Associations of Health Literacy, Social Media Use, and Self-Efficacy With Health Information-Seeking Intentions Among Social Media Users in China: Cross-sectional Survey.

BACKGROUND: Empirical research has demonstrated that people frequently use social media for gathering and sharing online health information. Health literacy, social media use, and self-efficacy are important factors that may influence people's health behaviors online. OBJECTIVE: We aimed to examine the associations between health literacy, health-related social media use, self-efficacy, and health behavioral intentions online. METHODS: We conducted a cross-sectional survey of adults 18 years and older (n=449) to examine predictors of health-related behavioral intentions online including health literacy, social media use, and self-efficacy in China using 2 moderated mediation models. Mediation and moderation analyses were conducted. RESULTS: Self-efficacy mediated the effects of health literacy (Bindirect=0.213, 95% CI 0.101 to 0.339) and social media use (Bindirect=0.023, 95% CI 0.008 to 0.045) on health behavioral intentions on social media. Age moderated the effects of health literacy on self-efficacy (P=.03), while previous experience moderated the effects of social media use on self-efficacy (P<.001). CONCLUSIONS: Health literacy and health-related social media use influenced health behavioral intentions on social media via their prior effects on self-efficacy. The association between health literacy and self-efficacy was stronger among younger respondents, whereas the association between health-related social media use and self-efficacy was stronger among those who previously had positive experiences with health information on social media. Health practitioners should target self-efficacy among older populations and increase positive media experience related to health.

Digital Professionalism in Patient Care: A Case-Based Survey of Surgery Faculty and Trainees.

BACKGROUND: Use of digital devices have become ubiquitous in healthcare and can create professionalism issues. This study presents opinions of faculty, residents, and medical students to inform policy on the appropriate use of digital devices in the patient care setting. MATERIALS AND METHODS: A survey was administered from September 2018 to October 2018 to faculty and residents within the general surgery department at a large academic medical center and all fourth-year medical students at an affiliated university. The survey included direct statements and case-based scenarios on similar themes to triangulate responses. RESULTS: There were 114 participants in the survey-50 faculty, 26 residents, and 38 medical students. Digital device utilization was equivalent among all groups, and all participants use a smartphone. Digital devices were most frequently used during rounds and clinical conferences. Overall, digital device use was found more appropriate when seen in the case-based format rather than as a direct statement. Furthermore, use of these devices was seen as most appropriate when the provider explained its use or left the room to use the device. CONCLUSIONS: Digital devices are used by faculty and trainees at similar rates for parallel purposes, and the benefits for patient-related care are evident. However, the use of digital devices in the presence of patients should be minimized and always preceded by an explanation. These findings can inform institutional policy when creating guidelines on the professional use of these devices in the patient care setting.

Physicians' Perceptions of the Use of a Chatbot for Information Seeking: Qualitative Study.

BACKGROUND: Seeking medical information can be an issue for physicians. In the specific context of medical practice, chatbots are hypothesized to present additional value for providing information quickly, particularly as far as drug risk minimization measures are concerned. OBJECTIVE: This qualitative study aimed to elicit physicians' perceptions of a pilot version of a chatbot used in the context of drug information and risk minimization measures. METHODS: General practitioners and specialists were recruited across France to participate in individual semistructured interviews. Interviews were recorded, transcribed, and analyzed using a horizontal thematic analysis approach. RESULTS: Eight general practitioners and 2 specialists participated. The tone and ergonomics of the pilot version were appreciated by physicians. However, all participants emphasized the importance of getting exhaustive, trustworthy answers when interacting with a chatbot. CONCLUSIONS: The chatbot was perceived as a useful and innovative tool that could easily be integrated into routine medical practice and could help health professionals when seeking information on drug and risk minimization measures.

A Cross-Cultural Comparison of an Extended Planned Risk Information Seeking Model on Mental Health Among College Students: Cross-Sectional Study.

