Navigating the Cancer Information Environment: The Reciprocal Relationship Between Patient–Clinician Information Engagement and Information Seeking from Nonmedical Sources

Abstract

Prior theory has argued and empirical studies have shown that cancer patients rely on information from their health care providers as well as lay sources to understand and make decisions about their disease. However, research on the dynamic and interdependent nature of cancer patients’ engagement with different information sources is lacking. This study tested the hypotheses that patient–clinician information engagement and information seeking from nonmedical sources influence one another longitudinally among a representative cohort of 1,293 cancer survivors in Pennsylvania. The study hypotheses were supported in a series of lagged multiple regression analyses. Baseline seeking information from nonmedical sources positively predicted subsequent patient–clinician information engagement at 1-year follow-up. The reverse relationship was also statistically significant; baseline patient–clinician information engagement positively predicted information seeking from nonmedical sources at follow-up. These findings suggest that cancer survivors move between nonmedical and clinician sources in a dynamic way to learn about their disease.

Notes

1. ¹An alternative version of the PCIE measure was tested to determine the robustness of these results. Specifically, there were concerns that the item referring to discussing information from nonmedical sources artificially inflated the relationship between the two main variables since this particular variable implied that patients had already searched for information from nonmedical sources. When removing this item from the baseline PCIE measure, the results remained essentially unchanged, PCIE predicted seeking from nonmedical sources (B = 0.125, SE = 0.064, p = .051) and vice versa (B = 0.058, SE = 0.018, p = .001). Similarly, the item about physicians making suggestions to patients to seek information from nonmedical sources raised concerns about whether the association between PCIE and seeking from nonmedical sources is because there is something novel about seeking information from one’s doctor that motivates future information-seeking behavior or whether it is simply a measure of the degree to which respondents follow their doctors’ orders. When this item was removed from the scale, baseline seeking from nonmedical sources predicted PCIE (B = 0.038, SE = 0.015, p = .011). In the reverse scenario, PCIE was positively related to seeking from nonmedical sources but marginally nonsignificant (B = 0.126, SE = 0.075, p = .091). Based on these two results, we are confident in the measures and the relationships already portrayed. Furthermore, this item may in fact reflect an important component of the mechanism through which medical contact leads to nonmedical seeking. The dynamic may indeed reflect this substantive advice.