Abstract
Purpose
Cancer survivors should have adequate e-health literacy to help them better use online health information. Online health communities (OHCs) can offer cancer survivors different types of social support that can represent another resource to improve health outcomes. However, there is little knowledge of how these OHC are directly related to a cancer survivors’ e-health literacy. This study explores how different types of social support in OHCs are associated with cancer survivors’ e-health literacy.
Methods
A questionnaire was developed to collect data from two Chinese OHCs used by cancer survivors. The questionnaire is composed of two parts: six sociodemographic variables (i.e., gender, age, city, education, tenure, and prior Internet experience), two scales for informational support behaviors (i.e., health knowledge seeking and provision of health knowledge), a measure of emotional support within such a setting, and a measure of e-health literacy. Based on 162 complete samples, we determined the measurement properties of the scales used, provided descriptive statistics on major sociodemographic variables and conducted bivariate and multivariable hierarchical regression.
Results
For cancer survivors, females demonstrate higher levels of e-health literacy. Higher education level was related to higher e-health literacy. Health knowledge seeking, contributing to health knowledge, and emotional support were all positively associated with e-health literacy. The interaction effect between health knowledge and emotional support is positively associated with e-health literacy.
Conclusions
Informational support and emotional support, as two major subtypes of social support within resources available in OHCs, are positively associated with e-health literacy among cancer survivors.
Implications for Cancer Survivors
Cancer survivors might benefit from an active strategy for improving personal e-health literacy that includes more active informational involvement and emotional support rather than a passive lurking through e-health information and seeking and reading postings in OHCs.
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References
Huber J, Muck T, Maatz P, Keck B, Enders P, Maatouk I, et al. Face-to-face vs. Online peer support groups for prostate cancer: a cross-sectional comparison study. J Cancer Surviv. 2018;12:1–9.
Falisi AL, Wiseman KP, Gaysynsky A, Scheideler JK, Ramin DA. Chou W-yS. Social media for breast cancer survivors: a literature review. J Cancer Surviv. 2017;11(6):808–21.
Absolom K, Holch P, Amir Z. Introduction to special section on digital technology and cancer survivorship. J Cancer Surviv. 2017;11:655–7.
Abrol E, Groszmann M, Pitman A, Hough R, Taylor RM, Aref-Adib G. Exploring the digital technology preferences of teenagers and young adults (tya) with cancer and survivors: a cross-sectional service evaluation questionnaire. J Cancer Surviv. 2017;11:670–82.
Heo J, Chun M, Lee HW, Woo J-H. Social media use for cancer education at a community-based cancer center in south korea. J Cancer Educ. 2018;33(4):769–73.
Zaidan AA, Zaidan BB, Kadhem Z, Larbani M, Lakulu MB, Hashim M. Challenges, alternatives, and paths to sustainability: better public health promotion using social networking pages as key tools. J Med Syst. 2015;39(2):7.
Roberts AL, Fisher A, Smith L, Heinrich M, Potts HWW. Digital health behaviour change interventions targeting physical activity and diet in cancer survivors: a systematic review and meta-analysis. J Cancer Surviv. 2017;11:704–19.
Lee J, McCullough JS, Town RJ. The impact of health information technology on hospital productivity. Rand J Econ. 2013;44(3):545–68.
Restuccia JD, Cohen AB, Horwitt JN, Shwartz M. Hospital implementation of health information technology and quality of care: are they related? BMC Med Inform Decis. 2012;12(1):109.
Da Costa CA, Pasluosta CF, Eskofier B, Da Silva DB, Da Rosa Righi R. Internet of health things: toward intelligent vital signs monitoring in hospital wards. Artif Intell Med. 2018;89:61–9.
Rodrigues JJ, Segundo DBDR, Junqueira HA, Sabino MH, Prince RM, Al-Muhtadi J, et al. Enabling technologies for the internet of health things. IEEE ACCESS. 2018;6:13129–41.
Lin YK, Chen H, Brown RA, Li SH, Yang HJ. Healthcare predictive analytics for risk profiling in chronic care: a bayesian multitask learning approach. MIS Quart. 2017;41(2):473–95.
Wang Y, Kung L, Byrd TA. Big data analytics: understanding its capabilities and potential benefits for healthcare organizations. Technol Forecast Soc Chang. 2018;126:3–13.
Walton AL, Albrecht TA, Lux L, Santacroce SJ. Social media: Support for survivors and young adults with cancer. Clin J Oncol Nurs. 2017;21(5):537–40.
Zhou J. Factors influencing people’s personal information disclosure behaviors in online health communities: A pilot study. Asia-Pac J Public He. 2018;30(3):286–95.
