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The Effects of the COVID-19 Pandemic on Age-Based Disparities in Digital Health Technology Use: Secondary Analysis of the 2017-2022 Health Information National Trends Survey.

The COVID-19 pandemic accelerated the adoption of digital health technology, but it could also impact age-based disparities as existing studies have pointed out. Compared with the pre-pandemic period, whether the rapid digitalization of the health care system during the pandemic widened the age-based disparities over a long period remains unclear. This study aimed to analyze the long-term effects of the COVID-19 pandemic on the multifaceted landscape of digital health technology used across diverse age groups among US citizens. We conducted the retrospective observational study using the 2017-2022 Health Information National Trends Survey to identify the influence of the COVID-19 pandemic on a wide range of digital health technology use outcomes across various age groups. The sample included 15,505 respondents, which were categorized into 3 age groups: adults (18-44 years), middle-aged adults (45-64 years), and older adults (more than 65 years). We also designated the time point of March 11, 2020, to divide the pre- and post-pandemic periods. Based on these categorizations, multivariate linear probability models were used to assess pre-post changes in digital health technology use, controlling for demographic, socioeconomic, and health-related variables among different age groups. Essentially, older adults were found to be significantly less likely to use digital health technology compared with adults, with a 26.28% lower likelihood of using the internet for health information (P<.001) and a 32.63% lower likelihood of using health apps (P<.001). The usage of digital health technology for all age groups had significantly increased after the onset of the pandemic, and the age-based disparities became smaller in terms of using the internet to look for health information. However, the disparities have widened for older adults in using the internet to look up test results (11.21%, P<.001) and make appointments (10.03%, P=.006) and using wearable devices to track health (8.31%, P=.01). Our study reveals a significant increase in the use of digital health technology among all age groups during the pandemic. However, while the disparities in accessing online information have narrowed, age-based disparities, particularly for older adults, have widened in most areas such as looking up test results and making appointments with doctors. Therefore, older adults are more likely left behind by the rapidly digitalized US health care system during the pandemic. Policy makers and health care providers should focus on addressing these disparities to ensure equitable access to digital health resources for US baby boomers.

Predicting and Empowering Health for Generation Z by Comparing Health Information Seeking and Digital Health Literacy: Cross-Sectional Questionnaire Study.

Generation Z (born 1995-2010) members are digital residents who use technology and the internet more frequently than any previous generation to learn about their health. They are increasingly moving away from conventional methods of seeking health information as technology advances quickly and becomes more widely available, resulting in a more digitalized health care system. Similar to all groups, Generation Z has specific health care requirements and preferences, and their use of technology influences how they look for health information. However, they have often been overlooked in scholarly research. First, we aimed to identify the information-seeking preferences of older individuals and Generation Z (those between the ages of 18 and 26 years); second, we aimed to predict the effects of digital health literacy and health empowerment in both groups. We also aimed to identify factors that impact how both groups engage in digital health and remain in control of their own health. The Health Information National Trends Survey was adopted for further use in 2022. We analyzed 1862 valid data points by conducting a survey among Chinese respondents to address the research gap. A descriptive analysis, 2-tailed t test, and multiple linear regression were applied to the results. When compared with previous generations, Generation Z respondents (995/1862, 53.44%) were more likely to use the internet to find out about health-related topics, whereas earlier generations relied more on traditional media and interpersonal contact. Web-based information-seeking behavior is predicted by digital health literacy (Generation Z: β=.192, P<.001; older population: β=.337, P<.001). While this was happening, only seeking health information from physicians positively predicted health empowerment (Generation Z: β=.070, P=.002; older population: β=.089, P<.001). Despite more frequent use of the internet to learn about their health, Generation Z showed lower levels of health empowerment and less desire to look for health information, overall. This study examined and compared the health information-seeking behaviors of Generation Z and older individuals to improve their digital health literacy and health empowerment. The 2 groups demonstrated distinct preferences regarding their choice of information sources. Health empowerment and digital health literacy were both significantly related to information-seeking behaviors.