BACKGROUND: Approximately 42.5 million adults have been affected by mental illness in the United States in 2013, and 173 million people have been affected by a diagnosable psychiatric disorder in China. An increasing number of people tend to seek health information on the Web, and it is important to understand the factors associated with individuals' mental health information seeking. Identifying factors associated with mental health information seeking may influence the disease progression of potential patients. The planned risk information seeking model (PRISM) was developed in 2010 by integrating multiple information seeking models including the theory of planned behavior. Few studies have replicated PRISM outside the United States and no previous study has examined mental health as a personal risk in different cultures. OBJECTIVE: This study aimed to test the planned risk information seeking model (PRISM) in China and the United States with a chronic disease, mental illness, and two additional factors, ie, media use and cultural identity, among college students. METHODS: Data were collected in both countries using the same online survey through a survey management program (Qualtrics). In China, college instructors distributed the survey link among university students, and it was also posted on a leading social media site called Sina Weibo. In the United States, the data were collected in a college-wide survey pool in a large Northwestern university. RESULTS: The final sample size was 235 for the Chinese sample and 241 for the US sample. Media use was significantly associated with mental health information-seeking intentions in the Chinese sample (P<.001), and cultural identity was significantly associated with intentions in both samples (China: P=.02; United States: P<.001). The extended PRISM had a better model fit than the original PRISM. CONCLUSIONS: Cultural identity and media use should be considered when evaluating the process of mental health information seeking or when designing interventions to address mental health information seeking.

Predictors of Internet Health Information-Seeking Behaviors Among Young Adults Living With HIV Across the United States: Longitudinal Observational Study.

BACKGROUND: Consistent with young adults' penchant for digital communication, young adults living with HIV use digital communication media to seek out health information. Understanding the types of health information sought online and the characteristics of these information-seeking young adults is vital when designing digital health interventions for them. OBJECTIVE: This study aims to describe characteristics of young adults living with HIV who seek health information through the internet. Results will be relevant to digital health interventions and patient education. METHODS: Young adults with HIV (aged 18-34 years) self-reported internet use during an evaluation of digital HIV care interventions across 10 demonstration projects in the United States (N=716). Lasso (least absolute shrinkage and selection operator) models were used to select characteristics that predicted whether participants reported seeking general health and sexual and reproductive health (SRH) information on the internet during the past 6 months. RESULTS: Almost a third (211/716, 29.5%) and a fifth (155/716, 21.6%) of participants reported searching for general health and SRH information, respectively; 26.7% (36/135) of transgender young adults with HIV searched for gender-affirming care topics. Areas under the curve (>0.70) indicated success in building models to predict internet health information seeking. Consistent with prior studies, higher education and income predicted health information seeking. Higher self-reported antiretroviral therapy adherence, substance use, and not reporting transgender gender identity also predicted health information seeking. Reporting a sexual orientation other than gay, lesbian, bisexual, or straight predicted SRH information seeking. CONCLUSIONS: Young adults living with HIV commonly seek both general health and SRH information online, particularly those exploring their sexual identity. Providers should discuss the most commonly sought SRH topics and the use of digital technology and be open to discussing information found online to better assist young adults with HIV in finding accurate information. Characteristics associated with health information-seeking behavior may also be used to develop and tailor digital health interventions for these young adults.

Preferential interactions promote blind cooperation and informed defection.

It is common sense that costs and benefits should be carefully weighed before deciding on a course of action. However, we often disapprove of people who do so, even when their actual decision benefits us. For example, we prefer people who directly agree to do us a favor over those who agree only after securing enough information to ensure that the favor will not be too costly. Why should we care about how people make their decisions, rather than just focus on the decisions themselves? Current models show that punishment of information gathering can be beneficial because it forces blind decisions, which under some circumstances enhances cooperation. Here we show that aversion to information gathering can be beneficial even in the absence of punishment, due to a different mechanism: preferential interactions with reliable partners. In a diverse population where different people have different-and unknown-preferences, those who seek additional information before agreeing to cooperate reveal that their preferences are close to the point where they would choose not to cooperate. Blind cooperators are therefore more likely to keep cooperating even if conditions change, and aversion to information gathering helps to interact preferentially with them. Conversely, blind defectors are more likely to keep defecting in the future, leading to a preference for informed defectors over blind ones. Both mechanisms-punishment to force blind decisions and preferential interactions-give qualitatively different predictions, which may enable experimental tests to disentangle them in real-world situations.

