Predictors of Online Cancer Prevention Information Seeking Among Patients and Caregivers Across the Digital Divide: A Cross-Sectional, Correlational Study

Abstract

BackgroundThe digital divide is a recognized public health problem caused by social determinants that exacerbate health disparities. Despite the “tectonic shift” in how most of the public obtains cancer information, underserved communities are at increased risk of being digitally marginalized. However, research that examines factors underlying eHealth information seeking in diverse health contexts is lacking.ObjectiveThe aim of this paper is to explore preferences and use of eHealth cancer prevention information (CPI) among patients and caregivers attending a minority-serving oncology clinic using the comprehensive model of information seeking as a theoretical framework. Specifically, the study examined the role of social determinants and prevention orientation in differences in preference and use of the Internet for CPI seeking among this diverse sample.MethodsSurvey methodology was used to identify social determinants and behavioral factors, including prevention orientation as correlates and predictors of respondents’ (n=252) preferences and use of eHealth for CPI seeking.ResultsLess than half (112/252, 44.4%) of respondents said that if faced with the need to seek CPI, they would seek this information online. In the final logistic regression model, education, ethnicity, age, and prevention orientation made significant contributions to the model (P<.05). Specifically, for each year increase in age, participants were 3% less likely to use the Internet for CPI seeking (P=.011). Compared to college graduates, respondents who did not complete high school were 11.75 times less likely to cite the Internet as a CPI carrier (P<.001) and those with a high school education were 3 times (2.99, P=.015) less likely. In addition, the odds that a Spanish speaker would cite the Internet as a CPI carrier were one-fifth (22%) of non-Hispanic whites (P=.032) and about one-quarter (26%) of English-speaking Latinos (P=.036). Finally, with each one point increase on the prevention orientation scale, respondents were 1.83 times less likely to cite online CPI seeking (P=.05).ConclusionsSocial determinants to health have profound influence on eHealth CPI seeking. Providers and policy makers should focus on meeting patients and family members’ CPI needs following diagnosis and increase eHealth accessibility and availability of evidence-based CPI to diverse populations. Future research is needed to unravel further differences in eHealth CPI seeking, including those among Native Americans that emerged as an additional digitally underserved racial/ethnic group. Finally, additional factors underlying these differences should be explored to better tailor CPI eHealth information to diverse communities’ information needs.

Web-Based Health Information Technology: Access Among Latinos Varies by Subgroup Affiliation (Preprint)

“…[26] Our post-hoc analysis of the Mexican-identified subpopulation shows that nativity also matters within Latinos groups, which is in line with other studies that use Spanish as a measures of acculturation, [3,26] and with previous state-level studies showing differences between US and foreign-born Latinos. [7] Additionally, the fact that age did not significantly affect all channels of online HISB and HIT within Mexican-identified populations bolsters previous findings where age was not related to online HISB.…”

Digital divide and Internet health information seeking among cancer survivors: A trend analysis from 2011 to 2017

“…Chou and colleagues asserted that due to the spread of online health misinformation, people may not trust Internet‐based information for fear of inaccuracies, and thus have less IHIS . In view of the disconnection between the advantages of IHIS and the low adoption of it, scholars highlighted the importance of examining the digital divide in cancer survivors …”

“…Health‐related Internet activities may include health information seeking, social networking with other patients, communicating with healthcare providers, and online medicine purchasing . With a higher level of health‐related Internet usage, individuals will be more familiar with online environments, and have greater awareness and health orientation to get more exposure to health resources, increasing the likelihood of IHIS . Empirical evidence supported that as cancer survivors use one online channel to attain health content, they will also explore other online activities that may fulfill similar needs …”

Content, Usability, and Utilization of Plain Language in Breast Cancer Mobile Phone Apps: A Systematic Analysis

“…Digital literacy is crucial to engage in health maintenance, change behavior, and utilize health care services [41]. People with low literacy are less likely to access the Internet to seek information about health concerns [20], despite strong information needs following cancer diagnosis [42,43]. Patients with low health literacy are less likely to use health apps or perceive them as easy or useful, and hence are less likely to benefit from this technology [31].…”