Colorectal cancer information avoidance is associated with screening adherence

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

Linking patient-centered communication with cancer information avoidance: The mediating roles of patient trust and literacy

OBJECTIVES

This study, drawing on the pathway mediation model developed by Street and his colleagues (2009) that links communication to health outcomes, explores how patient-centered communication affects cancer information avoidance.

METHODS

Data was gathered through online access panel surveys, utilizing stratified sampling across Germany, Switzerland, the Netherlands, and Austria. The final sample included 4910 non-cancer and 414 cancer patients, all receiving healthcare from clinicians within the past year.

RESULTS

The results demonstrated that patient-centered communication is directly associated with reduced cancer information avoidance, especially among cancer patients. Additionally, this association is indirectly mediated through patient trust and healthcare literacy.

CONCLUSION

The findings provide empirical evidence that reveals the underlying mechanism linking clinician-patient communication to patient health information behavior.

PRACTICE IMPLICATIONS

The potential of clinician-patient communication in addressing health information avoidance is highlighted by these findings. Future interventions in healthcare settings should consider adopting patient-centered communication strategies. Additionally, improving patient trust and literacy levels could be effective in reducing cancer information avoidance.

Counteracting sexual and reproductive health misperceptions: Investigating the roles of stigma, misinformation exposure, and information overload

OBJECTIVE

Sexual and reproductive health (SRH) misperceptions constitute a critical precursor to undesired health outcomes for women. Drawing on the model of stigma management communication and exposure effects, we aimed to investigate the underlying processes of SRH misperceptions.

METHODS

A nationwide survey was conducted via quota sampling with Chinese women (N = 1000). Structural equation modeling with maximum likelihood estimation and 5000 bootstrapping resamples were used to test the hypotheses.

RESULTS

Stigma perceptions positively predicted information avoidance (β = 0.207, p < 0.001), which, in turn, was positively associated with misperceptions (β = 0.195, p < 0.001). Misinformation exposure significantly predicted misperceptions (β = 0.607, p < 0.001), and this relationship was mediated by information avoidance (β = 0.020, 95% CI [0.007, 0.040]). Moreover, information overload strengthened the relationship between misinformation exposure and information avoidance (β = 0.153, p < 0.001) as well as the relationship between misinformation exposure and misperceptions (β = 0.077, p = 0.006).

CONCLUSION

Stigma and misinformation exposure play prominent roles in the formation of SRH misperceptions. Information overload facilitates the misinformation-misperception transformation.

PRACTICE IMPLICATIONS

To counteract SRH misperceptions, health education should alleviate SRH stigma perceptions and strategically design messages to avoid information avoidance and overload.

The effect of noninstrumental information on reward learning

Investigations of information-seeking often highlight people's tendency to forgo financial reward in return for advance information about future outcomes. Most of these experiments use tasks in which reward contingencies are described to participants. The use of such descriptions leaves open the question of whether the opportunity to obtain such noninstrumental information influences people's ability to learn and represent the underlying reward structure of an experimental environment. In two experiments, participants completed a two-armed bandit task with monetary incentives where reward contingencies were learned via trial-by-trial experience. We find, akin to description-based tasks, that participants are willing to forgo financial reward to receive information about a delayed, unchangeable outcome. Crucially, however, there is little evidence this willingness to pay for information is driven by an inaccurate representation of the reward structure: participants' representations approximated the underlying reward structure regardless of the presence of advance noninstrumental information. The results extend previous conclusions regarding the intrinsic value of information to an experience-based domain and highlight challenges of probing participants' memories for experienced rewards.

Using curiosity to counter health information avoidance

OBJECTIVE

Information that is beneficial for health decision-making is often ignored or actively avoided. Countering information avoidance can increase knowledge of disease risk factors and symptoms, aiding early diagnoses and reducing disease transmission. We examine whether curiosity can be a useful tool in increasing demand for, and engagement with, potentially aversive but useful health information.

METHODS

Four pre-registered randomized online studies were conducted with 5795 participants recruited from online survey platforms. Curiosity for aversive health information was manipulated by providing a 'curiosity incentive' - identity-related information alongside aversive information - (Study 1), obscuring information (Studies 2 and 3), and eliciting guesses about the information (Studies 2 and 4). Willingness to view four types of aversive health information was elicited: alcohol consumption screening scores (Study 1), colon cancer risk scores (Study 2), cancer risk factors (Study 3), and the sugar content of drinks (Study 4).

