Effects of scanning (routine health information exposure) on cancer screening and prevention behaviors in the general population

Engaging and (the Illusion of) Learning? Examining the Relationship Between Different Social Media Activities and Reproductive Health Knowledge

Social media have become fundamental platforms for learning about health, including reproductive health knowledge. However, little is known about what specific user activity is conducive to learning about reproductive health and by what means. Drawing upon the cognitive mediation model, this study examines how different social media activities function in terms of elaboration and knowledge gain. Our hypothesized model was largely supported by a nationwide online survey with 1,000 Chinese women residing in both rural and urban areas. The results revealed the crucial role of information elaboration in bridging different social media activities with both subjective and factual reproductive health knowledge. Interestingly, public reposting of reproductive health information was found to be positively related to subjective knowledge but negatively related to factual knowledge, suggesting the emergence of an illusion of knowing among our participants. Multigroup SEM analyses revealed that the positive roles of scanning and private sharing in encouraging elaboration were more pronounced among users with lower levels of need for cognition. The findings are expected to contribute to a more nuanced understanding of health learning based on users' social media activities and intrinsic motivations for learning.

"I Saw it Incidentally but Frequently": Exploring the Effects of Online Health Information Scanning on Lung Cancer Screening Behaviors Among Chinese Smokers

In China, lung cancer is the most common cancer with high mortality. While prior research suggests that health information scanning influences cancer screening within the general population, a deeper exploration of the underlying mechanisms is imperative. This study specifically targets smokers, aiming to investigate whether online health information scanning can effectively encourage lung cancer screening and elucidate the mechanisms driving this association. Data were extracted from a Chinese national survey conducted between January and September 2023, exclusively involving current smokers (N = 992). A moderated mediation model was employed to examine a cognitive-affective sequential chain of mediation through risk perceptions and cancer worry. Results showed that 99.1% of Chinese smokers reported online health information scanning, which possessed significant influence. Online health information scanning was positively associated with effective lung cancer screening among smokers directly (OR = 1.927, p < .01) and indirectly (OR = .065, p < .001). The perceived threat of smoking and cancer worry served as the cognitive and affective mediating mechanisms. Furthermore, a moderating effect of eHealth literacy was observed (OR = 6.292, p < .05). Smokers with higher eHealth literacy are more inclined to undergo effective lung cancer screening. Based on these findings, public health sectors should leverage online platforms to disseminate tailored cancer screening education and implement initiatives to enhance public eHealth literacy.

From Information Seeking and Scanning to the Practice of Healthy Habits: A Longitudinal Test of the Integrative Model of Behavioral Prediction in the Context of Fruit and Vegetable Consumption

Fruit and vegetable intake is essential for health, but global adherence to recommended levels remains insufficient. Health information exposure positively influences consumption, yet the underlying mechanisms are not fully understood. This study aims to explore the relationships between information seeking and scanning, attitudes, norms, perceived behavioral control (PBC), intentions, and fruit and vegetable intake, following the main tenets of the Integrative Model of Behavioral Prediction (IM). Data were collected through face-to-face surveys in Santiago, Chile, with a representative sample of individuals aged 25 and older in two waves. Findings revealed that intentions in Wave 1 predicted fruit and vegetable consumption in Wave 2, with positive associations between attitudes, norms, PBC, and intentions. Information seeking was positively associated with attitudes, norms, and PBC, and it had indirect effects on fruit and vegetable consumption through attitudes, norms, PBC, and intentions. Information scanning did not show significant indirect effects on fruit and vegetable consumption, even though the path between scanning and attitudes was significant. The study provides support for the IM and highlights the importance of information seeking in promoting fruit and vegetable consumption through its influence on attitudes, norms, and PBC. The findings have practical implications for health campaigns, educational programs, healthcare interactions, and public policies targeting healthier dietary habits.

Understanding the Effects of News-Finds-Me Perception on Health Knowledge and Information Seeking During Public Health Crises

News-finds-me (NFM) perception is a belief that, in the era of social media, individuals can remain adequately well-informed about current events even if they do not actively seek news. While it has been examined in the context of general and political news, NFM perception has not been explored in the context of other genres of news. Through an online survey involving 1,001 Singaporeans, with the Planned Risk Information Seeking Model, this study examines how NFM perception is related to information seeking and COVID-19 knowledge. An issue-specific NFM perception was also proposed and tested in order to determine whether NFM perception and its associated effects differ when operationalized as general news exposure or issue-specific news relating to COVID-19. The negative relationship between general NFM perception and knowledge and the mediating role of information seeking on social media in this relationship are detected. It is also found that when the NFM perception is issue-specific (i.e. COVID-NFM perception), information insufficiency and intentions of information seeking on social media fully mediated the relationship between NFM perception and knowledge. Theoretical and practical implications are discussed.

The impact of internet health information seeking on COVID-19 vaccination behavior in China

BACKGROUND

Amid the COVID-19 pandemic, the significance of vaccination has been emphatically underscored. As the foremost and pivotal measure for preventing COVID-19 transmission, the COVID-19 pneumonia vaccine plays an instrumental role in the global response to this infectious respiratory disease. However, COVID-19 vaccination coverage remains challenging in low- and middle-income countries and regions. Studies have found that frequent seeking to health information is also associated with healthier behaviors, but these studies have not yet focused on the impact of Internet health information seeking on individual vaccination and the mechanism of this effect.

METHODS

Data were obtained from the Chinese General Social Survey (CGSS) conducted in 2021, which included 7,218 individual samples. This study used COVID-19 vaccination as indicators for the health of interest, the key independent variable is Internet health information seeking. This study tried to analyze the impact of Internet health information seeking on COVID-19 vaccination using an OLS model and PSM method.

RESULTS

The results show that Internet health information seeking has a significant positive impact on COVID-19 vaccination. This result passed a series of robustness tests. The mechanism analysis indicated that compared to non-Internet health information seeking individuals, Internet health information seeking individuals could know the superior advantages of vaccination and the potential for immunization through this method. And individuals who use Internet to seeking health information are more likely to acknowledge the constructive impact of online information on health behavior. This helps to explain why Internet health information seeking individuals have a higher rate of COVID-19 vaccination.

CONCLUSIONS

This study delves into the influence of Internet health information seeking on individual COVID-19 vaccination within the digital era. The outcomes underscore that Internet-mediated seeking vaccine information holds the potential to bolster individuals' comprehension of vaccination benefits and foster increased acceptance of such information.

