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The Influences of Immigration on Health Information Seeking Behaviors Among Korean Americans and Native Koreans

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.

Social Media Made Easy: Guiding Patients to Credible Online Health Information and Engagement Resources

W ithin the changing dynamic of health care, health care professionals (HCPs) are no longer the sole sources of health information. Recent estimates suggest that 83% of Internet users with chronic conditions such as diabetes go online to look for health information.1 People with diabetes seek online information about the condition, treatment options, practical strategies and tools for managing diabetes in their daily lives, scientific breakthroughs, and advocacy efforts.2 Yet, a Google search for “diabetes” returns 290 million results. A search for “diabetes online support” yields close to 36 million results. This can be overwhelming for anyone. Some HCPs assist with this information overload by filtering and narrowing down online resources and search results for their patients. SurroundHealth, an online learning community for nonphysician HCPs, recently surveyed its members about the use of educational technology in health care. Many respondents reported that they used time during patient interactions to refer patients to online resources. Eighty-two percent of HCPs in private practice reported having referred patients to specific online resources, compared to 60% of HCPs in outpatient clinics and 52% of HCPs in hospital settings. The HCPs who made referrals intended to help patients overcome common online obstacles such as difficulty distinguishing between high-quality information and material that is out of date, inaccurate, or overly promotional.3 Connecting patients to credible online health information during office visits can facilitate more appropriate use of health care resources, shorter clinical encounters, more patient-centered decision-making, and, in some cases, reduced barriers to treatment adherence.4,5 This article explains how online health information and engagement resources are integrated into patients' overall health care experiences. In addition, it addresses common HCP concerns about patients accessing online resources and will outline steps that busy professionals can take to help connect patients to appropriate …

Evidence of Psychosocial and Behavioral Effects Related to the Intention to Quit Alcohol in South Korea

This study examined psychosocial and behavioral characteristics and factors that influenced certain subjects within a population-based sample of Korean drinkers to quit alcohol consumption (N = 8910). Explored were various factors of psychosocial behaviors such as socioeconomic reasons, health behavior, cues to action, and self-control related to the intentions of alcohol abstinence. Using path analysis, it was found that, for men, self-control (B = 0.51), health behavior (B = 0.78), and health literacy (B = 0.58) were positively associated with cues to action which in turn positively induced them to quit drinking. This pattern of results appeared to apply only to men and not to women. In conclusion, this study reveals that men who do not smoke, regularly exercise, have high self-control, and look for health information are likely to be active in acquiring cues for behavioral changes and making themselves motivated. However, conventions of alcohol consumption in the female population are more dependent on social factors in comparison to those of men.

Correlates of Health-Related Social Media Use Among Adults

BackgroundSixty percent of Internet users report using the Internet to look for health information. Social media sites are emerging as a potential source for online health information. However, little is known about how people use social media for such purposes.ObjectivesThe purpose of this study was two-fold: (1) to establish the frequency of various types of online health-seeking behaviors, and (2) to identify correlates of 2 health-related online activities, social networking sites (SNS) for health-related activities and consulting online user-generated content for answers about health care providers, health facilities, or medical treatment.MethodsThe study consisted of a telephone survey of 1745 adults who reported going online to look for health-related information. Four subscales were created to measure use of online resources for (1) using SNS for health-related activities; (2) consulting online rankings and reviews of doctors, hospitals or medical facilities, and drugs or medical treatments; (3) posting a review online of doctors, hospitals or medical facilities, and drugs or medical treatments, and (4) posting a comment or question about health or medical issues on various social media. Univariate and multivariate logistic regression analyses were performed.ResultsRespondents consulted online rankings or reviews (41.15%), used SNS for health (31.58%), posted reviews (9.91%), and posted a comment, question, or information (15.19%). Respondents with a chronic disease were nearly twice as likely to consult online rankings (odds ratio [OR] 2.09, 95% CI 1.66-2.63, P<.001). Lower odds of consulting online reviews were associated with less formal education (OR 0.49, 95% CI 0.37-0.65, P<.001) and being male (OR 0.71, 95% CI 0.57-0.87, P<.001). Respondents with higher incomes were 1.5 times as likely to consult online rankings or reviews (OR 1.49, 95% CI 0.10-2.24, P=.05), than respondents with a regular provider (OR 2.05, 95% CI 1.52-2.78, P<.001), or living in an urban/suburban location (OR 1.61, 95% CI 1.17-2.22, P<.001). Older respondents were less likely to use SNS for health-related activities (OR 0.96, 95% CI 0.95-0.97, P<.001), as were males (OR 0.70, 95% CI 0.56-0.87, P<.001), whereas respondents with a regular provider had nearly twice the likelihood of using SNS for health-related activities (OR 1.89, 95% CI 1.43-2.52, P<.001).ConclusionsPeople are using social media for seeking health information. However, individuals are more likely to consume information than they are to contribute to the dialog. The inherent value of “social” in social media is not being captured with online health information seeking. People with a regular health care provider, chronic disease, and those in younger age groups are more likely to consult online rankings and reviews and use SNS for health-related activities.