Investigating the Use of ChatGpt as a Novel Method for Seeking Health Information: A Qualitative Approach

ABSTRACT ChatGPT is becoming more and more popular in the healthcare sector as a way to deliver quick and easy access to health information. However, little is known about how participants view ChatGPT when seeking health information. To find participants’ perspectives on using ChatGPT for health information and to pinpoint areas where ChatGPT’s functionality and design should be improved. Sixteen individuals who had used ChatGPT to look for health information underwent semi-structured interviews. Themes were found via thematic data analysis. ChatGPT was easy for participants to use and handy for getting health information. They did, however, voice reservations over the dependability and credibility of ChatGPT for more complicated medical situations. Additionally highlighted as essential requirements while seeking health information were emotional support and empathy. For healthcare professionals and Chatbot developers, the study’s findings have both theoretical and real-world applications. The study highlights the necessity to create ChatGPT with accessibility, ease, trustworthiness, personalization, and usability in mind and underscores the significance of a person-centered approach to healthcare. ChatGPT has the potential to improve health information behavior. However, there is a constant demand for design and functionality advancements.

Perception of Internet Use in Relation to Health Decision-Making among Nursing Students.

Internet use has increased worldwide during the COVID-19 pandemic, to the point where it has inadvertently integrated into our lives. University students use the Internet daily for different purposes: seeking information, entertaining, as a teaching and learning tool, they consider social networks as a means of connection and social interaction, and to seek information to make health decisions. Because of this, the Internet and social networks have gained popularity among this group, to the point of developing an abusive use that is not perceived as an addictive risk. A descriptive analysis was performed through the adaptation of a survey about Internet use, social networks and health perception; this survey was given to nursing students of the Gimbernat School during the academic year 2021-2022. Students completed the ad hoc questionnaire (N = 486; 83.5% female, 16.3% male; only 1 declared to be non-binary gender). Our hypothesis had to do with whether the population of nursing students at Gimbernat School had increased, after the pandemic, its use of the Internet and social networks to make decisions about health problems. The objective of the study was to analyse differences in students' habits of use of the Internet and social networks as they look for health information, their decision-making when they find the information and their perception of health as nursing students from a gender perspective. The results showed a clear positive relationship between the variables studied. Of nursing students, 60.4% spend between 20 and more than 40 h a week using the Internet, and 43.6% of these hours are spent on social networks. Of students, 31.1% make health decisions by searching for information on the Internet and consider it useful and relevant. The use of the Internet and social media in relation to health decisions is clearly affected. To try to reduce the incidence of the problem, interventions are needed regarding the prevention and/or consequences of Internet abuse and health education of student nurses as future health assets.

Correlates of knowledge of clinical trials among U.S. adults: Findings from the 2020 Health Information National Trends Survey

BackgroundKnowledge about clinical trials affects efficient and equitable clinical trial recruitment and retention. This study explored correlates of clinical trial knowledge in a nationally representative sample of US adults. MethodsCross-sectional data from the 2020 Health Information National Trends Survey (HINTS 5, Cycle 4) were evaluated. There were 3,865 responses in the full dataset; 2,648 remained after eliminating respondents without complete data for all covariates of interest. Participants were asked, “How would you describe your level of knowledge about clinical trials?” The response options “know a little bit” and “know a lot” were combined and compared to the response option “don’t know anything.” Covariates of interest included patient-provider communication, history of medical conditions, eHealth use, knowledge of clinicaltrials.gov, prior invitation to join a clinical trial, and socio-demographic factors. ResultsParticipants with a history of cancer were 1.6 times more likely [CI 1.2, 2.2] to have knowledge of clinical trials. Participants who used electronic means to look for health information were 1.7 times more likely [CI 1.2, 2.4] to have knowledge of clinical trials. Participants who had heard of the website clinicaltrials.gov had 5.1 times greater odds of knowing about clinical trials [CI 2.6, 10.3] and 4.5 greater odds if they had been invited to participate in a clinical trial [CI 2.0, 9.8]. College graduates had higher odds than others. ConclusionSeveral factors affect clinical trial knowledge in US adults. Findings from this study may inform interventions to raise awareness about clinical trials and thereby, potentially improve enrollment.

