Post on 29-Jan-2016
description
Cancer-related information seeking: How does the American public rate its
experience?
Neeraj K. Arora, Ph.D.National Cancer Institute
Presented at the HINTS Data Users Conference, St. Pete Beach, FL.
January 20-21, 2005
2
Co-authors –
Bradford W. Hesse, Ph.D. National Cancer Institute
Barbara K. Rimer, Dr.P.H. University of North Carolina
Bryce B. Reeve, Ph.D. National Cancer Institute
Marla L. Clayman, Ph.D., M.P.H. Northwestern University
K. Viswanath, Ph.D. Harvard University & DFCI
3
Why Study Information Seeking? The shared/informed decision-making paradigm calls for
greater patient participation across the cancer care continuum.
Active information seeking results in greater patient participation.
The Internet revolution has drastically improved access to health information.
More informed patients report more positive health outcomes.
4
HINTS & Cancer Information Seeking
1. Who is seeking cancer information?
2. What information are they seeking?
3. Where are they seeking the information from?
4. What are their information seeking experiences like?
5. What are the consequences of their information seeking?
5
Who Seeks Cancer Information?
47.7% of the American public had at some point looked for information about cancer.
93.8% searched themselves; 6.2% relied on others.
– Of these 6.2%, majority (56.9%) relied on other family members.
75.5% had looked for cancer information within the past one year.
6
Who Seeks Cancer Information?
Personal history Family history No history
Cancer Experience
0
20
40
60
80
Wtd
% S
eeki
ng C
ance
r In
form
atio
n
30.98
70.87
54.01
p < 0.001
7
Who Seeks Cancer Information?
< High school High school Some college College graduate
Education
0
10
20
30
40
50
60
70
Wtd
% S
eeki
ng C
ance
r In
form
atio
n
29.77
41.08
53.56
63.63p < 0.001
8
Who Seeks Cancer Information?
<25k 25k - 35k 35k - 50k 50k - 75k >=75k
Annual Household Income in Dollars
0
10
20
30
40
50
60
70
Wtd
% S
eeki
ng C
ance
r In
form
atio
n
37.7
45.9 47.3
55.3
61.1
p < 0.01
9
Who Seeks Cancer Information?
Men Women
Gender
0
10
20
30
40
50
60
Wtd
% S
eeki
ng C
ance
r In
form
atio
n
55.17
39.67
p < 0.001
10
Who Seeks Cancer Information?
18-34 35-49 50-64 >=65
Age in Years
0
10
20
30
40
50
60
Wtd
% S
eeki
ng C
ance
r In
form
atio
n
46.10
50.7254.05
36.36
p < 0.001
11
Who Seeks Cancer Information?
Non-hispanic white Hispanic Non-hispanic black Non-hispanic other
Race/Ethnicity
0
10
20
30
40
50
60
Wtd
% S
eeki
ng C
ance
r In
form
atio
n
30.18
51.34
44.19
50.99
p = 0.001
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Information Seeking Experiences Six item Information SEeking Experience (ISEE) scale
Based on your overall search for information on cancer, how much do you agree/disagree with: (HC-19)
– You wanted more information, but did not know where to find it.
– It took a lot of effort to get the information you needed.
– You did not have the time to get all the information you needed.
– You felt frustrated during your search for the information.
– You were concerned about the quality of the information.
– The information you found was too hard to understand.
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Information Seeking Experiences
Wanted more info
Took effort Did not have time
Felt frustrated Quality concerns
Hard to understand
Information Seeking Experiences
0
10
20
30
40
50
60
Wtd
% A
gree
(S
tron
gly
/Som
ewha
t) 50.1348.35
46.54
58.25
41.85
37.66
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Information Seeking Experiences
Wtd Mean ISEE score: 54.21(range: 0-100)
PCA: Single factor accountsfor 52.8% of the variance
Cronbach’s = 0.820 20 40 60 80 100
ISEE Scale Score
0
50
100
150
200
250
300
Fre
quency
Frequency Distribution of the ISEE Scale
Linear regression model estimated the extent to which sociodemographics and cancer experience were associated with ISEE scores.
Age, Gender, and Race had no effect on information seeking experiences.
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Information Seeking Experiences: Correlates
Personal history Family history No history
Cancer Experience
40
45
50
55
60
Wtd
, Adj
Mea
n IS
EE
Sco
re (
0-10
0)
54.17 54.03
58.15p < 0.05
Mean: 54.21
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Information Seeking Experiences: Correlates
Not insured Insured
Health Insurance Status
40
45
50
55
60
Wtd
, Adj
Mea
n IS
EE
Sco
re (
0-10
0)
55.67
48.90
p = 0.001
Mean: 54.21
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Information Seeking Experiences: Correlates
< High school High school Some college College graduate
Education
40
45
50
55
60
Wtd
, Adj
Mea
n IS
EE
Sco
re (
0-10
0)
50.9151.95
57.57
55.88
p < 0.01
Mean: 54.21
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Information Seeking Experiences: Correlates
<25k 25k - 35k 35k - 50k 50k - 75k >=75k
Annual Household Income in Dollars
40
45
50
55
60
Wtd
, Adj
Mea
n IS
EE
Sco
re (
0-10
0)
52.8853.99
52.76
54.38
58.54p = 0.01
Mean: 54.21
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Information Seeking Experiences: Consequences
Examined the association of prior cancer-related information seeking experiences with:
– Current level of confidence in getting advice or information about cancer if needed
and
– Current beliefs about cancer and its prevention
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Information Seeking Experiences: Consequences
Not at all confident Slightly confident Somewhat confident Very confident
Cancer Information Seeking Self-efficacy
30
35
40
45
50
55
60
Wtd
Mea
n IS
EE
Sco
re (
0-10
0)
38.88
44.75
35.22
59.77
p < 0.001
Mean: 54.21
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Information Seeking Experiences: Consequences
Strongly agree Somewhat agree Somewhat disagree Strongly disagree
Almost Everything Causes Cancer
30
35
40
45
50
55
60
Wtd
Mea
n IS
EE
Sco
re (
0-10
0)
49.00
51.65
57.08
60.00p < 0.001
Mean: 54.21
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Information Seeking Experiences: Consequences
Strongly agree Somewhat agree Somewhat disagree Strongly disagree
Not Much Can Be Done to Lower Chances of Cancer
30
35
40
45
50
55
60
Wtd
Mea
n IS
EE
Sco
re (
0-10
0)
41.49
55.55
59.06
46.59
p < 0.001
Mean: 54.21
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Information Seeking Experiences: Consequences
Strongly agree Somewhat agree Somewhat disagree Strongly disagree
Too Many Recommendations Abour Cancer Prevention
30
35
40
45
50
55
60
65
70
Wtd
Mea
n IS
EE
Sco
re (
0-10
0)
48.11
61.48
67.46
54.12Mean: 54.21
p < 0.001
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Summary
A Iarge proportion of the American public engages in cancer-related information seeking.
Of these, a substantial percentage report suboptimal experiences, especially the underserved.
Past information seeking experiences are likely to shape people’s current levels of self-efficacy and cancer-related beliefs.
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Conclusion
Given the positive impact of health information on patient outcomes, greater efforts are needed to facilitate cancer-related information seeking by the American public, especially for the underserved.