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Information Seeking and Information Avoidance: The Case of Patients and Health Information by Donald O. Case UK College of Communications & Info. Studies Presented to SOASIST, Dayton, Ohio, March 13, 2003 Colleagues at UK ► J. David Johnson, Dean, CCIS, & author of Cancer-related Info. Seeking (Hampton) ► James E. Andrews, Asst. Prof., SLIS ► Suzanne L. Allard, doctoral candidate ► Kim M. Kelly, Fellow, genetics counselor Background of the Problem ► Exploration of Human Genome ► Pace of scientific discovery ► Public perception ► Complex field of health information ► Patient/Consumer movement ► Limited societal resources for coping Genetics and Cancer “We have learned that cancer is . . . the consequence of alterations in DNA. . . . Genetic information has the potential to transform how we prevent, detect, and treat cancer.” Klausner, 1996, p. 36 An Information Seeking Problem ► Complex topic, individual circumstances ► Importance to individual and society ► Rapidly changing knowledge base ► Low levels of health knowledge and skills ► Paradox ► “The Perfect Storm” Genetic-related Information ► Predisposition, e.g., BRCA1/2, ApoE ► Pre-symptomatic screening possibilities ► Individualized treatment intervention Common Findings of Information Seeking Studies ► Accessibility is THE critical factor ► People are preferred sources ► Many have primitive seeking skills ► Strong influence of habit and inertia Annual Kentucky Survey ► Annual UK Survey Research Center poll ► CATI, July and August, 2002 ► 2,329 contacted, 882 responses (41%) ► 92% white, 60% female, 28% rural, 23% city ► 51% had at least some college education Nine Genetics Questions, Plus ► Are there cancers that “run in your family”? ► Understand of genetics (Poor to Excellent) ► Worry about inheriting cancer (Never - Often) ► 1st, 2nd & 3rd places to look for info. about ► Need help to determine risk? ► How much help to decide about testing? (None to A Lot) ► Would you have test? ► (Other questions from other survey sponsors) Responses to “Source” Questions ► 93% at least one, 68% two, 34% three ► 15 unique source identified in free recall ► 1st: 47% Internet, 14% Library, 18% MD ► 2nd: 34% Library, 22% MD, 19% Internet, ► 3rd: 33% MD, 30% Library, 8% Family ► Overall: 63% Internet, 50% Library, 47% MD, 18% Family, 11% CIS, 10% Hospital Findings ► 42% believed cancers ran in family ► Understanding: 14% Excellent, 34% Good, 36% Fair, 11% Poor -- Self Ratings ► Identifying more sources positively related to high understanding (p<.001). ► 68% needed assistance; 59% want testing ► 12% worry Often, 26% Some, 28% Never Implications of Findings ► Dominance of Internet and Library ► Family and Friends high in earlier studies ► Emergence of Internet among “old” sources ► BUT: What IS the “Internet” or “Web”? ► Could be pages, email, discussion, etc. ► Doesn’t contain USABLE info on genetics Future Work ► Better understanding of “Internet” ► Explore beliefs about genetics information ► Explore tendency to avoid information ► Develop counseling protocols and test: GENIS2 grant proposal to work with callers to Cancer Information Service Suggested Reading ► Johnson, Andrews, Allard (2001). A model for understanding and affecting cancer genetics information seeking. LISR, 23. ► Case (2002). Looking for Information: A survey of research on info seeking, needs and behavior. Academic Press / Elsevier Science. ► Stopfer (2000). Genetics counseling and clinical cancer genetics services. Sem. Surg. Oncol., 18.