Internet Searches for Medical Symptoms Before Seeking Information on 12-Step Addiction Treatment Programs: A Web-Search Log Analysis.

BACKGROUND: Brief intervention is a critical method for identifying patients with problematic substance use in primary care settings and for motivating them to consider treatment options. However, despite considerable evidence of delay discounting in patients with substance use disorders, most brief advice by physicians focuses on the long-term negative medical consequences, which may not be the best way to motivate patients to seek treatment information. OBJECTIVE: Identification of the specific symptoms that most motivate individuals to seek treatment information may offer insights for further improving brief interventions. To this end, we used anonymized internet search engine data to investigate which medical conditions and symptoms preceded searches for 12-step meeting locators and general 12-step information. METHODS: We extracted all queries made by people in the United States on the Bing search engine from November 2016 to July 2017. These queries were filtered for those who mentioned seeking Alcoholics Anonymous (AA) or Narcotics Anonymous (NA); in addition, queries that contained a medical symptom or condition or a synonym thereof were analyzed. We identified medical symptoms and conditions that predicted searches for seeking treatment at different time lags. Specifically, symptom queries were first determined to be significantly predictive of subsequent 12-step queries if the probability of querying a medical symptom by those who later sought information about the 12-step program exceeded the probability of that same query being made by a comparison group of all other Bing users in the United States. Second, we examined symptom queries preceding queries on the 12-step program at time lags of 0-7 days, 7-14 days, and 14-30 days, where the probability of asking about a medical symptom was greater in the 30-day time window preceding 12-step program information-seeking as compared to all previous times that the symptom was queried. RESULTS: In our sample of 11,784 persons, we found 10 medical symptoms that predicted AA information seeking and 9 symptoms that predicted NA information seeking. Of these symptoms, a substantial number could be categorized as nonsevere in nature. Moreover, when medical symptom persistence was examined across a 1-month time period, a substantial number of nonsevere, yet persistent, symptoms were identified. CONCLUSIONS: Our results suggest that many common or nonsevere medical symptoms and conditions motivate subsequent interest in AA and NA programs. In addition to highlighting severe long-term consequences, brief interventions could be restructured to highlight how increasing substance misuse can worsen discomfort from common medical symptoms in the short term, as well as how these worsening symptoms could exacerbate social embarrassment or decrease physical attractiveness.

Patient-targeted googling and psychiatric professionals.

OBJECTIVE: This is a pilot study which assesses the beliefs of psychiatric professionals regarding obtaining patient information via the Internet as well as the frequency with which they do it in a variety of clinical settings. METHODS: Psychiatry faculty and residents were asked to participate in an anonymous online survey about their use of the search engine Google to find information about their patients. Data were analyzed with Microsoft Excel. RESULTS: The participants included 48 faculty and 34 residents (118 faculty and 44 residents were surveyed) with response rates of 41% and 77%, respectively. Majority of attending physicians and residents reported engaging in patient-targeted googling with no significant difference between the groups. Residents were most likely to search for patient information online in the psychiatric emergency room (45%). Psychiatric emergency room (36.8%) and private practice (31.6%) were notable clinical settings for obtaining further patient information on the Internet for the faculty. When describing reasons for engaging in patient-targeted googling, "patient care" was cited about twice as often as "curiosity" in the psychiatric emergency room, whereas "curiosity" and "patient care" were reasons mentioned in other clinical settings. In general, neither faculty nor residents report informing their patients of their Internet searches either before or after engaging in patient-targeted googling. CONCLUSION: This study raises important questions about education for trainees and faculty regarding patient-targeted googling.

