Cancer knowledge and disparities in the information age.
ABSTRACT Increasing information flow often leads to widening gaps in knowledge between different socioeconomic status (SES) groups as higher SES groups are more likely to acquire this new information at a faster rate than lower SES groups. These gaps in knowledge may offer a partial but robust explanation for differential risk behaviors and health disparities between different social groups. Drawing on the Health Information National Trends Survey (HINTS 2003), a national survey of communication behaviors conducted by the National Cancer Institute (NCI), we examine the relationship between publicity and knowledge gaps on two cancer topics that received different levels of publicity: knowledge about tobacco and sun exposure and their respective links to cancer. Analyses of the HINTS 2003 data suggest that differential knowledge levels of causes of cancer between SES groups are one potential explanation of cancer disparities that have been extensively reported in the literature. It is evident that high income and high education are associated with awareness about causes of major cancers such as lung and skin, and may allow people to protect themselves and minimize their risks. The data also show that heavier media attention could attenuate the knowledge gaps though moderate publicity or lack of news coverage may actually widen them. Last, the findings in this article suggest that it is necessary to take into account the SES variation within different racial and ethnic groups rather than mask them by treating the groups as one.
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ABSTRACT: Use of communication theories in the development of pictorial health warning labels (graphic warning labels) for cigarette packaging might enhance labels' impact on motivation to quit, but research has been limited, particularly among low socioeconomic status (SES) populations in the U.S. This qualitative study explored perceptions of theory-based graphic warning labels and their role in motivation to quit among low-income smokers. A cross-sectional qualitative study was conducted with 25 low-income adult smokers in Baltimore, Maryland, who were purposively sampled from a community-based source population. Semi-structured, in-depth interviews were conducted from January to February 2014. Participants were asked about the motivational impact of 12 labels falling into four content categories: negative depictions of the health effects of smoking to smokers and others, and positive depictions of the benefits of quitting to smokers and others. Data were coded using a combined inductive/deductive approach and analyzed thematically through framework analysis. Labels depicting negative health effects to smokers were identified as most motivational, followed by labels depicting negative health effects to others. Reasons included perceived severity of and susceptibility to the effects, negative emotional reactions (such as fear), and concern for children. Labels about the benefits of quitting were described as motivational because of their hopefulness, characters as role models, and desire to improve family health. Reasons why labels were described as not motivational included lack of impact on perceived severity/susceptibility, low credibility, and fatalistic attitudes regarding the inevitability of disease. Labels designed to increase risk perceptions from smoking might be significant sources of motivation for low SES smokers. Findings suggest innovative theory-driven approaches for the design of labels, such as using former smokers as role models, contrasting healthy and unhealthy characters, and socially-oriented labels, might motivate low SES smokers to quit.BMC Public Health 12/2015; 15(1). DOI:10.1186/s12889-015-1438-6 · 2.32 Impact Factor
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ABSTRACT: Cancer prevention information (CPI) needs are common among cancer patients and their families, but processes of CPI seeking following cancer diagnosis are largely unknown. The goal of this study was to examine antecedents of CPI seeking among a diverse sample of patients and their caregivers. Findings revealed high levels of perceived personal importance of CPI and motivational factors (health consciousness), but almost half of respondents never sought CPI. Non-seekers were more likely to have lower household income and educational attainment. Minority respondents were less likely to seek CPI compared with non-Hispanic Whites, with increased risk among Spanish-speaking Hispanics. However, only educational attainment, health consciousness, and marital status were significant predictors of CPI seeking in the final logistic regression model. These disparities demonstrate the need for communication interventions in healthcare settings.07/2014; 7(2):93-105. DOI:10.1179/1753807614Y.0000000053
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ABSTRACT: This study applies the knowledge gap hypothesis to examine the direct and interactive influence of socioeconomic status, mass media, and interpersonal discussion on public knowledge of the H1N1 flu pandemic in Singapore. Using a nationally representative random digit-dialing telephone survey of 1,055 adult Singaporeans, results show that attention to newspapers was not associated with a widened knowledge gap about the H1N1 pandemic between the high and low socioeconomic status individuals. Conversely, attention to television news and interpersonal discussion were associated with a narrowed knowledge disparity between the high and low socioeconomic status individuals. Findings suggest that the knowledge gap hypothesis was not supported in this study. Instead, results suggest that attention to television news and interpersonal discussions were associated with a reduced knowledge gap. Household income and risk perceptions were also found to be positively associated with public knowledge about the H1N1 flu pandemic. Both theoretical and practical implications were discussed.Mass Communication & Society 09/2012; 15(5):695-717. DOI:10.1080/15205436.2011.616275 · 0.83 Impact Factor