Does Context Matter? Examining PRISM as a Guiding Framework for Context-Specific Health Risk Information Seeking Among Young Adults

Why Are Young People Willing to Pay for Health? Chained Mediation Effect of Negative Emotions and Information Seeking on Health Risk Perception and Health Consumption Behavior

The perception of health risks can influence people's health behaviors. However, in the context of modern consumer society, few people delve into in-depth discussions on health consumption as a form of health protection behavior. Inspired by the Health Belief Model and Protection Motivation Theory, this study interprets health consumption behavior as a new form of health protection behavior. A survey was conducted on a sample of Chinese youth (N = 885) to explore the mechanisms of action between health risk perception and health consumption behavior using structural equation modeling. The study found that: (1) health risk perception has a significant positive impact on the health consumption behavior of young people; (2) negative emotions and information seeking play mediating roles respectively in the mechanism of the impact of health risk perception on health consumption behavior; and (3) in addition to their individual mediating roles, negative emotions and information seeking behavior collectively play a chained mediation role in this process. Implications of these results, both theoretical and practical, are further discussed.

Seeking information about waste-to-energy incineration projects: The role of objective knowledge and benefit perceptions in an extended PRISM

Although waste-to-energy (WtE) incineration projects have boosted the economic effectiveness of the waste management system, locals frequently view them with suspicion, opposition, or even outright rejection because of potential environmental and health risks. In this study, by incorporating two additional variables, namely, objective knowledge and benefit perceptions, the planned risk information seeking model (PRISM) was extended in the context of the WtE incineration project. A total of 1726 respondents were interviewed in person. Results from the structural equation modeling indicated that the extended PRISM achieved excellent fits, suggesting the generalizability of the model in these contexts. Objective knowledge and subjective knowledge have a positive and direct impact on perceived knowledge insufficiency. The impact of benefit and risk perceptions on worry is the opposite, with risk perceptions having a greater direct effect on worry. However, compared with risk perceptions, the direct effect that benefit perceptions have on perceived knowledge insufficiency is stronger. Additionally, perceived knowledge insufficiency partially or completely mediates the relationships between all antecedents, except perceived seeking control, and information-seeking intention. This study suggests that risk managers carefully consider how to establish powerful communication tactics to shape these antecedents when introducing a "not in my backyard" project to the local community.

A Mobile Health Information Behavior Model: Theoretical Development and Mixed-Method Testing in the Context of Mobile Apps on Child Poisoning Prevention

While several studies have explored the use of mobile health applications, few have observed determinants of mobile health information behavior. To develop a model explaining parents' mobile information behavior on child poisoning prevention, we first explored relevant theories to suggest a theoretical model. In that, we combine existing models on risk and health information seeking, such as the Planned Risk Information Seeking Model, with models on the acceptance of mobile technologies, such as the Unified Theory of Acceptance and Use of Technologies. Thereafter, we employed a sequential mixed-method design with an initial qualitative study (four online focus groups with n = 25 parents in total) and a standardized online survey of n = 1,013 parents to evaluate our research model. Results confirm that both, determinants of information seeking and determinants of technology acceptance, contribute to the explanation of mobile information behavior. App use intention was mainly related to the performance expectancy of app use, the subjective information norm, and social influence on app use. To increase the usage of prevention apps and contribute to the reduction of child injuries, communication on poisoning apps should address subdimensions of the performance expectancy, such as their utility and peoples' trust in app providers. Moreover, physicians are important multipliers for these messages.

