ABSTRACTS

Volume 11, Number 2
March 2006

Vol. 11, Number 2: Contents | Editorial | Abstracts

Web Chatter Before and After the Women's Health Initiative Results: A Content Analysis of On-line Menopause Message Boards
    Tara M. Cousineau A1, Diana Rancourt A1, Traci Craig Green A2

A1 Inflexxion, Inc., Newton, Massachusetts, USA
A2 Yale University, School of Public Health, New Haven, Connecticut, USA

A content analysis was conducted on two on-line menopause message boards over 18 months, before and after the announcement of the Women's Health Initiative (WHI) study results on hormone therapy risks. Messages (N = 785) were coded based on overall context themes and specific content (N = 1132 codes). Results showed that “seeking symptom advice” about physical symptoms represented half (49%) of all codes. More specific content codes reflected inquiries about taking prescription hormone therapies, (HTs) how to cope with the menopausal transition, checking in with community members, and questions related to menopause onset and changes in menstrual patterns. Chi–square tests showed an increase in pharmaceutical advice codings over time on the medical board (p = .057) and a trend on the community board after the WHI (p = .10). Similarly, after the WHI there was an increase in the frequency of codes on the community board related to “Is this menopause?” suggesting a heightened awareness about menopause as a health issue. In conclusion, analyses of on-line message boards provide a rich, economical method to discern the needs of menopausal women, as well as to observe the potential impact of a widely publicized medical event that can inform innovative strategies in health promotion for this target population.

Contributing Factors to the Use of Health-Related Websites
   Traci Hong A1

A1 Department of Community Health Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA

This study explicates the influence of audience factors on website credibility and the subsequent effect that credibility has on the intention to revisit a site. It does so in an experimental setting in which participants were given two health-related search tasks. Reliance on the web for health-related information positively influenced website credibility in both searches. Knowledge was a significant predictor for the search task that required more cognitive ability. Of the credibility dimensions, trust/expertise and depth were significant predictors of intention to revisit a site in both searches. Fairness and goodwill were nonsignificant predictors in both searches.

Formats for Improving Risk Communication in Medical Tradeoff Decisions
     Erika A. Waters A1, Neil D. Weinstein A2, Graham A. Colditz A3, Karen Emmons A4

A1 Department of Psychology, Rutgers, the State University of New Jersey, Piscataway, New Jersey, USA
A2 Department of Human Ecology, Rutgers, the State University of New Jersey, Piscataway, New Jersey, USA
A3 Harvard School of Public Health, Brigham and Women's Hospital, Boston, Massachusetts, USA
A4 Harvard School of Public Health, Dana-Farber Cancer Institute, Boston, Massachusetts, USA

To make treatment decisions, patients should consider not only a treatment option's potential consequences but also the probability of those consequences. Many laypeople, however, have difficulty using probability information. This Internet-based study (2,601 participants) examined a hypothetical medical tradeoff situation in which a treatment would decrease one risk but increase another. Accuracy was assessed in terms of the ability to determine correctly whether the treatment would increase or decrease the total risk. For these tradeoff problems, accuracy was greater when the following occurred: (1) the amount of cognitive effort required to evaluate the tradeoff was reduced; (2) probability information was presented as a graphical display rather than as text only; and (3) information was presented as percentages rather than as frequencies (n in 100). These findings provide suggestions of ways to present risk probabilities that may help patients understand their treatment options.

Interpersonal Issues Surrounding HIV Counseling and Testing, and the Phenomenon of “Testing by Proxy”
    Allison C. Morrill A1 and Carey Noland A2

A1 Capacities, Watertown, Massachusetts, USA
A2 Department of Communication Studies, Northeastern University, Boston, Massachusetts, USA

This multimethod study explored challenges faced by women in close heterosexual relationships who decided to test for HIV, and their experiences with instituting safer sexual practices and partner testing. Eighty-one women who sought HIV counseling and testing and had a regular male sexual partner were interviewed on five occasions, and 18 of these women and 15 men later took part in one of four focus groups (women only, men only, or couples). Findings identified difficulty understanding the unpredictability of HIV transmission, gender differences in how partners interpret their susceptibility to HIV, and male resistance to safer sex and testing. We also identified a pervasive phenomenon of “testing by proxy”—the belief that if one partner tests negative for HIV after having unprotected intercourse, the untested partner's serostatus is deemed to be negative. This dangerous practice must be addressed in public health prevention efforts. Programs aiming to reduce heterosexual HIV risk for women must include their male partners and incorporate effective interpersonal communication skills.