Health Information Obtained From the Internet and Changes in Medical Decision Making: Questionnaire Development and Cross-Sectional Survey.

BACKGROUND: The increasing utilization of the internet has provided a better opportunity for people to search online for health information, which was not easily available to them in the past. Studies reported that searching on the internet for health information may potentially influence an individual's decision making to change her health-seeking behaviors. OBJECTIVE: The objectives of this study were to (1) develop and validate 2 questionnaires to estimate the strategies of problem-solving in medicine and utilization of online health information, (2) determine the association between searching online for health information and utilization of online health information, and (3) determine the association between online medical help-seeking and utilization of online health information. METHODS: The Problem Solving in Medicine and Online Health Information Utilization questionnaires were developed and implemented in this study. We conducted confirmatory factor analysis to examine the structure of the factor loadings and intercorrelations for all the items and dimensions. We employed Pearson correlation coefficients for examining the correlations between each dimension of the Problem Solving in Medicine questionnaire and each dimension of the Online Health Information Utilization questionnaire. Furthermore, we conducted structure equation modeling for examining the possible linkage between each of the 6 dimensions of the Problem Solving in Medicine questionnaire and each of the 3 dimensions of the Online Health Information Utilization questionnaire. RESULTS: A total of 457 patients participated in this study. Pearson correlation coefficients ranged from .12 to .41, all with statistical significance, implying that each dimension of the Problem Solving in Medicine questionnaire was significantly associated with each dimension of the Online Health Information Utilization questionnaire. Patients with the strategy of online health information search for solving medical problems positively predicted changes in medical decision making (P=.01), consulting with others (P<.001), and promoting self-efficacy on deliberating the online health information (P<.001) based on the online health information they obtained. CONCLUSIONS: Present health care professionals have a responsibility to acknowledge that patients' medical decision making may be changed based on additional online health information. Health care professionals should assist patients' medical decision making by initiating as much dialogue with patients as possible, providing credible and convincing health information to patients, and guiding patients where to look for accurate, comprehensive, and understandable online health information. By doing so, patients will avoid becoming overwhelmed with extraneous and often conflicting health information. Educational interventions to promote health information seekers' ability to identify, locate, obtain, read, understand, evaluate, and effectively use online health information are highly encouraged.

TTaPP: Together Take a Pause and Ponder: A Critical Thinking Tool for Exploring the Public/Private Lives of Patients.

The broad use of social networking and user-generated content has increased the online footprint of many individuals. A generation of healthcare professionals have grown up with online search activities as part of their everyday lives. Sites like Facebook, Twitter, and Instagram have given the public new ways to share intimate details about their public and private lives and the lives of their friends and families. As a result, careproviders have the ability to find out more about their patients with just the tap of a key or the click of a mouse. This type of online searching for patient information is known as patient-targeted googling or PTG. This article provides an overview of the emergence of PTG, identifies the potential benefits and possible pitfalls of engaging in PTG, and explores current ethical frameworks that guide decisions about PTG. The article describes the development of a critical thinking tool developed by the Behavioral Health Ethics Committee at CHI Health, that can serve as a best-practice model for other hospitals and health systems. Called TTaPP (Together Take a Pause and Ponder), this tool is designed to help healthcare professionals across settings practice collaborative critical thinking skills as they consider the ethical questions of whether or not to engage in PTG. Finally, this article suggests areas for further study, including ways to prompt collaboration and appropriate documentation by maximizing electronic medical records systems, exploring the effectiveness of the TTaPP tool as a way to promote a culture of collaborative critical thinking practices, and the attitudes of patients and the public regarding PTG.

Patient-targeted Googling and social media: a cross-sectional study of senior medical students.

