Health-Related Internet Use Among Men With Prostate Cancer in Canada: Cancer Registry Survey Study

Background After a prostate cancer diagnosis, men want information about their disease and treatment options. The internet offers a convenient means to deliver health information to patients with prostate cancer. However, there are concerns about the use of the internet among this largely senior population. Objective This study aimed to determine the patterns and factors associated with the use of the internet as a source of health information among Canadian men with prostate cancer and the features and information required in a website. Methods Population surveys were conducted in four Canadian provinces (British Columbia, Alberta, Saskatchewan, and Ontario) in 2014-2015. Data analyses included descriptive, bivariable, and multivariable analyses. The Pearson Chi-square and univariable regression were used to examine associations between independent variables and health-related internet use. Correlates of health-related internet use were analyzed using multivariable logistic regression. Results A total of 1362 patients responded across the four provinces. The mean age of respondents was 69 years (SD 8.2). In addition, 82% (n=1071) were internet users and 71% (n=910) used the internet daily. Further, 65% (n=784) used the internet as a source of prostate cancer information, and 40% (n=521) were confident about using information obtained from the internet to make health decisions. Men who used the internet to obtain prostate cancer information were more likely to be active information seekers (odds ratio [OR]: 4.5, 95% CI 2.6-7.8), be confident using information from the internet to make health decisions (OR: 3.6, 95% CI 2.3-5.7), have broadband internet access (OR: 1.8, 95% CI 1.2-2.7), and have more unmet supportive care needs (OR: 1.05, 95% CI 1.0-1.1). Top features wanted in a website, reported by more than 50% of respondents, were a library of resources (n=893, 65.6%), tools to support treatment decision making (n=815, 59.8%), and tools to help navigate the prostate cancer journey (n=698, 51.2%). Top three topics of information wanted in such a website were treatment options (n=916, 67.3%), disease progression (n=904, 66.4%), and management of side effects (n=858, 63%). Conclusions Over two-thirds of Canadian patients with prostate cancer surveyed use the internet as a source of health information about prostate cancer, but over half did not feel confident using information from the internet to make health decisions. Being an active information seeker, having confidence in using information from the internet to make health decisions, having broadband internet, and having more unmet supportive care needs were significantly associated with health-related internet use. Future work should examine electronic health literacy interventions as a means to boost men’s confidence in using information from the internet and design websites that include information and features that help men navigate the prostate cancer journey and support treatment decision making and management of side effects.

Download Full-text

Health-Related Internet Use Among Men With Prostate Cancer in Canada: Cancer Registry Survey Study (Preprint)

10.2196/preprints.14241 ◽

2019 ◽

Author(s):

Jacqueline L Bender ◽

Deb Feldman-Stewart ◽

Christine Tong ◽

Karen Lee ◽

Michael Brundage ◽

...

Keyword(s):

