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The socio-technological context of health care wherein patient-consumer involvement is central increases the importance of examining the impact of Internet information on health-related attitudes and behavior. This paper examined the extent to which deployment of e-health information is associated with patient distrust and non-adherence. We examined the hypothesized associations in gender-stratified subsamples to uncover whether any differential patterns of associations exist among women and men. Our analyses allowed for estimation of significant covariate effects at the composite index and item level for both men and women while controlling for the moderation effect of race/ethnicity. Results indicate differential outcomes for patient distrust and non-adherence depending on socio-demographic characteristics. Findings suggest that it is not just health-related information that influences health-related behavior, but also mechanisms through which socio-demographic characteristics shape whether Internet use is associated with distrust and patient non-adherence. e-Health information consumers are overall less trustful and more likely to deviate from health care provider treatment. Non-adherence among those who consume e-health information is more pronounced for non-white women. Highly educated non-white men were more likely to diverge from their medical care provider's treatment recommendations than White men. Given the increasing diversification of the demographic profile of the U.S. population, understanding the dynamics though which health-related Internet use becomes racialized and gendered represents a critical contribution to the literature on Internet and health. [ABSTRACT FROM AUTHOR]

The advent of online communication is transforming how older adults find social support with a community of peers who cope with similar health issues. This article explores whether participation in virtual health support groups demonstrates a significant interaction with users’ appraisal of their illness experience and predicts self-reappraisal among adults 50 years of age and older (N = 157). Hierarchical multiple regressions demonstrate the significance of the combined effect of virtual health support and its interaction with illness appraisal measures to predict the outcome variable of self-reappraisal. The results indicate that even though appraisal of cancer as a traumatic experience reduces positive self-reappraisal, those who appraised their illness to have been a traumatic experience perceived virtual support to be more influential on their sense of positive change after cancer. In contrast, perceived benefit of virtual support on positive self-appraisal is reduced if illness is appraised as an opportunity for personal growth. [ABSTRACT FROM PUBLISHER]

There has been a growing interest among researchers about the Internet-based social support. However, not much is known about whether electronic support is associated with subjectively reported patient health outcomes. This study examines variation in satisfaction with physical health status among users of self-help groups for patients with cancer (N = 350). The analytical approach of the study differs from previous work in that satisfaction with physical health is modelled not as a predictor, but as an outcome variable. The study tested the hypothesis that perceived ability to cope with cancer mediates the association between electronic support and health satisfaction. Path analyses using ordinary least squares multiple regressions showed that there is an indirect association between electronic support and health satisfaction via perceived ability to cope with cancer. Electronic support increased perception of control over cancer, which in turn led to higher levels of satisfaction with health status. External health locus of control was associated with greater benefits derived from electronic support. This article concludes that the evaluation of physical health status includes not only clinical indicators but also subjective assessment of coping ability. Thus, the cyber social context in which health perceptions are developed has important medical implications for patient outcomes. [ABSTRACT FROM AUTHOR]

Purpose: This article presents initial psychometric validation of an instrument developed to measure cyber informational and decisional empowerment. The article provides preliminary insights into the extent to which cyber patients view the digital environment of peer-based information and support as a resource for informed and empowered participation in self health care management.Methods: Data come from cancer patients (N = 350) who participated in the Study of Virtual Health Networks for Cancer Patients of the 21st Century. Data were first analyzed using exploratory factor analysis with principle component extraction and Varimax rotation. Age-based split-sample analysis (≥ 51 and ≤ 50) was performed on a subsample, which consisted of only women (N = 255), in order to cross-validate psychometric data obtained from the full sample. A confirmatory factor analysis was conducted using AMOS 19.0. to further validate the scale.Results: The composite scale is unidimensional with excellent internal consistency reliability. The highest average scores were obtained for informational empowerment items. The lowest average was for the item that measured empowerment to seek second opinion from additional health care professionals.Conclusions: The ability of this composite measure to provide information about the extent to which computer-connected patients view digital peer support as an empowerment tool makes it a valuable addition to the literature in health informatics, supportive cancer care, and health quality of life research. [ABSTRACT FROM AUTHOR]

How do women who seek psychosocial support on the Internet by participating in cancer peer support groups respond to the process of coping with cancer? The current study examines whether older women with cancer have different perceptions about and are influenced to a different extent by online peer support than younger women. The study also explores age-based variations in outlook on coping with cancer as a result of using online support. Separate multivariate regression models estimated the effects of covariates on (1) positive coping affect (PCA) (2) positive coping affect-hopeful (PCA-H), and (3) positive coping affect-proud (PCA-P). A stratified analysis examined variations within age-based subsamples (≥51 and ≤50). Positive coping affect includes feeling proud about coping with cancer from a position of strength and empowerment rather than being a victim and being hopeful for a healthier future postdiagnosis. Online support was found to increase PCA significantly. This finding is consistent across age groups but was more pronounced for older patients. The only exception is that younger women perceive more benefit from using online support in terms of feeling proud. As severity of the symptoms increased, though the younger women increased the amount of time they were online, the older women increased the number of groups they participated in. The study concludes that the Internet might be particularly helpful for older adults who feel helpless to cope with cancer in old age. Online peer support services may help improve the patients’ outlook on fighting with cancer and help them to feel more in control of their health. [ABSTRACT FROM PUBLISHER]

