Although sources of medical knowledge have exploded, especially on the Internet, health professionals remain far and away the most trusted suppliers of medical information, according to a new report sponsored by the National Cancer Institute.
The report, Cancer Communication: Health Information National Trends Survey, is based on data from the Health Information National Trends Survey (HINTS), which NCI conducts every other year. This report covers 2003 and 2005, the most recent available information. Some 6,300 randomly dialed US respondents were surveyed in 2003, when the HINTS survey began, and more than 5,500 were surveyed in 2005. The surveys cover both general health information and specific cancer information.
“We began HINTS to fill a huge void in our understanding of the information environment in which the public, patients, and people who care about cancer exist,” Barbara K. Rimer, DrPH, Dean of the University of North Carolina at Chapel Hill School of Public Health, said in an introductory statement on the new report.
Dr. Rimer, a former director of NCI's Division of Cancer Control and Population Sciences and a former chair of the National Cancer Advisory Board, said that the survey is important for people at the NCI but also for researchers, voluntary health organizations, advocates, and other government agencies that develop and disseminate cancer information.
In 2003, 49.5% of respondents said that a health care professional was their preferred source of cancer information; in 2005 that figure had risen to 55%. In terms of trust, in 2003 the percentage of respondents reporting that they trusted information from their physician a lot was 62.4%; in 2005 that figure had risen to 67.2%.
Use of the Internet rose between 2003 and 2005, but it is nowhere near as trusted as physicians are as a source of health information: In 2003, 50.7% of respondents reported looking for medical information on the Internet for themselves; in 2005, 58.4% of respondents reported such use. And in 2003, 45.8% of respondents said they had looked for medical information on the Internet for others, while 59.5% reported that they did so in 2005.
However, trust in the Internet as a health information source actually declined; in 2003, 23.9% of respondents said they trusted information from the Internet a lot; in 2005, that percentage had dropped to 18.9%.
Other news from the surveys:
- ▪ The majority of respondents were confident that they could obtain cancer information if they needed it. In 2003, that percentage was 62.6%, which rose to 68.1% in 2005.
- ▪ Use of online communication between patients and physicians is slowly growing. In 2003, 7% of respondents said they communicated with their physician or his/her office online; in 2005, the figure was 10%.
- ▪ The public's appetite for cancer information is large and growing. In 2003, 44.9% of respondents reported looking for cancer information for themselves, while in 2005 48.7% of respondents reported having done so.
- ▪ Printed material as a preferred source of cancer information is losing favor. In 2003 27.9% of respondents reported printed material as the source for their most recent search for cancer information; in 2005, 15.5% of respondents reported printed material as the source for their most recent search for cancer information.
- ▪ Nearly half of respondents cited the Internet as the source of their most recent search for cancer information. In 2003 that figure was 48.6%; in 2005, it was 47.6%.
- ▪ Despite the fact that printed material is losing favor with consumers, trust in newspapers as a source of health information is on the rise. In 2003 13.1% of respondents said they trusted information from the newspaper a lot; in 2005 that figure was 18.9%.
- ▪ Trust in magazines as a source of health information is also on the rise—15.9% of respondents reported in 2003 that they trusted information from magazines, which had risen to 19.7% in 2005.
- ▪ Trust in television as a source of health information remained about the same in the two surveys: 20% in 2003, and 20.8% in 2005.
- ▪ Trust in the radio was lower than that in TV: In 2003 9.9% of respondents said they trusted information from the radio a lot; and in 2005 that figure was 12.3%.
Level of Effort Needed a Concern
Despite the public's confidence that they could find cancer information when they needed it, regardless of the source, they still expressed some concern about the level of effort required in conducting their information searches.
Still, that effort level appears to be falling: In 2003, 48.4% of respondents strongly or somewhat agreed with the statement that their last search for cancer information took a lot of effort; in 2005, 37.3% of respondents agreed with that statement.
The frustration level of finding cancer information also appears to be falling. In 2003, 41.9% of respondents strongly or somewhat agreed with the statement that they felt frustrated during their last search for cancer information; in 2005, 26.7% of respondents expressed that frustration.
Quality of Information
Survey respondents in the NCI report appear to be more confident in the quality of cancer information their searches yield. In 2003, 58.3% of respondents strongly or somewhat agreed with the statement that they were concerned about information quality during their last search for cancer information; in 2005, 47.5% of respondents expressed that concern.
The public overall seems to be gaining in sophistication in dealing with complex knowledge, although a substantial number are still stumped by the difficulty of the material. In 2003, 37.7% of respondents strongly or somewhat strongly agreed with the statement that the information they obtained during their last cancer information search was difficult to understand; in 2005, 23.7% of respondents felt that way.
NCI Director John E. Niederhuber, MD, said in a statement that the population-based HINTS data provide “a rich source of knowledge about the awareness of the American public.” The next step, he said, is to translate the findings “into better ways of educating and serving all of our patients through cancer prevention, screening, treatment, and survivorship.”
Different Levels of Health Literacy
One major challenge: dealing with different levels of health literacy in an increasingly pluralistic nation. In 2004 the Institute of Medicine (IOM) released a report stating that fully 90 million US adults have difficulty understanding complex medical terminology and concepts. A similar report that year from the Agency for Healthcare Research and Quality (AHRQ) found that low health literacy interferes with Americans' ability to get the best medical care.
For example, the IOM report Health Literacy: A Prescription to End Confusion found that patients with limited health literacy have a decreased ability to share in crucial decision-making about what prostate cancer treatment to have. And the AHRQ Literacy and Health Outcomes report found that patients with low health literacy are less likely than Americans with higher health literacy to receive potentially life-saving screening tests such as mammograms and Pap smears.
Contrary to popular myth, those two reports showed that low health literacy primarily affects native-born English speakers, not just those for whom English is a second language.
Full Report Online
Further information about the Health Information National Trends Survey is available at http://cancercontrol.cancer.gov/hints