Prostate Cancer ◽

Health Information ◽

Internet Use ◽

Treatment Options ◽

Cancer Information ◽

The Internet ◽

Care Needs ◽

Broadband Internet ◽

Health Decisions ◽

Health Related

BACKGROUND After a prostate cancer diagnosis, men want information about their disease and treatment options. The internet offers a convenient means to deliver health information to patients with prostate cancer. However, there are concerns about the use of the internet among this largely senior population. OBJECTIVE This study aimed to determine the patterns and factors associated with the use of the internet as a source of health information among Canadian men with prostate cancer and the features and information required in a website. METHODS Population surveys were conducted in four Canadian provinces (British Columbia, Alberta, Saskatchewan, and Ontario) in 2014-2015. Data analyses included descriptive, bivariable, and multivariable analyses. The Pearson Chi-square and univariable regression were used to examine associations between independent variables and health-related internet use. Correlates of health-related internet use were analyzed using multivariable logistic regression. RESULTS A total of 1362 patients responded across the four provinces. The mean age of respondents was 69 years (SD 8.2). In addition, 82% (n=1071) were internet users and 71% (n=910) used the internet daily. Further, 65% (n=784) used the internet as a source of prostate cancer information, and 40% (n=521) were confident about using information obtained from the internet to make health decisions. Men who used the internet to obtain prostate cancer information were more likely to be active information seekers (odds ratio [OR]: 4.5, 95% CI 2.6-7.8), be confident using information from the internet to make health decisions (OR: 3.6, 95% CI 2.3-5.7), have broadband internet access (OR: 1.8, 95% CI 1.2-2.7), and have more unmet supportive care needs (OR: 1.05, 95% CI 1.0-1.1). Top features wanted in a website, reported by more than 50% of respondents, were a library of resources (n=893, 65.6%), tools to support treatment decision making (n=815, 59.8%), and tools to help navigate the prostate cancer journey (n=698, 51.2%). Top three topics of information wanted in such a website were treatment options (n=916, 67.3%), disease progression (n=904, 66.4%), and management of side effects (n=858, 63%). CONCLUSIONS Over two-thirds of Canadian patients with prostate cancer surveyed use the internet as a source of health information about prostate cancer, but over half did not feel confident using information from the internet to make health decisions. Being an active information seeker, having confidence in using information from the internet to make health decisions, having broadband internet, and having more unmet supportive care needs were significantly associated with health-related internet use. Future work should examine electronic health literacy interventions as a means to boost men’s confidence in using information from the internet and design websites that include information and features that help men navigate the prostate cancer journey and support treatment decision making and management of side effects.

Download Full-text

Readability of Prostate Cancer Information Online: A Cross-Sectional Study

American Journal of Men s Health ◽

10.1177/1557988318780864 ◽

2018 ◽

Vol 12 (5) ◽

pp. 1665-1669 ◽

Cited By ~ 16

Author(s):

Corey H. Basch ◽

Danna Ethan ◽

Sarah A. MacLean ◽

Joseph Fera ◽

Phillip Garcia ◽

...

Keyword(s):

Prostate Cancer ◽

Health Information ◽

Cross Sectional Study ◽

Cancer Information ◽

The Internet ◽

Sectional Study ◽

Cross Sectional ◽

Related Information ◽

Internet Browser ◽

Health Related

Reading and understanding health information, both components of health literacy, can influence patient decisions related to disease management. Older adults, the population of males at greatest risk for prostate cancer, may have compromised capacity to understand and use health information. The purpose of this study was to determine the readability of prostate cancer materials on the Internet using five recommended readability tests. Using a cleared Internet browser, a search was conducted for “prostate cancer.” The URLs of the first 100 websites in English were recorded to create the sample. The readability scores for each website were determined using an online, recommended service. This service generates five commonly recommended readability tests. All five tests revealed that the majority of websites had difficult readability. There were no significant differences identified between websites with .org, .gov, or .edu extension versus those with .com, .net, or other extension. It is apparent that the Internet is used often as a resource for health-related information. This study demonstrates that the large majority of information available on the Internet about prostate cancer will not be readable for many individuals.

Download Full-text

Lifestyle Segmentation to Explain the Online Health Information–Seeking Behavior of Older Adults: Representative Telephone Survey

Journal of Medical Internet Research ◽

10.2196/15099 ◽

2020 ◽

Vol 22 (6) ◽

pp. e15099 ◽

Cited By ~ 2

Author(s):

Winja Weber ◽

Anne Reinhardt ◽

Constanze Rossmann

Keyword(s):