As a characteristic of modern society, the Internet has led to an information revolution and has become an essential information resource. Most patients use the Internet to gather information about their health problems, treatment options and even to check the credentials of their treating physicians. This paper presents results of a cross-sectional study (n=375) with online cancer patients. Results demonstrated that using the Internet health web sites is a characteristic of individuals with high levels of education and income. Most of the respondents were Caucasian women. Results are indicative of a larger social pattern that gender based digital divide in regards to utilization of health information web sites has narrowed down. However, race, education, and income based digital divide still characterized the sample. Finally, the data showed that older adults still lag behind the younger cohorts of Internet health web site users. This paper concludes with a discussion of some potential strategies that can be taken to reduce the digital divide and increase digital diversity. [ABSTRACT FROM AUTHOR]

Internet technology has become an informational resource for most health care consumers. Online information, discussion, and support groups, in the form of message boards, listservs, and chat rooms are emerging as parts of virtual self-health-care network. This paper examines the extent to which participation in online health discussion groups was reported to be helpful in increasing medical knowledge and in enhancing the participatory patient role of health care consumers in interaction with health care service professionals. Data for this study was collected from 350 patients who participated in Internet discussion groups for cancer patients. The findings of the study indicated the important impact of Internet health discussion groups on health care management practices as perceived by health care consumers, including empowerment through knowledge and proactive participation in cancer care management. This research contributes to understanding the patient perspective and assesses the perceived importance of Internet groups by health care consumers. [ABSTRACT FROM AUTHOR]

Objectives We explored the influence of e-trust, e-health literacy, e-health information seeking, and e-health information consumerism on medical satisfaction and positive health perceptions. Methods Our sample consisted of 499 randomly selected panel members aged 40–93. We employed hierarchical ordinary least squares (OLS) regression analyses and structural equation modeling (SEM). We examined the moderating role of age on the relationship between medical satisfaction and positive health perceptions. Results A significant interaction was found between age and medical satisfaction in predicting positive health perceptions in the OLS regression models. Medical satisfaction has a stronger association with self-care, health-related quality of life, and health status in the older adult sample as compared with the middle-aged sample. SEM analyses revealed that e-health information seeking has an indirect effect on both medical satisfaction and positive health perceptions through its significant direct effect on e-health information consumerism. Both e-trust and e-health consumerism were significant predictors. The e-health literacy and e-trust measures were significant predictors of the positive health perception index in the OLS regression models. Discussion The results contribute to our understanding of the potential benefits information technologies have for the health and well-being of computer-connected aging adults. [ABSTRACT FROM AUTHOR]

Background: The Internet, with its capacity to provide information that transcends time and space barriers, continues to transform how people find and apply information to their own lives. With the current explosion in electronic sources of health information, including thousands of websites and hundreds of mobile phone health apps, electronic health literacy is gaining an increasing prominence in health and medical research. An important dimension of electronic health literacy is the ability to appraise the quality of information that will facilitate everyday health care decisions. Health information seekers explore their care options by gathering information from health websites, blogs, Web-based forums, social networking websites, and advertisements, despite the fact that information quality on the Internet varies greatly. Nonetheless, research has lagged behind in establishing multidimensional instruments, in part due to the evolving construct of health literacy itself.Objective: The purpose of this study was to examine psychometric properties of a new electronic health literacy (ehealth literacy) measure in a national sample of Internet users with specific attention to older users. Our paper is motivated by the fact that ehealth literacy is an underinvestigated area of inquiry.Methods: Our sample was drawn from a panel of more than 55,000 participants maintained by Knowledge Networks, the largest national probability-based research panel for Web-based surveys. We examined the factor structure of a 19-item electronic Health Literacy Scale (e-HLS) through exploratory factor analysis (EFA) and confirmatory factor analysis, internal consistency reliability, and construct validity on sample of adults (n=710) and a subsample of older adults (n=194). The AMOS graphics program 21.0 was used to construct a measurement model, linking latent factors obtained from EFA with 19 indicators to determine whether this factor structure achieved a good fit with our entire sample and the subsample (age ≥ 60 years). Linear regression analyses were performed in separate models to examine: (1) the construct validity of the e-HLS and (2) its association with respondents' demographic characteristics and health variables.Results: The EFA produced a 3-factor solution: communication (2 items), trust (4 items), and action (13 items). The 3-factor structure of the e-HLS was found to be invariant for the subsample. Fit indices obtained were as follows: full sample: χ(2) (710)=698.547, df=131, P<.001, comparative fit index (CFI)=0.94, normed fit index (NFI)=0.92, root mean squared error of approximation (RMSEA)=0.08; and for the older subsample (age ≥ 60 years): χ(2) (194)=275.744, df=131, P<.001, CFI=0.95, NFI=0.90, RMSEA=0.08.Conclusions: The analyses supported the e-HLS validity and internal reliability for the full sample and subsample. The overwhelming majority of our respondents reported a great deal of confidence in their ability to appraise the quality of information obtained from the Internet, yet less than half reported performing quality checks contained on the e-HLS. [ABSTRACT FROM AUTHOR]