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Purpose: The aim of the study is to consider the use of the Internet as a potential facilitator of positive health-related perceptions. Specifically, we propose that online health information seeking fosters positive perceptions of health. Using path modeling, we theorized several mechanisms through which information seeking could be conducive to positive health perceptions, which we conceptualized into the following four dimensions: (1) sense of empowerment in managing health, (2) self-reported ability to take better care of health, (3) sense of improved health-related quality of life, and (4) self-reported improvement of health.

Methodology: Our sample consisted of respondents who have used the Internet as a resource for health information (n = 710), drawn from the largest national probability-based online research panel. Our comparison subsample consisted of older respondents (age ≥ 60; n = 194). We used Internet-specific measures and employed structural equation models (SEM) to estimate the direct, indirect, and total effects of health-related use of the Internet on subjective health perceptions. Based on our review of the literature, competent health communication with healthcare providers and sense of empowerment in managing personal health were modeled as mediator variables. We assessed whether the proposed mediational relationships, if significant, differed across our indicators of positive health perceptions and whether any differential associations were observed among older adults. We run parallel models for each indicator of positive health perception.

Findings: Provider-patient communication informed by the Internet resources were perceived to impart a greater sense of empowerment to manage health among our respondents, which in turn, was associated with perceived contributions to better self-reported ability to provide self-care, increased health-related quality of life, and improvement in self-reported health. The SEM results revealed a good fit with our full sample and subsample.

Research Implications: Conceptualization of the multidimensional aspects of online health information seeking with separate multi-indicator analyses of the outcome variable is important to further our understanding of how technology may impact the pathways involved in influencing health perceptions and as a result health outcomes.

This chapter examines the associations between gender, social support, and health outcomes for individuals living with HIV disease. We include social integration and social isolation as structural measures of social support as well as perceived social support and social conflict as functional measures of social support. We include both mental health and physical health outcomes, which are too often studied in isolation of each other.

Data are from the Coping with HIV/AIDS in the Southeast (CHASE) study; this study reports on baseline data from 611 participants collected from 2001 to 2002. We first examined differences by gender and race, and then used blocked linear regression to determine the additive effects of the social support variables on both mental and physical health outcomes while controlling for potential confounders.

There were notable differences in the significance and strength of social support variables in health outcome models for men and women. Unlike men, social conflict was the strongest predictor of greater psychological distress and poorer physical health-related quality of life among women.

While the results from this study contribute to a greater understanding of gender differences in the relationships between social support and health outcomes, the data used for this study are limited to those living with HIV/AIDS in the Southeast.

Our findings suggest that social conflict may be more detrimental for the health of women than men.

A policy of surveillance which interferes with the fundamental right to a private life requires credible justification and a supportive evidence base. The authority for such interference should be clearly detailed in law, overseen by a transparent process and not left to the vagaries of administrative discretion. If a state surveils those it governs and claims the interference to be in the public interest, then the evidence base on which that claim stands and the operative conception of public interest should be subject to critical examination. Unfortunately, there is an inconsistency in the regulatory burden associated with access to confidential patient information for non-health-related surveillance purposes and access for health-related surveillance or research purposes. This inconsistency represents a systemic weakness to inform or challenge an evidence-based policy of non-health-related surveillance. This inconsistency is unjustified and undermines the qualities recognised to be necessary to maintain a trustworthy confidential public health service. Taking the withdrawn Memorandum of Understanding (MoU) between NHS Digital and the Home Office as a worked example, this chapter demonstrates how the capacity of the law to constrain the arbitrary or unwarranted exercise of power through judicial review is not sufficient to level the playing field. The authors recommend ‘levelling up’ in procedural oversight, and adopting independent mechanisms equivalent to those adopted for establishing the operative conceptions of public interest in the context of health research to non-health-related surveillance purposes.

This study illustrates that differences across health-related websites, as well as different Internet usage patterns, have significant implications for how individuals view and interact with their health care providers.