BACKGROUND: Social media and Internet technologies present several emerging and ill-explored issues for a modern healthcare workforce. One issue is patient-targeted Googling (PTG), which involves a healthcare professional using a social networking site (SNS) or publicly available search engine to find patient information online. The study's aim was to address a deficit in data and knowledge regarding PTG, and to investigate medical student use of SNSs due to a close association with PTG. METHOD: The authors surveyed final year medical students at the Otago Medical School, University of Otago in January 2016. A subset completed focus groups that were analysed using thematic analysis to identify key themes relating to students' attitudes towards PTG, and reasons why they might engage in PTG. RESULTS: Fifty-four students completed the survey (response rate = 65.1%), which showed that PTG was uncommon (n = 9, 16.7%). Attitudes were varied and context dependent. Most participants saw problems with PTG and favoured more explicit guidance on the issue (n = 29, 53.7%). SNS usage was high (n = 51, 94.4%); participants were concerned by the content of their SNS profiles and who they were connecting with online. Participants showing high SNS use were 1.83 times more likely to have conducted PTG than lower use groups. CONCLUSIONS: The diverse attitudes uncovered in this study indicated that teaching or guidelines could be useful to healthcare professionals considering PTG. Though ethically problematic, PTG may be important to patient care and safety. The decision to conduct PTG should be made with consideration of ethical principles and the intended use of the information.

What Predicts Online Health Information-Seeking Behavior Among Egyptian Adults? A Cross-Sectional Study.

BACKGROUND: Over the last decade, the Internet has become an important source of health-related information for a wide range of users worldwide. Yet, little is known about the personal characteristics of Egyptian Internet users who search for online health information (OHI). OBJECTIVE: The aim of the study was to identify the personal characteristics of Egyptian OHI seekers and to determine any associations between their personal characteristics and their health information-seeking behavior. METHODS: This cross-sectional questionnaire study was conducted from June to October 2015. A Web-based questionnaire was sent to Egyptian users aged 18 years and older (N=1400) of a popular Arabic-language health information website. The questionnaire included (1) demographic characteristics; (2) self-reported general health status; and (3) OHI-seeking behavior that included frequency of use, different topics sought, and self-reported impact of obtained OHI on health behaviors. Data were analyzed using descriptive statistics and multiple regression analysis. RESULTS: A total of 490 participants completed the electronic questionnaire with a response rate equivalent to 35.0% (490/1400). Regarding personal characteristics, 57.1% (280/490) of participants were females, 63.4% (311/490) had a university level qualification, and 37.1% (182/490) had a chronic health problem. The most commonly sought OHI by the participants was nutrition-related. Results of the multiple regression analysis showed that 31.0% of the variance in frequency of seeking OHI among Egyptian adults can be predicted by personal characteristics. Participants who sought OHI more frequently were likely to be female, of younger age, had higher education levels, and good self-reported general health. CONCLUSIONS: Our results provide insights into personal characteristics and OHI-seeking behaviors of Egyptian OHI users. This will contribute to better recognize their needs, highlight ways to increase the availability of appropriate OHI, and may lead to the provision of tools allowing Egyptian OHI users to navigate to the highest-quality health information.

Identifying and Understanding the Health Information Experiences and Preferences of Caregivers of Individuals With Either Traumatic Brain Injury, Spinal Cord Injury, or Burn Injury: A Qualitative Investigation.

BACKGROUND: In order to meet the challenges of caring for an injured person, caregivers need access to health information. However, caregivers often feel that they lack adequate information. Previous studies of caregivers have primarily focused on either their time and emotional burdens or their health outcomes, but the information needs of caregivers have not been thoroughly investigated. OBJECTIVE: The purpose of this investigation was to identify the preferred sources of health information for caregivers supporting individuals with injuries and to explore how access to this information could be improved. METHODS: A total of 32 caregivers participated in semistructured interviews, which were used in order to develop a more in-depth understanding of these caregivers' information needs. Digital audio recordings of the interviews were used for analysis purposes. These audio recordings were analyzed using a thematic analysis or qualitative content analysis. All of participant's interviews were then coded using the qualitative analysis program, Nvivo 10 for Mac (QSR International). RESULTS: The caregivers endorsed similar behaviors and preferences when seeking and accessing health information. Medical professionals were the preferred source of information, while ease of access made the Internet the most common avenue to obtain information. The challenges faced by participants were frequently a result of limited support. In describing an ideal health system, participants expressed interest in a comprehensive care website offering support network resources, instructive services about the injury and caregiving, and injury-specific materials. CONCLUSIONS: According to the participants, an ideal health information system would include a comprehensive care website that offered supportive network resources, instructive services about the injury and caregiving, and materials specific to the type of patient injury.

