Examining the Health Information–Seeking Behaviors of Korean Americans

Background: Effective development and dissemination of cancer control messages to the public requires a firm understanding of individuals’ information-seeking practices and preferences, and cancer-relevant risk behaviors, attitudes, and knowledge. The Health Information National Trends Survey (HINTS) was developed by the U.S. National Cancer Institute (NCI) as a mechanism for collecting such data to inform effective health communication strategies across populations. It provides surveillance of the nation's investment in cancer communication tracking the effects of the changing communication environment on cancer-related knowledge, attitudes and behaviors. The University of Puerto Rico Comprehensive Cancer Center, the Puerto Rico Behavioral Risk Factors Surveillance System, and the NCI, implemented HINTS in Puerto Rico in 2009. HINTS Puerto Rico provides an opportunity to better understand the cancer information and education needs of the population and informed cancer control planning for Puerto Rico. In this study, we describe health and cancer information-seeking behaviors, sources of information and trust in information sources among the population in Puerto Rico. Methods: For HINTS-Puerto Rico, the Spanish version of HINTS 2007 telephone survey was carefully reviewed and edited for language appropriateness for the island population by the HINTS Puerto Rico team. Data was collected between April and June, 2009. Variables of interest for this analysis include: health and cancer information seeking and sources; trust in health information sources, use of the Internet for health, and sociodemographic characteristics (age, sex, education, and ethnic group, place of birth, annual household income, marital status, and employment status). We used multivariate logistic regression models for each of the outcomes of interest (health information seeking, cancer information seeking, and health-related use of the Internet) to estimate the odds ratios (ORs) and their 95% CIs for the association between sociodemographic characteristics and these behaviors. Results: A total of 639 (603 complete and 36 partially complete) interviews were conducted. Nearly one-third of respondents had ever looked for information about health (32.9%) or about cancer (28.1 %). The Internet was the most frequently reported source of information (56.4% of information seekers). The majority of respondents were generally positive in their characterization of their information-seeking experiences, and the most highly trusted sources of information were healthcare providers and government health agencies. College educated (OR=7.6,95% CI 3.0-19.3) and females (OR = 2.8,95% CI 1.6-5.0) were more likely to seek health information. Similarly, college educated (OR=5.4,95% CI 1.8-14.1) and females (OR=2.0,95% CI 1.2-3.3) were more likely to seek cancer information. Only 32.7% of respondents had ever accessed the Internet and college educated were more likely to use it (OR=12.2). Conclusion: Results provide insights into the health and cancer information-seeking behaviors and experiences of the population in Puerto Rico and contribute to the evidence base for cancer control planning on the island. Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A17.

Korean Americans (KAs) have low screening rates for cancer and are often not well informed about their chronic diseases. Reduced access to health-related information is one reason for gaps in knowledge and the widening health disparities among minority populations. However, little research exists about KAs' health information seeking behaviors. Guided by the Structural Influence Model, this study examines the influence of immigration status on KAs' trust in health information sources and health information seeking behaviors. Cross-sectional surveys were conducted in the Washington, D.C., metropolitan area as well as in the Gwangju metropolitan city in South Korea during 2006-2007. Two hundred and fifty-four KAs and 208 native Koreans who were 40 years of age or older completed the surveys. When comparing native Koreans to KAs, we found KAs were 3 times more likely to trust health information from newspapers or magazines (odds ratio [OR] = 3.13; 95% confidence interval [CI] = 1.49-6.54) and 11 times more likely to read the health sections of newspapers or magazines (OR = 11.35; 95% CI = 3.92-32.91) in multivariate adjusted models. However, they were less likely to look for health information from TV (OR = 0.29; 95% CI = 0.12-0.72) than native Koreans. Our results indicate that immigration status has profound influences on KAs' health information seeking behaviors. Increasing the availability of reliable and valid health information from printed Korean language magazines or newspapers could have a positive influence on increasing awareness and promoting screening behaviors among KAs.

