Kyunghye Kim|Nahyun Kwon
Racial differences in source awareness, trust, selection and information competence among cancer patients who sought cancer information: A preliminary analysis of HINTS 2007
Florida State University|University of South Florida
report preliminary analysis recent largescale national survey national cancer institute continued effort highlight health information seeking behaviors american public ncis health information national trends survey 2005 far 1 revealed digital health disparity use cancer information sources among vulnerable populations society kwon kim press 2 created profile epatients compared contrasted information source use preference information source trust epatients cancer types cancer information seekers kim kwon 2007 present study expanded research focus examine racial differences cancer information seeking cancer patients using hints 2007 dataset many claimed health disparity closely associated race eg kreps 2006 literature minority health informs number factors contributing health disparity example matthews sellergren manfredi williams 2002 found array cultural socioeconomic factors limited knowledge misinformation cancer mistrust medical community concerns privacy lack insurance religious beliefs play roles behavior african american cancer patients spanishspeaking cancer information seekers also low confidence getting cancer information compared englishspeaking counterparts vanderpool kornfeld rutten squires 2009 office minority health health disparities center disease control prevention 2007 also reports differences health health care among different racial groups due genetics environmental factors discrimination cultural barriers lack access care lack access health information including lack online access may also affect health disparities may play important role informed cancer patients certainly segments societyoften members sociodemographically underprivileged populationsstill lack access online health information kreps 2006 use internet information often uniformly low among ethnic minorities well eg james et al 2007 consumer health literature pointed race important factor differentiates quality health care cancer patients receive due unethical application clinical research people minority groups generally greater distrust health research slows progress clinical research help minority population digital divide appears reduced increased accessibility internet researchers argue surface level disparity still exists subtle way kwon kim 2007 digital divide ehealth information access predicted exacerbate digital health disparity proper measures taken chang et al 2004 chobot 2004 wood et al 2000 thus research attempt scrutinize race plays role cancer information seeking among cancer patients years lis researchers practitioners studied health information seeking channels needs behaviors specific ethnic groups eg spink cole 2001 detlefsen 2004 yet studies examined specific ethnic groups compared contrasted health information consumers different ethnic backgrounds example detlefsen 2004 study two vulnerable communities elderly african americans reported two groups prefer information health care providers andor established sources groups seek consumer health information increasingly using internet information searches thus much unknown competent racial minority cancer patients seeking using health information make informed decisions cancer patients different racial background different level trust selecting sources information competence socioeconomic backgrounds online access awareness trust selection health medical information sources information competence conducted secondary data analysis using national cancer institutes nci hints 2007 data 2009 httphintscancergovinstrumentjsp hints ongoing crosssectional survey us civilian noninstitutionalized adult population developed health communication scholars staff nci conducted independent company westat survey instrument includes validated measures selected existing surveys new items underwent extensive pretesting expert review nci 2003 hints 2007 data collected january 2008 may 2008 total 7674 adult americans participated national random survey study 1 random digit dial telephone survey n4092 2 random sample list addresses united states postal service administrative records n3582 study selected cancer patients nonhispanic white blackafrican american hispanic total hints participants combined blackafrican american hispanic order compare contrast cancer information seeking white nonwhite racial groups combined black hispanic groups nonwhite group two groups small number cases 32 30 respectively total 674 cancer patients sought cancer information good deal missing values valid statistical analyses contrast numbers indication racial disproportion cancer patients community select socioeconomic set cancer information seeking use variables hints 2007 answer research questions cancer information seeking ever looked information cancer source cancer history ever diagnosed cancer raceethnicity hispanic latino one following would say race age age gender male female education highest level school completed employment current occupational status combined annual income combined annual household income healthcare coverage kind health care coverage including health insurance prepaid plans hmos government plans medicare internet use ever go online access internet world wide web send receive emails internet access home use internet athome mainly access telephone modem cable dsl