RESULTS

In Study 1, the curiosity manipulation increased the likelihood that participants viewed information about the riskiness of their drinking. Studies 2 and 3 show that curiosity prompts can counter people's reluctance to learn about and assess their cancer risk. And Study 4 shows that using curiosity prompts to encourage engagement with aversive information (sugar content of drinks) also improves health-related choices (opting for a sugar-free drink alternative).

CONCLUSION

Curiosity prompts provide an effective and simple way to increase engagement with aversive health information.

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

OBJECTIVE

With screening, colorectal cancer can be detected when treatable, or even prevented. However, approximately one in five people tend to avoid colorectal cancer information, and avoidance is associated with being less likely to have been screened for the disease. Crucial to developing strategies to reduce information avoidance, we sought a comprehensive understanding of reasons people avoid colorectal cancer information.

METHODS AND MEASURES

In a mixed methods study, we surveyed 200 participants who varied with respect to avoidance and interviewed 15 people who tended to avoid colorectal cancer information (all aged 40-75) about reasons for avoiding.

RESULTS

In both survey and interviews, primary reasons for information avoidance were: (1) shielding from anxiety and other aversive emotion, (2) perceived information sufficiency and (3) feelings of information overload. Trait anxiety, fear of diagnosis, anticipating negative interactions with healthcare, and negative associations with screening procedures exacerbated avoidance. Participants justified information non-relevance by attributing risk to other people's characteristics such as family history, gastrointestinal symptoms, being male, or living an unhealthy lifestyle.

CONCLUSION

Novel findings include the triggering influence of trait anxiety and financial constraints on information avoidance. Also, information overload and incorrect understanding of risk factors may exacerbate perceptions of information sufficiency and avoidance.

[A gendered perspective of information behaviors, its drivers, and barriers : Results of an online survey of a sample stratified for the German population]

BACKGROUND

The gender perspective is an essential level of effective health communication approaches. Against the background of the gender perspective as an essential level of effective health communication approaches, we focus on health-related information behaviors. Complementary to information seeking, information avoidance is included. Both forms of information behavior are described in gender-specific ways, and their predictors are identified using a resource-centered approach covering the individual's health, empowerment, involvement, and social support.

METHOD

An online survey of a sample stratified for the German population (N = 3000) was conducted. The two modes of information behavior as well as their theoretically derived predictors were assessed. In addition to descriptive analyses, blockwise regression analyses were used to identify gender-specific predictors of information seeking and avoidance.

RESULTS

Information seeking occurs more frequently than information avoidance. Both differ only slightly between men and women and showed the strongest correlations with the respondents' involvement. For information seeking, coping resources are also a significant predictor, while information avoidance is associated with psychological well-being and social support. Similar patterns of association emerge across genders.

CONCLUSION

Across genders, it is evident that health communication measures should strengthen the involvement of the population and their coping resources to promote information seeking and counteract information avoidance. Additionally, the findings revealed that avoiders should be more focused as one of the main target groups of health communication.

Construction of influencing factors model for public information avoidance behavior in major infectious disease outbreaks based on meta-ethnography

Objective

Major infectious disease outbreaks are highly susceptible to diffuse outbreaks due to their sudden and more widespread nature. Compared to previous outbreaks such as the Spanish flu and SARS in China, COVID-19 has greatly affected the health of citizens and the economic development of countries worldwide, and is representative of major infectious disease outbreaks in many ways. Information avoidance, a common information behaviour during major infectious disease outbreaks, can alleviate the stress caused by information overload as a strategy to reduce negative emotions and maintain optimism. However, it can also bias risk perceptions and avoid content of greater value. Therefore, a deeper understanding of public information behaviour, particularly how and why relevant information is circumvented, places a demand on researchers.

Methods

A meta-ethnographic qualitative research methodology was used, and the seven steps of the methodology were strictly followed, including identifying integration themes, defining the connotations of integration themes, reading original studies, identifying relationships between studies, inter-translation between studies, synthetic translation, and presenting integration results. 26 original studies were integrated in a unified research framework, with a macro perspective that integrates consistent as well as complex and even contradictory findings and identifies dominant factors.