We rely on a qualitative study of three health-related websites and an ordinary least squares regression analysis of survey data to explore how websites with different organizational motives frame health-related issues and how variations in Internet usage patterns affect patients’ perceptions of the patient-doctor interaction.

Results reveal differences across three health-related websites and show that both the number and the type of websites patients visit affect their perceptions of physicians’ responses. Specifically, visiting multiple websites decreased perceptions of how well doctors listened to or answered patients’ questions, whereas using nonprofit or government health-related websites increased evaluations of how well doctors listened to and answered questions.

This study suggests that practitioners and scholars should look more closely at how patients use the Internet to understand how it affects doctor-patient interactions. Future research could expand the analysis of website framing or use methods such as in-depth interviewing to more fully understand on-the-ground processes and mechanisms.

This study highlights the importance of fleshing out nuances about what it means to be an Internet-informed patient given that varying patterns of Internet use may affect how patients perceive their physicians.

This study proposes targeted modernization of the Department of Defense (DoD's) Joint Forces Ammunition Logistics information system by implementing the optimized innovative information technology open architecture design and integrating Radio Frequency Identification Device data technologies and real-time optimization and control mechanisms as the critical technology components of the solution. The innovative information technology, which pursues the focused logistics, will be deployed in 36 months at the estimated cost of $568 million in constant dollars. We estimate that the Systems, Applications, Products (SAP)-based enterprise integration solution that the Army currently pursues will cost another $1.5 billion through the year 2014; however, it is unlikely to deliver the intended technical capabilities.

Purpose: The primary purpose of this study is to examine the association between Internet use, skills, and health-related Internet activities, on the one hand, and perceived health outcomes of health-related Internet use, use of healthcare services, and self-rated health (SRH), on the other hand, the latter conceptualized as gains constituting the “third digital divide.” Secondarily, we seek to examine whether the above associations are maintained after accounting for demographic characteristics.

Methodology: A nationally representative random-digital-dial (RDD) telephone household survey of Israeli adult population (aged 21 and older, N = 819). The survey measured different dimensions of Internet use – frequency, experience, Web 1.0 general consumption and health-related activities, Web 2.0 production activities (general and health-related), and content evaluation. Potential health benefits included perceived outcomes of Internet use for health purposes, use of healthcare services and SRH.

Findings: In a multiple hierarchical regression model, adjusting for demographic variables, Internet use was associated with increased use of healthcare services and better perceived outcomes of Internet use for health purposes, but not with SRH.

Research Implications and Limitations: Health-related Internet use is associated with a sense of empowerment and enhanced use of healthcare services, but – after accounting for background variables – is not associated with SRH. Limitations include self-reports and a cross-sectional design, the latter precluding inference on causality.

Practical Implications: Internet use, specifically Web 1.0 consumption activities, is associated with increased use of healthcare services and is positively associated with perceived health outcomes. No such relationships were found for Web 2.0 activities. Future technological developments in services should take the digital divide into account and design products that will benefit disadvantaged groups.

Originality/Value: While rigorously assessing various dimensions of Internet use, the study distinguishes between various benefits of Internet use in the health domain, clarifying which benefits are associated with Internet use for health purposes.

Despite mixed evidence, researchers often suggest that married adults tend to live generally healthier lifestyles than their unmarried counterparts. In this chapter, we propose and test a reconceptualization of the health lifestyle that distinguishes between “homebody” risks and “hedonic” risks that may help to make sense of previous findings concerning marriage and health-related behavior.

Using data from the 2004 Survey of Adults (n = 1,385), we employ ordinary least squares regression to model indices of normative and conventional homebody risks (greater body mass, infrequent exercise, poorer diet, and abstinence from alcohol) and unconventional and potentially dangerous hedonic risks (smoking, heavy drinking, going out to bars, eating out, inadequate sleep, and driving without seatbelts) as a function of marital status.

Our key findings indicate that married adults tend to score higher on homebody risks and lower on hedonic risks than never married adults, net of controls for age, gender, race/ethnicity, citizenship, interview language, education, employment status, household income, and religious involvement.