Older Adults ◽

Health Information ◽

Information Seeking ◽

Internet Use ◽

Information Seeking Behavior ◽

The Internet ◽

Online Health Information ◽

Sociodemographic Variables ◽

Seeking Behavior ◽

Health Related

Background As a result of demographic changes, the number of people aged 60 years and older has been increasing steadily. Therefore, older adults have become more important as a target group for health communication efforts. Various studies show that online health information sources have gained importance among younger adults, but we know little about the health-related internet use of senior citizens in general and in particular about the variables explaining their online health-related information–seeking behavior. Media use studies indicate that in addition to sociodemographic variables, lifestyle factors might play a role in this context. Objective The aim of this study was to examine older people’s health-related internet use. Our study focused on the explanatory potential of lifestyle types over and above sociodemographic variables to predict older adults’ internet use for health information. Methods A telephone survey was conducted with a random sample of German adults aged 60 years and older (n=701) that was quota-allocated by gender, age, educational status, and degree of urbanity of their place of residence. Results The results revealed that participants used the internet infrequently (mean 1.82 [SD 1.07]), and medical personnel (mean 2.89 [SD 1.11]), family and friends (mean 2.86 [SD 1.21]), and health brochures (mean 2.85 [SD 1.21]) were their main sources of health information. A hierarchical cluster analysis based on values, interests, and leisure time activities revealed three different lifestyle types for adults aged over 60 years: the Sociable Adventurer, the Average Family Person, and the Uninterested Inactive. After adding these types as second-step predictors in a hierarchical regression model with sociodemographic variables (step 1), the explained variance increased significantly (R2=.02, P=.001), indicating that the Average Family Person and the Sociable Adventurer use the internet more often for health information than the Uninterested Inactive, over and above their sociodemographic attributes. Conclusions Our findings indicate that the internet still plays only a minor role in the health information–seeking behavior of older German adults. Nevertheless, there are subgroups including younger, more active, down-to-earth and family-oriented males that may be reached with online health information. Our findings suggest that lifestyle types should be taken into account when predicting health-related internet use behavior.

Download Full-text

Lifestyle Segmentation to Explain the Online Health Information–Seeking Behavior of Older Adults: Representative Telephone Survey (Preprint)

10.2196/preprints.15099 ◽

2019 ◽

Author(s):

Winja Weber ◽

Anne Reinhardt ◽

Constanze Rossmann

Keyword(s):

Older Adults ◽

Health Information ◽

Information Seeking ◽

Internet Use ◽

Information Seeking Behavior ◽

The Internet ◽

Online Health Information ◽

Sociodemographic Variables ◽

Seeking Behavior ◽

Health Related

BACKGROUND As a result of demographic changes, the number of people aged 60 years and older has been increasing steadily. Therefore, older adults have become more important as a target group for health communication efforts. Various studies show that online health information sources have gained importance among younger adults, but we know little about the health-related internet use of senior citizens in general and in particular about the variables explaining their online health-related information–seeking behavior. Media use studies indicate that in addition to sociodemographic variables, lifestyle factors might play a role in this context. OBJECTIVE The aim of this study was to examine older people’s health-related internet use. Our study focused on the explanatory potential of lifestyle types over and above sociodemographic variables to predict older adults’ internet use for health information. METHODS A telephone survey was conducted with a random sample of German adults aged 60 years and older (n=701) that was quota-allocated by gender, age, educational status, and degree of urbanity of their place of residence. RESULTS The results revealed that participants used the internet infrequently (mean 1.82 [SD 1.07]), and medical personnel (mean 2.89 [SD 1.11]), family and friends (mean 2.86 [SD 1.21]), and health brochures (mean 2.85 [SD 1.21]) were their main sources of health information. A hierarchical cluster analysis based on values, interests, and leisure time activities revealed three different lifestyle types for adults aged over 60 years: the Sociable Adventurer, the Average Family Person, and the Uninterested Inactive. After adding these types as second-step predictors in a hierarchical regression model with sociodemographic variables (step 1), the explained variance increased significantly (R2=.02, P=.001), indicating that the Average Family Person and the Sociable Adventurer use the internet more often for health information than the Uninterested Inactive, over and above their sociodemographic attributes. CONCLUSIONS Our findings indicate that the internet still plays only a minor role in the health information–seeking behavior of older German adults. Nevertheless, there are subgroups including younger, more active, down-to-earth and family-oriented males that may be reached with online health information. Our findings suggest that lifestyle types should be taken into account when predicting health-related internet use behavior.

