly based on metadata systems, to further advance the lay public's information seeking and health literacy.

Understanding Eating Behaviors through Parental Communication and the Integrative Model of Behavioral Prediction.

OBJECTIVE: Emerging adulthood (EA) is an important yet overlooked period for developing long-term health behaviors. During these years, emerging adults adopt health behaviors that persist throughout life. This study applies the Integrative Model of Behavioral Prediction (IMBP) to examine the role of childhood parental communication in predicting engagement in healthful eating during EA. METHODS: Participants included 239 college students, ages 18 to 25, from a large university in the southern United States. Participants were recruited and data collection occurred spring 2012. Participants responded to measures to assess perceived parental communication, eating behaviors, attitudes, subjective norms, and behavioral control over healthful eating. SEM and mediation analyses were used to address the hypotheses posited. RESULTS: Data demonstrated that perceived parent-child communication - specifically, its quality and target-specific content - significantly predicted emerging adults' eating behaviors, mediated through subjective norm and perceived behavioral control. CONCLUSION: This study sets the stage for further exploration and understanding of different ways parental communication influences emerging adults' healthy behavior enactment.

News Portrayal of Cancer: Content Analysis of Threat and Efficacy by Cancer Type and Comparison with Incidence and Mortality in Korea.

How the news media cover cancer may have profound significance for cancer prevention and control; however, little is known about the actual content of cancer news coverage in Korea. This research thus aimed to examine news portrayal of specific cancer types with respect to threat and efficacy, and to investigate whether news portrayal corresponds to actual cancer statistics. A content analysis of 1,138 cancer news stories was conducted, using a representative sample from 23 news outlets (television, newspapers, and other news media) in Korea over a 5-year period from 2008 to 2012. Cancer incidence and mortality rates were obtained from the Korean Statistical Information Service. Results suggest that threat was most prominent in news stories on pancreatic cancer (with 87% of the articles containing threat information with specific details), followed by liver (80%) and lung cancers (70%), and least in stomach cancer (41%). Efficacy information with details was conveyed most often in articles on colorectal (54%), skin (54%), and liver (50%) cancers, and least in thyroid cancer (17%). In terms of discrepancies between news portrayal and actual statistics, the threat of pancreatic and liver cancers was overreported, whereas the threat of stomach and prostate cancers was underreported. Efficacy information regarding cervical and colorectal cancers was overrepresented in the news relative to cancer statistics; efficacy of lung and thyroid cancers was underreported. Findings provide important implications for medical professionals to understand news information about particular cancers as a basis for public (mis)perception, and to communicate effectively about cancer risk with the public and patients.

Outrage Factors in Government Press Releases of Food Risk and Their Influence on News Media Coverage.

An appropriate level of risk perception should be a critical issue in modern "risk society." There have been many studies on the influences on risk perception. This study investigates whether risk communication scholar Dr. Peter Sandman's outrage factors intensify journalistic attention to health risks from food consumption. A content analysis of a health institution's press releases was conducted to examine 15 outrage factors of food risks conveyed in the governmental risk communication. In addition, the news stories covering the food risks informed by the press releases were calculated to evaluate the relation between outrage factors of a risk and the number of news stories covering the risk. Results showed that controllability was the most salient outrage factor, followed by trust, voluntariness, familiarity, and human origin; the greater the outrage score of a risk, the more news stories of the risk. For individual outrage factors, a risk with an implication of catastrophic potential was associated with an increase of news stories. Food providers' distrustful behaviors also influenced journalistic attention to the food risks. The implication of the findings to health message designers is discussed.

Communication competence, psychological well-being, and the mediating role of coping efforts among women with breast cancer: cross-sectional and longitudinal evidence.

Despite existing research identifying psychological benefits of patients' interpersonal competence in various contexts, little longitudinal research has addressed underlying mechanism(s). To address this limitation, we examined both the cross-sectional and longitudinal associations between cancer patients' communication competence in close relationships and psychological well-being, as well as the mediating role of coping efforts. Data came from a larger project with women with breast cancer (N = 661), recruited from April 2005 to May 2007 at three large university-affiliated cancer centers in the U.S. to study the effects of an Internet-based system providing patients and families with a range of services. The present study focused on survey data at baseline, 6 weeks, and 12 weeks after the intervention (controlling for the possible effects of the intervention). Results from both cross-sectional and longitudinal analyses indicated that competence in open communication between patients and their close support persons had a positive association with patients' psychological well-being and that approach coping efforts partially mediated this association. We discussed the implications and limitations of the study.

Cancer risk factors in Korean news media: a content analysis.

BACKGROUND: Little is known about the news coverage of cancer risk factors in Korea. This study aimed to examine how the news media encompasses a wide array of content regarding cancer risk factors and related cancer sites, and investigate whether news coverage of cancer risk factors is congruent with the actual prevalence of the disease. MATERIALS AND METHODS: A content analysis was conducted on 1,138 news stories covered during a 5-year period between 2008 and 2012. The news stories were selected from nationally representative media in Korea. Information was collected about cancer risk factors and cancer sites. RESULTS: Of various cancer risk factors, occupational and environmental exposures appeared most frequently in the news. Breast cancer was mentioned the most in relation to cancer sites. Breast, cervical, prostate, and skin cancer were overrepresented in the media in comparison to incidence and mortality cases, whereas lung, thyroid, liver, and stomach cancer were underrepresented. CONCLUSIONS: To our knowledge, this research is the first investigation dealing with news coverage about cancer risk factors in Korea. The study findings show occupational and environmental exposures are emphasized more than personal lifestyle factors; further, more prevalent cancers in developed countries have greater media coverage, not reflecting the realities of the disease. The findings may help health journalists and other health storytellers to develop effective ways to communicate cancer risk factors.

