Valued sources of health information among Hispanics, Asians, and the general U.S. population

Theoretical Background and research questions/hypothesis:

In 2017, approximately 70% of reported cases of tuberculosis disease (TB) in the United States occurred among non-U.S.-born persons. TB rates have been steadily declining among U.S.-born persons, but have remained steady among non-U.S.-born persons living in the U.S. In 2017, Asians accounted for 35.7% of TB cases while Hispanics accounted for 28.2%. Of TB cases reported among non-U.S.-born persons, 90% are due to reactivation of latent TB infection (LTBI). CDC’s Division of Tuberculosis Elimination (DTBE) has prioritized research that increases awareness of LTBI among these at-risk populations. Doing so requires a better understanding of their health information seeking behaviors (HISBs).

Studies show that immigrant populations and ethnic minorities diverge from the general population in their HISB. However, many studies look at a small subset of HISBs and therefore cannot evaluate overall habits. Drawing on a more comprehensive list of HISBs, we investigated patterns among Hispanics and Asians across several U.S. markets with the aim of more effectively communicating about LTBI.

Methods:

The data used for this study comes from Scarborough’s MARS 2018 Release 2, using multiple metropolitan markets. We focused on markets that had high respondent rates of Hispanics or Asians (two at-risk populations for LTBI). Key outcome variables come from a series of questions on “personal value of healthcare sources.” We used descriptive statistics to analyze patterns overall and by key sub-groups. For each sub-group, we compared to the overall adult population in that market.

Results:

Across all groups and markets, healthcare professionals—especially doctors—were the most valued source for health information. Other valued sources included search engine results, websites devoted to a specific health cause, family/friends, and communication materials presented in a healthcare setting (such as brochures and wallboards).

However, stratifying data revealed key differences. Non-U.S.-born Hispanics (as well as low-SES and Spanish-dominant Hispanics) valued pharmacists over nurses/physician assistants in 6 of the 8 markets analyzed, a pattern which is reversed in the general population and Asians. By contrast, US-born Hispanics converged to the general population. Non-U.S.-born Hispanics also valued materials found in pharmacies more than the general population. In all markets, Hispanics (both U.S. and non-U.S.-born) valued online videos (e.g., YouTube) and TV programs more than the general population and Asians. Univision and Telemundo-owned Spanish-language channels were the most watched channels in 7 of the 8 markets among non-U.S.-born Hispanics who cited TV as a health source. Asians were more likely to value government websites and alternative medicine professionals than the general population and Hispanics.

Conclusions:

Healthcare professionals are the main avenue through which all patients seek trusted healthcare information. Additionally, many people use the internet for HSBI, but important differences emerge in what types of sites and sources are valued.

Implications for research and/or practice:

These findings suggest that initiatives targeting increased awareness of LTBI should prioritize partnerships with healthcare providers and their facilities. When specifically targeting non-US-born Hispanics, initiatives should partner with pharmacies and Spanish-language sources. Finally, developing targeted online search content will reach a wide cross-section of patients who all rely on search engine results.