Internet health information seeking is a team sport: Analysis of the Pew Internet Survey

BackgroundPrevious studies examining characteristics of Internet health information seekers do not distinguish between those who only seek for themselves, and surrogate seekers who look for health information for family or friends. Identifying the unique characteristics of surrogate seekers would help in developing Internet interventions that better support these information seekers. ObjectiveTo assess differences between self seekers versus those that act also as surrogate seekers. MethodsWe analyzed data from the cross-sectional Pew Internet and American Life Project November/December 2008 health survey. Our dependent variable was self-report of type of health information seeking (surrogate versus self seeking). Independent variables included demographics, health status, and caregiving. After bivariate comparisons, we then developed multivariable models using logistic regression to assess characteristics associated with surrogate seeking. ResultsOut of 1250 respondents who reported seeking health information online, 56% (N=705) reported being surrogate seekers. In multivariable models, compared with those who sought information for themselves only, surrogate seekers were more likely both married and a parent (OR=1.57, CI=1.08, 2.28), having good (OR=2.05, CI=1.34, 3.12) or excellent (OR=2.72, CI=1.70, 4.33) health status, being caregiver of an adult relative (OR=1.76, CI=1.34, 2.30), having someone close with a serious medical condition (OR=1.62, CI=1.21, 2.17) and having someone close to them facing a chronic illness (OR=1.55, CI=1.17, 2.04). ConclusionsOur findings provide evidence that information needs of surrogate seekers are not being met, specifically of caregivers. Additional research is needed to develop new functions that support surrogate seekers.

Searching the Internet for help with pain: Adolescent search, coping, and medication behaviour

To explore a community sample of adolescents for engagement with online pain resources. To assess if the use of the Internet to search for health information correlated with measures of coping, risk taking, catastrophizing about pain, and engaging in the self-management of pain. A cross-sectional online study of community-based adolescents (n = 105) recruited via schools to examine their use of the Internet to seek pain-related information. Adolescents completed questionnaires of pain coping, catastrophic thinking, risk-taking behaviour, and medication use. Descriptive analyses were undertaken on event rates of pertinent behaviours, principally on information seeking and pain management behaviour. Correlational analyses were undertaken between coping and information seeking, and medication use. Few participants engaged in online pain information seeking. Those who did were more likely to be female and scored higher on medication use, catastrophizing, risk taking, and the total score on the Pain Coping Questionnaire. Although adolescents are high users of the Internet, paradoxically they do not appear to use the Internet for information about pain and pain management. Further research should assess inhibitory and disinhibitory factors associated with information seeking about pain and chronic illness on the Internet. What is already known on this subject? Internet use in adolescents is common, mobile, and displays a level of technical awareness unparalleled by adults. The internet is postulated in previous research to present a platform for the delivery of health care, particularly information to aid health decision-making for young people. What does this study add? This study explores how adolescents use the internet to look for health information, particularly on pain and where this falls in a general profile of coping with illness. Interestingly and counterintuitively, adolescents did not use the internet to look for health or pain information. We hypothesize that there may be something about information on pain management that does not readily transfer to the digital world in a way that is useful to adolescent users.

Factors related to use of the Internet as a source of health information by urological cancer patients

The aims of this study were to describe the profile of urological cancer patients who look for health information on the Internet and to analyse the factors related to use of the Internet as a source of health information. A cross-sectional descriptive study using individual, semi-structured, questionnaire-based interviews was carried out in oncology clinics in a hospital in Granada (Spain) in a sample group of 169 patients with prostate, bladder and kidney cancer. The dependent variable was use of the Internet as a source of health information. The independent variables were sociodemographic variables, health status, relationship with healthcare services, patient's role in decision-making process, satisfaction with healthcare, Internet use, Internet skills and attitude. Data analyses include descriptive, bivariate and multivariate analyses. Of the patients in the sample group, 72.2 % had prostate cancer, 19.4 % had bladder cancer and 8.3 % had kidney cancer. Only 11.2 % of patients in the group used the Internet as a source of health information. These patients were typically men of an average age of 62 years, who live in urban areas, who have completed secondary or university education, with a high income and who usually share the role of decision maker with their doctor. Patients who use the Internet as a source of health information usually look for support from psychological support groups, have family members who also look for information on the Internet and prefer sources of information other than those provided by the health services. The study outlines the profile of urological cancer patients who use the Internet as a source of health information. Internet use is related to a patient's attitude towards decision making, level of education and whether or not they look for information from sources other than the health system itself.