Download Full-text

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

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17186856 ◽

2020 ◽

Vol 17 (18) ◽

pp. 6856 ◽

Cited By ~ 1

Author(s):

Rose Calixte ◽

Argelis Rivera ◽

Olutobi Oridota ◽

William Beauchamp ◽

Marlene Camacho-Rivera

Keyword(s):

Social Media ◽

Health Information ◽

Information Seeking ◽

Internet Use ◽

Secondary Data ◽

The United States ◽

The Internet ◽

Health Related ◽

Demographic Patterns ◽

National Trends

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.

Download Full-text

Evolution of online health-related information seeking in France from 2010 to 2017: results from nationally representative surveys (Preprint)

10.2196/preprints.18799 ◽

2020 ◽

Author(s):

Pauline Ducrot ◽

Ilaria Montagni ◽

Viet Nguyen-Thanh ◽

Anne-Juliette Serry ◽

Jean-Baptiste Richard

Keyword(s):

Health Information ◽

Information Seeking ◽

Internet Use ◽

The Internet ◽

Online Health Information ◽

Health Related ◽

Nationally Representative ◽

Source Of Information ◽

Over Time ◽

The Way

BACKGROUND Given the fast ongoing progression of the Internet and the increase in health information available from disparate sources, it is important to understand how these changes impact the online health information-seeking behavior of the population and the way of managing one’s health. OBJECTIVE This paper aims at describing the evolution of Internet use as a source of health information between 2010 and 2017, as well as the characteristics of online health information-seekers, the topics of interest, the sources of information, and the trust in this information and the potential impact on behavior. METHODS Data from French nationally-representative surveys Health Barometers were used (N=4,141 in 2010, 4,811 in 2014 and 6,255 in 2017.) Evolutions over time were assessed using chi-2 tests. Associations with sociodemographic characteristics and health status were evaluated using logistic regression models. RESULTS The use of the Internet as a source of health information rose between 2010 and 2014 (from 37.3% to 67.9%, P<.0001) but decreased significantly in 2017 (60.3%, P<.0001). Overall, the profile of health information-seekers compared to non-seekers did not change over time. They were more likely to be women, to be younger, to have a higher educational level, to have a higher household income and to be executives. Between 2014 and 2017, the proportion of those who did not pay attention to the source of information significantly increased to reach 39.7% (P<.0001). In 2017 as in 2014, health-related websites for general population remained the first source of information (38.6%) while institutional websites were the third (8.1%). If the credibility given to the online information is good for a large part of the information seekers since 2010 (more than 80%), it slightly decreased between 2014 and 2017 (P=.048). Above the individual characteristics, credibility was the main determinant of the way of managing one’s health (in 2017: OR=4.62; 95%CI=[3.35;6.36]). CONCLUSIONS After a rapid growth in the Internet use for seeking health information in the 2010-2014 period, a decrease was recorded in 2017 linked to a decreasing trust in the quality and reliability of information found online. These findings underlined the need for public health authorities to increase citizens’ eHealth literacy and/or to provide alternative trustworthy sources combining the popularity and accessibility of general health-information websites.

Download Full-text

Digital Health Information as Friend or Foe: The Question of (Mis)Trust Among Older Internet Users

Innovation in Aging ◽

10.1093/geroni/igaa057.1322 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 410-410

Author(s):

Gul Seckin ◽

Patricia Campbell ◽

Megan Lawson

Keyword(s):