Geographic location or experience: Using PRISM to understand how people seek flood risk information

Flooding is increasing worldwide, and with climate change, people need help understanding these changing conditions and that their flood risk may also change. This study extends the planned risk information seeking model (PRISM) into the flood risk domain and examines the antecedents that explain flood risk information seeking behavior. Using a survey reflective of the population in the state of Texas (N = 1079), this study includes an operationalization of risk perception specific to the complexity of floods and explores two key moderators in the PRISM model. Findings suggest that using PRISM to elaborate flood risk information seeking behaviors explains 48% of the variance in information seeking intent and 37% of the variance in affective risk perception. Using multigroup modeling, the findings also reveal that simply living in an area at high risk for floods does not significantly impact any relationships in the model. However, having experience with flooding increases the strength of risk perception paths-in particular, perceived probability of flood risk-and better explains flood risk information seeking. Suggestions for how to use communication to influence risk perceptions and information seeking, as well as future directions for research, are also discussed.

Intentions of Patients With Cancer and Their Relatives to Use a Live Chat on Familial Cancer Risk: Results From a Cross-Sectional Web-Based Survey

BACKGROUND

An important prerequisite for actively engaging in cancer prevention and early detection measures, which is particularly recommended in cases of familial cancer risk, is the acquisition of information. Although a lot of cancer information is available, not all social groups are equally well reached because information needs and communicative accessibility differ. Previous research has shown that a live chat service provided by health professionals could be an appropriate, low-threshold format to meet individual information needs on sensitive health topics such as familial cancer risk. An established German Cancer Information Service is currently developing such a live chat service. As it is only worthwhile if accepted by the target groups, formative evaluation is essential in the course of the chat service's development and implementation.

OBJECTIVE

This study aimed to explore the acceptance of a live chat on familial cancer risk by patients with cancer and their relatives (research question [RQ] 1) and examine the explanatory power of factors associated with their intentions to use such a service (RQ2). Guided by the Extended Unified Theory of Acceptance and Use of Technology (UTAUT2), we examined the explanatory power of the following UTAUT2 factors: performance expectancy, effort expectancy, social influence, facilitating conditions, and habit, supplemented by perceived information insufficiency, perceived susceptibility, perceived severity, and cancer diagnosis as additional factors related to information seeking about familial cancer.

METHODS

We conducted a cross-sectional survey via a German web-based access panel in March 2022 that was stratified by age, gender, and education (N=1084). The participants are or have been diagnosed with cancer themselves (n=144) or have relatives who are or have been affected (n=990). All constructs were measured with established scales. To answer RQ1, descriptive data (mean values and distribution) were used. For RQ2, a blockwise multiple linear regression analysis was conducted.

RESULTS

Overall, 32.7% of participants were (rather) willing, 28.9% were undecided, and 38.4% were (rather) not willing to use a live chat on familial cancer risk in the future. A multiple linear regression analysis explained 47% of the variance. It revealed that performance expectancy, social influence, habit, perceived susceptibility, and perceived severity were positively associated with the intention to use a live chat on familial cancer risk. Effort expectancy, facilitating conditions, information insufficiency, and cancer diagnosis were not related to usage intentions.

CONCLUSIONS

A live chat seems promising for providing information on familial cancer risk. When promoting the service, the personal benefits should be addressed in particular. UTAUT2 is an effective theoretical framework for explaining live chat usage intentions and does not need to be extended in the context of familial cancer risk.

A Comparison of Women's and Men's Web-Based Information-Seeking Behaviors About Gender-Related Health Information: Web-Based Survey Study of a Stratified German Sample

BACKGROUND

Gender-sensitive approaches to health communication aim to integrate gender perspectives at all levels of communication, as an individual's biological sex and socially assigned gender identity have an impact on whether and how one acquires what type of health information. Due to the fast and low-cost opportunity to search for a wide range of information, the internet seems to be a particularly suitable place for gender-related health information about diseases of sex-specific organs and diseases where biological differences are associated with different health risks.

OBJECTIVE

This study aims to inform gender-related information provision and acquisition in 2 ways. The first objective was to provide a theory-driven analysis of web-based health information-seeking behavior (HISB) regarding gender-related issues. Therefore, the Planned Risk Information Seeking Model (PRISM), which is one of the most integrative models of HISB, was adapted and applied. Second, we asked for gender-specific motivational determinants of gender-related web-based HISB comparing the predictors in the groups of women and men.