wireless devices source awareness heard following organizations contacted study national cancer institute center disease control american cancer society source trust much trust information cancer doctor family friends newspapers radio internet tv government charities religious organizations primary source cancer information recent time looked cancer information go first book brochures cancer organization family friedcoworkers doctor health provider internet library magazines newspaper telephone numbers 1800 complementary alternative medicine provider health insurance provider television others effort taking took lot effort get information needed frustration felt frustrated search information concerns quality information concerned quality information hard understand information found hard understand confidence getting information overall confident could get advice information cancer needed main analysis dataset use descriptive statistics inferential statistics including chisquare tests mannwhitney u tests logistic regression analysis preliminary analysis report interesting dataset may lead us draw research hypotheses test among 7674 respondents number cancer information seekers 3570 among cancer information seekers 689 respondents history cancer among selfinformed cancer patients numbers white group 583 nonwhite group 62 interpreted according results hints 2007 analysis 47 adult americans estimated ever sought information cancer self 9 population cancer patients seeking cancer information 0008 population nonwhite cancer patients also cancer information seekers white nonwhite groups show statistically significant differences sociodemographic variables compared white group nonwhite group less numbers people age 65 order 2 3 n638 1265 p001 less males 2 1 n652 574 p05 less college graduates 2 4 n652 1835 p001 less people insurance coverage 21 n640 2043 p001 numbers unemployed 2 3 n6451349 p01 people make combined household income 35000 less year 2 3 n556 1111 p01 white group experience using internet 694 nonwhite group 565 2 1 n652 472 p05 however two groups different mode access internet home two groups show similarity primary source selection top four choices groups internet printed materials including books brochures magazines newspaper doctor friends family order one percent white group uses library 08 uses cancer organizations information cancer interestingly single members nonwhite group use library primary source nonwhite respondents use cancer organizations primary source 17 08 respectively overall nonwhite group less aware established cancer information organizations white group nonetheless american cancer society best known groups 2 1 n6461758 p001 followed national cancer institute 21 n641 832 p 01 center disease control 2 1 n641 965 p01 nonwhite group shows higher level trust tv 370228 p05 religious organizations 368212 p05 white group among five information competence variables confidence getting advice information shows significant difference two groups nonwhite group shows slightly higher confidence 376246 p05 biannual national hint 2007 study portrays nonwhite cancer patients sought cancer information following comparisons white counterpart nonwhite group tend composed younger generations females fewer college graduates unemployed less healthcare coverage people lower income people less internet experience revealing clear differences socioeconomic characteristics two groups exploratory study confirms findings reported numerous studies outside health communication field finding younger cancer patients proportionally higher nonwhite group white group needs scrutiny may attributed higher mortality rates among racial minority groups high rates elderly racial minorities seek information explanations contrast socioeconomic characteristic found major differences cancer information seeking two groups general two groups showed similar source selection behavior commonly groups primary information source internet followed printed materials doctor nonetheless study revealed noteworthy information seeking source selection behaviors among cancer patients nonwhite group distinctive counterparts cancer patients nonwhite group less aware established cancer information organizations nci one nonwhite group reported use library primary information source furthermore nonwhite cancer patients sought cancer information higher trusts tv religious organizations selfconfidence getting advice information white group conclusion analysis 2007 hints data reveals continuing health disparity closely associated race people racial monitory groups composed vulnerable people society terms gender education income employment healthcare coverage internet accessibility finding calls continuing multifaceted efforts assist racial minority bridge gap still existing findings shows distinctive health information seeking source selection behavior informs field effective health information education campaign tendency use less trustworthy cancer information source cancer information organizations library yet another tendency greater trust tv urges greater emphasis health literacy racial minority group addition greater trust information religious organizations also informs strategic planning health literacy health information campaign channeled religious organization well television next steps study carry weighted analyses hints 2007 minorities oversampled run logistic regression analyses find predictors information competence investigate whether predictors differ two racial groups