Older Adults ◽

Gender Differences ◽

Health Information ◽

Internet Use ◽

Digital Health ◽

Self Care ◽

Positive Association ◽

Older Age ◽

The Internet ◽

Health Related

Abstract Gathering health information is among the major motivations for getting online among older adults who want to be better prepared with knowledge to manage their health and personal care. Prior research also showed significant gender differences in health-related use of the Internet. This research examined the effect of Internet use for health information on (a) mistrust of physician, (b) empowerment, (c) self-care, and (d) worry and/or anxiety. The sample (N=710; Mean= 48.82, SD=16.43) was randomly drawn from a national probability-based online panel. We performed gender-stratified sub-sample analyses of older respondents (age ≥60, N= 194). Hierarchical linear regression analyses showed that there is a negative association between older age and feeling empowered because of using the internet for health information (β = -.23, p < .05) and a positive association between older age and mistrust of diagnosis and/or treatment of physician (β = .19, p < .05). Study respondents did not report better self-care as a result of obtaining information from the Internet (β = -.15, p > .05). Lastly, older adults reported less worry and/or anxiety because of information stumbled upon the Internet that may not be accurate (β = -.25, p < .05). Sub-sample analyses showed that there are gender differences. Particularly, older men reported greater mistrust (β = .32, p < .05), and less worry (β = -.44, p ≤ .01) while these associations were not significant among older women. Results call for examination of the synergy of age and gender in perceived benefits of health-related Internet use.

Download Full-text

Relative Quality of Internet-Derived Oesophageal Cancer Information

Bulletin of The Royal College of Surgeons of England ◽

10.1308/147363510x523190 ◽

2010 ◽

Vol 92 (8) ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

TD Reid ◽

C Beaton ◽

IL Davies ◽

D Arnold ◽

JBM Ward ◽

...

Keyword(s):

Health Information ◽

Medical Information ◽

Internet Access ◽

Cancer Information ◽

The Internet ◽

Related Information ◽

Internet Users ◽

Health Related ◽

The Usa ◽

The Uk

Worldwide internet access is increasing exponentially. The UK Government Office for National Statistics reported that between 2002 and 2009 the proportion of UK households with internet access increased from 46% to 70%. Between 2007 and 2009 the proportion of UK adults using the internet to access health information rose from 27% to 42%. Similar situations exist in Continental Europe and the USA, where 52% of internet users and 61% of adults respectively search online for medical information. In 2003 it was estimated that 4.5% of all internet searches globally were for health related information. Moreover, patients now frequently choose to seek health information online. Indeed Hesse et al reported that almost one in two patients search the internet before consulting a physician.

Download Full-text

Characterizing the Digital Health Citizen: Mixed-Methods Study Deriving a New Typology (Preprint)

10.2196/preprints.11279 ◽

2018 ◽

Author(s):

John Powell ◽

Ulrike Deetjen

Keyword(s):

Cluster Analysis ◽

Mixed Methods ◽

Health Behavior ◽

Health Information ◽

Internet Use ◽

The Internet ◽

Online Health Information ◽

Digital Inclusion ◽

Internet Users ◽

Health Related

BACKGROUND A key challenge for health systems harnessing digital tools and services is that of digital inclusion. Typically, digital inequalities are conceptualized in relation to unequal access or usage. However, these differences do not fully explain differences in health behavior as a result of health-related internet use. OBJECTIVE Our objective was to derive a new typology of health internet users based on their antecedent motivations and enablers, to explain how individuals’ different orientations influence their health behavior. METHODS We used a mixed-methods design using (1) qualitative data from 43 semistructured interviews about individuals’ general and health-related internet use, and how this influenced their health perception and their help-seeking decisions, and (2) quantitative data from the Oxford Internet Surveys (OxIS), a household survey of 2150 adults in England about their internet use and other characteristics. We used the interview data to identify constructs that described motivations and enablers affecting how internet use shaped respondents’ health perception and health service use. We then used these constructs to identify variables in OxIS, which provided a quantitative measure of these constructs. We then undertook a hierarchical cluster analysis of these constructs, using the numerical variables, to derive a proposed typology of health information seekers. RESULTS Both the qualitative findings and the subsequent cluster analysis suggested the existence of 6 types of individuals, categorized as learners, pragmatists, skeptics, worriers, delegators, and adigitals. Learners had a strong desire to understand health better. They used the internet to make decisions about whether they needed to see a professional and to learn about their and others’ health. Pragmatists primarily used the internet to decide whether seeing a doctor was worthwhile. Skeptics were skeptical of physicians and the medical system and valued the internet for solving health problems that doctors may not be able to deal with. Worriers found it difficult to interpret health information online, described health information seeking online as frightening, and reported a critical attitude toward online health information despite seeking it frequently. Delegators comprised nonusers and users valuing the internet as an information source, but not necessarily wanting or being able to use the internet themselves. Adigitals comprised many nonusers, but also users, who did not see the internet as a useful information tool and presented strong views on its low suitability for health care. CONCLUSIONS This research supports a shift in the understanding of the digital divide in health, away from only access and usage issues, toward also conceptualizing an outcomes divide, whereby different types of health behavior result from the differing orientations of internet users accessing online health information. This new typology can be used to inform digital inclusion policies in health systems.

