Educated but anxious: How emotional states and education levels combine to influence online health information seeking

This study combined conceptual frameworks from health information seeking, appraisal theory of emotions, and social determinants of health literatures to examine how emotional states and education predict online health information seeking. Nationally representative data from the Health Information National Trends Survey (HINTS 4, Cycle 3) were used to test the roles of education, anxiety, anger, sadness, hope, happiness, and an education by anxiety interaction in predicting online health information seeking. Results suggest that women, tablet owners, smartphone owners, the college educated, those who are sad some or all of the time, and those who are anxious most of the time were significantly more likely to seek online health information. Conversely, being angry all of the time decreased the likelihood of seeking. Furthermore, two significant interactions emerged between anxiety and education levels. Discrete psychological states and demographic factors (gender and education) individually and jointly impact information seeking tendencies.

[1]  Michelle Pannor Silver,et al.  Patient Perspectives on Online Health Information and Communication With Doctors: A Qualitative Study of Patients 50 Years Old and Over , 2015, Journal of medical Internet research.

[2]  C. Carver,et al.  Anger is an approach-related affect: evidence and implications. , 2009, Psychological bulletin.

[3]  S. Cotten,et al.  Characteristics of online and offline health information seekers and factors that discriminate between them. , 2004, Social science & medicine.

[4]  Tilo Hartmann,et al.  Online health anxiety and consultation satisfaction: A quantitative exploratory study on their relations. , 2016, Patient education and counseling.

[5]  B. Fredrickson.  What Good Are Positive Emotions? , 1998, Review of general psychology : journal of Division 1, of the American Psychological Association.

[6]  Jessica Fitts Willoughby,et al.  Does Context Matter? Examining PRISM as a Guiding Framework for Context-Specific Health Risk Information Seeking Among Young Adults , 2016, Journal of health communication.

[7]  Ira J. Roseman.  Emotional Behaviors, Emotivational Goals, Emotion Strategies: Multiple Levels of Organization Integrate Variable and Consistent Responses , 2011 .

[8]  K. Scherer,et al.  Appraisal processes in emotion: Theory, methods, research. , 2001 .

[9]  J. Moskowitz,et al.  The role of discrete emotions in health outcomes: A critical review , 2007 .

[10]  R. Hornik,et al.  Cancer Information Scanning and Seeking Behavior is Associated with Knowledge, Lifestyle Choices, and Screening , 2006, Journal of health communication.

[11]  R. Lazarus.  Emotion and Adaptation , 1991 .

[12]  C. Green,et al.  Gender, psychosocial factors and the use of medical services: a longitudinal analysis. , 1999, Social science & medicine.

[13]  A. Maslow.  A Theory of Human Motivation , 1943 .

[14]  Lawrence S Wissow.  Emotional states and information seeking. , 2007, Patient education and counseling.

[15]  P. Gilster.  Digital Literacy , 1997, Encyclopedia of Education and Information Technologies.

[16]  Jessica Gall Myrick,et al.  The role of emotions and social cognitive variables in online health information seeking processes and effects , 2017, Comput. Hum. Behav..

[17]  S. Dunwoody,et al.  Proposed model of the relationship of risk information seeking and processing to the development of preventive behaviors. , 1999, Environmental research.

[18]  Annie Lang.  Using the Limited Capacity Model of Motivated Mediated Message Processing to Design Effective Cancer Communication Messages , 2006 .

[19]  Matthew S. Eastin,et al.  Worried and Wired: Effects of Health Anxiety on Information-Seeking and Health Care Utilization Behaviors , 2006, Cyberpsychology Behav. Soc. Netw..

[20]  Robin L. Nabi.  The Case for Emphasizing Discrete Emotions in Communication Research , 2010 .

[21]  N. Frijda,et al.  Relations among emotion, appraisal, and emotional action readiness , 1989 .

