Effect of information seeking and avoidance behavior on self-rated health status among cancer survivors.

OBJECTIVE Social determinants, such as socioeconomic status (SES) and race/ethnicity are linked to striking health disparities across the cancer continuum. One important mechanism linking social determinants and health disparities may be communication inequalities that are caused by differences in accessing, processing and utilizing cancer information. In this context, we examined health information-seeking/avoidance as a potential mediator between social determinants and self-rated health (SRH) status among cancer survivors. METHODS Data came from the 2008 well-informed, thriving and surviving (WITS) study of post-treatment cancer survivors (n=501). We examined the mediating effect of health communication-related behavior between SES and disparities in SRH. RESULTS The likelihood of belonging to the Low SRH group was higher among patients who had avoided health information and whose family members had not sought health information on behalf of the survivor, those in the lowest household income bracket, and those who had high school or less education after adjusting for potential confounders. CONCLUSION Differences in SRH among cancer survivors are associated with SES as well as communication inequalities. PRACTICE IMPLICATIONS It is necessary to provide a supportive environment in which health information is made available if disparities in health-related quality of life among cancer survivors are to be reduced.

[1]  Alastair Baker,et al.  Crossing the Quality Chasm: A New Health System for the 21st Century , 2001, BMJ : British Medical Journal.

[2]  S. Fosså,et al.  Morbidity associated with "self-rated health" in epithelial ovarian cancer survivors , 2009, BMC Cancer.

[3]  D. Goldsmith,et al.  Information Seeking and Avoiding in Health Contexts , 2002 .

[4]  Martin Fishbein,et al.  Psychosocial Determinants of Cancer-Related Information Seeking Among Cancer Patients , 2011, Journal of health communication.

[5]  I. Bates,et al.  Medicine information needs of patients: the relationships between information needs, diagnosis and disease , 2008, Quality & Safety in Health Care.

[6]  L. Kohn,et al.  A Comprehensive Approach to Improving Patient Safety , 2000 .

[7]  K. McPherson,et al.  Cancer patients' information needs and information seeking behaviour: in depth interview study , 2000, BMJ : British Medical Journal.

[8]  P. Bath,et al.  Information-seeking behaviors of women with breast cancer. , 2001, Oncology nursing forum.

[9]  K. Viswanath,et al.  Health Information Seeking , 2011 .

[10]  D. Gustafson,et al.  Perceived helpfulness and impact of social support provided by family, friends, and health care providers to women newly diagnosed with breast cancer , 2007, Psycho-oncology.

[11]  Sun Young Lee,et al.  Interplay of Negative Emotion and Health Self-Efficacy on the Use of Health Information and Its Outcomes , 2008, Commun. Res..

[12]  Zahava Berkowitz,et al.  Information-Seeking Styles Among Cancer Patients Before and After Treatment by Demographics and Use of Information Sources , 2009, Journal of health communication.

[13]  S. L. Stewart,et al.  Surveillance of demographic characteristics and health behaviors among adult cancer survivors--Behavioral Risk Factor Surveillance System, United States, 2009. , 2012, Morbidity and mortality weekly report. Surveillance summaries.

[14]  Thomas R. Miller,et al.  Self-Rated Health , 2008, Journal of aging and health.

[15]  P. Wingo,et al.  Health‐related quality of life in cancer survivors between ages 20 and 64 years , 2008, Cancer.

[16]  John T. Wei,et al.  Quality of life and satisfaction with outcome among prostate-cancer survivors. , 2008, The New England journal of medicine.

[17]  Eric C. Schneider,et al.  Patient Centered Experiences in Breast Cancer: Predicting Long-Term Adherence to Tamoxifen Use , 2007, Medical care.

[18]  C. Charles,et al.  Shared treatment decision making: what does it mean to physicians? , 2003, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[19]  Hugh McKenna,et al.  Never-ending making sense: towards a substantive theory of the information-seeking behaviour of newly diagnosed cancer patients. , 2007, Journal of clinical nursing.

[20]  Y. Benyamini,et al.  Self-rated health and mortality: a review of twenty-seven community studies. , 1997, Journal of health and social behavior.

[21]  S. Galea.  Macrosocial Determinants of Population Health , 2010 .

[22]  S Larry Goldenberg,et al.  Assessing Information and Decision Preferences of Men With Prostate Cancer and Their Partners , 2002, Cancer nursing.

[23]  M. Shim,et al.  Connecting Internet Use with Gaps in Cancer Knowledge , 2008, Health communication.

[24]  Jiang He,et al.  Mortality prediction with a single general self-rated health question , 2006, Journal of General Internal Medicine.

[25]  Faith Mitchell,et al.  Examining the Health Disparities Research Plan of the National Institutes of Health , 2006 .

[26]  L. Kohn,et al.  To Err Is Human : Building a Safer Health System , 2007 .

[27]  Suzanne Pingree,et al.  Barriers to information access, perceived health competence, and psychosocial health outcomes: test of a mediation model in a breast cancer sample. , 2002, Patient education and counseling.

[28]  E. Lenz,et al.  Perceived Self‐Care Information Needs and Information‐Seeking Behaviors Before and After Elective Spinal Procedures , 1997, The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses.

[29]  L. Kohn,et al.  COMMITTEE ON QUALITY OF HEALTH CARE IN AMERICA , 2000 .

[30]  K. Viswanath,et al.  Health and the Information Nonseeker: A Profile , 2006, Health communication.

[31]  Suzanne L. Allard,et al.  Avoiding versus seeking: the relationship of information seeking to avoidance, blunting, coping, dissonance, and related concepts. , 2005, Journal of the Medical Library Association : JMLA.

[32]  David R. Williams,et al.  Integrating multiple social statuses in health disparities research: the case of lung cancer. , 2012, Health services research.

[33]  D. Miller,et al.  Health-related quality of life , 2002, Multiple sclerosis.

[34]  Faith Mitchell,et al.  Public Communications and Its Role in Reducing and Eliminating Health Disparities , 2006 .

[35]  R. Czaja,et al.  The Determinants and Consequences of Information Seeking Among Cancer Patients , 2003, Journal of health communication.

[36]  S. Shiloh,et al.  Effects of Controllability, Predictability, and Information-Seeking Style on Interest in Predictive Genetic Testing , 1999 .

[37]  J T Huber,et al.  Information Needs and Information-Seeking Behaviors of HIV Positive Men and Women , 2000, Medical reference services quarterly.

[38]  Gary L. Kreps,et al.  Cancer survivors information seeking behaviors: a comparison of survivors who do and do not seek information about cancer. , 2007, Patient education and counseling.

[39]  D. Jeffe,et al.  Estimated effects of potential interventions to prevent decreases in self-rated health among breast cancer survivors. , 2012, Annals of epidemiology.

[40]  Gary G Bennett,et al.  Barriers and Facilitators to Home Computer and Internet Use Among Urban Novice Computer Users of Low Socioeconomic Position , 2007, Journal of medical Internet research.

[41]  R. Sanson-Fisher,et al.  Consumer participation in the development of psychosocial clinical practice guidelines: opinions of women with breast cancer. , 2000, European journal of cancer care.

[42]  M. Hjermstad,et al.  Multiple Predictors of Health-Related Quality of Life in Early Stage Breast Cancer. Data from a Year Follow-up Study Compared with the General Population , 2005, Quality of Life Research.

[43]  B. Hesse,et al.  Cancer-Related Information Seeking: Hints from the 2003 Health Information National Trends Survey (HINTS) , 2006, Journal of health communication.

[44]  J. Nussbaum,et al.  The Routledge Handbook of Health Communication , 2011 .