Center of Excellence in Cancer Communication Research

Information Seeking and Scanning

The new emphasis on patients as active consumers of health care and the rapid growth in the availability of health information lend urgent significance to the question of how people make sense of public health information to make decisions about their health. Although the new information paradigm has the potential to greatly improve health and health care in the US, the reality of what people actually do with the new responsibility and the new access is what matters. This project seeks to explore how people make sense of public health information to make decisions about cancer prevention, screening and treatment related to colon, breast and prostate cancer. This project joins two constructs, information scanning and information seeking, into a common analysis. Scanning recognizes that in the routine exposure to mass media and conversations with others people are exposed to a wide variety of cancer-related health information, and asks what people attend to and what they retain of all the information that passes in front of them. Information seeking focuses on the seeking people do in an active way. People may gain information that affects their behavior either through passive scanning, active searching or through both processes.

The central aims of this project are:

  1. To develop and validate a set of measures that improve our understanding of the relevant dimensions of seeking and scanning behavior in the general population as well as among cancer patients
  2. To determine what factors are associated with variations in the amount and nature of information seeking and scanning, including socio-demographic and personality characteristics; knowledge and beliefs; social context; the relationship of the individual with the health care system; and the nature of the target cancer-related behavior
  3. To determine whether the amount and nature of information seeking and scanning behavior is predictive of knowledge and beliefs, attitudes, subjective norms, self-efficacy, treatment and lifestyle behavioral choices for each of the target cancer behaviors

General Population

Describing the Prevalence, Characteristics, Correlates and Consequences of Seeking and Scanning in the General Population

In-depth interviews

J. Niederdeppe, R. C. Hornik, B. Kelly, D. L. Frosch, A. Romantan, R. Stevens, J. Weiner

This study represented the first phase of a two-part study investigating the ways that the general population makes sense of cancer-related public health information to make decisions about cancer prevention and screening. The goal was to examine target cancer prevention and screening seeking and scanning behavior (SSB) in a randomly selected sample of people ages 50-70 and living in the greater Philadelphia area. In depth interviews were conducted with 86 participants and covered general health-related SSB, information sources for target cancer behaviors, the range of SSB employed and circumstances that might cause SSB to vary. Data from this study was used for the development of SSB measures for phase two of this study. (Niederdeppe et al., in press.)

Published:Niederdeppe, J., Hornik, R.C., Kelly, B., Frosch, D.L., Romantan, A., Stevens, R., Barg, F., & Weiner, J. (2007). Exploring the dimensions of cancer-related information seeking and scanning behavior. Health Communication, 22(2), 153-167.

Prospective Survey Study of U.S. population

R. Hornik, A. Romantan, B. Kelly, A. S. Ramirez, D. Frosch, J. Niederdeppe, J. Weiner, M. Fishbein, J. S. Schwartz, A. DeMichele, K. Armstrong, S. Hull, R. Nagler, A. Smith-McLallen, N. Wong

This study builds on the in-depth interview study investigating the ways that members of the general population make sense of cancer-related public health information to make decisions about cancer prevention and screening. This study will conduct two rounds of population-based surveys with a national sample of 2400 adults between 40- 75 years of age. Approximately 50 respondents are being interviewed each week, beginning in November 2005. Each of them will be interviewed again about 12 months after their first interview, with the final interviews in August 2007. The survey data will serve to (1) validate the dimensions of information scanning/searching behaviors that emerged from the in-depth interviews for screening and cancer prevention behaviors; (2) estimate the distribution of these behaviors in the relevant general populations; (3) test the association of hypothesized determinants with seeking and scanning behavior and using the follow-up data; (4) examine whether baseline seeking and scanning behavior predicts subsequent screening and prevention behaviors. This study is being conducted online with the representative national sample developed by Knowledge Networks.

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Cancer Population

Cross-sectional Surveys to Describe the Prevalence, Characteristics and Correlates of SSB in the Population of Patients Diagnosed with Breast, Colon and Prostate Cancer

In-depth interviews

A. Romantan, B. Kelly, R. Hornik, R. Stevens, S. Gray, A. S. Ramirez, S. Hull, R. Nagler, A. Kim, N. Wong

This study investigates how cancer patients make sense of cancer-related public health information to make decisions about cancer treatment and survivorship issues (e.g. changes in lifestyle behaviors). The study involved in-depth interviews with a random sample of 44 patients aged 40-70 diagnosed with breast, prostate and colon cancer living in the larger Philadelphia area. Patients were recruited through the Pennsylvania Cancer Registry and completed interviews in June-August 2005. The central aim of this study was to develop and validate a set of measures that allow meaningful description of information seeking and scanning around treatment decisions and survivorship issues. This pilot study provided in-depth qualitative information about health information seeking and scanning behavior, defining what must be examined in a larger representative study of cancer patients.