Answers to the Health Questions People Ask in Libraries

When consumers look for health information or attempt to answer a specific health question, one of their primary destinations is often their local library. In Answers to the Health Questions People Ask in Libraries, a team of medical librarians in consultation with a physician have identified some of the most common health questions encountered by all types of librarians and then answered those questions in a readable, consumer-friendly format. While the health care consumer is certainly the primary audience for this book, the content will also inform librarians about the kinds of health questions they are most likely to encounter and resources to consult for further information on the topic. Answers to the Health Questions People Ask in Libraries is organized in six broad chapters, each of which begins with a brief overview of the content. The book is ideally used as a reference resource, with a detailed table of contents reflecting the sections covered in each chapter, followed by a list of the specific health questions answered in that section. The answer to each question includes a concise overview of the topic, highlights relevant facts and background information, and concludes with a short list of references. Many of the referenced works are free and accessible on the web. Key points are highlighted in gray boxes, as are pointers to resources for additional information. Each of the chapters concludes with an “Ask the Experts” section that lists the types of health care professionals and specialists trained to address more specific or in-depth questions similar to those discussed in the chapter. The book also contains some very useful appendixes, including a copy of the survey tool used by the authors to collect the questions included in the book. It also includes a summary of the types of libraries that responded to the survey, a glossary of experts with a brief description of the expert's role, and pointers to additional information. An annotated bibliography of print and electronic resources will also assist those seeking more information. Additional navigation of the content is facilitated by a comprehensive index. The primary audience for this work is the health care consumer, and the writing style, organization of content, and appendixes make it a very useful tool for that target group. In addition to libraries, it would be helpful to make the title available in a variety of venues where health care consumers are found, such as clinics, pharmacies, and public health agencies. Librarians will also find the work beneficial because it identifies many of the consumer health questions they are likely to encounter. They can also use the book as a guide when planning consumer health programming as well as a tool for resource discovery and collection development. This title is a nice complement to other recently published consumer health volumes that specifically target librarians such as Michele Spatz's Answering Consumer Health Questions: The Medical Library Association Guide for Reference Librarians and the Medical Library Association Guide to Health Literacy at the Library, edited by Marge Kars, Lynda M. Baker, and Feleta L. Wilson. Answers to the Health Questions People Ask in Libraries is a valuable addition to the consumer health collections of all types of libraries.

Designing e-Health Interventions for Low-Health-Literate Culturally Diverse Parents: Addressing the Obesity Epidemic

Child and adolescent obesity is a significant problem contributing to long-term trends in adult obesity. Educating parents about strategies for raising healthy children is complicated by the problem of low health literacy. E-health provides new opportunities to educate lowhealth-literate audiences, and this project was intended as formative research to guide design of interventions for low-health-literate parents. Focus groups were conducted with African American, Hispanic, and white parents (n = 43), 18 years of age or older, and at or below median income for the region. Each focus group included the following: a discussion of parents' general use of the Internet for health information, the demonstration of a Web site designed specifically for low-health-literate users, and asking participants about ideas under consideration for future interventions. Participants use search engines to look for health information and use heuristics, such as position in search results, to evaluate Web site quality. Some participants avoid information from .edu and .gov domains due to perceived complexity, and there was an almost-universal lack of trust in the government for health information. University researchers, by contrast, were trusted sources as information providers. Content and usability that meet the needs of extremely low-literate audiences may be perceived as slow and lacking depth by more literate and Internet-savvy users. E-health can be used to educate low-health-literate audiences, but interventions designed for these users must be layered in terms of content and usability to meet varying levels of functional and media literacy.

Clinical decision-making: physicians' preferences and experiences

BackgroundShared decision-making has been advocated; however there are relatively few studies on physician preferences for, and experiences of, different styles of clinical decision-making as most research has focused on patient preferences and experiences. The objectives of this study were to determine 1) physician preferences for different styles of clinical decision-making; 2) styles of clinical decision-making physicians perceive themselves as practicing; and 3) the congruence between preferred and perceived style. In addition we sought to determine physician perceptions of the availability of time in visits, and their role in encouraging patients to look for health information.MethodsCross-sectional survey of a nationally representative sample of U.S. physicians.Results1,050 (53% response rate) physicians responded to the survey. Of these, 780 (75%) preferred to share decision-making with their patients, 142 (14%) preferred paternalism, and 118 (11%) preferred consumerism. 87% of physicians perceived themselves as practicing their preferred style. Physicians who preferred their patients to play an active role in decision-making were more likely to report encouraging patients to look for information, and to report having enough time in visits.ConclusionPhysicians tend to perceive themselves as practicing their preferred role in clinical decision-making. The direction of the association cannot be inferred from these data; however, we suggest that interventions aimed at promoting shared decision-making need to target physicians as well as patients.

Finding Consumer Health Information in Other Languages

As our society becomes more diverse, patrons visit the library to look for health information in languages other than English. Locating this material is a challenge. The World Wide Web is a good source. This paper presents an introduction to Web resources for consumer health information in foreign languages and basic search strategies for locating it.