Heuristic Information Processing as a Mediating Factor in the Process of Exposure to COVID-19 Vaccine Information and Misinformation Sharing on Social Media

Social media use for risk communication during the COVID-19 pandemic has caused considerable concerns about an overabundance of information, particularly misinformation. However, how exposure to COVID-19 information on social media can lead to subsequent misinformation sharing during the pandemic has received little research attention. This study adopted the social amplification of risk framework to delineate how exposure to COVID-19 vaccine information on social media can be associated with individuals' misinformation sharing through heuristic information processing. The role of social media trust was also examined. Results from an online survey (N = 1488) of Chinese Internet users revealed that exposure to COVID-19 vaccine information on social media was associated with misinformation sharing, mediated by both affect heuristics (i.e., negative affect toward the COVID-19 pandemic in general) and availability heuristics (i.e., perceived misinformation availability). Importantly, both high and low levels of trust in social media strengthened the mediating associations. While a low level of trust strengthened the association between exposure to COVID-19 vaccine information on social media and the affect heuristics, a high level of trust strengthened its association with the availability heuristics, both of which were associated with misinformation sharing. Our findings suggest that heuristic information processing is essential in amplifying the spread of misinformation after exposure to risk information on social media. It is also suggested that individuals should maintain a middle level of trust in social media, being open while critical of risk information on social media.

Information scanning in the COVID-19 pandemic: a test and expansion of the channel complementarity theory using latent class analysis

BACKGROUND

During health crisis, individuals need information to comprehend their circumstances. Channel complementarity theory posits that in meeting their informational needs, people will use different sources in a complementary fashion. This paper puts to test the main tenet of channel complementarity theory by focusing on information scanning (i.e. routine health information exposure) in the context of the COVID-19 pandemic in Chile.

METHOD

A survey was conducted among a sample of Chilean adults (N = 2,805). The questionnaire addressed information scanning across six sources (television, radio, internet, social media, family, and friends or coworkers) and explores how socioeconomic and demographic variables, as well as COVID-19 perceived risk related to scanning. Latent class analysis was employed to identify patterns of complementarity across channels.

RESULTS

The analysis yielded a solution of five classes, namely 'high complementarity and high frequency' (21%), 'high complementarity and low frequency' (34%), 'high frequency on television and digital media' (19%), 'mass media predominant' (11%), and 'no scanning' (15%). Educational attainment, age, and COVID-19 perceived risk were associated with scanning.

CONCLUSIONS

Television was a central channel for information scanning during the pandemic in Chile and more than half of participants scanned COVID-19 information complementarily. Our findings expand channel complementarity theory to information scanning in a non-US context and provide guidelines for designing communication interventions aiming at informing individuals during a global health crisis.

A community-based participatory protocol to improving communication with Black men about oral and pharyngeal cancers: Research protocol

Black men are disproportionately impacted by oral and pharyngeal cancer (OPC) mortality. This is in part due to a lack of information received about OPCs and their associated risk factors during health encounters. Discussions between dentists and Black men may improve Black men's knowledge, screening, and treatment uptake. Yet, dentists do not commonly communicate with Black men about OPCs due to their own discomfort. This paper describes the protocol for our research project, which proposes an initiative, grounded in community-based participatory research, to adapt a culturally-specific OPC communication tool. This tool will be adapted using a mixed-methods approach to assess the knowledge, attitudes, and experiences of Black men discussing OPCs and associated risk factors with dental providers. The tool will then be assessed for feasibility and acceptability among Black men, as well as dental students and dental providers in community-based clinical settings.

Effect of information encounter on concerns over healthy eating- mediated through body comparison and moderated by body mass index or body satisfaction

BACKGROUND

Understanding factors that influence healthy or unhealthy eating can inform intervention strategies. This study ascertained whether and how unintentional exposure to food and nutrition information influenced healthy eating concerns. The study tested body comparison, body satisfaction, and body mass index as three mechanisms that potentially link food information encounter, commonly known as information scanning, to healthy eating concerns.

METHODS

A sample of 440 online participants (mean age = 29.15 years) was used to investigate: (1) how unintentional exposure to food and nutrition information, i.e., information encounter (IE), affects healthy eating concerns (HEC); (2) how the effect of IE on HEC is mediated by body comparison (BC); (3) how the paths of the mediation model are moderated by body satisfaction (BS) or body mass index (BMI).

RESULTS

The findings show a positive and sizable total effect of IE on HEC - a whole-scale increase in information encounter is associated with a substantial increase in healthy eating concerns by 15 percentage points (b_p = 0.150). BC is found to mediate the effect of IE on HEC in an all-positive complementary mediation. Both the indirect and the direct-and-remainder paths show sizable effects. The mediated path contributes about 20% of the total effect between IE and HEC (c_p = 20%), while the direct-and-remainder path contributes the rest (c_p = 80%). BS was found to moderate the relationship between IE and BC, the first leg of the mediation. The moderation effect is large - the effect of IE on BC is much smaller on the highly and the moderately satisfied than on the lowly satisfied (slope differential b_p = -.60). BMI was found to moderate the direct-and-remainder effect of IE on HEC, controlling BC. That is, the effect of IE on HEC, after filtering out the mediated effect through BC, is much larger for those with high or low BMI than those with healthy BMI (slope differential b_p = .32).

CONCLUSIONS

Exposure, even if unintentional, to food and nutrition information is an important predictor of HEC. BC, BS, and BMI are important factors that help to explain the process through which information affects behaviors.

[COVID-19 risk groups and their strategies for navigating information overload during the first year of the pandemic in Chile]

As a part of the EIS-COVID project on the access and use of information during the COVID-19 pandemic in Chile, the objective of this paper was to ascertain how people's informational environment was constructed during the first stage of the pandemic. It discusses the results of a qualitative study of people belonging to risk groups for COVID-19: people over 18 and under 65 with chronic diseases (hypertension and diabetes) and people 65 and over. Ninety semi-structured interviews were conducted in the Metropolitan and Valparaíso regions between September 2020 and January 2021. The results reveal the problematic nature of the information overload encountered by these groups and the strategies they used to navigate it: a) information avoidance; b) content corroboration and active search for reliable sources; and c) differentiated media use.