No man's land: information needs and resources of men with metastatic castrate resistant prostate cancer.

The majority of men treated for prostate cancer will eventually develop castrate-resistant disease (CRPC) with metastases (mCRPC). There are several options for further treatment: chemotherapy, third-line hormone therapy, radium, immunotherapy, and palliation. Current ASCO guidelines for survivors of prostate cancer recommend that an individual's information needs at all stages of disease are assessed and that patients are provided with or referred to the appropriate sources for information and support. Earlier reviews have highlighted the dearth of such services and we wished to see if the situation had improved more recently. Unfortunately, we conclude that there is still a lack of good-quality congruent information easily accessible specifically for men with mCRPC and insufficient data regarding the risks, harms, and benefits of different management plans. More research providing a clear evidence base about treatment consequences using patient reported outcome measures is required.

For your interest? The ethical acceptability of using non-invasive prenatal testing to test 'purely for information'.

Non-invasive prenatal testing (NIPT) is an emerging form of prenatal genetic testing that provides information about the genetic constitution of a foetus without the risk of pregnancy loss as a direct result of the test procedure. As with other prenatal tests, information from NIPT can help to make a decision about termination of pregnancy, plan contingencies for birth or prepare parents to raise a child with a genetic condition. NIPT can also be used by women and couples to test purely 'for information'. Here, no particular action is envisaged following the test; it is motivated entirely by an interest in the result. The fact that NIPT can be performed without posing a risk to the pregnancy could give rise to an increase in such requests. In this paper, we examine the ethical aspects of using NIPT 'purely for information', including the competing interests of the prospective parents and the future child, and the acceptability of testing for 'frivolous' reasons. Drawing on several clinical scenarios, we claim that arguments about testing children for genetic conditions are relevant to this debate. In addition, we raise ethical concerns over the potential for objectification of the child. We conclude that, in most cases, using NIPT to test for adult-onset conditions, carrier status or non-serious traits presenting in childhood would be unacceptable.

Prenatal screening: an ethical agenda for the near future.

Prenatal screening for foetal abnormalities such as Down's syndrome differs from other forms of population screening in that the usual aim of achieving health gains through treatment or prevention does not seem to apply. This type of screening leads to no other options but the choice between continuing or terminating the pregnancy and can only be morally justified if its aim is to provide meaningful options for reproductive choice to pregnant women and their partners. However, this aim should not be understood as maximizing reproductive choice per se. Only if understood as allowing prospective parents to avoid suffering related to living with (a child with) serious disorders and handicaps can prenatal screening be a publicly or collectively funded programme. The alternative of moving prenatal testing outside the healthcare system into the private sector is problematic, as it makes these tests accessible only to those who can afford to pay for it. New developments in prenatal screening will have to be assessed in terms of whether and to what extent they either contribute to or undermine the stated aim of providing meaningful options for reproductive choice. In the light of this criterion, this article discusses the introduction of the new non-invasive prenatal test (NIPT), the tendency to widen the scope of follow-up testing, as well as the possible future scenarios of genome-wide screening and 'prenatal personalised medicine'. The article ends with recommendations for further debate, research and analysis.

The Association Between Online Health Information-Seeking Behaviors and Health Behaviors Among Hispanics in New York City: A Community-Based Cross-Sectional Study.

