Traditional and Online Health Information Seeking Among Individuals With Limited English Proficiency in the United States: Cross-Sectional Study

PURPOSE

We investigate how individuals with Limited English Proficiency (LEP) seek, access, and evaluate traditional and online sources they rely on for health information.

DESIGN

Retrospective cross-sectional survey analysis from the United States.

SETTING

Pooled Health Information National Trends Survey surveys (2013-2019).

SUBJECTS

The sample was comprised 15,316 respondents; 236/15,316 (1.54%) completed the survey in Spanish and 1727/14,734 (11.72%) had LEP (did not speak English "very well"). The sample was nationally representative across demographic categories.

MEASURES

Independent and dependent variables were self-reported using validated measures.

ANALYSIS

Multivariable logistic regression models using jackknife replicate weights for population estimates.

RESULTS

Adults with LEP were less confident in their capacity to access health information (aOR = 0.59, CI: 0.47-0.75) and had less trust in health information from medical professionals (aOR = 0.57,CI: 0.46-0.72) than English proficient (EP) adults. Although LEP and EP adults were both most likely to use the internet as their first source of information, LEP adults were more likely than EP adults to consult health professionals, print sources like books, news or brochures, family and friends, television and radio. Spanish language survey respondents were more likely to trust health information from government agencies (aOR = 1.99, CI: 1.09-3.62) and watch health-related videos on the internet than respondents who took the survey in English (aOR = 2.51, CI: 1.23-5.12).

CONCLUSION

Our results show how language barriers may contribute to health disparities experienced by linguistic minorities. Government agencies and health care organizations need to promote health information dissemination in underserved communities and may need to embrace the use of alternative information sources such as television, radio, and the internet to reach LEP populations.

Exploring how members of the public access and use health research and information: a scoping review

BACKGROUND

Making high-quality health and care information available to members of the general public is crucial to support populations with self-care and improve health outcomes. While attention has been paid to how the public accesses and uses health information generally (including personal records, commercial product information or reviews on healthcare practitioners and organisations) and how practitioners and policy-makers access health research evidence, no overview exists of the way that the public accesses and uses high quality health and care information.

PURPOSE

This scoping review aimed to map research evidence on how the public accesses and uses a specific type of health information, namely health research and information that does not include personal, product and organisational information.

METHODS

Electronic database searches [CINAHL Plus, MEDLINE, PsycInfo, Social Sciences Full Text, Web of Science and SCOPUS] for English language studies of any research design published between 2010-2022 on the public's access and use of health research or information (as defined above). Data extraction and analysis was informed by the Joanna Briggs Institute protocol for scoping reviews, and reported in accordance with the PRISMA extension for scoping reviews.

RESULTS

The search identified 4410 records. Following screening of 234 full text studies, 130 studies were included. One-hundred-and-twenty-nine studies reported on the public's sources of health-research or information; 56 reported the reasons for accessing health research or information and 14 reported on the use of this research and information. The scoping exercise identified a substantial literature on the broader concept of 'health information' but a lack of reporting of the general public's access to and use of health research. It found that 'traditional' sources of information are still relevant alongside newer sources; knowledge of barriers to accessing information focused on personal barriers and on independent searching, while less attention had been paid to barriers to access through other people and settings, people's lived experiences, and the cultural knowledge required.

CONCLUSIONS

The review identified areas where future primary and secondary research would enhance current understanding of how the public accesses and utilises health research or information, and contribute to emerging areas of research.

Mapping the Health Information Landscape in a Rural, Culturally Diverse Region: Implications for Interventions to Reduce Information Inequality

The media is an important source of health information, especially critical in rural communities with geographically-dispersed populations that are harder to reach through other channels. Yet health information is unequally distributed; these information disparities are compounded in rural areas, which may contribute to health disparities. We identify and describe health-related news in a culturally-diverse rural California county characterized by high levels of poverty, unemployment, low educational attainment, and over half of Mexican-origin. We conducted a census of all available print news sources and then used content analysis to identify and characterize all health information printed in a 6-month study period. A total of 570 health-related articles were published. Five newspapers accounted for more than 80% of published health-related articles (n = 466); only one targeted the majority Latino population. The most common topic was access to health care/insurance/policy (33%), followed by diet/nutrition (13%), infectious disease (10%), and general prevention (9%). Just over one-quarter of health-related articles included useful information. Differences across newspaper types existed: independent newspapers reported more on health-related events compared with chain newspapers, and both ethnic-targeted newspapers and independently-published papers were more likely to include useful information compared with chain newspapers. While this region suffers from high rates of obesity and diabetes, there were relatively few articles on obesity and diabetes themselves, or linking behavioral risk factors with these conditions. One area we found absent from coverage pertained to the numerous environmental health threats prevalent in this heavily polluted, agricultural area (just 40 articles discussed environmental health threats). We also discovered that coverage of social determinants of health was lacking (just 24 of the 570 health articles), which was notable in a region that suffers extreme economic, educational, and health disparities. This analysis of a rural region's local news coverage of health issues demonstrates significant opportunity to engage with rural local media, particularly ethnic media, to disseminate health information. Such a strategy holds considerable promise to advance public health goals using a multilevel approach: From an individual perspective, improving the amount and utility of the information can inform and educate publics in areas with otherwise low levels of health information access. From a policy perspective, improving coverage of the social determinants of health could shape public opinion to support policies that improve health.

Seeking Information on Behalf of Others: An Analysis of Calls to a Spanish-Language Radio Health Program

OBJECTIVE

Spanish-monolingual Latinos account for 13% of U.S. residents and experience multiple barriers to effective health communication. Information intermediaries/proxies mediate between the linguistically isolated and health care providers. This study characterizes the information needs of surrogate callers and their subjects to a U.S.-based Spanish-language radio health program.

METHOD

Content analysis of calls placed (N = 281 calls).

RESULTS

Women made 70% of calls; 39.1% of calls were on behalf of children, 11.0% on behalf of parents/older adults, and 18.5% on behalf of spouses/siblings/contemporary adults. Most common topics were disease symptoms/conditions (19.6%), cancer (13.9%), and reproduction/sexuality (12.9%). Calls for children were more likely than those for parents/other adults to pertain to current illness symptoms or conditions; calls for parents were more likely to be about cancer/chronic conditions. Half of all calls sought clarification about a previous medical encounter.

CONCLUSION

Information-seeking surrogates may represent a useful strategy for linguistic minorities to overcome structural and individual barriers to health information access. Results suggest that Latinos are willing to seek information on behalf of friends and family and highlight the need for improved, culturally and linguistically appropriate health communication sources.

PRACTICE IMPLICATIONS

Leveraging Latinos' natural familial social networks/willingness to share information may improve dissemination of culturally and linguistically appropriate health information. Further implications for patient activation and doctor-patient communication are discussed.