Preferences for Accessing Patient Reported Outcomes and Health Information Among Thrombotic Thrombocytopenic Purpura Survivors

Introduction: Our previous qualitative studies of immune-mediated thrombotic thrombocytopenic purpura (iTTP) survivors revealed that patients did not communicate to their hematologists about residual cognitive and fatigue issues. A way to overcome this communication barrier is implementation of patient-reported outcomes (PROs) in routine care. Integration of PROs into the clinical care of other diseases has resulted in improved patient-provider communication, symptom management, quality of life and overall patient satisfaction. However, decisions about the mode of administration are challenging. Although 92% of the United States population has access to the internet, studies have shown minorities prefer alternative modes of administration. Given that iTTP disproportionately affects Black women, understanding patient preference is critical for integrating PRO instruments into routine care. The primary study goal was to determine the preferred mode of administration of PRO instruments in iTTP. Furthermore, many individuals use the internet as a source of medical information/advice. A study of iTTP literacy reported that only 34% of survivors correctly identified disease relapse risk factors suggesting a critical knowledge gap. A secondary goal was to describe iTTP survivors' behaviors regarding using the internet for medical information or support.Methods: We utilized a cross-sectional study design. iTTP survivors were recruited from August 2019 until present. Eligibility included: 1) age >18 years, 2) documented ADAMTS13 deficiency (< 10% activity) at diagnosis or during a relapse and 3) > 1-year clinical remission. Multi-center recruitment of survivors included: Oklahoma University, Ohio State University, University of Minnesota, Johns Hopkins University, University of Rochester, University of Pennsylvania, University of Alabama at Birmingham, University of Utah and the University of Vermont. Following informed consent, survivors were administered the PROMIS ® cognitive function ability, anxiety and fatigue instruments via their preferred mode (online, telephone, or self-administered). Typical internet usage, behaviors regarding searching for health information online and demographics were also obtained.Results: To date, 94 survivors have completed the study (83% female; 54% White; 34% Black; median age 49 years [range 26-85 years]). A majority (54%) preferred completing PROMIS ® surveys online vs. self-administered or telephone administered. However, among Black survivors, only 38% preferred online administration and among survivors aged ≥65 years only 22% preferred online administration. Interestingly, there was an overall shift in a preference toward online administration following the onset of the COVID-19 pandemic (45% (21/47) preferred online pre vs 66% (31/47) preferred online post).Ninety-one percent (86/94) of survivors reported at least occasional internet use vs 8 (9%) reported none. Similarly, 82% (70/85) had searched the internet for health/medical information for themselves in the past year. Also 62% (53/86) of the survivors selected ‘strongly agree’ or ‘agree’ to the statement that the internet helps them determine if symptoms are important enough to see a doctor. Likewise, 62% used the internet to interpret doctor's recommendations. Additionally, 47% (40/86) ‘strongly agree/agree’ the internet helped determine if they would take a medication/seek alternative treatment.Moreover, 64% (55/86) agreed the internet was a good way to find others experiencing similar health problems. However, when asked about behaviors over the past year, only 42% (36/85) used online social networking sites like Facebook to look for health information or find others with iTTP and only 36% (31/85) had actually participated in online iTTP support groups.Conclusions: Overall iTTP survivors preferred online PRO administration; however, Black and older survivors preferred other methods. Recognizing these preferences is a vital step toward integrating PROs into routine care. Furthermore, iTTP survivors are using the internet as a source of medical support and information. Therefore, it is critical to not only educate iTTP survivors about credible online resources but also to create additional content. Also, future studies are needed to further explore the impact of the COVID-19 pandemic on online health behaviors. DisclosuresTerrell: Sanofi: Consultancy; Takeda: Consultancy. Journeycake: HEMA Biologics: Honoraria; LFB: Honoraria. Mazepa: Answering TTP Foundation: Research Funding; Sanofi Aventis: Other. Cuker: Spark Therapeutics: Research Funding; Sanofi: Research Funding; Pfizer: Research Funding; Takeda: Research Funding; Novo Nordisk: Research Funding; Novartis: Research Funding; Bayer: Research Funding; Alexion: Research Funding; UpToDate: Patents & Royalties; Synergy: Consultancy. Chaturvedi: Dova: Other: Advisory board member; UCB: Other: Advisory board participation; Argenx: Other: Advisory board member; Alexion: Other: Advisory board member; Sanofi Genzyme: Other: Advisory board member. Lim: Hema Biologics: Honoraria; Sanofi Genzyme: Honoraria; Dova Pharmaceuticals: Honoraria. Gangaraju: Alexion: Consultancy; Sanofi Genzyme: Consultancy. Cataland: Alexion: Consultancy, Research Funding; Sanofi Genzyme: Consultancy; Ablynx/Sanofi: Consultancy, Research Funding; Takeda: Consultancy.

