Cyberchondria severity and utilization of health services in Polish society: a cross-sectional study.

BACKGROUND: It has been suggested that cyberchondria leads to increased utilization of healthcare services. Unfortunately, not many studies have analyzed this effect comprehensively. The aim of this study was to analyze the relationship between cyberchondria severity and the utilization of healthcare services among adult Internet users after adjusting for sociodemographic characteristics and the health status of respondents. METHODS: The analysis detailed in this paper examined data from a computer-based, web-based interviewing survey performed among a representative sample of 1613 Polish Internet users. Cyberchondria severity was assessed with the Cyberchondria Severity Scale (CSS). The variables reflecting the use of healthcare services were based on the frequency of visits to family physicians and specialists, diagnostic procedures, hospital admissions, and emergency services, and finally being vaccinated against COVID-19. The effect of cyberchondria severity on the utilization of healthcare services and alternative medicine was adjusted for key sociodemographic variables, the presence of chronic diseases, disability, and unspecific symptoms. For variables reflecting the use of services, ordinal logistic regression and multivariable logistic regression models were developed. RESULTS: Cyberchondria severity was a significant predictor of the utilization of all but one of the analyzed healthcare services and alternative medicine. The odds of being in a higher category of the utilization of visits to family physicians and specialists, hospital admissions, emergency services and alternative medicine services increased by a factor of 1.01-1.02 for every unit increase of the cyberchondria score. The cyberchondria score was a negative predictor of COVID-19 vaccine uptake. The effect of cyberchondria on outcome variables was independent of the level of health anxiety, sociodemographic variables, and variables reflecting the health status of respondents. CONCLUSIONS: Cyberchondria leads to more intensive use of nearly all healthcare services, but in the case of vaccination against COVID-19, cyberchondria severity was a negative predictor. Cyberchondria's effect extends beyond health anxiety.

Does Health Literacy Protect Against Cyberchondria: A Cross-Sectional Study?

Introduction: The use of online health resources and self-diagnosis intensified during the COVID-19 pandemic, often resulting in symptoms of cyberchondria. However, little is still known about this phenomenon's real scale and determinants. The aim of the study was to examine the prevalence of cyberchondria among adult internet users in Poland. Furthermore, the study was focused on analyzing the determinants of cyberchondria, with special regard to health literacy (HL) and e-health literacy (eHL). Methods: The analysis was based on data from a computer-assisted web-based interviewing survey performed with a sample of 1,613 internet users. Uni- and multivariable linear regression models were developed for potential determinants of cyberchondria. Results: Younger respondents were more likely to have higher cyberchondria scores than older respondents. Men were more likely to have lower cyberchondria scores than women. Higher health anxiety was significantly associated with cyberchondria severity. In the multivariable regression model, the severity of cyberchondria was significantly higher among respondents with inadequate rather than sufficient HL (B = 6.24, p < 0.001). In turn, greater eHL was significantly correlated with more severe cyberchondria (B = 0.92, p < 0.001). Conclusions: Our study confirmed that HL may be perceived as a protecting factor against cyberchondria. Unexpectedly, higher eHL predicts more severe cyberchondria.

Manifestation of Health Denialism in Attitudes toward COVID-19 Vaccination: A Qualitative Study.

Science denialism is characterized by the refusal to accept existing consensus and available evidence. Typical strategies denialists employ include spreading conspiracies, selective use of information, relying on fake experts, or general fallacies in logic. A flood of misinformation, fake news, and conspiracy theories accompanied the COVID-19 pandemic. Simultaneously, it was a subject of many denialistic opinions, from denying the existence of the epidemic challenge to claims that questioned the safety and effectiveness of the COVID-19 vaccines. This study's main aim was to assess the manifestations of denialism in attitudes toward the preventive measures recommended during the pandemic, with a special focus on vaccination. In-depth interviews were conducted with fifty representatives of the general population, demonstrating diversified opinions about COVID-19 vaccines and other preventive behaviors. The interviews were performed face to face in participants' houses or at other places they identified as convenient. Some of the interviewees preferred to do the interview via teleconference. The interviews were carried out from November 2022 to March 2023. The interviewees were recruited initially by convenience, and in further stages, the snowball technique was used. The interviewees were residents of four main administrative districts in Poland. Out of 50 participants, 26 were males, 29 were between 18-40, 16 were inhabitants of rural areas, and 28 had a university level of education. The interviews were based on a semi-structured guide that addressed, in addition to views about the origin of the new coronavirus, respondents' attitudes toward vaccination and sanitary recommendation, the health status of interviewees, their use of healthcare services, and their health behaviors. The interviews were transcribed and analyzed with MAXQDA Analytics Pro 2022 software (Release 22.7.0). Thematic analysis (TA) was applied to the content generated from the interviews. Based on the uptake of the COVID-19 vaccine, the participants were divided into three groups: unvaccinated, hesitant, and vaccinated (18, 4, and 28 interviewees, respectively). The main themes were established based on the TA of the interviews: attitudes toward COVID-19 vaccination, perception of sources of information, and the origin of the new coronavirus. The first theme decidedly drew the greatest attention of the interviewees. There was also a clear relationship between vaccination status and the presence of denialist thinking among interviewees. Interestingly, the role of experts as a key source of information about the pandemic was underlined by study participants. However, the criteria for being an expert differed. The subject of the origin of a new coronavirus was not interesting to interviewees. The analysis of the adherence to preventive measures revealed an interplay of diversified attitudes and motivations. Individuals presenting denialist views most frequently abstained from COVID-19 vaccination. However, such views were also present among those who hesitated or even among those who had been vaccinated. Furthermore, denialism was only one of the determinants of adherence to preventive measures.