The spread of health-related information across the internet necessitates an evaluation of public eHealth literacy, trust in different health information sources, including healthcare providers, and how eHealth literacy is related to trust in different sources. 407 individuals participated in a web-based survey in the Tabuk region of Saudi Arabia. Univariate analysis was used to evaluate the relationships between eHealth literacy and demographic variables, and multiple linear regression was used to measure the relationship between eHealth literacy and trust in health information sources after adjustment for demographic factors. The average eHealth literacy of the respondents was 27.17 out of 40. eHealth literacy levels were higher among females, younger age groups, those in the higher-education category, and those with a chronic disease or currently on medication. For 51.9% of participants, physicians and healthcare workers were their main source of health information, while 40% considered the internet their main source. None of the study participants perceived physicians and healthcare workers as untrustworthy, and social media was the least trusted source. eHealth literacy was not related to trust in physicians and health workers but was positively associated with trust in specialized health websites and negatively associated with trust in social media. The findings suggest that the public tends to prefer and trust physicians and other healthcare workers as a primary source of health information, regardless of their eHealth literacy levels. A higher eHealth literacy level was associated with trust in specialized health websites and distrust in social media.

BackgroundThe transmission of health information from in-person communication to web-based sources has changed over time. Patients can find, understand, and use their health information without meeting a health care provider and are able to participate more in their health care management. In recent years, the internet has emerged as the primary source of health information, although clinical providers remain the most credible source. The ease of access, anonymity, and busy schedules may be motivating factors to seek health information on the web. Social media has surfaced as a popular source of health information, as it can provide news in real time. The increase in the breadth and depth of health information available on the web has also led to a plethora of misinformation, and individuals are often unable to discern facts from fiction. Competencies in health literacy (HL) can help individuals better understand health information and enhance patient decision-making, as adequate HL is a precursor to positive health information–seeking behaviors (HISBs). Several factors such as age, sex, and socioeconomic status are known to moderate the association between HL and HISBs.ObjectiveIn this study, we aimed to examine the relationship between HL and HISBs in individuals living in a southern state in the United States by considering different demographic factors.MethodsParticipants aged ≥18 years were recruited using Qualtrics Research Services and stratified to match the statewide demographic characteristics of race and age. Demographics and source and frequency of health information were collected. The Health Literacy Questionnaire was used to collect self-reported HL experiences. SPSS (version 27; IBM Corp) was used for the analysis.ResultsA total of 520 participants met the criteria and completed the survey (mean age 36.3, SD 12.79 years). The internet was cited as the most used source of health information (mean 2.41, SD 0.93). Females are more likely to seek health information from physicians than males (r=0.121; P=.006). Older individuals are less likely to seek health information from the internet (r=−0.108; P=.02), social media (r=−0.225; P<.001), and friends (r=−0.090; P=.045) than younger individuals. Cluster analysis demonstrated that individuals with higher levels of HISBs were more likely to seek information from multiple sources than those with lower levels of HISBs (mean range 3.05-4.09, SD range 0.57-0.66; P<.001).ConclusionsAge and sex are significantly associated with HISB. Older adults may benefit from web-based resources to monitor their health conditions. Higher levels of HL are significantly associated with greater HISB. Targeted strategies to improve HISB among individuals with lower levels of HL may improve their access, understanding, and use of health information.

PurposeThis study aims to examine the relationships between consumer self‐confidence in health information search and health‐related outcomes (i.e. knowledge about cancer prevention, healthcare behavior, and use of the web as a primary source for health information). The associations between self‐confidence in health information search and its predictors (i.e. health literacy and trust in health information sources) are explored as well.Design/methodology/approachThis study used the 2007 Health Information National Trends Survey data. Stepwise linear regression analyses, a logistic regression analysis, and stepwise multiple regression analyses were used to test the hypotheses.FindingsThe results from this study revealed that consumer self‐confidence in health information search appears to be linked with perceptions of health literacy and trust in information sources, particularly, trust in health professionals (e.g. doctors, healthcare professionals, government health agencies, family and friends, the internet), but not in information‐focused media (newspapers or magazines). Furthermore, as expected, consumer self‐confidence in health information search determines two health‐related outcomes, which are knowledge about cancer prevention and healthcare behavior.Originality/valueThe results of this study provide researchers with a better understanding about the key factors guiding consumers to have informed healthcare and enabling public health agencies to evaluate the effectiveness of their policies.