Access to Broadband Internet and its Utilization for Health Information Seeking and Health Communication among Informal Caregivers in the United States.

Informal caregivers provide unpaid care to their physically or mentally ill loved ones and play a critical role in the healthcare delivery. eHealth tools, including the broadband internet, can facilitate care processes and impact the caregiving burden through seeking health information and health communication. This study examines the predictors of access to broadband internet and the factors associated with health information seeking and health communication among informal caregivers with broadband internet. We used data from cycles 1 and 2 of the Health Information National Trends Survey (HINTS 5) and employed generalized linear regression models with the maximum likelihood estimation. Specifically, we performed a two-part model: (1) a logistic regression model of broadband internet access among all caregivers (n = 929) and (2) a logistic regression model of health information seeking and health communication among caregivers with broadband internet access (n = 404). We found that caregivers who were younger (18-34years versus 45+ years), female (versus male), and those who were divorced/widowed/separated (versus singles) were less likely to have broadband internet access. While those who were married/living as married (versus singles), with higher incomes (≥$100,000 versus <$35,000), and those living in metropolitan areas were more likely to have broadband internet access. Among caregivers with broadband internet access, younger, female, non-Hispanic white caregivers, and those with higher levels of education and income, as well as those who cared for cancer patients, were more likely to seek health information for someone else. Additionally, caregivers aged 35-39years and those with more education were more likely to look for health information for themselves than their counterparts. Furthermore, caregivers who were aged 40-44years, females, divorced/widowed/separated, those with higher incomes, and those who cared for patients with Alzheimer's, confusion, and dementia were more likely to communicate electronically with a provider. The results suggest disparities in broadband internet access and indicate variations in factors associated with health information seeking and health communication. The findings underscore the need to address barriers attributed to the digital divide among informal caregiving groups.

EHealth Practices in Cancer Survivors With BMI in Overweight or Obese Categories: Latent Class Analysis Study.

BackgroundeHealth technologies have been found to facilitate health-promoting practices among cancer survivors with BMI in overweight or obese categories; however, little is known about their engagement with eHealth to promote weight management and facilitate patient-clinician communication.ObjectiveThe objective of this study was to determine whether eHealth use was associated with sociodemographic characteristics, as well as medical history and experiences (ie, patient-related factors) among cancer survivors with BMI in overweight or obese categories.MethodsData were analyzed from a nationally representative cross-sectional survey (National Cancer Institute’s Health Information National Trends Survey). Latent class analysis was used to derive distinct classes among cancer survivors based on sociodemographic characteristics, medical attributes, and medical experiences. Logistic regression was used to examine whether class membership was associated with different eHealth practices.ResultsThree distinct classes of cancer survivors with BMI in overweight or obese categories emerged: younger with no comorbidities, younger with comorbidities, and older with comorbidities. Compared to the other classes, the younger with comorbidities class had the highest probability of identifying as female (73%) and Hispanic (46%) and feeling that clinicians did not address their concerns (75%). The older with comorbidities class was 6.5 times more likely than the younger with comorbidities class to share eHealth data with a clinician (odds ratio [OR] 6.53, 95% CI 1.08-39.43). In contrast, the younger with no comorbidities class had a higher likelihood of using a computer to look for health information (OR 1.93, 95% CI 1.10-3.38), using an electronic device to track progress toward a health-related goal (OR 2.02, 95% CI 1.08-3.79), and using the internet to watch health-related YouTube videos (OR 2.70, 95% CI 1.52-4.81) than the older with comorbidities class.ConclusionsClass membership was associated with different patterns of eHealth engagement, indicating the importance of tailored digital strategies for delivering effective care. Future eHealth weight loss interventions should investigate strategies to engage younger cancer survivors with comorbidities and address racial and ethnic disparities in eHealth use.