METHODS

Data from a stratified web-based survey of the German population (N=3000) explained gender-related web-based HISB and influencing patterns comparing women and men. The applicability of PRISM to gender-related web-based HISB was tested using structural equation modeling and a multigroup comparison.

RESULTS

The results revealed PRISM as an effective framework for explaining gender-related web-based HISB. The model accounted for 28.8% of the variance in gender-related web-based HISB. Gender-related subjective norms provided the most crucial explanatory power, followed by perceived seeking control. The multigroup comparison revealed differences in the model's explanatory power and the relevance of predictors of gender-related web-based HISB. The share of explained variances of web-based HISB is higher in men than in women. For men, norms were a more relevant promoting factor, whereas web-based HISB of women was more strongly associated with perceived seeking control.

CONCLUSIONS

The results are crucial for gender-sensitive targeting strategies and suggest gender-related health information interventions that address gender-related subjective norms. Furthermore, programs (eg, web-based learning units) should be developed and offered to improve individuals' (perceived) abilities to perform web-based searches for health information, as those with higher control beliefs are more likely to access web-based information.

Integrating the Theory of Planned Behavior and Bonding Social Capital to Examine Chinese Women's Tampon Use Intentions

This study integrates the theory of planned behavior with a structural approach to examining social capital to investigate how bonding social capital affected Chinese women's tampon use intentions. Bonding social capital was operationalized as network closure, which included two main dimensions: density and hierarchy. Results from an online survey (N = 766) showed that network density was positively associated with attitudes toward, social norms about, and perceived behavior control around tampon usage, while network hierarchy negatively predicted attitudes only. Moreover, the indirect effects of network density on tampon use intentions were mediated by descriptive norms and perceived behavior control. Examining women's intentions to adopt a rarely used product in China, this study extended the theory of planned behavior into the realm of social capital in an understudied context. The findings provide practical implications for health communication practitioners in public education concerning feminine hygiene products and gynecological health.

Social media exposure, interpersonal network, and tampon use intention: A multigroup comparison based on network structure

The scarcity of tampons in China has attracted scholarly attention. Extending the theory of planned behavior with social network structure, this cross-sectional online survey (N = 763) found that exposure to tampon-related information on social media was positively related to Chinese women's tampon use intentions. This association was mediated through attitudes, descriptive norms, and self-efficacy toward using tampons. Furthermore, the effects of social media exposure differed among people with different network structures. Our findings shed light on the promotion of nonconventional feminine hygiene products, which, in turn, may enhance Chinese women's well-being and gender equity across the globe.

Exploring direct and indirect predictors of heart disease information seeking

BACKGROUND

Based on the integrative model of behavioral prediction, we examined predictors of heart disease information seeking. We also examined demographic and individual factors associated with seeking-related perceived norms, attitudes, and perceived behavioral control.

METHODS

Non-Hispanic White and Black participants, aged 45 and older, completed a cross sectional online survey (N = 383). Stepwise logistic and multiple linear regression models were tested to assess study hypotheses, as well as tests of indirect effects.

RESULTS

Perceived norms, attitudes and perceived behavioral control were positively associated with heart disease information seeking, but when controlling for distal variables only the perceived norm-behavior association remained significant (p <.05). Indirect effects of distal variables (race, heart disease risk, perceived heart disease susceptibility and information engagement orientation) on information seeking were also detected via perceived norms.

CONCLUSIONS

Our results provide support for the integrative model as a framework for predicting information seeking, but further highlight the important role of distal predictors and perceived norms on heart disease seeking intentions. When communicating to promote heart disease information acquisition, communicators should pay particular attention to promoting information seeking as a normative behavior, particularly among those who perceive a lower risk of heart disease and who may be less engaged with health information more generally.

