Health communication strategies using mass media (e.g., television, print, and internet) have been associated with health beliefs and behaviors^{1 ,2}. In addition, social ties such as friends/family or Community organizations may also be sources of health information, and have been associated with health beliefs and possibly behaviors^3-6. The primary goal of this study was to explore the associations of various sources of health information with health behaviors in a nationally representative sample of United States adults⁷.

The Health Information National
Trends Surveys (HINTS)

The HINTS are biennial, crosssectional surveys designed to assess use of cancer related health information, general health status, cancer screening practices, and lifestyle behaviors⁸. The 2005 HINTS queried respondents’ use of health information sources within the past Twelve months including interpersonal sources (community organizations, and friends and family), and mass media sources (internet, print, and television). “Users” were participants who reported “yes” to using a particular source of health information with any frequency. Those answering “Don’t know” or “refused” as well as missing responses were classified as “non-users”. Respondents were also asked about various lifestyle behaviors (appropriate fruit and vegetable intake, regular exercise, and smoking cessation) and cancer screening (routine mammography, Pap smears, and colon cancer screening). Respondents reporting the lifestyle behavior or age and gender appropriate cancer screening were classified as “meeting recommendations” and all other participants were classified as not achieving recommendations.

To evaluate whether exposure to a particular health information source was associated with a specific health behavior outcome, separate logistic regression models were fit for each behavior and adjusted for the other information sources, accounting for the possibility of a subject using multiple sources, as well as sociodemographic and clinical characteristics. Additionally, the cumulative impact of multiple information sources on meeting recommendations for health behaviors was explored.

Sources of health information

Friends and family were the most frequent sources of health information and community organizations the least frequent. Only about 11% of the Survey respondents met recommendations for diet, 58% met recommendations for exercise, and 78% were non-smokers. Among eligible respondents, 93% reported receiving a screening Pap smear, 84% reported receiving a mammogram, and 49% reported receiving colonoscopy or sigmoidoscopy.

HINTS 2005 respondents who reported community organizations as information sources had 44% increased odds of meeting recommendations for fruit and vegetable intake. Use of print media, community organizations, or friends and family were also associated with 21%, 91%, and 38% increased odds, respectively, of being a non-smoker. None of the health information sources were associated with meeting recommendations for exercise. Among eligible respondents, television and internet users had 61% and 42% increased odds, respectively, of reporting ever receiving a mammography. None of the health information sources were associated with increased odds of reporting ever receiving a Pap smear. All health information sources, except television, were associated with 41-57% increased odds of reporting colonoscopy or sigmoidoscopy screening. There were no significant increases in odds of meeting dietary or exercise recommendations with the cumulative use of social networks or mass media. Increased number of social networks used for health information was associated with increased odds of being a non-smoker or obtaining a colonoscopy/sigmoidoscopy. Use of more mass media sources increased the odds of obtaining mammography and colonoscopy/sigmoidoscopy.

Use of Social Networks may enhance adoption of health behaviors

In these nationally-representative surveys, use of print media and interpersonal sources such as friends and family and community organizations were associated with self-reported health behaviors.

Additionally, these data show that increasing the number and/or classes of health information used often increases the odds of reporting recommended health behaviors. Hence, efforts should focus on using multiple health communication modalities, including better use of social networks, to disseminate health recommendations (e.g., identifying leaders of Community organizations to help formulate and disseminate health information).