Social and Demographic Patterns of Health-Related Internet Use Among Adults in the United States: A Secondary Data Analysis of the Health Information National Trends Survey

National surveys of U.S. adults have observed significant increases in health-related internet use (HRIU), but there are documented disparities. The study aims to identify social and demographic patterns of health-related internet use among U.S. adults. Using data from the Health Information National Trends Survey (HINTS) 4 cycle 3 and HINTS 5 cycle 1, we examined HRIU across healthcare, health information seeking, and participation on social media. Primary predictors were gender, race/ethnicity, age, education, income, and nativity with adjustments for smoking and survey year. We used multivariable logistic regression with survey weights to identify independent predictors of HRIU. Of the 4817 respondents, 43% had used the internet to find a doctor; 80% had looked online for health information. Only 20% had used social media for a health issue; 7% participated in an online health support group. In multivariable models, older and low SES participants were significantly less likely to use the internet to look for a provider, use the internet to look for health information for themselves or someone else, and less likely to use social media for health issues. Use of the internet for health-related purposes is vast but varies significantly by demographics and intended use.

Digital Health and Inequalities in Access to Health Services in Bangladesh: Mixed Methods Study.

BackgroundGlobally, the rapid growth of technology and its use as a development solution has generated much interest in digital health. In line with global trends, Bangladesh is also integrating technology into its health system to address disparities. Strong political endorsement and uptake of digital platforms by the government has influenced the rapid proliferation of such initiatives in the country. This paper aims to examine the implications of digital health on access to health care in Bangladesh, considering who uses electronic devices to access health information and services and why.ObjectiveThis study aims to understand how access to health care and related information through electronic means (digital health) is affected by sociodemographic determinants (ie, age, gender, education, socioeconomic status, and personal and household ownership of mobile phones) in a semiurban community in Bangladesh.MethodsA cross-sectional survey of 854 households (between October 2013 and February 2014) and 20 focus group discussions (between February 2017 and March 2017) were conducted to understand (1) who owns electronic devices; (2) who, among the owners, uses these to access health information and services and why; (3) the awareness of electronic sources of health information; and (4) the role of intermediaries (family members or peers who helped to look for health information using electronic devices).ResultsA total of 90.3% (771/854) of households (471/854, 55.2% of respondents) owned electronic devices, mostly mobile phones. Among these, 7.2% (34/471) used them to access health information or services. Middle-aged (35-54 years), female, less (or not) educated, and poorer people used these devices the least (α=.05, α is the level of significance). The lack of awareness, discomfort, differences with regular care-seeking habits, lack of understanding and skills, and proximity to a health facility were the main reasons for not using devices to access digital health.ConclusionsAlthough influenced by sociodemographic traits, access to digital health is not merely related to device ownership and technical skill. Rather, it is a combination of general health literacy, phone ownership, material resources, and technical skill as well as social recognition of health needs and inequity. This study’s findings should serve as a basis for better integrating technology within the health system and ensuring equitable access to health care.

Web-Based Medical Information Searching by Chinese Patients With Breast Cancer and its Influence on Survival: Observational Study.