Prospective Surveys of Pennsylvania Cancer Patients

R. Hornik, A. Romantan, B. Kelly, S. Gray, A. S. Ramirez, S. Hull, R. Nagler, A. Kim, N. Wong, S. Schwartz, A. DeMichele, K. Armstrong, A. Smith-McLallen, M. Fishbein

This study is the second phase of research into how cancer patients make sense of cancer-related public health information to make decisions about cancer treatment and survivorship issues (e.g. changes in lifestyle behaviors). It will describe seeking and scanning behavior (SSB) and then examine the predictors and outcomes of it in a random sample of cancer patients living in Pennsylvania. Patients with breast, prostate and colon cancer ages 40-70 will be recruited through the Pennsylvania Cancer Registry and will receive mail surveys in the summer of 2006. They will be re-surveyed one year later. We want to understand how much cancer patients make use of non-medical information sources (interpersonal sources, the internet, printed sources) as a complement to or as a reinforcement of their engagement with their physicians. The amount of SSB that people engage in, as well as the way in which they do it, may influence (a) awareness of and choices among available treatment choices (b) how satisfied patients are with their treatment decision; and (c) how they deal with survivorship issues. Results from this study may help doctors, researchers and the health care system to develop new ways to effectively share information about cancer treatments and to enhance patients' participation in medical decision-making and their satisfaction with treatment.

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Pilot Projects

Cancer Mass Media Communication about Survival and Death

Jessica Fishman, PhD, Katrina Armstrong, MD, MSCE, David Casarett, MD, MA, Robert Hornik, PhD

Prior research on patient decision making has shown that patients making choices about their cancer care are influenced by information pertaining to treatment side effects, effectiveness and chance of survival. Because African American and Caucasian cancer patients have different preferences for cancer care, we will investigate the potential contribution of relevant information provided by news media coverage of cancer treatments and outcomes.

This pilot focuses on the cancer news reporting provided by national magazines. The aim of this project is to compare the proportion of cancer-focused articles in “mainstream” and African American-targeted magazines that report on cancer treatment side effects, treatment effectiveness, survival, and death. This project contributes to a line of research designed to investigate whether cancer care preferences linked to end-of-life disparities are associated with African American and Caucasian exposure to and perceptions of cancer news coverage. Ultimately, the findings will be used to gain a better understanding of the relationship between cancer media exposure and patients' clinical cancer care preferences. This research will aid our investigation of factors influencing patient treatment decisions that are linked to racial/ethnic disparities in late-stage cancer care.

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Cancer-Related Information Seeking and Scanning Behaviors among Vietnamese Immigrants

Giang T. Nguyen, MD, MPH

This pilot project is an extension of the larger Information Seeking and Scanning study. Researchers performed 20 semi-structured interviews with Vietnamese immigrants, ages 50-70, using bilingual, bi-cultural research assistants to conduct the interviews in the native language of the participants. Questionnaires used for this study are an adapted version of the instrument used for the general population in the Information Seeking and Scanning study. In addition to assessing and identifying themes related to sources of cancer-related information, researchers are exploring the interplay between mainstream and ethnically specific media sources and its impact upon individual decision-making. Preliminary findings show that older Vietnamese immigrants in this study report a fairly limited number of cancer information sources. Frequently mentioned sources include Vietnamese newspapers and interpersonal communication with friends and family. Physicians appear to be a trusted source of information, but study participants did not generally report a history of seeking information from their doctors. Internet use is extremely limited in this population.

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Marketing Prescription Drugs: A Content Analysis of Television Direct-to-Consumer Advertising

Dominick L. Frosch, PhD, Patrick Krueger, PhD, Robert Hornik, PhD, Frances Barg, PhD

American television viewers see as many as 16 hours of prescription drug advertisements per year, yet no research has examined how television ads attempt to influence consumers. The study attempts to explore the messages embedded in these ads. Ads shown during evening news and primetime were coded for factual information about the target condition, how the ads attempt to appeal to consumers, and portrayals of medication and lifestyle behaviors in the lives of ad characters. Results indicate that despite the claims that prescription drug advertisements serve an educational purpose, they provide limited information about the causes of a disease or who may be at risk; show characters that have lost control over their social, emotional or physical lives without the medication; and minimize the value of health promotion through lifestyle changes.

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