The Effects of Receiving and Expressing Health Information on Social Media during the COVID-19 Infodemic: An Online Survey among Malaysians

Social media is used by the masses not only to seek health information but also to express feelings on an array of issues, including those related to health. However, there has been little investigation on the influence of expressing and receiving information in terms of health-related engagement on social media. Moreover, little is known of the cognitive mechanisms underlying the expression and reception of health information on information overload (IO) during an infectious disease outbreak. Guided by the Cognitive Mediation Model (CMM), this study proposes a conceptual model to understand the effects of receiving and expressing COVID-19 information on social media on IO. Using an online survey conducted in Malaysia, our results indicated that risk perception positively predicted the reception and expression of information which, in turn, was positively associated with perceived stress and IO. Additionally, perceived stress triggered IO, indicating that the greater the perceived stress from health information engagement, the higher the likelihood of one experiencing IO during the pandemic. We conclude that the CMM can be extended to study IO as an outcome variable. More studies in diverse health contexts need to be conducted to enhance the conceptualization and operationalization of IO in health information processing.

COVID-19 Vaccine-related Information Seeking and Scanning: A Test of Mediators between Information Acquisition and Vaccination Intention among Unvaccinated Black Americans

Health information seeking and scanning are two important information acquisition strategies that can influence subsequent health behaviors. This research was contextualized in COVID-19 vaccinations and examined the effects of information seeking and scanning on vaccination intention among unvaccinated Black Americans (N = 1,278). Moreover, this research conceptualized perceived risk and efficacy as the intervening factors for the relationship between information acquisition and behavioral intention. The results indicated that information seeking had a significant effect on vaccination intention, whereas information scanning had no effect. Perceived susceptibility and response efficacy mediated the relationship between information seeking and vaccination intention. The proposed mediators did not mediate the relationship between information scanning and vaccination intention. Theoretical and practical implications are offered.

Associations Between COVID-19 Information Acquisition and Vaccination Intention: The Roles of Anticipated Regret and Collective Responsibility

While public health communication has been suggested to be a key for improving acceptance of COVID-19 vaccination, this study tested mediation pathways through which three types of vaccine information acquisition, i.e. seeking, scanning, and discussing, affect COVID-19 vaccination intention. The pathways comprise two mediators, i.e. anticipated regret due to inaction and collective responsibility. Results suggest that information seeking and discussing may have encouraged the intention to get vaccinated, but mainly indirectly through the two mediators. Information seeking and discussing may have elicited anticipated regret and collective responsibility, which in turn increased vaccination intention. The paths from information scanning were smaller in effect sizes and statistically unacknowledged. Implications and limitations are discussed.

Information Scanning Impacts Nonmedical Drug Use Among College Students: A Longitudinal Study of Scanning Effects

Health information that is acquired through information scanning has been shown to play an important role in shaping individual beliefs and health behavior. This study examines the direct and indirect effects of the breadth of scanning from media and interpersonal sources about two risk behaviors (nonmedical use of amphetamines and marijuana) on subsequent drug use behavior through changes to perceived norms. We test effects of scanning using a longitudinal online survey design with data collected at six-month intervals over three time points among 800 Israeli undergraduate students in their freshman year. Of the 800 respondents who participated in the first wave, 62.4% completed the second wave (N = 499), among which 347 (69.5%) completed a follow-up 6 months later. Results of cross-lagged structural equation models find that scanning information about amphetamines from interpersonal sources at 6 months predicted an increased likelihood of nonmedical use of amphetamines at 12-months. In addition, young adults who scanned information about marijuana from media sources at 6 months reported greater nonmedical marijuana use at 12 months. Breadth of scanning about marijuana from media sources mediated the relationship between perceived norms and marijuana use at 12 months. Results also showed indirect effects of scanning at baseline on nonmedical drug use at 12 months through scanning from the same source at 6 months. These findings contribute to our understanding of the role of information scanning and perceived norms in shaping substance use behaviors, and suggest that scanning may serve as a potential early indicator of risk.

A communication inequalities approach to disparities in fruit and vegetable consumption: Findings from a national survey with U.S. adults

OBJECTIVES

This study assessed whether socioeconomic disparities in fruit and vegetable consumption and its differences by social capital are accounted for by exposure to media information about fruits and vegetables and reflective integration of that information.

METHODS

Online survey data were collected in July 2014 from 572 U.S. adults from a nationally representative online panel. Path analysis was employed to test our models.

RESULTS

Education and social capital were positively associated with media exposure, which was in turn positively related to reflective integration and finally led to fruit and vegetable consumption. Education and income were positively associated with social capital.

CONCLUSION

Differences in fruit and vegetable consumption across social groups are at least partly explained by exposure to information about fruits and vegetables from the media, and by reflective integration of that information.

PRACTICE IMPLICATIONS

Healthcare professionals and health educators should create health messages delivered via the media that are easy to understand with an appropriate level of health literacy. Also, health interventions that aim to build social capital may promote health media use and its reasoning processes, thereby reducing communication inequalities by SES as well as disparities in fruit and vegetable consumption.

Linking Risk Perception to Breast Cancer Examination Intention in China: Examining an Adapted Cognitive Mediation Model

Drawn upon the cognitive mediation model, this study proposes an adapted model and examines the mechanisms by which Chinese women's risk perception of breast cancer becomes associated with their breast cancer examination intention. Our hypothesized model was largely supported by an online survey with a nationwide sample of 458 Chinese women. The results indicated that a person's perceived risk for breast cancer motivated information seeking and scanning using various mass media and online channels, which then positively predicted the person's quest for greater elaboration and more interpersonal discussion. In addition, elaboration was positively associated with breast cancer-related factual knowledge and subjective norms, whereas interpersonal discussion only exerted a positive relationship with subjective norms but not factual knowledge. As predicted, knowledge and subjective norms were positively associated with people's intentions to pursue breast cancer examination. Future research should consider both information seeking and scanning in the process of media learning and reflection. In addition to intrapersonal factors like knowledge, the interpersonal reasoning process that cultivates a favorable social influence is pivotal in promoting breast cancer examination in China.

Explicating the health-related digital divide: A mediation mechanism between education level and online cancer information seeking frequency among Chinese adults

In China, highly educated adults seek online cancer information more frequently than less educated adults. This health-related digital divide may impede the less-educated from effectively preventing cancer. To explicate the divide, we introduce informational subjective norms (ISN) and information sufficiency threshold (IST) as two socio-psychological mediators between education level and online cancer information seeking (OCIS) frequency. ISN represents one's perceived social pressure about seeking cancer information, while IST manifests individual evaluation of the amount of information needed to prevent cancer. An online survey supported a serial mediation effect of ISN and IST. ISN and IST also independently mediated the relationship between education level and OCIS frequency. Besides, the mediation effect of ISN was stronger than that of IST. The findings suggest that increasing ISN among less educated Chinese adults could facilitate their OCIS and to narrow the health-related digital divide. These implications may also inform other developing countries.