Conclusions

Identify demographic factors, information literacy, risk perception, cognitive structure, information quality, information sources, external characteristics of information, and environmental characteristics sub-dimensions around the dimensions of 'individual', 'information' and 'environment'. The study also explored the factors under each sub-dimension. The study finally identified three dimensions, nine sub-dimensions and 26 factors, and obtained a more complete theoretical framework to construct a "model of factors influencing public information avoidance behaviour in major infectious disease epidemics", with a view to providing a theoretical basis and practical reference for relevant departments in guiding public information behaviour and health practices in major infectious disease epidemics.

Information avoidance: Self-image concerns, inattention, and ideology

We report the results of an experiment on willful information avoidance regarding measures to address Covid-19. In the experiment, participants choose between two options, each associated with a contribution to the Corona Fund of the Red Cross USA and a payment to the participant. Depending on the treatment, either the participants' payoff, the donation, both or none of these pieces of information were hidden, but revealable. With this design, we can separate motivated reasons for ignorance from non-motivated reasons, both of which are present in our data. Furthermore, we find evidence of both self-serving and pro-social information avoidance. These behavioral patterns correlate with the subjects' political attitudes: while voters of the Democratic Party are prone to exhibit pro-social information avoidance, Republican voters rather engage in self-serving information avoidance.

Evidence that Mental Contrasting Reduces Health Information Avoidance

BACKGROUND

Although learning health information is beneficial for physical well-being, many people opt to avoid learning this information due to its potentially threatening nature. Such avoidance can lead to delays in seeking treatment.

PURPOSE

This study tested the effectiveness of a self-regulation technique, mental contrasting (MC), specifically MC of a negative future with a positive current reality, in reducing health information avoidance regarding skin cancer (melanoma). We hypothesized that participants who engaged in MC would be more likely to choose to learn about their melanoma risk than those who completed a control, reflection activity.

METHODS

We conducted a randomized controlled trial (N = 354). Participants were assigned to complete a MC or reflection (control) exercise prior to filling out a melanoma risk calculator. Participants were then asked whether they wanted to learn their melanoma risk, and how much information they would like to know.

RESULTS

Chi-Square tests revealed that MC decreased melanoma risk information avoidance compared to the reflection activity (12% vs. 23.4%) but did not make participants more likely seek additional information.

CONCLUSION

MC is a brief, engaging, and effective strategy for reducing health information avoidance that could prove useful in medical settings.

Anticipation of deteriorating health and information avoidance

We integrate anticipatory utility and endogenous beliefs about future negative health shocks into a life-cycle model of physiological aging. Individuals care about their future utility derived from their health status and form endogenous beliefs about the probability of a negative health shock. We calibrate the model with data from gerontology and use the model to predict medical testing decisions of individuals. We find that anticipation in combination with endogenous beliefs provides a quantitatively strong motive to avoid medical testing for Huntington's disease, which explains the low testing rates found empirically. We also study the case of breast and ovarian cancer and provide an explanation for why testing rates depend on the individual's income when treatment is available.

Expressive voting versus information avoidance: experimental evidence in the context of climate change mitigation

We theoretically and experimentally investigate the effect of self-serving information avoidance on moral bias in democratic and individual decisions in the context of climate change mitigation. Subjects choose between two allocations that differ in payoffs and contributions to climate change mitigation. We vary the observability of the environmental contribution, as well as the decision context associated with different levels of pivotality. If the contribution is directly observable, we find evidence for lower pivotality leading to higher levels of "green" decisions, as predicted by the low-cost theory of voting. This effect disappears if subjects can avoid information on the contribution. Instead, we find evidence for the exploitation of moral wiggle room via information avoidance in larger democracies as well as in the consumption context. Our results indicate that information avoidance substitutes expressive voting as an instrument to manage cognitive dissonance on the part of the voter. Hence, moral biases in elections might be less likely than previously thought.

SUPPLEMENTARY INFORMATION

The online version of this article (10.1007/s11127-022-01016-x) contains supplementary material, which is available to authorized users.