Boulos MNK, Brewer AC, Karimkhani C, Buller DB, Dellavalle RP. Mobile medical and health apps: state of the art, concerns, regulatory control and certification. Online J Public Health Inform. 2014;5(3):229.
Ventola CL. Mobile devices and apps for health care professionals: uses and benefits. Pharmacy and Therapeutics. 2014;39(5):356–64.
Kasemsap K. Analyzing the role of health information technology in global health care. In: Wickramasinghe N, editor. Handbook of research on healthcare administration and management. Hershey, Penn: IGI Global; 2017. p. 287–307.
Negash S, Musa P, Vogel D, Sahay S. Healthcare information technology for development: improvements in people’s lives through innovations in the uses of technologies. Inform Technol Dev. 2018;24(2):189–97.
Norman CD, Skinner HA. Ehealth literacy: essential skills for consumer health in a networked world. J Med Internet Res. 2006;8(2):e9.
Ioannidis JP, Stuart ME, Brownlee S, Strite SA. How to survive the medical misinformation mess. Eur J Clin Invest. 2017;47(11):795–802.
Bianchini C, Truccolo I, Bidoli E, Group CIQA, Mazzocut M. Avoiding misleading information: a study of complementary medicine online information for cancer patients. Libr Inform Sci Res. 2019;41(1):67–77.
Zhou J, Liu F, Zhou H. Understanding health food messages on twitter for health literacy promotion. Perspect Public Heal. 2018;138(3):173–9.
Gage-Bouchard EA, LaValley S, Warunek M, Beaupin LK, Mollica M. Is cancer information exchanged on social media scientifically accurate? J Cancer Educ. 2018;33(6):1328–32.
Cole J, Watkins C, Kleine D. Health advice from internet discussion forums: how bad is dangerous? J Med Internet Res. 2016;18(1):e4.
Saunders C, Rutkowski AF, Pluyter J, Spanjers R. Health information technologies: from hazardous to the dark side. J Assoc Inf Sci Tech. 2016;67(7):1767–72.
Zhou J, Fan T. Understanding the factors influencing patient e-health literacy in online health communities (ohcs): a social cognitive theory perspective. Int J Env Res Pub He. 2019;16(14):2455.
Levin-Zamir D, Bertschi I. Media health literacy, ehealth literacy, and the role of the social environment in context. Int J Environ Res Public Health. 2018;15(8):1643.
Eysenbach G. Medicine 2.0: Social networking, collaboration, participation, apomediation, and openness. J Med Internet Res. 2008;10(3):e22.
Rodgers S, Chen Q. Internet community group participation: psychosocial benefits for women with breast cancer. J Comput-Mediat Comm. 2005;10(4):JCMC1047.
Cumbo A, Agre P, Dougherty J, Callery M, Tetzlaff L, Pirone J, et al. Online cancer patient education: Evaluating usability and content. Cancer Pract. 2002;10(3):155–61.
Zhou J, Zuo M, Ye C. Understanding the factors influencing health professionals’ online voluntary behaviors: evidence from yixinli, a chinese online health community for mental health. Int J Med Inform. 2019;130:103939.
Shi J, Chen L, Su Y, Chen M. Offspring caregivers of chinese women with breast cancer: their social support requests and provision on social media. Telemed E-Health. 2019;25(5):748–55.
Nambisan P, Gustafson DH, Hawkins R, Pingree S. Social support and responsiveness in online patient communities: impact on service quality perceptions. Health Expect. 2016;19(1):87–97.
Harkin LJ, Beaver K, Dey P, Choong K. Navigating cancer using online communities: a grounded theory of survivor and family experiences. J Cancer Surviv. 2017;11(6):658–69.
Huang K-Y, Chengalur-Smith I, Ran W. Not just for support: companionship activities in healthcare virtual support communities. Communications of the Association for Information Systems. 2014;29:561–94.
Yan L, Tan Y. Feeling blue? Go online: an empirical study of social support among patients. Inf Syst Res. 2014;25(4):667–891.
Mathers M, Canterford L, Olds T, Hesketh K, Ridley K, Wake M. Electronic media use and adolescent health and well-being: cross-sectional community study. Acad Pediatr. 2009;9(5):307–14.
Eysenbach G, Powell J, Englesakis M, Rizo C, Stern A. Health related virtual communities and electronic support groups: systematic review of the effects of online peer to peer interactions. BMJ. 2004;328(7449):1166.
Willems RA, Mesters I, Lechner L, Kanera IM, Bolman CAW. Long-term effectiveness and moderators of a web-based tailored intervention for cancer survivors on social and emotional functioning, depression, and fatigue: randomized controlled trial. J Cancer Surviv. 2017;11:691–703.
Cutrona CE, Suhr JA. Controllability of stressful events and satisfaction with spouse support behaviors. Commun Res. 1992;19(2):154–74.