The Role of Physician Characteristics in Clinical Trial Acceptance: Testing Pathways of Influence
    Barbara Curbow A1, Linda A. Fogarty A1, Karen A. McDonnell A2, Julia Chill A3, Lisa Benz Scott A4

A1 Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, Baltimore, Washington, USA
A2 George Washington University, Washington, DC, USA
A3 Johns Hopkins Bloomberg School of Public Health, Department of Health Policy and Management, Baltimore, MD, USA
A4 SUNY at Stony Brook, School of Health, Technology, and Management, Stony Brook, New York, USA

Eight videotaped vignettes were developed that assessed the effects of three physician-related experimental variables (in a 2 × 2 × 2 factorial design) on clinical trial (CT) knowledge, video knowledge, information processing, CT beliefs, affective evaluations (attitudes), and CT acceptance. It was hypothesized that the physician variables (community versus academic-based affiliation, enthusiastic versus neutral presentation of the trial, and new versus previous relationship with the patient) would serve as communication cues that would interrupt message processing, leading to lower knowledge gain but more positive beliefs, attitudes, and CT acceptance. A total of 262 women (161 survivors and 101 controls) participated in the study. The manipulated variables primarily influenced the intermediary variables of post-test CT beliefs and satisfaction with information rather than knowledge or information processing. Multiple regression results indicated that CT acceptance was associated with positive post-CT beliefs, a lower level of information processing, satisfaction with information, and control status. Based on these results, CT acceptance does not appear to be based on a rational decision-making model; this has implications for both the ethics of informed consent and research conceptual models.

Relationship of Internet Health Information Use With Patient Behavior and Self-Efficacy: Experiences of Newly Diagnosed Cancer Patients Who Contact the National Cancer Institute's Cancer Information Service
     Sarah Bauerle Bass A1, Sheryl Burt Ruzek A1, Thomas F. Gordon A1, Linda Fleisher A2, Nancy McKeown-Conn A2, Dirk Moore A3

A1 Temple University Department of Public Health, Philadelphia, Pennsylvania, USA
A2 Atlantic Region Cancer Information Service, Fox Chase Cancer Center, Cheltenham, Pennsylvania, USA
A3 University of Medicine and Dentistry of New Jersey, School of Public Health, Department of Biostatistics, Piscataway, New Jersey, USA

This study examines the relationship of Internet health information use with patient behavior and self-efficacy among 498 newly diagnosed cancer patients. Subjects were classified by types of Internet use: direct use (used Internet health information themselves), indirect use (used information accessed by friends or family), and non-use (never accessing Internet information). Subjects were recruited from callers of the National Cancer Institute's (NCI's) Cancer Information Service, Atlantic Region. They were classified by type of Internet use at enrollment and interviewed by telephone after 8 weeks. There were significant relationships among Internet use and key study variables: subject characteristics, patient task behavior, and self-efficacy. Subjects' Internet use changed significantly from enrollment to 8 week follow-up; 19% of nonusers and indirect users moved to a higher level of Internet use. Significant relationships also were found among Internet use and perceived patient–provider relationship, question asking, and treatment compliance. Finally, Internet use was also significantly associated with self-efficacy variables (confidence in actively participating in treatment decisions, asking physicians questions, and sharing feelings of concern). The results of this study show that patients who are newly diagnosed with cancer perceive the Internet as a powerful tool, both for acquiring information and for enhancing confidence to make informed decisions.

Book Review

A Review of: “Thompson, T. L., Dorsey, A. M., Miller, K. I., & Parrott, R. (Editors). (2003). Handbook of Health Communication”: Mahwah, NJ: Lawrence Erlbaum Associates.
Jim L. Query, Ellen W. Bonaguro, Toni Siriko, Brittney Maslowski, Jill Yamasaki