BackgroundThe internet allows patients to easily look for health information. However, how Chinese patients with breast cancer use the internet has rarely been investigated, and there is a scarcity of information about the influence of internet use on survival.ObjectiveThis observational study aimed to investigate the details of online medical information searching by Chinese patients with breast cancer and to determine whether internet use has any survival benefits.MethodsPatients who were diagnosed with invasive breast cancer at Peking Union Medical College Hospital between January 2014 and December 2015 were enrolled. We obtained information on their internet-searching behavior and gathered data from the patients’ medical and follow-up records. The associations between internet use and other clinic-pathological factors were analyzed. A Cox proportional-hazards model and the Kaplan-Meier method were used for disease-free survival (DFS) analyses.ResultsA total of 973 patients with invasive breast cancer who underwent definitive surgery took part in the study. Among them, 477 cases (49.0%) performed web-based breast cancer information searching before the initial treatment. A multivariate logistic regression analysis suggested that web-based breast cancer information searching was significantly associated with younger age (odds ratio [OR] 0.95, 95% CI 0.94-0.97, P<.001), higher education level (OR 1.37, 95% CI 1.01–1.86, P=.04), and breast conserving surgery (OR 1.35, 95% CI 1.04-1.77, P=.03). Baidu (73.4%, 350/477) and WeChat (66.7%, 318/477) were the two most popular online information sources for breast cancer; however, only 44.9% (214/477) felt satisfied with the online information. In contrast to the nonweb searching group, the web-using patients who were satisfied with online information showed significantly improved DFS (hazard ratio 0.26; 95% CI 0.08-0.88, P=.03).ConclusionsThe patients who were most likely to search the internet for breast cancer information were younger and well-educated, and they were more likely to have breast conserving therapy. Web-using patients who were satisfied with the internet information showed significantly improved DFS. Patients should browse credible websites offering accurate and updated information, and website developers should provide high-quality and easy-to-understand information to better meet the needs of patients with breast cancer.

A spectrum of approaches to health information interaction: From avoidance to verification

AbstractPeople respond to illness in a range of ways, and take different approaches to engaging with health information throughout the course of their illness. This study describes and explains the variety of approaches to health information interactions made by patients on hemodialysis. Ethnographic observations (156 hours) were conducted in three hemodialysis clinics, and semistructured interviews about health information were held with 28 patients. Demographic data were collected. Data were analyzed qualitatively. We found a spectrum of five approaches to health information: avoiders, who close themselves off from health information; receivers, who encounter information in the dialysis clinic but do not seek it out; askers, who only pose questions about health to their healthcare providers but otherwise do not seek; seekers, who actively look for health information both in and out of the clinic; and verifiers, who seek information and triangulate it among multiple sources. Trust in healthcare providers and coping sociality differed across approaches. The findings indicate that health information should be provided to patients using strategies tailored to their preferences and existing approaches to information interaction.

Preferences for Health Information and Decision-Making Autonomy among Chinese Patients with T2DM in the mHealth Era

This cross-sectional survey study explored (1) individual preferences for health information and decision-making autonomy among Chinese patients with type 2 diabetes (T2DM); (2) their use of mHealth in diabetes self-management; and (3) the relationship between their mHealth use and preferences for health information and decision-making autonomy. Sample size: 200 Mandarin-speaking Chinese patients with T2DM; age range: 26-90 years (Mean: 59.91; SD: 12.17); Mean time since diabetes diagnosis: 7.4 years. Data were collected in February 2017 via a paper-and-pen questionnaire at a general hospital in China. The questionnaire was in Chinese, and measured preferences for health information and decision-making autonomy and mHealth use. Key findings: Participants wanted to have a wide range of health information and participation in decision-making. Gender, health status, and knowledge about diabetes were associated with differences in information wanted and participation in decision-making, but age was not. Half (50.5%) of the participants used smartphones to access the Internet and look for health information; 71% used smartphones to receive/read health-related posts; and 24% had at least one health-related application installed on their smartphones. Smartphone use frequency for health information and participation in decision-making had a significant interaction effect (p &amp;lt; .01), the strength of which varied across seven subscales (specific health condition, treatment, laboratory tests, self-management, complementary/alternative medicine, psychosocial aspects, and healthcare providers). The overall health information wanted was positively related to use of smartphones to receive health-related posts (p &amp;lt;.01). This study has implications for research and clinical practice, especially given the shift from disease-centered to patient-centered care and increasing use of mobile technology in health care. Disclosure L. Nie: None. B. Xie: None. Y. Yang: None. S.A. Brown: None.