Atanasova S, Kamin T, Petrič G. Exploring the benefits and challenges of health professionals’ participation in online health communities: emergence of (dis) empowerment processes and outcomes. Int J Med Inform. 2017;98:13–21.
Guo S, Guo X, Zhang X, Vogel D. Doctor–patient relationship strength’s impact in an online healthcare community. Inform Technol Dev. 2018;24(2):279–300.
Myneni S, Cobb N, Cohen T. In pursuit of theoretical ground in behavior change support systems: analysis of peer-to-peer communication in a health-related online community. J Med Internet Res. 2016;18(2):e28.
Vlahovic TA, Wang Y-C, Kraut RE, Levine JM. Support matching and satisfaction in an online breast cancer support community. Proceedings of the SIGCHI conference on human factors in computing systems: ACM; 2014.
Chung JE. Social interaction in online support groups: preference for online social interaction over offline social interaction. Comput Hum Behav. 2013;29(4):1408–14.
Setoyama Y, Yamazaki Y, Namayama K. Benefits of peer support in online japanese breast cancer communities: differences between lurkers and posters. J Med Internet Res. 2011;13(4):e122.
Wang X, Zhao K, Street N. Analyzing and predicting user participations in online health communities: a social support perspective. J Med Internet Res. 2017;19(4):e130.
Mo PK, Coulson NS. Exploring the communication of social support within virtual communities: a content analysis of messages posted to an online hiv/aids support group. Cyberpsychol Behav. 2008;11(3):371–4.
Coursaris CK, Liu M. An analysis of social support exchanges in online hiv/aids self-help groups. Comput Hum Behav. 2009;25(4):911–8.
Beaudoin CE, Tao C-C. Benefiting from social capital in online support groups: an empirical study of cancer patients. Cyberpsychol Behav. 2007;10(4):587–90.
Chiu CM, Hsu MH, Wang ETG. Understanding knowledge sharing in virtual communities: an integration of social capital and social cognitive theories. Decis Support Syst. 2006;42(3):1872–88.
Johnson DS, Lowe B. Emotional support, perceived corporate ownership and skepticism toward out-groups in virtual communities. J Interact Mark. 2015;29:1–10.
Zhou J, Zuo M, Yu Y, Chai W. How fundamental and supplemental interactions affect users’ knowledge sharing in virtual communities? A social cognitive perspective. Internet Res. 2014;24(5):566–86.
Chung JE. Social networking in online support groups for health: how online social networking benefits patients. J Health Commun. 2014;19(6):639–59.
Feuerstein M. Defining cancer survivorship. Journal of Cancer Survivorship: Research and Practice. 2007;1(1):5–7.
China Daily. Top 15 ‘new first-tier’ cities in China. In: ChinaDaily. 2017. www.chinadaily.com.cn/business/2017top10/2017-05/15/content_29343927.htm.
Korda H, Itani Z. Harnessing social media for health promotion and behavior change. Health Promotion Practice. 2013;14(1):15–23.
Yang X, Li G, Huang SS. Perceived online community support, member relations, and commitment: differences between posters and lurkers. Inform Manage. 2017;54(2):154–65.
You J, Lu Q. Sources of social support and adjustment among chinese cancer survivors: gender and age differences. Support Care Cancer. 2014;22(3):697–704.
Yang M. Health information literacy of the older adults and their intention to share health rumors: an analysis from the perspective of socioemotional selectivity theory. International Conference on Human-Computer Interaction: Springer, Cham; 2019.
Acknowledgments
We are grateful to the reviewer for his/her constructive and actionable suggestions in helping us to improve this paper. We are grateful to MiJian (www.mijian360.com) and YuAiGongWu (www.yuaigongwu.com) for their help in data collection.
Funding
Dr. Zhou received financial support from the National Natural Science Foundation of China (grant number 71501062), Key Projects of Philosophy and Social Sciences Research of Chinese Ministry of Education (grant number 19JZD021), Guangdong Provincial Science and Technology Research Project (grant number 2019A101002110), and Shantou University STU Scientific Research Initiation Grant (grant number STF18011). Dr. Wang received financial support from National Natural Science Foundation of China (grant number 71901106), Ministry of Education of Humanities and Social Science Project (grant number 18YJC630169), and Philosophy and Social Science Foundation in Colleges and Universities of Jiangsu Education Department (grant number 2018SJA0818).
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Zhou, J., Wang, C. Improving cancer survivors’ e-health literacy via online health communities (OHCs): a social support perspective. J Cancer Surviv 14, 244–252 (2020). https://doi.org/10.1007/s11764-019-00833-2
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DOI: https://doi.org/10.1007/s11764-019-00833-2