BACKGROUND: Hispanics are the fastest-growing minority group in the United States and they suffer from a disproportionate burden of chronic diseases. Studies have shown that online health information has the potential to affect health behaviors and influence management of chronic disease for a significant proportion of the population, but little research has focused on Hispanics. OBJECTIVE: The specific aim of this descriptive, cross-sectional study was to examine the association between online health information-seeking behaviors and health behaviors (physical activity, fruit and vegetable consumption, alcohol use, and hypertension medication adherence) among Hispanics. METHODS: Data were collected from a convenience sample (N=2680) of Hispanics living in northern Manhattan by bilingual community health workers in a face-to-face interview and analyzed using linear and ordinal logistic regression. Variable selection and statistical analyses were guided by the Integrative Model of eHealth Use. RESULTS: Only 7.38% (198/2680) of the sample reported online health information-seeking behaviors. Levels of moderate physical activity and fruit, vegetable, and alcohol consumption were low. Among individuals taking hypertension medication (n=825), adherence was reported as high by approximately one-third (30.9%, 255/825) of the sample. Controlling for demographic, situational, and literacy variables, online health information-seeking behaviors were significantly associated with fruit (ß=0.35, 95% CI 0.08-0.62, P=.01) and vegetable (ß=0.36, 95% CI 0.06-0.65, P=.02) consumption and physical activity (ß=3.73, 95% CI 1.99-5.46, P<.001), but not alcohol consumption or hypertension medication adherence. In the regression models, literacy factors, which were used as control variables, were associated with 3 health behaviors: social networking site membership (used to measure one dimension of computer literacy) was associated with fruit consumption (ß=0.23, 95% CI 0.05-0.42, P=.02), health literacy was associated with alcohol consumption (ß=0.44, 95% CI 0.24-0.63, P<.001), and hypertension medication adherence (ß=-0.32, 95% CI -0.62 to -0.03, P=.03). Models explained only a small amount of the variance in health behaviors. CONCLUSIONS: Given the promising, although modest, associations between online health information-seeking behaviors and some health behaviors, efforts are needed to improve Hispanics' ability to access and understand health information and to enhance the availability of online health information that is suitable in terms of language, readability level, and cultural relevance.

[Clinical, ethical and legal issues on medical information to patients and relatives]. / Información médica a pacientes y familiares: aspectos clínicos, éticos y legales.

Providing information to patients and relatives (IPAR) is a clinical, ethical and legal need. IPAR is inherent to the medical team work as diagnostic and therapeutic procedures are. In some cases, it is a key step for patient's recovery. From an ethical point of view, the patient is not only the subject of the medical work but also its main owner and who must, previously informed, decide about options which would directly affect him. After the promulgation of a special law in Chile, this prerogative became a legal right. This paper proposes an empirically developed model or protocol that should be used to inform hospitalized patients and their relatives about their disease, in a pertinent way. Considering that IPAR is a skill that should be learned and practiced, the written protocol is provided to neurology residents as supporting material. Although IPAR protocols are completely justified, they have not been evaluated in terms of efficiency of communication, user satisfaction, patient and relatives reassurance and clinical impact. Therefore, they require a prospective validation.

Anti-intellectualism and the mass public's response to the COVID-19 pandemic.

Anti-intellectualism (the generalized distrust of experts and intellectuals) is an important concept in explaining the public's engagement with advice from scientists and experts. We ask whether it has shaped the mass public's response to coronavirus disease 2019 (COVID-19). We provide evidence of a consistent connection between anti-intellectualism and COVID-19 risk perceptions, social distancing, mask usage, misperceptions and information acquisition using a representative survey of 27,615 Canadians conducted from March to July 2020. We exploit a panel component of our design (N = 4,910) to strongly link anti-intellectualism and within-respondent change in mask usage. Finally, we provide experimental evidence of anti-intellectualism's importance in information search behaviour with two conjoint studies (N ~ 2,500) that show that preferences for COVID-19 news and COVID-19 information from experts dissipate among respondents with higher levels of anti-intellectual sentiment. Anti-intellectualism poses a fundamental challenge in maintaining and increasing public compliance with expert-guided COVID-19 health directives.