Perceived Needs Versus Predisposing/Enabling Characteristics in Relation to Internet Cancer Information Seeking Among the US and Chinese Public: Comparative Survey Research

Abstract

Background: Since the rise of the internet, online health information seeking has become a worldwide phenomenon. However, health and health communication are inherently culture bound. A data-driven cross-country comparison enables us to better understand how cultural factors moderate the association between individual-level determinants and online health information seeking.

Objective: The objective of the study was to examine similarities and differences in determinants of internet cancer information seeking between the US and Chinese general public (excluding cancer patients and survivors) under the framework of a behavioral model of health services use.

Methods: This study used Health Information National Trends Survey (HINTS) 2017 (US data) and HINTS-China 2017 data to answer the research question. It focused on people with no cancer history and with internet access. For the HINTS 2017, the sample size was 2153; for the HINTS-China 2017, the sample size was 2358. To compare China and the United States, the researchers selected the same set of study variables for each dataset. Under the framework of the behavioral model of health services use, these predictors were predisposing factors, enabling factors, and need factors.

Results: In terms of the predisposing factors, a higher age, college degree or above, being currently unemployed, and having a family history of cancer were associated with internet cancer information seeking for the Chinese respondents; none of these factors were related to information seeking for the US respondents, although a lower age was associated with information seeking. Regarding the enabling conditions, lower trust in family members and friends as reliable information sources was the only factor associated with information seeking for the Chinese respondents, while no enabling factor was related to information seeking for the US respondents. Regarding the need factors, perceived health status was not related to information seeking for the Chinese respondents, while perception of poorer health condition was related to information seeking for the US respondents. Higher cancer fear was related to information seeking for both groups, but the magnitude of association was smaller for the Chinese respondents than for the US respondents.

Conclusions: Overall, under the framework of the behavioral model of health services use, the results based on multivariate logistic regression reveal clear patterns of cross-country/cultural differences in the factors associated with internet cancer information seeking behaviors: predisposing characteristics and enabling conditions are more important in China, while perceived needs are more significant in the US. Such differences might reflect possible US-China differences in job environment (eg, job pressure) and culture (individualism vs collectivism and family structure).

Keywords: China; HINTS; United States; comparative research; cultural sensitivity; health information seeking behavior (HISB).