The use of Web-based interactive technology to promote HPV vaccine uptake among young females: a randomized controlled trial

BACKGROUND

Currently no study has investigated whether Web-based interactive technology can influence females to adopt healthy behaviors. We investigated how and under what conditions do Web-based interactivity influence vaccination intentions among young females.

METHODS

In this randomized controlled trail, we conduct a 2 (mode of information presentation: narrative vs. data visualization) × 2 (interactivity: interactive information vs. noninteractive information) between-groups design. A total of 180 Chinese female undergraduate students who had never received HPV vaccination were randomly allocated to 4 experimental groups. Each participant was assessed for their information avoidance behavior and vaccination intention. The hypotheses were tested using a moderated mediation model. All analyses were performed using SPSS version 22.0 with probability set at 0.05 alpha level.

RESULTS

The indirect relationship between interactivity and behavioral intention though information avoidance was moderated by the mode of presentation. Under the narrative condition, interactivity (vs. non-interactivity) decreased information avoidance and increased the intention to receive HPV vaccination (B = -.23, SE = 0.10, P < 0.05). However, under data visualization condition, no significant difference was observed between the effects of interactivity and non-interactivity on intention.

CONCLUSION

The findings suggest that when young females experience difficulties in manipulating or understanding HPV-related information, their information-avoidance behavior is likely to increase. Rather than use interactive statistical or graphical information, young females are more likely to be persuaded by interactive narratives.

Examining an Integrative Cognitive Model of Predicting Health App Use: Longitudinal Observational Study

BACKGROUND

Specifying the determinants of using health apps has been an important research topic for health scholars as health apps have proliferated during the past decade. Socioeconomic status (SES) has been revealed as a significant determinant of using health apps, but the cognitive mechanisms underlying the relationship between SES and health app use are unknown.

OBJECTIVE

This study aims to examine the cognitive mechanisms underlying the relationships between SES and use of health apps, applying the integrative model of behavioral prediction (IM). The model hypothesizes the indirect influences of SES on intentions to use health apps, which in turn predict actual use of health apps. The relationships between SES and intentions to use health apps were assumed to be mediated by proximal variables (attitudes, perceived behavioral control [PBC], injunctive norms, and descriptive norms).

METHODS

We conducted path analyses using data from a two-wave opt-in panel survey of Korean adults who knew about health apps. The number of respondents was 605 at baseline and 440 at follow-up. We compared our model with two alternative theoretical models based on modified IM to further clarify the roles of determinants of health app use.

RESULTS

Attitudes (β=.220, P<.001), PBC (β=.461, P<.001), and injunctive norms (β=.186, P<.001) were positively associated with intentions to use health apps, which, in turn, were positively related to actual use of health apps (β=.106, P=.03). Income was positively associated with intentions to use health apps, and this relationship was mediated by attitudes (B=0.012, 95% CI 0.001-0.023) and PBC (B=0.026, 95% CI 0.004-0.048). Education was positively associated with descriptive norms (β=.078, P=.03), but descriptive norms were not significantly related to intentions to use health apps. We also found that PBC interacted with attitudes (B=0.043, SE 0.022, P=.046) and jointly influenced intentions to use health apps, whereas the results did not support direct influences of education, income, and PBC on health app use.

CONCLUSIONS

We found that PBC over using health apps may be the most important factor in predicting health app use. This suggests the necessity of designing and promoting health apps in a user-friendly way. Our findings also imply that socioeconomic inequalities in using health apps may be reduced by increasing positive attitudes toward, and boosting PBC over, health app use among individuals with low income.

Odds of Meeting Cancer Prevention Behavior Recommendations by Health Information Seeking Behavior: a Cross-Sectional HINTS Analysis

People who seek health information frequently may be more likely to meet health behavior goals; however, people use many different information sources. The purpose of this paper is to assess how different sources of health information influence likelihood of meeting cancer prevention behavior guidelines. Logistic regression of cross-sectional data from 6 years of the Health Information National Trends Survey (HINTS) was conducted. Independent variables included first source of health information, gender, age, race, education level, income, cancer history, general health, and data year; dependent variables were fruit and vegetable intake, exercise, smoking, mammography, Pap test, and colon cancer screening. Those who seek health information from doctors, the internet, or publications had higher odds of meeting more cancer prevention guidelines than those who do not seek health information. Those who used healthcare providers as an initial information source had higher odds of meeting diet, cervical, and colon cancer screening recommendations, while using the internet as an initial source of health information was associated with higher odds of meeting diet, smoking, and colon cancer screening recommendations. No health information source was associated with meeting either exercise or mammography recommendations. People should be encouraged to seek health information to help them meet their behavior goals, especially from sources that are more likely to be accurate and encourage cancer prevention behavior. Future research is needed to understand the accuracy of health information and what kinds of health information have positive influences on cancer prevention behavior.

The Alzheimer case: perceptions, knowledge and the acquisition of information about Alzheimer's disease by middle-aged and older adults in Flanders

Alzheimer's disease (AD) is a major health concern as the world population ages. Yet, few studies have examined what the public over the age of 50 knows about AD. This qualitative study, based on 40 in-depth interviews, examines the knowledge of AD by Flemish people between 50 and 80 years old and their cross-source engagement with information sources. Building on AD media representations and theories on media complementarity and health information behaviour, we find that respondents mostly encounter AD information non-purposively via traditional mass media and interpersonal communication, while the internet is occasionally used to purposefully seek information. Novels, personal experiences/social proximity, public figures and particularly film stand out as channels and sources of AD information, suggesting that fictional narratives, personal experiences and being able to identify with others leave lasting impressions and help to communicate and disperse AD information. However, common misconceptions and gaps in knowledge persist, including AD being considered part of the normal ageing process and old age as well as confusing AD with Parkinson's disease. The biomedical perspective and the tragedy discourse prevail among the majority of respondents, who describe AD in terms of decline, loss and death and as ‘the beginning of the end’. Only a few, typically female respondents, appear aware of the role of individual health behaviour and lifestyle choices to prevent dementia or delay its onset. The misconceptions of AD and gaps in knowledge, as well as the fact that a third of all cases of dementia might be delayed or prevented by managing lifestyle and other risk factors, stress the importance of public educational programmes and the need to emphasise and raise awareness of preventative behaviour. Overall, the findings from this study can be of help to public health communicators and dementia-awareness campaigns, as well as AD training programmes for health-care professionals and family care-givers.