Analysis of the Influencing Factors of Seeking Intention on COVID-19 Risk Information: A Cross-Sectional Study

Background

Information seeking, as an important part of the prevention and control of infectious diseases, can lead to positive outcomes by reducing uncertainty and alleviating panic. However, most previous studies have limited their analysis to individual-level psychosocial factors, and little is known about how social-level factors influence individuals' information-seeking intentions.

Methods

The cross-sectional survey was conducted from July 30, 2020 to August 15, 2020 in China. We used a convenience sampling strategy to recruit participants from among the Internet users. The structural equation model was used to identify the incentives associated with coronavirus disease 2019 (COVID-19) risk information-seeking intention.

Results

In this study, the responses of 871 Internet users who reflected a response rate of 85% were analyzed. Information-seeking intention was found to be directed by informational subjective norms (ISNs), perceived information need, risk knowledge, the sense of community (SOC), and negative affective responses, and ISNs were found to be the strongest driving factor. Individuals with a stronger SOC, which was associated with greater pressure and expectations, show negative affective responses. COVID-19 risk knowledge can affect the information-seeking intention of Internet users not only directly but also indirectly through their perceived information need. In addition, more risk knowledge was associated with a lower perceived risk likelihood.

Conclusion

When formulating risk communication strategies, governments and health institutions should take targeted measures to improve the public's SOC and knowledge. This will provide an opportunity to explore the role of individual cognition and environmental risk information in public health.

Information-Seeking Behavior for COVID-19 Boosters in China: A Cross-Sectional Survey

As China launches its second COVID-19 booster campaign and races to bring new vaccine technologies to protect against severe COVID-19 infections, there is limited research on how Chinese residents search for vaccine-related information. This study examined the factors influencing Chinese residents' information-seeking behaviors regarding COVID-19 boosters with a sample of 616 respondents with a mean age of 31.53 from a research panel. Structural equation modeling was used to report factors that influenced respondents' seeking intent. The results indicated that seeking-related subjective norms (β = -0.55, p < 0.001), negative affect (β = 0.08, p < 0.05), positive affect (β = 0.18, p < 0.001), and perceived knowledge insufficiency (β = 0.10, p < 0.001) are strong predictors of one's seeking intent. We also discovered that there was an inverse relationship between risk perception and positive affect (β = -0.55, p < 0.001) and between negative and positive affect (β = -0.19, p < 0.01), while all measurements were either directly or indirectly related to information-seeking intent. A few more indirect but important relationships were also included in our discussion. In conclusion, the present study helps understand what motivates Chinese residents to seek COVID-19 booster information when limited information is available.

Health Disparities in Online COVID-19 Information Seeking and Protective Behaviors: A Two-Wave Longitudinal Study

The COVID-19 outbreak was declared a pandemic by the World Health Organization and claimed hundreds of thousands of lives in the U.S. However, the adoption of protective behaviors in response to COVID-19 varies among sociodemographic groups. To better understand the disparities in U.S. adults' adoption of protective behaviors in relation to sociodemographic factors, we conducted a two-wave panel survey in the U.S. Although sociodemographic factors were not found to be significant predictors in lagged regression analysis, results from a cross-sectional analysis showed that the White, younger, and higher educated individuals were more likely to take protective behaviors. Furthermore, based on the structural equation modeling, indirect effects were observed. Specifically, online COVID-19 information seeking mediated the effects of age and education on performance of protective behaviors, and subjective norms and online COVID-19 information seeking were found to be significant serial mediators of these relationships. The study not only extends the health disparities and health information seeking literature, but also offers practical insights to health campaigns and interventions promoting protective behaviors during a pandemic and reducing health disparities.