Are we getting the message out to all?: Health information sources and ethnicity

Purpose: Previous research has found that people’s trust in a source of information affects whether they will expose themselves to information from that source, pay attention to that source, and the likelihood that they will act on the information obtained from that source. This study tracked trends in levels of trust in different health information sources over time and investigated sociodemographic predictors of trust in these sources. Methodology/Approach: Data were drawn from the Health Information National Trends Survey (HINTS), a nationally representative, cross-sectional survey of adults in the USA. Weighted percentages, means, and standard errors for trust in health information sources were computed using data from four iterations of the survey (2005, 2009, 2012, and 2013). Weighted multivariable logistic regression models were employed to investigate associations between sociodemographic variables and level of trust in health information sources using HINTS 2013 data. Findings: Trend analyses revealed declining trust in “traditional” mass media channels, such as television and radio, for health information and consistently high trust in interpersonal sources, like physicians, over the past decade. Regression analyses showed that those with more education (ORs 2.93–4.59, p < 0.05) and higher incomes (ORs 1.65–2.09, p < 0.05) were more likely to trust the Internet for health information than those with less education and lower incomes. Non-Hispanic Blacks and Hispanics were more likely to trust mass media channels in comparison to Non-Hispanic Whites (ORs 1.73–2.20, p < 0.05). Implications: These findings can be used to inform the strategic selection of channels for disseminating health information to certain demographic groups.

Confidence in health information access is a measure of the perceived ability to obtain health information. One's beliefs or perceived ability to access health information is particularly important in understanding trends in health care access. Previous literature has found that access to health information is lowest among society's most vulnerable population groups. These groups include older, less educated, and low-income populations. While health confidence has previously been used as a scale to measure health outcomes, additional research is needed describing the demographic factors associated with users' confidence in health information access. This may be a key component of health information seeking that affects beneficial health outcomes such as prevention and treatment. This study examines the demographic factors associated with the levels of confidence in using the internet to access health information for adults 18 years and older in the United States. Using a cross-sectional design, secondary data from the Health Information National Trends Survey (HINTS) 5, Cycle 3 (2019) were analyzed (N=5374). An ordinal regression stratified by internet use was used to determine the association between demographic characteristics and level of confidence in health information access. When the internet is the primary source for health information, high school graduates (adjusted odds ratio [AOR] 0.58, 95% CI 0.37-0.89) compared to those with a college degree or more had significantly lower odds of being confident in obtaining health information. In addition, non-Hispanic Asian participants (AOR 0.44, 95% CI 0.24-0.82) compared to non-Hispanic White participants, male participants (AOR 0.72, 95% CI 0.54-0.97) compared to female participants, and those who made between US $20,000-$35,000 annually (AOR 0.55, 95% CI 0.31-0.98) compared to those who made US $75,000 or more annually had significantly lower odds of being confident in obtaining health information via the internet. Moreover, when the internet is the primary source for health information, those with health insurance had significantly higher odds of being confident in obtaining health information (AOR 2.91, 95% CI 1.58-5.34) compared to those who do not have health insurance. Lastly, a significant association was observed between confidence in health information access and primary health information source and frequency of visiting a health care provider. Confidence in accessing health information can differ by individual demographics. Accessing health-related information from the internet has become increasingly more common and can provide insight into health information-seeking behaviors. Further exploration of these factors can inform the science of health education by providing deeper insight into improving access to health information for vulnerable populations.

Introduction: Few studies identify which health information (HI) people trust and use, and some studies have focused on health information-seeking behaviors (HISB) of individuals with varying perceived cancer risk (PCR). However, most HISB and PCR studies focus on mainstream populations with typical hearing ability. The purpose of this study was to examine the association between HISB and high PCR (HPCR) among English speakers who experienced hearing loss. Methods: Data from the English version of the 2013 Health Information National Trends Survey (HINTS) 4 Cycle 3 were analyzed. Frequencies were calculated from HINTS 4 Cycle 3 survey questions. Correlation analysis was used to examine relationships between HPCR status and the various trusted HI sources. A significant correlation coefficient (Pearson’s r) was p set at .05. Results: Of the 229 participants self-identifying as experiencing hearing loss, 46 identified as having HPCR. Moreover, over 95% of HCPR participants endorsed speaking English well. In their latest HI search, participants reported they first accessed HI from the internet (28.3%) yet also indicated their most trusted HI source were doctors (97.8%). Pearson’s r indicated no significant relationship between PCR status of participants and degree of trust in HI sources (p &lt; .05). Conclusions: Health professionals should deliver clear and relevant health messages and materials that are understood by individuals who experience hearing loss, including those with HPCR. For individuals who experience hearing loss, health education and communication specialists need to consider alternate communication methods such as writing, speech recognition apps, or captions to support health communication. Keywords: health information seeking-behaviors, hearing loss, perceived cancer risk

