Reasons people avoid colorectal cancer information: a mixed-methods study

Reducing information avoidance: The effectiveness of humour, cute animals and coping messages

OBJECTIVES

Guided by the hedonic surplus/mood-as-resource hypotheses, we sought to identify message components that prevent health information avoidance by inducing hedonic psychological states.

DESIGN

Two experimental studies.

METHODS

Participants, age 45-75, recruited from the online survey platform, Prolific (Study 1 N = 288, Study 2 N = 505), completed a survey of their colorectal cancer (CRC) information avoidance tendency and demographics. They were reinvited to participate in a study where they were randomized to view one of four types of images: humorous comics, cute animals, coping messages or streetscapes images (control condition). To assess CRC information avoidance behaviour after viewing the stimuli, participants choose whether to be directed to a website to complete a CRC risk calculator (Study 1), or whether to view a CRC information video or a video about foot care (Study 2). Using logistic regression, we regressed each outcome variable on interactions between self-reported CRC information avoidance tendency and experimental condition. We then used the PROCESS macro to test if mood mediated these interaction effects.

RESULTS

In Study 1, to the degree participants reported CRC information avoidance tendency, viewing humorous comics compared to control images increased their odds of choosing to view the risk calculator (OR = 5.26, p = .02). The same was true in Study 2 for choosing to watch the video about CRC vs. foot care (OR = 2.42, p = .04). Effects were not mediated through mood and there were no effects for the cute animals or coping messages.

CONCLUSIONS

Using humour at the outset of a health message may increase reach to people who otherwise avoid CRC or other health messaging.

A model for predicting factors affecting health information avoidance on WeChat

Objective

WeChat serves as a crucial source of health information, distinguished by its highly personalized nature. Avoidance of such personalized health information has a direct impact on individuals' health decision-making. This study aims to identify the factors influencing personalized health information avoidance on WeChat and to construct a hierarchical framework illustrating the relationships among these factors.

Methods

A hybrid method was utilized. Semi-structured interviews and grounded theory were used to identify the influencing factors. The interpretive structural modeling (ISM) method was adopted to develop a hierarchical model of the identified factors, followed by matrice d'impacts croises-multiplication appliqué a un classemen (MICMAC) to analyze the dependence and driving power of each factor.

Results

The 20 predictors of personalized health information avoidance were broadly categorized into three groups: personal, informational, and social factors. These factors collectively form a three-tier explanatory framework, consisting of the top, middle and bottom layers. At the root layer, health characteristics and cognition exerted a strong driving force, while negative emotions and affective factors at the top layer showed a high degree of dependence. In contrast, the decision-making cognition, informational factors, and social factors in the middle layer exhibited relatively weaker driving force and dependence power.

Conclusion

This study bridged the research gap of information avoidance by providing new insights targeting the factors influencing personalized health information avoidance behavior on WeChat. It also contributed to enhancing personal health information management and the health information services provided on WeChat.

Colorectal cancer information avoidance is associated with screening adherence

Colorectal cancer (CRC) is the fourth most common cancer among U.S. men and women and the second deadliest. Effective screening modalities can either prevent CRC or find it earlier, but fewer than two thirds of U.S. adults are adherent to CRC screening guidelines. We tested whether people who defensively avoid CRC information have lower adherence to CRC screening recommendations and weaker intentions for being screened and whether CRC information avoidance adds predictive ability beyond known determinants of screening. Participants, aged 45-75 years, completed a survey about known structural determinants of CRC screening (healthcare coverage, healthcare use, provider recommendation), CRC information avoidance tendencies, and screening behavior (n = 887) and intentions (n = 425). Models were tested with multivariable regression and structural equation modeling (SEM). To the extent that participants avoided CRC information, they had lower odds of being adherent to CRC screening guidelines (OR = 0.55) and if non-adherent, less likely to intend to be screened (b=-0.50). In the SEM model, avoidance was negatively associated with each known structural determinant of screening and with lower screening adherence (ps < 0.01). Fit was significantly worse for nested SEM models when avoidance was not included, (i.e., the paths to avoidance were fixed to zero). Information avoidance was associated with screening behavior and other known structural determinants of screening adherence, potentially compounding its influence. Novel strategies are needed to reach avoiders, including health communication messaging that disrupts avoidance and interventions external to the healthcare system, with which avoiders are less engaged.