Social and psychological determinants of levels of engagement with an online breast cancer support group: posters, lurkers, and nonusers.

Despite the benefits and growing availability of online cancer support groups, many breast cancer patients still do not actively participate in them. To better understand cancer patients' online information- and support-seeking behaviors, this study explores how various social and psychological characteristics predict different levels of engagement with an online breast cancer support group: posters, lurkers, and nonusers. The study sample included 231 recently diagnosed breast cancer patients. Data included baseline survey scores of demographic, disease-related, and psychosocial factors and automatically collected discussion group use data over the 4-month intervention. Patterns of engagement with the cancer support group differed according to the patients' characteristics, suggesting that (a) cancer patients have very different orientations to and engagement with an online support group, and (b) deficits in social and psychological resources may not be barriers to participation in a cancer support group, but rather motivators to interact with other patients. The authors discuss the theoretical and practical implications of their findings.

How Does Insightful and Emotional Disclosure Bring Potential Health Benefits?: Study Based on Online Support Groups for Women with Breast Cancer.

Despite much research on the beneficial effects of written disclosure, relatively little attention has been paid to specifying the mechanism underlying the effects. Building upon the two theoretical models (the cognitive adaptation model and the emotional exposure-habituation model), this research focused on two aspects of disclosure content-insights and emotions-and examined how women with breast cancer benefit from written disclosure in online support groups. Using survey data collected at baseline and after four months and messages posted in bulletin-board-type online groups in between, we analyzed how the content of disclosive messages predicted health outcomes. Disclosure of insights led to greater improvements in health self-efficacy, emotional well-being, and functional well-being, which was mediated by lowered breast cancer concerns. Disclosure of negative emotions did not have main effects on health outcomes; instead, it weakened the unfavorable association between concerns at baseline and functional well-being at follow-up. Our findings support both theoretical models, but in regard to different aspects of disclosure content.

The role of provider-patient communication and trust in online sources in Internet use for health-related activities.

Provider-patient communication is an important factor influencing patients' satisfaction and health outcomes. This study draws upon the uses and gratification theory to examine how individuals' perception of communication with healthcare providers is associated with their Internet use for health-related activities. Using the data from the 2007 Health Information National Trends Survey (HINTS), we found that as individuals perceived their communication with providers to be less patient-centered, they were more likely to engage in various types of online health activities, such as using websites for healthy lifestyles, searching for healthcare providers, and seeking health information. Trust in online health information was also found to be a significant predictor of online health activities. The results of this study emphasized the important role of provider-patient communication in motivating individuals to turn to the Internet for health purposes.

Connecting internet use with gaps in cancer knowledge.

This study applies the knowledge gap hypothesis to the specific domain of Internet use for cancer information. In particular, this study examines disparities in online information seeking by education and ethnicity, and subsequent gaps in cancer knowledge. Perceived risk of cancer and ease of connection to the Internet are concerned as contingent factors influencing knowledge gaps. A subsample of the 2003 Health Information National Trends Survey-t-hose who have ever been online--was analyzed. Data supported the hypothesis that high education groups and White Americans were more likely to use the Internet for cancer information than were their counterparts, and online information seeking enlarged to some degree the cancer knowledge gaps between education groups. Perceived cancer risk had a weak but significant three-way interaction effect with ethnicity and online seeking on cancer knowledge, which suggests the importance of motivation in attenuating the knowledge gaps. The moderating role of ease of connection to the Internet was not supported. Discussion about the findings and further suggestions are offered.

Photograph use on social network sites among South Korean college students: the role of public and private self-consciousness.

This study challenges theories of computer-mediated communication (CMC) that typically assume a lack of visual cues in CMC and conceptualize them as a situational factor. We examine individual differences in photo use on social network sites and link them to the dispositional tendency of self-consciousness (SC). Included were 231 students from one university in South Korea, who owned and maintained Cyworld profiles (called "mini-homepages"). Findings suggest that public SC, but not private SC, was positively associated with the higher frequency of posting photos, replying to comments on the photos, and scrapping photos on their mini-homepages. The frequency of posting specific content types of photos (concerning social relationships or life events) was also determined by participants' public SC but not by private SC. Implications of the findings for CMC theories are discussed.

Cancer information scanning and seeking behavior is associated with knowledge, lifestyle choices, and screening.

Previous research on cancer information focused on active seeking, neglecting information gathered through routine media use or conversation ("scanning"). It is hypothesized that both scanning and active seeking influence knowledge, prevention, and screening decisions. This study uses Health Information National Trends Survey (HINTS, 2003) data to describe cancer-related scanning and seeking behavior (SSB) and assess its relationship with knowledge, lifestyle behavior, and screening. Scanning was operationalized as the amount of attention paid to health topics, and seeking was defined as looking for cancer information in the past year. The resulting typology included 41% low-scan/no-seekers; 30% high-scan/no-seekers; 10% low-scan/seekers, and 19% high-scan/seekers. Both scanning and seeking were significantly associated with knowledge about cancer (B=.36; B=.34) and lifestyle choices that may prevent cancer (B=.15; B=.16) in multivariate analyses. Both scanning and seeking were associated with colonoscopy (OR = 1.38, for scanning and OR=1.44, for seeking) and with prostate cancer screening (OR=4.53, scanning; OR=10.01, seeking). Scanning was significantly associated with recent mammography (OR=1.46), but seeking was not. Individuals who scan or seek cancer information are those who acquire knowledge, adopt healthy lifestyle behaviors, and get screened for cancer. Causal claims about these associations await further research.