Modeling Electronic-Cigarette Users' Risk Information Avoidance

The current study examined e-cigarette users' risk information avoidance (i.e., RIA), which is a significant challenge to e-cigarette risk communication. Applying and extending previous RIA studies and the risk information seeking and processing (RISP) model, this study identified the predictors of e-cigarette users' RIA with a comprehensive model that incorporated new roles for scientific uncertainty and relevant channel beliefs. Responses collected from an online survey were analyzed (N = 593) and support was found for two pathways that explain e-cigarette users' motivation for RIA. One suggests heightened risk perceptions were associated with strong negative affective responses that include fear, anger, sadness, and guilt. These affective responses, in turn, were positively associated with RIA intentions. The second was a direct, positive association between scientific uncertainty and RIA as well as an indirect path mediated by relevant channel beliefs. More specifically, scientific uncertainty was negatively associated with quality perceptions of e-cigarette information making it more likely e-cigarette users would avoid it. Suggestions for how to prevent or mitigate these processes that result in e-cigarette users' maladaptive response of RIA are discussed.

Application of theory of planned behavior in identifying factors affecting online health information seeking intention and behavior of women

Purpose

Today, the Internet has become an attractive source for obtaining health information. Since women play an important role in maintaining the health of the family and community and since they are active seekers of health information through the Internet, it is essential to examine their online health information seeking behavior. Therefore, the main purpose of this article is to identify the factors affecting the online health information seeking intention and behavior of women.

Design/methodology/approach

The theoretical framework of this quantitative study was based on the theory of planned behavior. A total of five hypothesized relationships were formulated to develop a conceptual model. The study approach was quantitative. Using simple random sampling, 400 women referred to specialized and sub-specialized clinics of Hamadan University of Medical Sciences, Iran participated in the study and responded to the survey. Descriptive and inferential data analysis was performed using SPSS 21 and Smart PLS 3 software.

Findings

The results showed that the intention to find health information online is a function of psychological variables. These variables include attitude, subjective norms and perceived behavioral control. Findings showed that attitude is the most important factor affecting online health information seeking intention. It was also found that online health information seeking intention has a positive and significant effect on women's information seeking behavior.

Originality/value

This study is the first attempt to use an important and universally accepted theory to identify the factors affecting the online health information seeking behavior of women referring to specialized and sub-specialized clinics and provides important practical concepts for health officials and managers to improve and develop online health information seeking behavior.

Explaining Online Information Seeking Behaviors in People With Different Health Statuses: German Representative Cross-sectional Survey

Background

Worldwide, the internet is an increasingly important channel for health information. Many theories have been applied in research on online health information seeking behaviors (HISBs), with each model integrating a different set of predictors; thus, a common understanding of the predictors of (online) HISB is still missing. Another shortcoming of the theories explaining (online) HISB is that most existing models, so far, focus on very specific health contexts such as cancer. Therefore, the assumptions of the Planned Risk Information Seeking Model (PRISM) as the latest integrative model are applied to study online HISB, because this model identifies the general cognitive and sociopsychological factors that explain health information seeking intention. We shift away from single diseases and explore cross-thematic patterns of online HISB intention and compare predictors concerning different health statuses as it can be assumed that groups of people perceiving themselves as ill or healthy will differ concerning their drivers of online HISB. Considering the specifics of online HISB and variation in individual context factors is key for the development of generalizable theories.

Objective

The objective of our study was to contribute to the development of the concept of online HISB in 2 areas. First, this study aimed to explore individual-level predictors of individuals’ online HISB intention by applying the postulates of PRISM. Second, we compared relevant predictors of online HISB in groups of people with different health statuses to identify cross-thematic central patterns of online HISB.

Methods

Data from a representative sample of German internet users (n=822) served to explain online HISB intentions and influencing patterns in different groups of people. The applicability of the PRISM to online HISB intention was tested by structural equation modeling and multigroup comparison.

Results

Our results revealed PRISM to be an effective framework for explaining online HISB intention. For online HISB, attitudes toward seeking health information online provided the most important explanatory power followed by risk perceptions and affective risk responses. The multigroup comparison revealed differences both regarding the explanatory power of the model and the relevance of predictors of online HISB. The online HISB intention could be better explained for people facing a health threat, suggesting that the predictors adopted from PRISM were more suitable to explain a problem-driven type of information-seeking behavior.