How individual and neighborhood characteristics relate to health topic awareness and information seeking

Structural determinants of health like neighborhood are often overlooked in the context of understanding public awareness of health topics and health information seeking behaviors. Seeking health information is particularly relevant given that some communities have higher prevalence of disease than others. Using the Structural Influence Model of Health Communication (SIMHC), this paper examines how both individual and neighborhood level characteristics contribute to health communication outcomes such as being aware of health topics like cancer, obesity, and HIV, and whether or not individual seeking health-related information or coming across information in the course of their general media use. Respondents to the Southeastern Pennsylvania Household Health Survey (SEPa HHS), a county-stratified random sample of adults ages 18-75 years old, who completed the survey in 2015, were recontacted for participation in 2017. Over one-thousand respondents (n=1,005) completed the survey, and the final sample size for this analysis was 887. Individual level correlates included demographic factors and relevant lifestyle behaviors (e.g., smoking); neighborhood level variables- determined by ZIP Code- included such socioeconomic status (SES) measures as percent unemployed, percent with a high school education, and percent living in poverty. Multilevel modeling was used to determine whether there were random effects on the health communication outcomes of interest. Analyses showed our outcomes of interest did not vary across neighborhoods, whether they were treated as random or fixed effects. Different characterizations of neighborhood (e.g., census block group) and different indicators of neighborhood media environments may be more likely to demonstrate macro level effects on health communication outcomes.

•

Neighborhood characteristics were not related to awareness of different health topics or health information seeking behavior.

•

For most topics, reported awareness of health topics from the media was greater than from medical providers.

•

Information scanning was more prevalent among those with a college education and who were younger and female.

Associations Between the Intention to Use Early Palliative Care, Sources of Information, and Attitudes Toward a Good Death in Korean Adults

CONTEXT

Providing hospice and palliative care (HPC) early in the course of care for patients with life-threatening illness is important for improving patient quality of life. However, little literature exists for factors affecting to the intention to use early palliative care (EPC) of general population.

OBJECTIVES

This study aimed to identify the sources of information about HPC, investigate whether they affect intention to use HPC and EPC, and examine the relationship between the components of a good death and the intention to use HPC and EPC.

METHODS

A stratified nationwide cross-sectional survey including 1500 participants, 20-74 years old, was conducted to investigate their intentions to use HPC and EPC, available information sources, and perceived components of a good death.

RESULTS

The main sources of information about HPC were television and radio. Information acquired from health professionals was positively associated with the intention to use EPC. Although regarding a good relationship with family as a component of a good death was related to low intention to use EPC, being able to trust medical staff, being involved in decisions about care, and being respected as an individual were associated with high intention to use EPC.

CONCLUSION

Information from health care providers and public awareness through education and publicity efforts are necessary to inform the public about the benefits of EPC. Furthermore, it is essential that medical staff cultivate the skills necessary to secure public trust and provide care that respects patients until the end of their lives.

Information Seeking as A Predictor of Risk Behavior: Testing A Behavior and Risk Information Engagement Model (BRIE)

Prior theoretical models of information seeking have examined its role, primarily, as a determinant of recommended behaviors. In this study, we develop and test the "behavior and risk information engagement" (BRIE) model, which accounts for the reciprocal effects of information seeking from interpersonal and media sources on two risk behaviors - nonmedical marijuana and amphetamine use. We test the model among young Israeli adults (N = 800) using a three-wave prospective observational study (at 6-month intervals). Autoregressive cross-lagged structural equation models showed good fit. Information seeking from interpersonal sources at baseline predicted amphetamine use and marijuana use at 6 months. In both models, seeking drug-related information from interpersonal sources at baseline was also a predictor of seeking information from media sources at 6 months. Information seeking from media sources at 6 months was also a significant predictor of amphetamine use at 12 months. Implications for theory and practice are discussed.

Barriers and Attitudes toward Breast Cancer Screening among Omani Women

Background:

Breast cancer (BC) is the most common cancer accounting for 24.5% of Omani female cancer. Early detection of BC through regular breast cancer screening (BCS) has been found to decrease mortality rates. The aim of this study was to identify knowledge, attitudes and barriers of Omani women toward BCS.

Methods:

A cross-sectional study was conducted among adult Omani women attending the Sultan Qaboos University Hospital (SQUH).

Results:

A total of 358 Omani women participated from 420 invited (response rate = 85.2%). Most women (92.1%) thought that BC could be cured if detected early, but less than half (46.8%) thought that they were at risk of BC if a relative had BC. The majority (81.1%) were aware that BCS was available in Oman, though less than half (48.5%) knew where to go for BCS and most (83.8%) had not undergone BCS before. The most common personal-related barriers to BCS were fear of BC diagnosis (40.8%), fear of treatment (52.1%) and embarrassment of the breast examination (46.6%). The most perceived system-related barriers to BCS were the concern over the availability of a male doctor (46.6%) or a non-Arabic speaking doctor (38.7%) and not recommended by the doctor (46.3%). Univariate binary logistic regression showed that attitudes toward BCS were influenced by their previous experiences of BCS (odds ratio [OR] = 2.28; 95% confidence interval [CI]: 1.18-4.41) and their willingness to participate in the future BCS [OR = 1.96; 95% CI: 1.14-3.37).

Conclusion:

Although Omani women showed an interest toward BCS, few had undergone BCS. Several cultural, practical and personal-related barriers were noted to interfere with BCS in Oman. Addressing these concerns through involving healthcare providers to reassure the women and implementing a national strategy of BCS could improve BCS screenings and early diagnosis of BC.

Media Complementarity and Health Information Acquisition: A Cross-sectional Analysis of the 2017 HINTS-China Survey

Given the myriad of media channels and available health information, it is important to investigate how health consumers navigate and choose from multiple media channels in seeking health information and their preferences among different media sources. Previous research has routinely measured health information-seeking behavior (HISB), especially online health information seeking as a whole, which does not capture the complexity and diversity of media channels used in HISB. On the basis of the channel complementarity theory, this study further classified new media into search engines, social media, and mobile health applications. The results of a secondary analysis of the Health Information National Trends Survey in China (HINTS-China) reinforced the occurrence of media complementary between information-oriented media (newspapers and magazines) and entertainment-oriented media (television). In addition, people used traditional media complementarily with new media, except information-oriented media and search engine use exhibited a displacement relationship. Moreover, the results indicated different profiles of health information seekers varied according to the diverse media channels, although media trust, perceived poor health status, chronic disease, and family cancer history consistently propelled HISB for both online and offline media channels. Implications for theory and practice for health communication were discussed.