Why people choose deliberate ignorance in times of societal transformation

The opening of East Germany's Stasi archives in 1991 has often been lauded as a model of transparency in a transformative period. Yet many citizens have rejected the opportunity to read their files. To examine the reasons people invoke for this deliberate ignorance, we combined survey methods from psychology with historiographical methodologies. Our findings reveal a diverse range of reasons for deliberate ignorance, including regulation of negative emotions, avoidance of personal conflict, scepticism about the information compiled, and rejection of the victorious political system's authority over the files. Participants thus appear to prioritise cooperation and harmony over justice concerns-in stark contrast to the institutional norm of transparency and justice. Shining a light on the role of deliberate ignorance at the individual level-and specifically the convergence or divergence of individual and collective memory culture-may help explain the pace of societal change.

Developing a framework for understanding health information behavior change from avoidance to acquisition: a grounded theory exploration

BACKGROUND

Health information avoidance is common in real life, but because it is not always conducive to health promotion and maintenance, people often actively switch to health information acquisition. Understanding this process of active change can facilitate intervention in unreasonable avoidance behaviors. However, studies so far have mostly focused on why and how avoidance takes place, little is known about the process of active change from avoidance to acquisition. We thus use a grounded theory approach (GT) to explore how the active change takes place, and to generate a grounded theoretical framework capable of illustrating stages and influencing factors involved in the active change process.

METHODS

Straussian grounded theory (Corbin & Strauss, 2015) was used to analyze data collected through semi-structured interviews with 30 adults (14 in good health, 11 with disease, 5 in other health status) who had experienced health information behavior change from avoidance to acquisition. These interviews focused on how the change occurred and what effected the change.

RESULTS

The core category of Health Information Avoidance Change and 12 categories were identified and integrated to form a theoretical framework termed the Health Information Avoidance Change Model (HIACM). This model describes the process using five non-linear stage variables (initiation, preparation, action, maintenance, and abandonment) and seven moderating factor variables (cognitive change, social stimulus, beliefs and attitudes, intrapsychic literacy, social resources, information source, time and material resources).

CONCLUSIONS

HIACM can be used to explain the process of active change from health information avoidance to health information acquisition. HIAC is a non-linear and holistic process, and it is necessary to dynamically analyze the impact of relevant factors and take targeted intervention measures in stages. HIAC is usually not only an individual behavior, but also a socialized behavior requiring the collaboration of individuals, families, health information providers, healthcare providers, and governments.

Double burden of COVID-19 knowledge deficit: low health literacy and high information avoidance

OBJECTIVE

People with lower levels of health literacy are likely to report engaging in information avoidance. However, health information avoidance has been overlooked in previous research on responses to viral outbreaks. The purpose of this cross-sectional survey study was to assess the relationship between health literacy and COVID-19 information avoidance. Students (n = 561) at a university in the south central region of the U.S. completed our online survey conducted from April to June 2020 using simple random sampling. We measured information avoidance and the degree to which people opt not to learn about COVID-19 when given the choice. We assessed participants' health literacy level using the Newest Vital Sign (NVS), eHealth Literacy Scale (eHEALS), and All Aspect of Health Literacy Scale (AAHLS).

RESULTS

Those with lower health literacy were more likely to avoid information about COVID-19. This negative association between health literacy and information avoidance was consistent across all types of health literacy measures: NVS scores (b = - 0.47, p = 0.033), eHEALS scores (b = - 0.12, p = 0.003), functional health literacy (b = - 0.66, p = 0.001), communicative health literacy (b = - 0.94, p < 0.001), information appraisal (b = - 0.36, p = 0.004), and empowerment (b = - 0.62, p = 0.027). The double burden of low health literacy and high information avoidance is likely to lead to a lack of knowledge about COVID-19.

Unpalatable truths: Commitment to eating meat is associated with strategic ignorance of food-animal minds

Animal minds are of central importance to debates about their rights and welfare. Remaining ignorant of evidence that animals have minds is therefore likely to facilitate their mistreatment. Studying samples of adults and students from the UK and US we found that, consistent with motivational perspectives on meat consumption, those who were more (vs. less) committed to eating meat were more motivated to avoid exposure to information about food-animals' sentience (Studies 1), showed less interest in exposure to articles about intelligent food animals (Studies 2a and 2b), and were quicker to terminate exposure to internet pop-ups containing information about food-animals' minds (Studies 3a and 3b). At the same time, those who were more (vs. less) committed to eating meat approached information about companion-animals' minds (Studies 2a-3b) and unintelligent food animals (Studies 2a and 2b) in largely the same ways. The findings demonstrate that, within the UK and US, the desire to eat meat is associated with strategies to avoid information that is likely to challenge meat consumption.

