JMIR Publications

ABSTRACT

Background:

Since the rise of the internet, online health information seeking has attracted worldwide scholarly attention. However, most scholars conducted such studies in single countries. Some scholars did design comparative studies across countries, but they were normally based on small non-probability college student samples. Data-driven multi-country comparison makes it possible to better understand how cultural factors moderate the association between individual-level determinants and online health information seeking, which further helps practitioners evaluate the desirability of experiences and lessons in a given country being transferred and promoted in other countries. The results of this study can contribute to the health communication literature, particularly in the field of online cancer information seeking, by generating more reliable insights on country differences in internet cancer information seeking.

Objective:

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

Methods:

This study used the HINTS 2017 (US data) and HINTS-China data collected in 2017 to answer the research question. This study was only interested in people without cancer history and with internet access. For HINTS 2017, the sample size was 2,153; for HINTS-China 2017, the sample size was 2,358. To compare China and the United States, the researchers selected as predictors the same set of study variables in HINTS and HINTS-China 2017. Under the framework of behavioral model of health services use, these predictors included predisposing, need and enabling factors.

Results:

This study found that enabling conditions are more important in China, while perceived needs are more significant in the United States. Chinese online cancer information seekers are employed, have lower annual family income, see or hear their family members diagnosed with cancer and do not trust their family and friends as health information sources, but none of them can be used to describe their US counterparts, who are instead more associated with their perceptions of personal health status and fear of cancer.

Conclusions:

Overall, under the framework of the behavioral model of health services use, the results reveal clear patterns of cross-country/cultural differences. Perceived needs of individuals may play bigger roles in influencing internet cancer information seeking behaviors in more individualistic cultures such as the United States. The importance of enabling conditions outweighs perceived needs in predicting internet health information seeking behaviors in more collectivistic countries such as China.