BackgroundMis- and disinformation on social media have become widespread, which can lead to a lack of trust in health information sources and, in turn, lead to negative health outcomes. Moreover, the effect of mis- and disinformation on trust in information sources may vary by racial and ethnic minoritized populations.ObjectiveWe evaluated how trust in multiple sources of cancer information varied by perceptions of health mis- and disinformation on social media and by race and ethnicity.MethodsCross-sectional, nationally representative survey data from noninstitutionalized adults in the United States from the 2022 Health Information National Trends Survey 6 (HINTS 6) were analyzed (N=4137). The dependent variable measured the level of trust in cancer information sources. The independent variables were perceptions about health mis- and disinformation on social media and race and ethnicity. Multivariable logistic regression models were adjusted for survey weight and design, age, birth gender, race and ethnicity, marital status, urban/rural designation, education, employment status, feelings about household income, frequency of social media visits, and personal and family history of cancer. We also tested the interaction effect between perceptions of social media health mis- and disinformation and participants’ self-reported race and ethnicity.ResultsPerception of “a lot of” health mis- and disinformation on social media, relative to perception of “less than a lot,” was associated with a lower likelihood of high levels of trusting cancer information from government health agencies (odds ratio [OR] 0.60, 95% CI 0.47-0.77), family or friends (OR 0.56, 95% CI 0.44-0.71), charitable organizations (OR 0.78, 95% CI 0.63-0.96), and religious organizations and leaders (OR 0.64, 95% CI 0.52-0.79). Among White participants, those who perceived a lot of health mis- and disinformation on social media were less likely to have high trust in cancer information from government health agencies (margin=61%, 95% CI 57%-66%) and family or friends (margin=49%, 95% CI 43%-55%) compared to those who perceived less than a lot of health mis- and disinformation on social media. Among Black participants, those who perceived a lot of health mis- and disinformation on social media were less likely to have high trust in cancer information from religious organizations and leaders (margin=20%, 95% CI 10%-30%) compared to participants who perceived no or a little health mis- and disinformation on social media.ConclusionsCertain sources of cancer information may need enhanced support against the threat of mis- and disinformation, such as government health agencies, charitable organizations, religious organizations and leaders, and family or friends. Moreover, interventions should partner with racial and ethnically minoritized populations that are more likely to have low trust in certain cancer information sources associated with mis- and disinformation on social media.

Objectives The rise of social networking services (SNS) has significantly impacted how patients with systemic lupus erythematosus (SLE) acquire health information, potentially influencing their discussions with healthcare providers. This study aimed to identify the preferences, actual access, and trust levels in various health information sources among SLE patients, along with associated factors. Methods A cross-sectional study was conducted from June 2020 to August 2021 across five university medical centres in Japan, involving 510 SLE patients aged 20 years and older. The study measured access to and preferences for health information sources, including SNS, and assessed trust in these sources. Factors influencing, such as internet usage and health literacy (HL) (functional, communicative, and critical), were analyzed using Poisson regression with robust error variance. Results Among the respondents, 98.2% expressed trust in doctors, whereas lower trust was observed in websites/blogs (52.0%) and SNS (26.9%). Despite this, the internet was the most frequent initial source of health information (45.3%), encompassing medical institutions' homepages, patient blogs, Twitter, and Instagram. Longer internet use was linked to increased trust in homepages/blogs and SNS. Higher functional HL correlated with greater trust in doctors and lower trust in websites/blogs and SNS, while higher communicative HL was associated with increased trust in doctors, homepages, and blogs. Conclusion Many SLE patients seek online health information, including SNS, before consulting rheumatologists. Internet usage duration and multidimensional HL influence trust in online health information sources. Rheumatologists and healthcare providers should account for these factors when disseminating health information and engaging with patients.

Many Korean Americans (KAs) suffer high cancer incidence levels and have low cancer screening rates. A significant number of KAs lack adequate information about cancer screening tests. However, little is known about the health information seeking behaviors of KAs. This study examines the types of cancer information searched for, the cancer information seeking experiences, and the awareness of major cancer information sources, such as the National Cancer Institutes (NCI) and the NCI's Cancer Information Service, among KAs. It also examines associations with demographic characteristics and media use influencing variations in the awareness of cancer information sources. Data for this study were gathered with a cross-sectional, community-based survey (254 KAs). The survey results indicated that KA's involvement in cancer information seeking is relatively low, and they have somewhat negative experiences in seeking cancer information. In addition, their awareness of cancer information sources was limited. Despite of the heavy use of Korean ethnic media, it did not connect to cancer information source awareness. Rather, use of US mainstream media was significantly related with awareness. Campaigns using the Korean language through partnerships with Korean ethnic media to inform KAs about credible sources of health information appear to be warranted by our findings.