[22]  Wen-Ying Sylvia Chou,et al.  Predictors of eHealth Usage: Insights on The Digital Divide From the Health Information National Trends Survey 2012 , 2014, Journal of medical Internet research.

[23]  Jessica Fitts Willoughby,et al.  How and why young adults do and do not search for health information: Cognitive and affective factors , 2016 .

[24]  L. Kahlor,et al.  What, Me Worry? The Role of Affect in Information Seeking and Avoidance , 2013 .

[25]  S. Folkman,et al.  Socioeconomic Status and Health , 1994 .

[26]  Gary L. Kreps,et al.  Rethinking Communication in the E-health Era , 2003, Journal of health psychology.

[27]  L. Solberg,et al.  Are physicians less likely to recommend preventive services to low-SES patients? , 1997, Preventive medicine.

[28]  D. Zillmann.  Mood Management Through Communication Choices , 1988 .

[29]  E. Harmon-Jones,et al.  State anger and prefrontal brain activity: evidence that insult-related relative left-prefrontal activation is associated with experienced anger and aggression. , 2001, Journal of personality and social psychology.

[30]  Maxine Weinstein,et al.  Socioeconomic Status and Biological Markers of Health , 2015, Journal of aging and health.

[31]  Craig A. Smith,et al.  Appraisal components, core relational themes, and the emotions , 1993 .

[32]  C M Lawrence,et al.  Melanoma screening clinics: are we detecting more melanomas or reassuring the worried well? , 2006, The British journal of dermatology.

[33]  L. Kahlor.  PRISM: A Planned Risk Information Seeking Model , 2010, Health communication.

[34]  Janet Morahan-Martin,et al.  How Internet Users Find, Evaluate, and Use Online Health Information: A Cross-Cultural Review , 2004, Cyberpsychology Behav. Soc. Netw..

[35]  Ye Sun,et al.  Health information seeking and scanning among US adults aged 50–75 years: Testing a key postulate of the information overload model , 2017, Health Informatics J..

[36]  Ira J. Roseman,et al.  Phenomenology, Behaviors, and Goals Differentiate Discrete Emotions , 1994 .

[37]  Alexander Johannes Aloysius Maria van Deursen,et al.  Rethinking Internet skills: The contribution of gender, age, education, Internet experience, and hours online to medium- and content-related Internet skills , 2011 .

[38]  Jeff T. Larsen,et al.  Can people feel happy and sad at the same time? , 2001, Journal of personality and social psychology.

[39]  Jiyeon So.  A Further Extension of the Extended Parallel Process Model (E-EPPM): Implications of Cognitive Appraisal Theory of Emotion and Dispositional Coping Style , 2013, Health communication.

[40]  Z. J. Yang,et al.  Trust and affect: how do they impact risk information seeking in a health context? , 2012 .

[41]  A. Damasio.  Descartes' error: emotion, reason, and the human brain. avon books , 1994 .

[42]  B. Tabachnick,et al.  Using multivariate statistics, 5th ed. , 2007 .

[43]  Michel Tuan Pham,et al.  All Negative Moods Are Not Equal: Motivational Influences of Anxiety and Sadness on Decision Making. , 1999, Organizational behavior and human decision processes.

[44]  James Price Dillard,et al.  Affect and Persuasion , 2000, Commun. Res..

[45]  P J Wagner,et al.  Health beliefs and physician identified "worried well". , 1984, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[46]  James Price Dillard,et al.  The Multiple Affective Outcomes of AIDS PSAs , 1996 .

[47]  K. Thorpe,et al.  Treated disease prevalence and spending per treated case drove most of the growth in health care spending in 1987-2009. , 2013, Health affairs.

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

[49]  Walid A. Afifi,et al.  Toward a Theory of Motivated Information Management , 2004 .

[50]  S. Fortmann,et al.  Socioeconomic status and health: how education, income, and occupation contribute to risk factors for cardiovascular disease. , 1992, American journal of public health.