Research limitations include cross-sectional data, restricted indicators of health-related behavior, and narrow external validity.

Contrary to previous research, we conclude that the lifestyle of married adults is not uniformly healthy.

Purpose: For deaf people who use American Sign Language (ASL), including cancer survivors, there are documented reports of difficulties in accessing and understanding health information. More than five years ago, a local breast cancer knowledge study with deaf signers found that only 23% of this sample cited the Internet as a source of health information. More research is needed to understand the current trends of a nationwide adult sample of deaf people’s experience with seeking and understanding health information across technology-mediated platforms.

Methodology/Approach: The Health Information National Trends Survey in American Sign Language survey included sections on health status, Internet use, and social media. We used several approaches to recruit deaf people across the USA, including Hawaii, Alaska, and Puerto Rico. The survey was administered online, in person, or through videophone. Following data cleaning, we conducted multiple logistic regression analyses, controlling for demographic factors associated with eHealth-seeking behaviors. The outcome variables of interest were Internet use and sharing health information on social media.

Findings: A total of 713 deaf people in USA (M = 49 years old; SD = 19) provided informed consent and took the survey. Half of the participants had a college degree. Twenty percent of the sample included those who self-identified as lesbian, gay, or bisexual and 38% who were people of color. White, educated, or younger deaf adults were more likely to cite the Internet as the first source of health information. Although all sub-groups were comparable in using social media, younger or ASL/English bilingual deaf adults were more likely to actively share health information through social media. While perceived trust in health information on the Internet did not differ across subgroups within the deaf sample, frustration in finding and understanding information was strongly linked to increasing age as well as those who prefer using ASL only. Users of YouTube for health-related information were likely to be younger or female.

Conclusions: Deaf users of eHealth information are diverse in terms of language usage, which affects their perception of accessing and using health information across technology-mediated platforms. While using YouTube for health appears to be accessible to deaf people, further improvements are needed to make health information sharing through social media inclusive of people who prefer ASL only. The addition of multimodal delivery features (text, audio, and video) in social networking sites has the strong potential to improve health information access and inclusion for all groups, including deaf ASL users. To make online health information inclusive of all groups, materials need to be accessible and easy to understand by all groups.

Scholarship has demonstrated important consequences of segregation on health and health care outcomes, yet the mechanisms behind this association remain poorly understood. Several recent studies have shown inequities in the distribution of a wide variety of health-related organizations across urban neighborhoods, which may account for some portion of this negative health association. Though, within this literature, relatively little attention has been given to the distribution of health care facilities in particular.

Here, I consider how segregation is related to the distribution of several auxiliary health care practitioners in a series of spatial regression models of zip codes across the United States using data from the 2010 US Census and County Business Patterns (CBP).

I find that both Black and Latino segregation is negatively related to the density of a number of auxiliary health care practitioners, including mental health providers, dentists, physical/occupational/speech therapists, chiropractors, optometrists, podiatrists, and miscellaneous health care practitioners. However, this association is reduced (in certain instances to non-significance) with the inclusion of socioeconomic indicators, chiefly the percent of college educated individuals and the unemployment rate of the zip code. This is association is reduced for both Black and Latino segregation, with a larger reduction in the size of the effects for Latino segregation.

This research suggests that segregation plays an important role in the distribution of health care facilities, but that policy and public health interventions should focus on the intersection between racial residential segregation and socioeconomic considerations.

Literature suggests that the poor often face a myriad of health care constraints and health problems. This study uses bivariate and multivariate analyses to examine the effects of systemic factors such as the availability of health care providers and neighborhood poverty on individual health decisions for a sample of African Americans, Whites, Mexicans, and Puerto Ricans in poor Chicago neighborhoods. Results show that Medicaid usage and having a regular physician increase the number of days home ill and days hospitalized, while frequenting clinics decreases such activity. Additionally, residents in more impoverished urban areas are less likely to stay home ill. Differences in health profiles and providers are also evident based on race/ethnicity. These findings illustrate the important relationship between macro-level factors and specific health choices many residents in poor urban areas make at the micro-level.