Conclusions

Our findings indicate that attitudes toward seeking health information online and risk perceptions are of central importance for online HISB across different health-conditional contexts. Predictors such as self-efficacy and perceived knowledge insufficiency play a context-dependent role—they are more influential when individuals are facing health threats and the search for health information is of higher personal relevance and urgency. These findings can be understood as the first step to develop a generalized theory of online HISB.

Information Seeking Behaviors and Intentions in Response to Environmental Health Risk Messages: A Test of A Reduced Risk Information Seeking Model

This study tests the effects of environmental health risk messages on perceived risk, information needs and decisions to seek information, testing a reduced risk information seeking and processing model (R-RISP). Participants (N = 1,823) were randomized to one of three risk conditions (arsenic, bisphenol A [BPA] or volatile organic compounds [VOCs]) and one of the three message conditions (high threat, low threat or no message); participants in the high and low threat message conditions were also randomly assigned to a seeking cue to action condition (with or without seeking cue). Overall, the results support the R-RISP model, demonstrating the importance of current knowledge perceptions and informational subjective norms in information acquisition decisions. In addition, the results also provide initial evidence that environmental health risk messages can prompt information seeking and increase intentions to seek information in the future. Avenues for future research are discussed.

Information avoidance during health crises: Predictors of avoiding information about the COVID-19 pandemic among german news consumers

This study investigates the prevalence of source-specific information avoidance among German consumers and predictors of information-avoidance behavior in the context of the COVID-19 pandemic. Guided by the Risk Information Seeking and Processing Model (RISP), we propose that the perceived social norms, information insufficiency, risk perception, affective risk response, and attitudes toward seeking predict information avoidance. We supplement the RISP model by considering information overload as the vast volume and the incredulous quality of information in the COVID-19 pandemic challenge individuals' information acquisition and processing. Using a stratified demographic sample of news consumers of a federal German state (N = 1,000), we empirically examined the proposed model, answered the research question, and tested our hypotheses using structural equation modeling. The results reveal information avoidance among one-third of the respondents. They avoided online sources, including online-mediated interpersonal sources, more often than interpersonal sources and traditional mass media. Information avoidance was linked to more negative attitudes toward seeking and negative affective risk responses, more pronounced descriptive and injunctive avoidance norms, and perceived information overload. Attitudes and information overload were the most influential predictors of avoidance. In contrast, risk perception and information insufficiency were not associated with information avoidance. This study provides insights into theory development, contributes to the information behavior literature, and identifies barriers to communication during health crises.

The Role of Fairness in Early Characterization of New Technologies: Effects on Selective Exposure and Risk Perception

Previous research suggests that when individuals have limited knowledge to make sense of new or emerging technologies, they may rely more on available cues, such as the fairness of those managing the risks, when developing their attitudinal and behavioral responses to the technology. To examine this further, we designed an online experiment (N = 1,042) to test the effects of risk managers' nonoutcome fairness on individuals' selective exposure to additional information and perceived risk. As the study context, we used the development of enhanced geothermal systems (EGS), which uses drilling to tap deep underground sources of heat for district heating and electricity and remains low in familiarity among the U.S. public. The results suggest that participants who read about the fair risk manager were subsequently more likely to have positive attitudes toward EGS development. In turn, those with more positive attitudes were more likely to select and read positively valenced articles about EGS, resulting in an indirect effect of the fairness condition. Although this study also explored whether uncertainty moderated this fairness effect on information seeking, it found no evidence. Additionally, when participants were exposed to information featuring fair risk managers, perceived risk decreased, an effect that was mediated by beliefs that EGS was controllable and not dreadful. These results underscore the importance of using practices that will increase nonoutcome fairness in the introduction of new technologies.

Few changes shown in cancer information-seeking behaviour among young adults in China between 2012 and 2017

BACKGROUND

The increasing incidence of cancer among young adults (18-40 years old) is of concern in China.