Exploring the Effect of Health App Use on Fruit and Vegetable Consumption

People may use multiple health apps at the same time or in close sequence, and the effect of health apps may vary across different socioeconomic groups. However, in the context of healthy eating, studies have focused on the effect of using a single health app. This study aims to test the relationship of using multiple health apps with fruit and vegetable consumption, assessing moderation by education level. Employing longitudinal survey data from South Korean adults, we conducted regression analyses to test the lagged association between use of health apps and intake of fruits and vegetables, and whether education moderates the relationship. The results supported the positive lagged relationship of health app use with fruit and vegetable consumption, significant after controlling for confounders and baseline fruit and vegetable consumption. The association was smaller among respondents with higher education. Our findings suggest the positive effect of using multiple health apps on fruit and vegetable consumption, implying the importance of finding the best combination of health apps to maximize their effectiveness in promoting healthy eating. Also, the negative interaction of health app use and education support using mobile communication technology to improve the public health of low socioeconomic status individuals.

Breadth of Media Scanning Leads to Vaping among Youth and Young Adults: Evidence of Direct and Indirect Pathways from a National Longitudinal Survey

Electronic cigarette use among youth and young adults has reached an epidemic proportion of growth. This study examined the direct and indirect effects of the breadth of media scanning about e-cigarette use on subsequent vaping behavior through interpersonal communication and changes in descriptive norm perceptions. We conducted a nationally representative longitudinal phone survey of 13- to 25-year-olds from June 2014 to March 2017, with 11,013 respondents who completed a baseline survey, among which 3,212 completed a follow-up 6 months later. The results from both cross-sectional and lagged analyses provided robust evidence to suggest that passive routine exposure to e-cigarette use content from more media outlets predicted increased likelihood of vaping among youth and young adults. High scanners were about twice as likely to vape as non-scanners (17% versus 9%). Mediation models using bootstrapping procedures found that breadth of scanning predicted higher descriptive norm perceptions which were associated with subsequent vaping; in addition, interpersonal communication mediated the relationship between breadth of scanning and changes in descriptive norm perceptions. These findings highlight the important roles of scanning, norm perceptions and interpersonal discussions in shaping cognition and behavior changes. The results also suggest an overall pro-e-cigarette public communication environment, which warrants further examination.

Toward an Aggregate, Implicit, and Dynamic Model of Norm Formation: Capturing Large-Scale Media Representations of Dynamic Descriptive Norms Through Automated and Crowdsourced Content Analysis

Media content can shape people's descriptive norm perceptions by presenting either population-level prevalence information or descriptions of individuals' behaviors. Supervised machine learning and crowdsourcing can be combined to answer new, theoretical questions about the ways in which normative perceptions form and evolve through repeated, incidental exposure to normative mentions emanating from the media environment. Applying these methods, this study describes tobacco and e-cigarette norm prevalence and trends over 37 months through an examination of a census of 135,764 long-form media texts, 12,262 popular YouTube videos, and 75,322,911 tweets. Long-form texts mentioned tobacco population norms (4-5%) proportionately less often than e-cigarette population norms (20%). Individual use norms were common across sources, particularly YouTube (tobacco long-form: 34%; Twitter: 33%; YouTube: 88%; e-cigarette long form: 17%; Twitter: 16%; YouTube: 96%). The capacity to capture aggregated prevalence and temporal dynamics of normative media content permits asking population-level media effects questions that would otherwise be infeasible to address.

Exploring Health Information Sharing Behavior Among Chinese Older Adults: A Social Support Perspective

This study investigated the determinants of health information sharing behaviors of Chinese older adults living in rural areas. Drawing upon a widely used categorization of social support, we tested the effect of social embeddedness and perceived social support on health information sharing behavior, which is conceptualized as a type of enacted social support-informational support. Data were collected between June and August 2014 from 387 older Chinese adults aged 60-79 years in Linxi County of northern China. The results of hierarchical ordinary least squares regression analyses revealed that Chinese older adults' perceived social support from families and social embeddedness were positively associated with health information sharing behavior, net of the influence of social demographic controls and health information seeking and scanning behaviors. Furthermore, health information sharing behavior was also found to be positively associated with health information seeking and scanning behaviors. Overall, this study enriched the existing literature on health information sharing behavior by taking a social support perspective. A number of practical implications were also discussed.

Neighborhoods and Perceived Norms: Understanding the Impact of Neighborhoods on Perceived Norms and Cancer Screening

This study examines the importance of urban ethnic neighborhoods as the context of everyday life, where normative influences on health are formed, modified, and maintained. Built on communication infrastructure theory, this study investigates the role of women's connections to their neighborhood storytelling network-consisting of residents, local/ethnic media, and community organizations-in shaping their descriptive normative perceptions regarding cervical cancer screening. Specifically, we explore the communication mechanisms that underlie Latinas' exposure and attention to media information about Pap tests, their discussions with health-care professionals about Pap tests, their perceptions about how normative Pap tests are among "women like them", and their compliance with cervical cancer screening guidelines. Our findings suggest that neighborhood storytelling resources hold promise for health communication research to understand not only the uptake of Pap tests but also health disparities in other domains that affect diverse populations and communities.

Breast health, risk factors, and cancer screening among lesbian, bisexual, and queer/questioning women in China

In this study, we examine the health disparities of sexual minority women by surveying 310 lesbian, bisexual, and queer/questioning women (LBQW) in China about their breast health and cancer screening practices. We found that Chinese LBQW, particularly those identified with a masculine gender role and practice chest binding, are vulnerable to breast cancer given their high rates of behavioral risk factors (e.g., cigarette smoking) and symptoms (e.g., breast lumps) but low rates of self and clinical breast examinations. Salient barrier (stigma) and facilitators (social support availability, self-efficacy, and breast cancer information exposure) of breast cancer screening were also identified.