Download Full-text

Patient-Reported Outcomes in a Nationally Representative Sample of Older Internet Users: Cross-sectional Survey (Preprint)

10.2196/preprints.16006 ◽

2019 ◽

Author(s):

Gul Seckin ◽

Susan Hughes

Keyword(s):

Health Information ◽

Health Problem ◽

Patient Reported Outcomes ◽

Internet Use ◽

The Internet ◽

Affective Distress ◽

Ehealth Literacy ◽

Patient Reported ◽

Health Related ◽

Reported Health

BACKGROUND The rapid diffusion of the internet has decreased consumer reliance on health care providers for health information and facilitated the patients’ ability to be an agent in control of their own health. However, empirical evidence is limited regarding the effects of health-related internet use among older adults, which is complicated by the proliferation of online health and medical sources of questionable scientific accuracy. OBJECTIVE We explore the effects of health-related internet use, education, and eHealth literacy on medical encounters and patient-reported outcomes. Patient-reported outcomes are categorized into two dimensions: (1) self-reported health problem and (2) affective distress (feeling worried and anxious) due to information obtained. We were particularly interested in whether education and eHealth literacy moderate the association between perceived strain in medical encounters and patient-reported outcomes. METHODS Our study sample consisted of online panel members who have used the internet as a resource for health information, randomly drawn from one of the largest probability-based online research panels. This paper specifically reports results obtained from older panel members (age≥60 years: n=194). First, we examined descriptive statistics and bivariate associations (Pearson correlations and independent samples t tests). We used hierarchical ordinary least squares regression analyses by running separate regressions for each patient-reported outcome. In model 1, we entered the main effects. In model 2, technology and medical encounter variables were included. Model 3 added the statistical interaction terms. RESULTS Age (β=–.17; P=.02), gender (β=–.22; P=.01), and medical satisfaction (β=–.28; P=.01) were significant predictors of self-reported health problems. Affective distress was positively predicted by gender (β=.13; P=.05) and satisfaction with medical encounters (β=.34; P<.001) but negatively predicted by education (β=–.18; P=.03) and eHealth literacy (β=–.32; P=.01). The association between experiencing a health problem in relation to health-related internet use and perception of strained medical encounters was greater among respondents with lower levels of education (β=–.55; P=.04). There was also a significant interaction between education and eHealth literacy in predicting the level of affective distress (β=–.60; P=.05), which indicated that higher levels of education predicted lower averages of feeling anxiety and worry despite lower eHealth literacy. Older women reported higher averages of affective distress (β=.13; P=.05), while older men reported higher averages of experiencing a self-reported health problem (β=–.22; P=.01). CONCLUSIONS This study provides evidence for the effect of health-related internet use on patient-reported outcomes with implications for medical encounters. The results could be used to guide educational and eHealth literacy interventions for older individuals.

Download Full-text