The Awareness of the Role of Commercial Determinants of Health and the Readiness to Accept Restrictions on Unhealthy Food Advertising in Polish Society.

The negative consequences of commercial determinants of health (CDoH) have become a major challenge for public health systems, especially in terms of non-communicable diseases (NCDs). CDoH are defined as profit-driven factors that influence health. In this study, we assessed the awareness of CDoH and the attitudes toward potential restrictions on advertising, as well as fiscal interventions targeting food products with harmful effects on health in Polish society. Our analysis is based on data from a computer-based web interviewing (CAWI) survey performed in May 2022 among 2008 adult internet users from Poland. Multivariable logistic regression models were developed for variables derived from three items exploring the respondents' understanding of the relationship between CDoH and NCDs, as well as three items asking about their acceptance of a prohibition of advertising unhealthy products during sports events, a general ban on unhealthy food advertising, and their attitudes toward sugar-sweetened beverages (SSBs). Food (FL) and e-health literacy (eHL) levels were consistently positive predictors of both awareness of CDoH and acceptance of the proposed actions. Both higher FL and eHL were significantly associated with the opinion that advertising unhealthy food is associated with the prevalence of NCDs (OR, 95% CI: 1.03, 1.02-1.05, and 1.04, 1.02-1.06, respectively). Health literacy was less frequently a significant predictor of the dependent variables. Among sociodemographic factors, a respondent's level of education and age showed a significant relationship with their awareness and acceptance of countermeasures against CDoH. Respondents with a university master's level of education were more likely to agree with the statement on the relationship between big industry profits and harm to society's health (OR, 95% CI: 1.96, 1.42-2.69) and to support a ban on advertising unhealthy food similar to that for tobacco products (OR, 95% CI: 1.66, 1.21-2.27). Respondents suffering from chronic diseases were also consistently more likely to show a greater understanding of the harmful impact of CDoH and support proposed restrictions. For example, they were more likely to agree with restrictions on advertising harmful products during sports events (OR, 95% CI: 1.23, 1.02-1.50) and the introduction of a sugar tax (OR, 95% CI: 1.26, 1.03-1.54). Our study revealed that more than 50% of the Polish population is conscious of the problem of the harmful effects of big industries producing and selling processed food, sugar-sweetened beverages, and alcoholic beverages. Interestingly, slightly more than half of the respondents supported the introduction of restrictions on advertising such products. Still, only approximately 30% of them accepted a sugar tax to counter the obesity epidemic. The results of our study indicate that Polish society is open to the introduction of regulations aimed at limiting the impact of commercial determinants of health. To our knowledge, this is one of the first studies to assess the awareness of CDoH and the acceptance of restrictions to limit their impact.

Validation of the Short Food Literacy Questionnaire in the Representative Sample of Polish Internet Users.

Analogous to health literacy, food literacy can be defined as a set of cognitive and social skills associated with the ability to acquire and understand information about food and nutrition to make appropriate nutritional decisions. In the literature, several terms such as food, nutrition, or nutritional literacy are used in parallel, differing in some aspects of their meaning. Food literacy is an important measure of the effectiveness of nutritional education interventions and appropriate instruments for its measurement should be available in every society. The aim of this study was the assessment of the validity and testing of a proposed model of the Short Food Literacy Questionnaire (SFLQ) culturally adapted into Polish. The analysis was performed on data from an online survey in a representative sample of 1286 adult internet users. Exploratory (EFA) and confirmatory factor (CFA) analyses were performed on two different subsets obtained through random splitting of the initial dataset. The Polish version of the SFLQ had good internal consistency (Cronbach's α 0.841; Guttman split-half coefficient was 0.812). The EFA revealed that the tool had a three-factor latent structure. The distinguished dimensions were 'information accessing', 'knowledge', and 'information appraisal'. The subscales also showed acceptable internal consistency based on the values of the Cronbach's α coefficients (ranging from 0.768 to 0.845). The CFA confirmed a good fit of the three-factor model with at least five indexes achieving acceptable levels (CFI = 0.972, GFI = 0.963, AGFI = 0.940, NFI = 0.959, and RMSEA = 0.059). The validation of the Polish version of the SFLQ revealed, contrary to earlier reports, not a single but a three-factor structure of the instrument. The SFLQ will be an important tool for the assessment of the effectiveness of educational interventions and population studies analyzing the determinants of food literacy in Poland.