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.

[1]  V. Strecher.  Internet methods for delivering behavioral and health-related interventions (eHealth). , 2007, Annual review of clinical psychology.

[2]  Mohamad M. Saab,et al.  Men's information‐seeking behavior regarding cancer risk and screening: A meta‐narrative systematic review , 2018, Psycho-oncology.

[3]  Peter C Black,et al.  Prostate cancer on the Internet--information or misinformation? , 2006, The Journal of urology.

[4]  Bo Xie,et al.  Effects of an eHealth Literacy Intervention for Older Adults , 2011, Journal of medical Internet research.

[5]  Samantha R. Paige,et al.  eHealth Literacy and Web 2.0 Health Information Seeking Behaviors Among Baby Boomers and Older Adults , 2015, Journal of medical Internet research.

[6]  Douglas G Altman,et al.  [The Strengthening the Reporting of Observational Studies in Epidemiology [STROBE] statement: guidelines for reporting observational studies]. , 2007, Gaceta sanitaria.

[7]  M. Brundage,et al.  Prostate cancer patients' experience and preferences for acquiring information early in their care. , 2018, Canadian Urological Association journal = Journal de l'Association des urologues du Canada.

[8]  Suzanne M. Miller,et al.  Monitoring style of coping with cancer related threats: a review of the literature , 2014, Journal of Behavioral Medicine.

[9]  Ernest Johnson,et al.  Internet Use and Access to Health Information among Canadians: Are the Elderly on the Sidelines? , 2016 .

[10]  Alejandro R Jadad,et al.  What patients with cancer want to know about pain: a qualitative study. , 2008, Journal of pain and symptom management.

[11]  J. Protheroe,et al.  The digital divide: Examining socio-demographic factors associated with health literacy, access and use of internet to seek health information , 2019, Journal of health psychology.

[12]  J.L. Bender,et al.  Supporting cancer patients through the continuum of care: a view from the age of social networks and computer-mediated communication , 2008, Current oncology.

[13]  Chandy S Ellimoottil,et al.  Readability of websites containing information about prostate cancer treatment options. , 2012, The Journal of urology.

[14]  Matthias Egger,et al.  The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for Reporting Observational Studies , 2007, PLoS medicine.

[15]  Cameron D. Norman,et al.  eHEALS: The eHealth Literacy Scale , 2006, Journal of medical Internet research.

[16]  Deb Feldman-Stewart,et al.  What Questions Do Patients with Curable Prostate Cancer Want Answered? , 2000, Medical decision making : an international journal of the Society for Medical Decision Making.

[17]  M. Brundage,et al.  Overall information needs of early-stage prostate cancer patients over a decade: highly variable and remarkably stable , 2009, Supportive Care in Cancer.

[18]  M. Jefford,et al.  Informing and involving cancer patients in their own care. , 2002, The Lancet. Oncology.

[19]  S. Aranda,et al.  Validation of the Supportive Care Needs Survey—short form 34 with a simplified response format in men with prostate cancer , 2012, Psycho-oncology.

[20]  N. Choi,et al.  The Digital Divide Among Low-Income Homebound Older Adults: Internet Use Patterns, eHealth Literacy, and Attitudes Toward Computer/Internet Use , 2013, Journal of medical Internet research.

[21]  Juliana Genova,et al.  Communication AssessmenT Checklist in Health: Assessment and Comparison of Web-Based Health Resources , 2016 .

[22]  Hsiu-Fang Hsieh,et al.  Three Approaches to Qualitative Content Analysis , 2005, Qualitative health research.

[23]  C. Mathers,et al.  Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008 , 2010, International journal of cancer.

[24]  Wura Jacobs,et al.  Health information seeking in the digital age: An analysis of health information seeking behavior among US adults , 2017 .

[25]  Katrina Armstrong,et al.  Differences in information seeking among breast, prostate, and colorectal cancer patients: results from a population-based survey. , 2010, Patient education and counseling.

[26]  G. Regehr,et al.  Malignant websites? Analyzing the quality of prostate cancer education web resources. , 2018, Canadian Urological Association journal = Journal de l'Association des urologues du Canada.

[27]  W. Chou,et al.  Health-related Internet use among cancer survivors: data from the Health Information National Trends Survey, 2003–2008 , 2011, Journal of cancer survivorship : research and practice.

[28]  Michael Massimi,et al.  Life transitions and online health communities: reflecting on adoption, use, and disengagement , 2014, CSCW.

[29]  Suzanne M. Miller,et al.  Monitoring versus blunting styles of coping with cancer influence the information patients want and need about their disease. Implications for cancer screening and management , 1995, Cancer.