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 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.

Willingness to pay for reductions in health risks under anticipated regret

In this paper, we study the willingness to pay for reductions in health risks within a framework of anticipated regret. We show that ex post information provision can be a relevant factor for regret theory to account for why people are sometimes so inclined to protect themself against certain types of health risks but not others. In particular, we find that under full resolution of uncertainty disproportionate aversion to large regrets exaggerates willingness to pay estimates. The effect induced by this notion of regret aversion can be interpreted as if regret-averse people overweight risk reductions due to prevention. However, as feedback over forgone acts is missing, the regret aversion effect disappears. Finally, we show that information avoidance induced by regret aversion can significantly bias our evaluation to prefer those health programs that completely eliminate a risk, i.e., the certainty effect.

Information Avoidance, Self-affirmation, and Intentions to Receive Genomic Sequencing Results Among Members of an African Descent Cohort

BACKGROUND

Information avoidance tendencies have been found to be associated with lower intentions to pursue medically actionable genomic sequencing results, but less so among individuals who engage more in spontaneous self-affirmation. Yet these results were obtained with a largely non-Hispanic White, high-SES cohort.

PURPOSE

To assess these variables, their magnitude, and their associations in an African-descent cohort as part of the same ClinSeq® exome sequencing program.

METHODS

Participants reported levels of spontaneous self-affirmation, information avoidance, and intentions to receive three types of results - medically actionable, non-medically actionable, and carrier status as part of a baseline survey.

RESULTS

Relative to the original, non-Hispanic White cohort, those in the African-descent cohort had higher levels of spontaneous self-affirmation and lower intentions of learning about carrier genomic results; they reported comparable levels of information avoidance and intentions to receive other results. Information avoidance was negatively associated with intention to receive non-actionable results in the African-descent cohort, as found in the initial cohort, with no moderating effect of spontaneous self-affirmation. Information avoidance, spontaneous self-affirmation, and their interaction were not associated with intentions to receive actionable results (contrary to findings in the initial cohort), or carrier results.

CONCLUSIONS

Individuals of African descent may engage in relatively more spontaneous self-affirmation, and do not appear to engage in more information avoidance. Their information avoidance tendencies were associated with pursuit of non-actionable sequencing results, with no moderating effect of self-affirmation, and were not associated with pursuit of actionable results or carrier results.

From information seeking to information avoidance: Understanding the health information behavior during a global health crisis

•

The study examines the factors leading to information avoidance during COVID-19 pandemic.

•

Mass Media, Print Media and official websites are used for information seeking during the pandemic.

•

Only Social Media exposure results in information overload and information anxiety.

•

Information overload is strongly associated with information anxiety which gives rise to information avoidance.

•

We extend the applicability of S-O-R model to the information behavior domain, especially during the uncertain times.

Individuals seek information for informed decision-making, and they consult a variety of information sources nowadays. However, studies show that information from multiple sources can lead to information overload, which then creates negative psychological and behavioral responses. Drawing on the Stimulus-Organism-Response (S-O-R) framework, we propose a model to understand the effect of information seeking, information sources, and information overload (Stimuli) on information anxiety (psychological organism), and consequent behavioral response, information avoidance during the global health crisis (COVID-19). The proposed model was tested using partial least square structural equation modeling (PLS-SEM) for which data were collected from 321 Finnish adults using an online survey. People found to seek information from traditional sources such as mass media, print media, and online sources such as official websites and websites of newspapers and forums. Social media and personal networks were not the preferred sources. On the other hand, among different information sources, social media exposure has a significant relationship with information overload as well as information anxiety. Besides, information overload also predicted information anxiety, which further resulted in information avoidance.