OBJECTIVES

This study aims to examine the influence of cancer information-seeking behaviours (CISB) on young adults' worries about cancer and participation in screening.

METHODS

This study analysed data from two probability sample surveys conducted in 2012 and 2017 in China. The questions in the questionnaire remained the same for better comparison. The sample size was 1212 in the 2012 survey, and 2178 in the 2017 survey.

RESULTS

From 2012 to 2017, among young adults, there was a decline in cancer information seeking, diversity of cancer information sought and cancer worry, while an improvement in cancer information-seeking experience was found. Also, CISB had significant associations with cancer worry and health screening over the 5 years.

DISCUSSION

The level of young adults' cancer information seeking remains low in China, and this group is not fully aware of their potential risks of getting cancer.

CONCLUSION

Although young adults find the experience of looking for cancer information easier in 2017, health campaigns may be necessary to encourage young adults to find out more about their cancer risks, and to participate more in health screening.

Emotional and Cognitive Responses to COVID-19 Information Overload under Lockdown Predict Media Attention and Risk Perceptions of COVID-19

The present study examined positive and negative effects of health communication on the fight against the COVID-19 under lockdown, during the first wave of the pandemic in Greece. An online survey (N = 1,199) examined the relationships among media trust, emotional and cognitive reactions to COVID-19 information overload, media attention, and risk perceptions regarding COVID-19. Participants' media attention (exposure and attention combined) to information about the pandemic was positively related to their risk perceptions (perceived susceptibility and severity) about the disease. Media attention was dependent on participants' trust in the media as valid sources of information, but also on their cognitive and emotional reactions to COVID-19 information overload. In response to this overload, they produced negative thoughts and more negative (fear and anger) than positive (protection) emotions. These distinct reactions had differential effects on media attention and risk perceptions. Fear and protection were positively related to media attention and risk perceptions, while anger and negative thinking undermined attention and perceptions. Furthermore, all reactions depended on media trust, which mediated the effect on media attention. These findings highlighted desirable and some undesirable effects of health communication in the fight against COVID-19, which can be used to improve health communication in the future.

The Public's Risk Information Seeking and Avoidance in China During Early Stages of the COVID-19 Outbreak

This study uses the Planned Risk Information Seeking Model (PRISM) to estimate the public's information seeking and avoidance intentions during the COVID-19 outbreak based on an online sample of 1031 Chinese adults and provides support for the applicability of PRISM framework in the situation of a novel high-level risk. The results indicate that information seeking is primarily directed by informational subjective norms (ISN) and perceived seeking control (PSC), while the main predictors of information avoidance include ISN and attitude toward seeking. Because ISN are the strongest predictor of both information seeking and avoidance, the way the public copes with COVID-19 information may be strongly affected by individuals' social environment. Furthermore, a significant relationship between risk perception and affective risk response is identified. Our results also indicate that people who perceive greater knowledge of COVID-19 are more likely to report greater knowledge insufficiency, which results in less information avoidance.

Understanding Risk Information Seeking and Processing during an Infectious Disease Outbreak: The Case of Zika Virus

This study draws on the Planned Risk Information Seeking Model (PRISM) to assess Zika virus information seeking and systematic processing, paying particular attention to the relationship between perceived knowledge and knowledge insufficiency. Novel risks, such as Zika, provide an interesting context for examining whether information-seeking models, such as PRISM, are able to predict information seeking when available information is limited or scarce. A cross-sectional, online study of men and women of childbearing age (N = 494) residing in the state of Florida was conducted. Our results provide some support for the PRISM for predicting Zika information seeking intention, as well as systematic processing of information. We also found that individuals with high levels of perceived knowledge were more likely to report high level of knowledge insufficiency, illustrating that contextual factors may impact the fit of risk information seeking models.