Dr Google as the source of health information – the results of pilot qualitative study

Abstract Introduction Google is the most popular search engine that covers nearly 90% of the total online searches. It is likely to be used by both, patients and physicians to look for health information. Aim The objective of the study was to find out deep motives for using the Internet to obtain health information. Material and methods Anonymous study was carried out with the use of individual in-depth interviews (IDI). As many as 20 persons participated in the study (10 women and 10 men). The IDI scenario included the questions on health, the Internet as the source of health information and the credibility of information published online. Results and discussion The majority of respondents (15 persons) admit that they sometimes search the Internet for health information because of curiosity, concern, and motivation to increase knowledge as well as broad and quick access to the network. The respondents search for useful information when the information provided by a physician and medical terms are incomprehensible or when the therapy prescribed by a physician is ineffective. For the majority of respondents Internet portals dedicated to one topic only are the most credible. Conclusions Women search the Internet for health information more often than men and the scope of their search is broader. The Internet helps to shape basic knowledge, makes it possible to formulate questions asked to the physician and to understand the information provided by a physician.

Cigarette graphic health warning labels and information avoidance among individuals from low socioeconomic position in the U.S.

Although graphic health warning labels (GHWs) on cigarette packs have influenced cessation behaviors in other countries, no U.S. studies have explored the impact of avoidance of GHW content among individuals from low socioeconomic position (SEP). The purpose of this study was to determine the predictors of intention to avoid GHWs, and how avoidance impacts cessation intention, in a low SEP sample in the U.S. Data come from low SEP smokers (n = 541) involved in a field experiment. The participants responded to questions pre- and post viewing of GHWs assessing SEP, intention to avoid them, emotional reactions, and intention to seek health information or quit smoking. Backwards stepwise logistic regression determined the predictors for intention to avoid GHWs. Simple and adjusted logistic regression analyzed the association between avoidance and its main predictors and outcomes of intentions to seek information or quit smoking. Predictors for avoidance included being somewhat addicted to cigarettes (OR 2.3, p = 0.002), younger than 25 (OR 2.6, p = 0.008), and having medium (OR 3.4, p < 0.001) or high (OR 4.7, p < 0.001) levels of negative emotional reaction to the labels. Intention to avoid GHWs was positively associated with the intent to look for health information about smoking (OR 2.2, p = 0.002). Higher levels of negative emotional reaction were positively associated with cessation behaviors, with high negative emotional reaction associated with nine times the odds of quitting (p < 0.001). Results indicate avoidance of GHWs does not detract from the labels' benefit and that GHWs are an effective means of communicating smoking risk information among low SEP groups.

Abstract A13: African American breast cancer survivors in the digital age

Abstract The information needs of breast cancer survivors are varied and complex. How African American breast cancer survivors (AABCS) access cancer-related information and the extent to which they find the information helpful is not well understood. We conducted a statewide survey with 297 female AABCS and led 8 in-depth focus groups with 60 female AABCS to understand where AABCS look for health information and their preferred format of materials. We were also interested in the extent to which AABCS used social media services to look for information or to bolster their supportive networks. The average age of those who completed the survey was 57.5 years, and almost all (95%) received surgical treatment for their breast cancer; 77% received radiotherapy and 53% chemotherapy. Almost all (95%) reported at least one co-morbid health condition such as hypertension or diabetes; 22% reported five or more co-morbid conditions. The majority of AABCS (85%) reported using informational books or brochures, followed by in-person talks or lectures by experts (56%). AABCS also found these two formats to be the most helpful. Not surprisingly, most AABCS preferred to receive information in written form (59%) or in-person (60%). Although most of the AABCS in our sample (70%) had access to the Internet in their home and many (61%) were on Facebook, the majority (63%) reported that they are not members of social networking sites such as Twitter or Google Plus, and few (&amp;lt;10%) reported using these platforms for sharing their cancer-related experiences, connecting to other survivors, or accessing health-related information. The discussions of AABCSs in the focus groups echo these findings with stories of difficulty finding information tailored to their needs and frustration that too many resources are only available online. The results from this mixed-methods study suggest that while many organizations have moved their cancer information online, there are segments of the population, such as AABCS, who continue to rely on and prefer print materials and in-person formats to manage their health care needs. Organizations should aim to increase AABCS' familiarity and ease of accessing online health information, as many AABCS have access to the Internet yet do not perceive online materials or social networking services to be as helpful for addressing their needs. Citation Format: Amy Leader, Melissa DiCarlo, Patricia Bradley, Sarah Hagerty, Andrea Barsevick. African American breast cancer survivors in the digital age. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr A13.