What motivates Chinese consumers to avoid information about the COVID-19 pandemic?: The perspective of the stimulus-organism-response model

This study investigated consumers' information-avoidance behavior in the context of a public health emergency-the COVID-19 pandemic in China. Guided by the stimulus-organism-response paradigm, it proposes a model for exploring the effects of external stimuli (perceived threat and perceived information overload) related to COVID-19 on consumers' internal states (sadness, anxiety, and cognitive dissonance) and their subsequent behavioral intentions to avoid health information and engage in preventive behaviors. With a survey sample (N = 721), we empirically examined the proposed model and tested the hypotheses. The results indicate that sadness, anxiety, and cognitive dissonance, which were a result of perceived threat and perceived information overload, had heterogeneous effects on information avoidance. Anxiety and cognitive dissonance increased information avoidance intention, while sadness decreased information avoidance intention. Moreover, information avoidance predicted a reluctance on the part of consumers to engage in preventive behaviors during the COVID-19 pandemic. These findings not only contribute to the information behavior literature and extend the concept of information avoidance to a public health emergency context, but also yield practical insights for global pandemic control.

Non-use of cancer information services among people experiencing cancer in Ireland

PURPOSE

The purpose of this study was to explore the reasons for non-use of a national cancer society's cancer information services among people experiencing cancer.

METHOD

This study used a qualitative design. Semi-structured interviews were conducted with a total of 17 participants who had not previously utilised the Cancer Society's information services. Data were analysed using Thematic Analysis.

RESULTS

The key themes to emerge from the date were 'living in the here and now' and 'awareness of the Cancer Society'. For most participants, not utilising cancer information services was a means of coping with the initial diagnosis and the impact of treatment. Those who progressed to being ready to seek information identified the multi-disciplinary team as the primary source of trusted information, with particular mention of cancer nurse specialists. For participants with children, their role as a parent was central in how they managed their diagnosis. The majority of participants lacked awareness of the range of services provided by the Cancer Society.

CONCLUSIONS

Reasons for non-use of cancer information services were identified as: readiness to seek information and a lack of knowledge of the Cancer Societies' services. Cancer information services need to continue make a concerted effort to enhance visibility and awareness of its services to optimise patient engagement.

Cancer information overload: Discriminant validity and relationship to sun safe behaviors

OBJECTIVE

Past research suggests a large number of adults feel overwhelmed by the amount of cancer information - a phenomenon labeled cancer information overload (CIO). The current study examines whether CIO is discriminant from other negative message perceptions (reactance, information avoidance) and related to sun safe behaviors.

METHODS

U.S. adults (N = 2,219) completed survey questions assessing CIO, dispositional reactance, defensive/information avoidance, sun safe behavior, and knowledge.

RESULTS

The results demonstrated that CIO was discriminant from dispositional reactance, information avoidance, and defensive avoidance, and individuals with higher overload were more likely to tan, less likely to have an annual checkup with a healthcare provider, and less knowledgeable about sun safe protection. Unexpectedly, individuals with higher CIO were more likely to wear wide-brimmed hats.

CONCLUSION

CIO is distinct from reactance and avoidance, and related to performance/knowledge of sun safe behaviors, and receiving annual healthcare checkups.

PRACTICE IMPLICATIONS

The correlation between CIO and sun safe behavior differs by behavior; a pattern which suggests practitioners might benefit from adapting their communication strategy based on the target population and behavior.

Population Whole Exome Screening: Primary Care Provider Attitudes About Preparedness, Information Avoidance, and Nudging

Compared to clinicians previously surveyed, primary care providers employed in a health system known for clinical genomics were more likely to have ordered or referred a patient for genetic testing, but had only modestly more genetics training and reported similarly low levels of comfort answering patient questions about genetic risk. Most supported population genomic screening, reported willingness to get screened themselves, and judged a hypothetical patient's decision to be screened favorably relative to a similar patient's decision to decline screening. Stakeholder perceptions of the ethical appropriateness of nudging at-risk patients to discuss testing with counselors were mixed.

Cancer information-seeking preferences linked to distinct patient experiences and differential satisfaction with cancer care

OBJECTIVE

True person-centered care (PCC) involves anticipating, responding to, and integrating patients' needs and preferences as the illness experience unfolds. PCC success rests, in part, on quality provider-patient communication and tailored information exchange. These processes can have profound effects on the patient experience, self-management and health outcomes including survival. Cancer information-seeking preferences (CISP) by patients are increasingly found to modulate illness and care processes. However, research has yet to document the CISP types and prevalence as well as their associations with satisfaction with care.