Background: By knowing the various sources of health information accessed by the people, it helps different organizations in better targeted delivery for health information. Methodology: A cross sectional study was conducted among college going students from non-medical streams and adult in-patients seeking health care in the study hospitals using a semi- structured self-validated questionnaire. Results: The demographic details of the student study population consisted of 64.1% females and 35.9% males and that of adult population consisted of 20% females and 80% males. 36% of the adult population had finished high school education while on the other hand students were either graduates (72.8%) or postgraduates (27.2%). Among 41.2% students sought health information to know about the new health issues whereas 66.7% adult population sought health information for their general well-being. Internet is the major source of health information amongst the student population (55.6%) while 58.8% adult population sought health information from television. 9.8% adult population used journals to seek health information. 22.6% of students sought health information when they were ill on the other hand it was 5.9% among the adult population. In the Internet, 55% students accessed health information through social network and various search engines and 83.3% adult population accessed search engines. Family physician was the most trusted source of health information among both students(54%) and adult population(76.5%). Conclusion: Among the participants, most of the active seekers were students whose main source of health information was from the internet. Majority of the participants said family Physicians are the most trusted source of health- related information.

BackgroundPeople use a variety of means to find health information, including searching the Internet, seeking print sources, and talking to healthcare providers, family members, and friends. Doctors are considered the most trusted source of health information, but people may be underutilizing them in favor of searching the Internet.MethodsA multinomial logistic regression of cross-sectional data from Cycle 4 of the Health Information National Trends Survey (HINTS) was conducted. Independent variables included gender, age, rurality, cancer history, general health, income, race, education level, insurance status, veteran status, Internet use, and data year; the dependent variable was the first chosen source of health information.ResultsThe most frequent initial source of health information was the Internet, and the second most frequent was healthcare providers. There were significant differences in odds of using healthcare providers as the first source of health information. Those likely to use doctors as their initial source of health information were older adults, black adults, adults with health insurance, those who do not use the Internet, and adults who do not have a college degree.ConclusionsPeople who use healthcare providers as the first source of health information may have better access to health care and be those less likely to use the Internet. Doctors may have to provide more information to those who do not use the internet and spend time verifying information for those who do use health information from the internet.

BackgroundThe recent surge in online health information and consumer use of such information has led to expert speculations and prescriptions about the credibility of health information on the World Wide Web. In spite of the growing concern over online health information sources, existing research reveals a lacuna in the realm of consumer evaluations of trustworthiness of different health information sources on the Internet.ObjectiveThis study examines consumer evaluation of sources of health information on the World Wide Web, comparing the demographic, attitudinal, and cognitive differences between individuals that most trust a particular source of information and individuals that do not trust the specific source of health information. Comparisons are made across a variety of sources.MethodsThe Porter Novelli HealthStyles database, collected annually since 1995, is based on the results of nationally-representative postal-mail surveys. In 1999, 2636 respondents provided usable data for the HealthStyles database. Independent sample t tests were conducted to compare the respondents in the realm of demographic, attitudinal, and cognitive variables.ResultsThe most trusted sources of online health information included the personal doctor, medical university, and federal government. The results demonstrated significant differences in demographic and health-oriented variables when respondents who trusted a particular online source were compared with respondents that did not trust the source, suggesting the need for a segmented approach to research and application. Individuals trusting the local doctor were younger ( t 2634= 4.02, P< .001) and held stronger health beliefs (F 1= 5.65, P= .018); individuals trusting the local hospital were less educated ( t 2634= 3.83, P< .001), low health information oriented (F 1= 6.41, P= .011), and held weaker health beliefs (F 1= 5.56, P= .018). Respondents with greater trust in health insurance companies as online health information sources were less educated ( t 2634= 1.90, P= .05) and less health information oriented (F 1= 4.30, P= .04). Trust in medical universities was positively associated with education ( t 2634= 11.83, P< .001), income ( t 2634= 10.19, P< .001), and health information orientation (F 1= 10.32, P<.001). Similar results were observed in the realm of federal information credibility, with individuals with greater trust in federal sources being more educated ( t 2634= 7.45, P< .001) and health information oriented (F 1= 4.45, P= .04) than their counterparts.ConclusionsThe results suggest systematic differences in the consumer segment based on the different sources of health information trusted by the consumer. While certain sources such as the local hospital and the health insurance company might serve as credible sources of health information for the lower socioeconomic and less health-oriented consumer segment, sources such as medical universities and federal Web sites might serve as trustworthy sources for the higher socioeconomic and more health-oriented groups.