Future of the Smartphone for Patients and Healthcare Providers.

Future of the Smartphone for Patients and Healthcare Providers.

Sociodemographic and health-(care-)related characteristics of online health information seekers: a cross-sectional German study.

BackgroundAlthough the increasing dissemination and use of health-related information on the Internet has the potential to empower citizens and patients, several studies have detected disparities in the use of online health information. This is due to several factors. So far, only a few studies have examined the impact of socio-economic status (SES) on health information seeking on the Internet. This study was designed to identify sociodemographic and health-(care-)related differences between users and non-users of health information gleaned from the Internet with the aim of detecting hard-to-reach target groups.MethodsThis study analyzed data from the NRW Health Survey LZG.NRW 2011 (n = 2,000; conducted in North Rhine–Westphalia, Germany, via telephone interviews). Logistic regression analysis was used to examine the determinants of online health information seeking behavior.Results68% of Internet users refer to the Internet for health-related purposes. Of the independent variables tested, SES proved to exert the strongest influence on searching the Internet for health information. The final multivariate regression model shows that people from the middle (OR: 2.2, 95% CI: 1.6–3.2) and upper (OR: 4.0, 95% CI: 2.7–6.2) social classes are more likely to seek health information on the Internet than those from the lower class. Also, women are more likely to look for health information on the Internet than men (OR: 1.5, 95% CI: 1.1–2.1). Individuals with a migration background are less likely to conduct health searches on the Internet (OR: 0.6, 95% CI: 0.4–0.8). Married people or individuals in a stable relationship search the Internet more often for health information than do singles (OR: 1.9, 95% CI: 1.2–2.9). Also, heavy use of health-care services compared to non-use is associated with a higher likelihood of using the Internet for health-related matters (OR: 1.7, 95% CI: 1.2–2.5).ConclusionsIn order to achieve equity in health, health-related Internet use by the socially deprived should be promoted through measures to increase their level of e-health literacy. Furthermore, longitudinal studies are needed in order to gain reliable data/results on determinants of health-related Internet use.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-1423-0) contains supplementary material, which is available to authorized users.

Social media and online health services: A health empowerment perspective to online health information

This study investigates how differences in the use of online health information and social media affect the use of online health services. We attempt to predict the extent to which the use of social media and online health information prompt individuals to use online health services. We draw upon a combination of sociology and communication studies and integrate relational maintenance assumptions regarding the quality of online social relationships to promote the importance of health empowerment factors–socio-demographic characteristics, internet attitudes and health status models to predict the likelihood of using online health services. The study’s sample consists of 1406 individuals using the Internet, including 633 individuals using the Internet and social media to look for health information. The study’s results provide evidence that (a) online health information empowers most of the examined individuals to use online health services; (b) among all social media only those that offer consulting have a significant effect on the likelihood of using online health services. The implications of these findings support that a conceptual integration of CMC and social media use theories along with health empowerment assumptions, is a promising theoretical framework to test the effectiveness of social media use in prompting use of online health services. The practical applications for health management are highlighted as well. Finding practical and affordable ways to support the use of social media and encourage access to online health information and use of online health services could improve health literacy and self-management of health at the individual level and increase the efficiency in the provision of health services at the institutional level.

SOURCES OF HEALTH INFORMATION IN BRAZIL: a perspective from students of the federal university of Rio de Janeiro

In Brazil, health communication and information is an important field, but it has yet to be determined where segments of the population look for health information. This research is a pilot study exploring the use and rating of sources of health information of students at the Federal University of Rio de Janeiro (UFRJ). A survey was administered to students of 18-33 years. The questionnaire was culturally adapted from the Health Information National Trends Survey (HINTS) of the National Cancer Institute-USA. Preference in primary source of health information varied slightly with age; older students depended more on physicians and medical professionals, while younger students used the Internet. While the Internet is the leading primary source of health information for university students, there are still doubts as to its reliability and accuracy. Students tend to use more than one source when finding out information on health, indicating a search process that can be useful for program planners when developing campaigns.