Health information exposure from information and communication technologies and its associations with health behaviors: Population-based survey

Health information and communication technologies (ICTs) are increasingly used but little is known about routine exposure to health information from ICTs and its associations with health behaviors. A territory-wide population-based dual landline and mobile telephone survey was conducted in 2016 in Hong Kong, where smartphone ownership and Internet access are among the most prevalent, easiest and fastest in the world. Health information exposure from traditional sources (television/radio/newspaper/magazine), Internet websites, social media sites and instant messaging (IM); and information on smoking, alcohol consumption and physical activity were recorded. Prevalence was weighted by age, sex and education level of the general population. Multinomial logistic regression was used to assess the association of health information exposure with smoking and alcohol consumption, whilst multivariable linear regression was used to assess the association with frequency of moderate and vigorous physical activity (days/week). Of 3063 respondents, most (71.6%) were often or sometimes exposed to health information from traditional sources, followed by Internet websites (40.9%), social media sites (40.7%), and IM (27.0%). Respondents with lower education and household income were less frequently exposed to health information from Internet websites, social media sites and IM (all P < 0.001). Health information exposure from IM was associated with being never smokers, and more frequent moderate and vigorous physical activity (all P for trend <0.05). Health information exposure from IM was least frequent but associated with healthier behaviors. Further public health education campaigns can consider using IM to deliver information, particularly to disadvantaged groups.

Choosing Channels, Sources, and Content for Communicating Prostate Cancer Information to Black Men: A Systematic Review of the Literature

The purpose of this study was to identify effective channels, sources, and content approaches for communicating prostate cancer prevention information to Black men. The Web of Science, PubMed and GoogleScholar databases, as well as reviews of reference lists for selected publications, were searched to select articles relevant to cancer communication channels, sources or content for Black men, focused on male-prevalent cancers and published in English. Articles were excluded if they examined only patient–provider communication, dealt exclusively with prostate cancer patients or did not separate findings by race. The selection procedures identified 41 relevant articles, which were systematically and independently reviewed by two team members to extract data on preferred channels, sources, and content for prostate cancer information. This review revealed that Black men prefer interpersonal communication for prostate cancer information; however, video can be effective. Trusted sources included personal physicians, clergy, and other community leaders, family (especially spouses) and prostate cancer survivors. Men want comprehensive information about screening, symptoms, treatment, and outcomes. Messages should be culturally tailored, encouraging empowerment and “ownership” of disease. Black men are open to prostate cancer prevention information through mediated channels when contextualized within spiritual/cultural beliefs and delivered by trusted sources.

Insights for public education provided by French media on ideas about prostate cancer – A media analysis study

Background: This study explored the French media’s presentation of ideas and medical information about prostate cancer (PC) that may influence men’s understanding, attitudes and behavior.

Methods: A qualitative media content analysis centered on PC information delivered by French professional media. The selected data were produced in the aftermath of the High Health Authority's decision in 2008 not to recommend systematic screening by prostate specific antigen(PSA) for men over 50. Source was the Media Archives of the French National Library. Content was analyzed from 15 television programs, 14 radio programs, and 55 articles from 35 popular French newspapers (online and printed, weekly and monthly) and 20 magazines. Audio content was narrated into textual form and submitted to manual coding along with the print content.

Results: Television and radio content focused on the nature of PC, screening and treatment,and conveyed a gender-centric position linked to male sexuality and virility. Newspapers and magazines targeted the testing controversy, the lack of consensus among professionals, and scientific advances in screening and treatment.

Conclusion: Media participation in the European testing debate is valuable for allowing patients to hear all opinions on PC risk factors. Debate on testing policy contributes to confusion and uncertainty regarding appropriate action.

Understanding Associations between Information Seeking and Scanning and Health Risk Behaviors: An Early Test of the Structural Influence Model

This study examined proposed direct and mediating relationships in the Structural Influence Model (SIM) of Communication within the chronic disease context. Using data from the Annenberg National Health Communication Survey (N = 14,472), we tested the potential mediating roles of information seeking, information scanning, and social capital between social determinants of health and four chronic disease risk behaviors: exercise level, fruit and vegetable intake, cigarette smoking, and excessive alcohol use. Information seeking, information scanning, and social capital received support as potential mediators. Our results are largely consistent with predictions of the SIM and highlight the important role of communication in reducing health risks and increasing healthy behaviors.

The Effects of Repetitive Information Communication through Multiple Channels on Prevention Behavior during the 2015 MERS Outbreak in South Korea

Although people nowadays engage in information communication repetitively through multiple channels during a public health crisis, the impacts of this communication on behavioral outcomes have not been fully examined. The present study empirically tests the effects of repetitive information communication through multiple channels (RICMC) on risk-prevention behavior. Additionally, the mediating roles of knowledge, perceived susceptibility, severity, response efficacy, and self-efficacy in the association between RICMC and risk-prevention behavior are examined. Analyses of online survey data (N = 1,036) collected during the 2015 Middle East respiratory syndrome (MERS) outbreak in South Korea revealed that RICMC was positively associated with MERS-prevention behavior. Furthermore, this association was mediated by perceived susceptibility, severity, and self-efficacy. Although response efficacy and knowledge were not significant mediators, RICMC was positively associated with all mediating variables. The implications, theoretical contributions, and limitations of this study are discussed.

A Cross-Comparative Survey of Information Seeking and Scanning About Drug-Related Sources and Topics Among U.S. and Israeli College Students

There is an increasing amount of drug-related information that is easily accessible from media and interpersonal sources. Recent research shows significant positive associations between information acquisition and nonmedical drug use intentions among college students. This study examines information about amphetamines and marijuana that was actively searched ("seeking") as well as information that was encountered during routine media use ("scanning"). Data are drawn from a cross-national comparative survey of college students in the United States (N = 734) and in Israel (N = 800). U.S. participants reported seeking and scanning information about marijuana across a broader range of sources than Israeli participants. Among U.S. and Israeli participants, the most frequently searched marijuana-related topics included the benefits of marijuana, negative effects of marijuana use, and political reasons why marijuana should be legal. Participants from both countries reported the benefits of amphetamines, and the negative effects of amphetamine use as the most frequently searched topics about amphetamines. Participants in both countries identified the internet and friends as the most popular sources of drug-related information and noted that physicians, friends, and the internet were the most trusted sources. Implications for research on information seeking and health communication are discussed.

