Nonmedical information seeking amid conflicting health information: negative and positive effects on prostate cancer screening

Abstract

This study investigates the impact of seeking information about the prostate-specific antigen (PSA) test on men’s PSA test use during a period of conflicting recommendations. Analyses used longitudinal survey data collected in 2005 and 2006 from a nationally representative sample of U.S. males aged 40–70 years (n = 777). Cross-sectionally, nonmedical information seeking was significantly associated with increased odds of having a PSA test in the past year (Time 1 odds ratio [OR] = 9.74, p < .01, 95% confidence interval [CI] = 4.37, 21.70; Time 2 OR = 5.78, p < .01, 95% CI = 3.17, 10.55). However, lagged analyses showed that among men who had a PSA at Time 1, active seeking is associated with reduced odds of later having a PSA test (OR = 0.33, p < .05, 95% CI = 0.13, 0.85). Participants who had not had a PSA test in the past year very rarely sought information about PSA tests. Information acquisition in an environment of conflicting recommendations may influence adoption of cancer screening behaviors.

Notes

¹ This is the same data set used by Hornik et al. (2013), Kelly et al. (2010), Kelly et al. (2009), and Ramírez et al. (2013).

² Note that the analytic sample, reflecting the assignment and rounding of weights, appears slightly smaller (n = 769).

³ An alternate version of the lagged analyses incorporating medical and nonmedical seeking as a single predictor (three categories: nonseekers, medical seekers only, and both nonmedical and medical seekers [nonmedical seekers only were lumped with nonseekers as there weren’t many of them]) was conducted in response to a reviewer suggestion. The results indicate that ORs only reversed among those who did both nonmedical and medical seeking relative to nonseekers; medical seekers only were not different from nonseekers. This is consistent with our interpretation that nonmedical seeking, and not medical seeking, is associated with lower odds of PSA testing at follow-up. Detailed results are available from the authors upon request.