METHOD

Individuals (N = 2142) treated for cancer in the last 6 months completed the Ambulatory Oncology Patient Satisfaction Survey (AOPSS) and a CISP measure.

RESULTS

Whereas 60.3% (n = 1292) reported wanting to actively seek information about their cancer, a surprisingly high percentage (i.e., 39.7%; n = 850) did not. Men reported avoiding cancer information to a greater extent than women, χ² (4, N = 2108) = 12.00, p =  0.02. CISP were also differentially associated with 6 key domains of satisfaction, with intense seekers consistently being less satisfied.

CONCLUSION AND PRACTICE IMPLICATIONS

These findings underscore how CISP can significantly affect patients' cancer experience as well as their care satisfaction.

Powerful audiences are linked to health information avoidance: Results from two surveys

OBJECTIVE

We examined the extent to which community members avoid medical information that they may very much want, yet fear that others may use to harm them.

METHODS

In two online studies, we surveyed participants (N = 659) about their experiences with insurer and employer harm, past avoidance of medical information, intentions to avoid medical information, and reasons for avoiding medical information. Study 2 was a conceptual replication of Study 1 with some minor variations.

RESULTS

Several key findings emerged. 1) Although reports of past audience harm were relatively rare, reports of past avoidance were common, both for audience reasons and resource reasons. 2) Participants who were younger and who reported avoiding medical tests in the past (for audience or resource reasons) generally reported greater intentions to avoid health information in the future. 3) Participants reported that receiving unfavorable medical test results would elicit more harm from financially powerful audiences (health insurers and employers) than from interpersonally powerful audiences (close friends/family and others). 4) Participants indicated that the prospect of harm from an audience (i.e., negative effects on insurance coverage) rather than the prospect of bad news would dissuade them from seeking a medical test. Finally, 5) Participants reported that they were most inclined to avoid testing for medical conditions that were untreatable, unimportant, embarrassing/stigmatizing, or expensive.

CONCLUSIONS

Findings demonstrate that people are concerned with audience perceptions of their health and these concerns may adversely affect decision making and behavior.

Avoiding cancer risk information

RATIONALE

Perceived risk for health problems such as cancer is a central construct in many models of health decision making and a target for behavior change interventions. However, some portion of the population actively avoids cancer risk information. The prevalence of, explanations for, and consequences of such avoidance are not well understood.

OBJECTIVE

We examined the prevalence and demographic and psychosocial correlates of cancer risk information avoidance preference in a nationally representative sample. We also examined whether avoidance of cancer risk information corresponds with avoidance of cancer screening.

RESULTS

Based on our representative sample, 39% of the population indicated that they agreed or strongly agreed that they would "rather not know [their] chance of getting cancer." This preference was stronger among older participants, female participants, and participants with lower levels of education. Preferring to avoid cancer risk information was stronger among participants who agreed with the beliefs that everything causes cancer, that there's not much one can do to prevent cancer, and that there are too many recommendations to follow. Finally, the preference to avoid cancer risk information was associated with lower levels of screening for colon cancer.

CONCLUSION

These findings suggest that cancer risk information avoidance is a multi-determined phenomenon that is associated with demographic characteristics and psychosocial individual differences and also relates to engagement in cancer screening.

The role of current affect, anticipated affect and spontaneous self-affirmation in decisions to receive self-threatening genetic risk information

One reason for not seeking personally threatening information may be negative current and anticipated affective responses. We examined whether current (e.g., worry) and anticipated negative affect predicted intentions to seek sequencing results in the context of an actual genomic sequencing trial (ClinSeq®; n = 545) and whether spontaneous self-affirmation mitigated any (negative) association between affect and intentions. Anticipated affective response negatively predicted intentions to obtain and share results pertaining to both medically actionable and non-actionable disease, whereas current affect was only a marginal predictor. The negative association between anticipated affect and intentions to obtain results pertaining to non-actionable disease was weaker in individuals who were higher in spontaneous self-affirmation. These results have implications for the understanding of current and anticipated affect, self-affirmation and consequential decision-making and contribute to a growing body of evidence on the role of affect in medical decisions.