The Scoop on Health: How Native American Newspapers Frame and Report Health News

The health status of Native Americans is known to be lower than that of other Americans. One way to get relevant health information to this population is through Native-produced media. Tribal newspapers are the most popular form of Native media, consumed more often than their mainstream counterparts. As such, these community-based newspapers are meaningful tools for relevant health information gathering. This study content analyzes a census of health-related newspaper articles (N = 644) over a 1-year period from 20 Tribal newspapers across 10 regions designated by the U.S. Bureau of Indian Affairs. Findings profile the nature of health topics reported in Native news publications. Health news stories were shown to use episodic frames significantly more than thematic frames. Inclusion of supplementary information (e.g., causes/symptoms, treatment, and prevention) and inclusion of mobilizing information (i.e., provides readers resources for further action) were both shown to significantly differ by health topic. Results provide an important baseline understanding of how health news is reported in Native news publications.

Who Avoids Cancer Information? Examining a Psychological Process Leading to Cancer Information Avoidance

Although cancer information avoidance (CIA) is detrimental to public health, predictors of CIA have not been fully investigated. Based on uncertainty management theory, this study viewed CIA as a response to uncertainty related to the distress associated with cancer information and illustrated the psychological process leading to CIA. Given the current information context, it was hypothesized that cancer information overload (CIO), accompanied by confusion and stress about cancer information, causes CIA. As trait anxiety is a strong predictor of CIO, it was also hypothesized that trait anxiety has an indirect effect on CIA through CIO. Study 1 tested this relationship in a U.S. sample (N = 384); the results showed that CIO was positively associated with CIA and that trait anxiety indirectly influenced CIA through CIO. Whereas Study 1 tested the relationship with cross-sectional data in the general cancer context, Study 2 replicated Study 1 with 3-wave longitudinal data in the context of a specific cancer (i.e., stomach cancer) in South Korea (N = 1,130 at Wave 1, 813 at Wave 2, and 582 at Wave 3). Trait anxiety at Wave 1 predicted CIO at Wave 2, which in turn increased CIA at Wave 3, suggesting that some people are inherently inclined to avoid cancer information due to their trait anxiety, which results in confusion about cancer information.

Media Coverage of Pediatric Environmental Health Risks and its Effects on Mothers' Protective Behaviors

This study explores the relationship between exposure to U.S. media coverage of chemical threats to pediatric environmental health and mothers' behaviors to protect their children. Prior content analytic work revealed that media coverage volume from September 2012 to February 2013 differed significantly by type of chemical (i.e., pesticides = high coverage volume; bisphenol A [BPA] = moderate; and arsenic = low). Survey data collected from new and expecting mothers in March 2013 (n = 822) revealed mothers incidentally encountered-or scanned-this information in the media in the prior six months, and after adjusting for a series of potential confounders, such scanning was positively associated with mothers' self-reported behaviors to reduce chemical exposures. To test the hypothesis that coverage volume moderates the relationship between scanning and behavior, content analysis and survey data were combined in mixed effects regression analyses. Results showed significant differences between the effects of media scanning at different levels of coverage volume, but in a direction not entirely consistent with the study's hypothesis. The relationship between scanning and behavior was strongest for BPA, suggesting that a characteristic of media coverage other than volume may drive maternal responses to environmental health threats. Implications of these findings for risk communication research and practice are discussed.

Health Information Seeking and Cancer Screening Adherence Rates

Effective screening tools are available for many of the top cancer killers in the USA. Searching for health information has previously been found to be associated with adhering to cancer screening guidelines, but Internet information seeking has not been examined separately. The current study examines the relationship between health and cancer Internet information seeking and adherence to cancer screening guidelines for breast, cervical, and colorectal cancer in a large nationally representative dataset. The current study was conducted using data from the Health Information National Trends Survey from 2003 and 2007. The study examined age-stratified models which correlated health and cancer information seeking with getting breast, cervical, and colorectal cancer screening on schedule, while controlling for several key variables. Internet health and cancer information seeking was positively associated with getting Pap screening on schedule, while information seeking from any sources was positively associated with getting colorectal screening on schedule. People who look for health or cancer information are more likely to get screened on schedule. Some groups of people, however, do not exhibit this relationship and, thus, may be more vulnerable to under-screening. These groups may benefit more from targeted interventions that attempt to engage people in their health care more actively.

Selective Exposure to Health Information: The Role of Headline Features in the Choice of Health Newsletter Articles

This study investigated how content and context features of headlines drive selective exposure when choosing between headlines of a monthly e-mail health newsletter in a naturalistic setting over a period of nine months. Study participants received a monthly e-mail newsletter and could freely open it and click any headline to read the accompanying article. In each e-mail newsletter, nine headlines competed with each other for selection. Textual and visual information of the headlines was content-analyzed, and clickstream data on the headlines were collected automatically. The results showed that headlines invited more frequent audience selections when they provided efficacy-signaling information in an imperative voice, when they used a moderate number of negative emotion words, when they presented negative thumbnail images while mentioning cancer or other diseases, and when they were placed higher in position.

Theorizing the Pathways From Seeking and Scanning to Mammography Screening

This study combines insights from existing theories in mass communication and health communication, and builds an integrated model accounting for the mechanisms by which an individual's acquisition of mammogram-related media information becomes associated with intentions to obtain a mammogram. Our model was largely supported by a survey with a nationally representative sample of American females between the ages of 40 and 70 years. As expected, seeking and scanning mammogram-related information from the media were both positively associated with reflective integration of media health information, which in turn was positively related to behavioral attitudes and perceived normative pressures. Attitudes and normative pressures were then positively linked to the intention to get a mammogram. Based on these findings, we offer some suggestions for future research in this area.

Information scanning and vaccine safety concerns among African American, Mexican American, and non-Hispanic White women

OBJECTIVE

A significant number of parents delay or refuse vaccinating their children. Incidental exposure to vaccine information (i.e., scanned information) may be an important contributor to anti-vaccine sentiment. This study examines the association between scanned information, trust in health information sources and vaccine safety concerns among African American, Mexican American, and non-Hispanic White women.

METHODS

Women (N=761) in Los Angeles County were sampled via random digit dial and surveyed regarding use of and trust in health information resources and vaccine safety concerns.

RESULTS

Analyses indicate that the sources of information associated with vaccine safety concerns varied by ethnicity. Each ethnic group exhibited different patterns of association between trust in health information resources and vaccine safety concerns.

CONCLUSIONS

Information scanning is associated with beliefs about vaccine safety, which may lead parents to refuse or delay vaccinating their children. These relationships vary by ethnicity.

PRACTICE IMPLICATIONS

These findings help inform practitioners and policy makers about communication factors that influence vaccine safety concerns. Knowing these sources of information will equip practitioners to better identify women who may have been exposed to anti-vaccine messages and counter these beliefs with effective, vaccine-promoting messages via the most relevant information sources.