A Cross-Cultural Comparison of an Extended Planned Risk Information Seeking Model on Mental Health Among College Students: Cross-Sectional Study

Background

Approximately 42.5 million adults have been affected by mental illness in the United States in 2013, and 173 million people have been affected by a diagnosable psychiatric disorder in China. An increasing number of people tend to seek health information on the Web, and it is important to understand the factors associated with individuals’ mental health information seeking. Identifying factors associated with mental health information seeking may influence the disease progression of potential patients. The planned risk information seeking model (PRISM) was developed in 2010 by integrating multiple information seeking models including the theory of planned behavior. Few studies have replicated PRISM outside the United States and no previous study has examined mental health as a personal risk in different cultures.

Objective

This study aimed to test the planned risk information seeking model (PRISM) in China and the United States with a chronic disease, mental illness, and two additional factors, ie, media use and cultural identity, among college students.

Methods

Data were collected in both countries using the same online survey through a survey management program (Qualtrics). In China, college instructors distributed the survey link among university students, and it was also posted on a leading social media site called Sina Weibo. In the United States, the data were collected in a college-wide survey pool in a large Northwestern university.

Results

The final sample size was 235 for the Chinese sample and 241 for the US sample. Media use was significantly associated with mental health information–seeking intentions in the Chinese sample (P<.001), and cultural identity was significantly associated with intentions in both samples (China: P=.02; United States: P<.001). The extended PRISM had a better model fit than the original PRISM.

Conclusions

Cultural identity and media use should be considered when evaluating the process of mental health information seeking or when designing interventions to address mental health information seeking.

Race/Ethnic Variations in Predictors of Health Consciousness Within the Cancer Prevention Context

PURPOSE

Although the literature establishes a link between health consciousness (HC) and prevention behavior, less explored are the individual, social, and health characteristics that are associated with increased HC. Similarly, underexamined is the influence of race and ethnicity on the relationship of these characteristics to higher levels of HC.

DESIGN

This cross-sectional study aims to identify and assess the relative importance of factors associated with higher levels of HC, highlighting the role of race and ethnicity.

PARTICIPANTS

Participants came from a national research panel survey (N = 1007).

MEASURES

Participants completed a 4-item scale capturing key concepts of HC as well as questionnaires capturing demographic profiles, social support, social networking activities, and health status.

ANALYSIS

A stepwise multiple regression was used to identify significant predictors of HC.

RESULTS

Female and more educated participants report higher levels of HC. African American and Hispanic participants report higher levels of HC compared to white participants. Findings indicate social support, social network participation, education, cancer survivorship, and health status were positively associated with higher HC for the collective sample. However, results revealed variations in factors associated with higher HC when stratified by race/ethnicity.

CONCLUSION

Findings suggest that interventions aiming to motivate cancer prevention behaviors within at-risk communities may find more success by incorporating factors that are aligned with increased HC among culturally diverse populations.

Correlates of health information seeking between adults diagnosed with and without cancer

PURPOSE

To examine predictors of information seeking behavior among individuals diagnosed with cancer versus those without.

METHODS

Cross-sectional data from the Health Information National Trends Survey 4 Cycles 1-3 (October 2011 to November 2013) were analyzed for 10,774 survey respondents aged ≥18 years. Binary logistic regression was used to examine the effect of socio-demographic and behavioral factors on health information seeking.

RESULTS

Cancer diagnosis did not predict health information seeking. However, respondents diagnosed with cancer were more likely to seek health information from a healthcare practitioner. Compared to males, females were more likely to seek health information irrespective of cancer diagnosis. Regardless of cancer diagnosis, those without a regular healthcare provider were less likely to seek health information. Likelihood of seeking health information declined across education strata, and significantly worsened among respondents without high school diplomas irrespective of cancer diagnosis.

CONCLUSIONS

Respondents sought health information irrespective of cancer diagnosis. However, the source of health information sought differed by cancer diagnosis. Gender, education, and having a regular healthcare provider were predictors of health information seeking. Future health communication interventions targeting cancer patients and the general public should consider these findings for tailored interventions to achieve optimal results.

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.