Abstract
American Indians and Alaska Natives suffer significant health disparities for many infectious and chronic diseases as compared to the general population. Providing accurate and culturally tailored health information to underserved groups has been shown to influence health behaviors and health outcomes. Little prior research has explored American Indians health information use and preferences. National representative sample surveys such as the Health Information National Trends Survey provide some data on minority groups but are underpowered to provide useful information on American Indians. The present study analyzes data from a survey of over 900 American Indians from the Midwest United States and explores their sources of health information, their preferences for information presentation, and their use of health information prior to and during medical encounters. We conclude that campaigns targeting Natives should be narrowly focused and be community driven or employing community resources. American Indians use a diversity of media sources to obtain health information, with the Internet being underutilized compared to the general population. Partnership with Indian Health Service providers and pharmacists, as well as traditional healers, in the development and dissemination of new health information for Natives may provide the “expert” tone needed to promote health improvements in American Indians.
Similar content being viewed by others
References
Ahmad, F., Hudak, P., Bercovitz, K., Hollenberg, E., & Levinson, W. (2006). Are physicians ready for patients with internet-based health information? Journal of Medical Internet Research, 8(3), e22.
Albarracín, D., Gillette, J., Earl, A., Glasman, L., Durantini, M., & Ho, M. (2005). A test of major assumptions about behavior change: A comprehensive look at the effects of passive and active HIV-prevention interventions since the beginning of the epidemic. Psychological Bulletin, 131(6), 856.
Anderson, C. (2000). Health promotion in community pharmacy: The UK situation. Patient Education and Counseling, 39(2–3), 285–291.
Anderson, G., Frogner, B., Johns, R., & Reinhardt, U. (2006). Health care spending and use of information technology in OECD countries. Health Affairs, 25(3), 819.
Atkin, C. (2001). Theory and principles of media health campaigns. Public Communication Campaigns, 3, 49–67.
Blanch, D., Sciamanna, C., Lawless, H., & Diaz, J. (2005). Effect of the internet on the doctor-patient relationship: A review of the literature. Journal on Information Technology in Healthcare, 3(3), 179–201.
Bureau of Indian Education. (2010). Bureau-Wide Annual Report Card, 186 of 187 School Reports Accepted, 2009–2010 Retrieved February 22, 2011, from http://www.bie.edu/HowAreWeDoing/Scorecards/index.htm.
Centers for Disease Control and Prevention. (2011). CDC Health disparities and inequalities report—United States, 2011. MMWR, 60, 116.
Choi, W. S., Daley, C. M., James, A., Thomas, J., Schupbach, R., Segraves, M., et al. (2006). Beliefs and attitudes regarding smoking cessation among American Indians: a pilot study. Ethnicity and Disease, 16(1), 35.
Cline, R., & Haynes, K. (2001). Consumer health information seeking on the Internet: the state of the art. Health Education Research, 16(6), 671.
Cote, I., Gregoire, J., Moisan, J., Chabot, I., & Lacroix, G. (2003). A pharmacy-based health promotion programme in hypertension: Cost-benefit analysis. Pharmacoeconomics, 21(6), 415–428.
Cotten, S., & Gupta, S. (2004). Characteristics of online and offline health information seekers and factors that discriminate between them. Social Science and Medicine, 59(9), 1795–1806.
D’Alessandro, D., Kingsley, P., & Johnson-West, J. (2001). The readability of pediatric patient education materials on the World Wide Web. Archives of Pediatrics and Adolescent Medicine, 155(7), 807.
Daley, C. M., James, A. S., Barnoskie, R. S., Segraves, M., Schupbach, R., & Choi, W. S. (2006). Tobacco Has a Purpose, Not Just a Past: Feasibility of Developing a Culturally Appropriate Smoking Cessation Program for a Pan‐Tribal Native Population. Medical Anthropology Quarterly, 20(4), 421–440.
Daley, C. M., Cowan, P., Nollen, N. L., Greiner, K. A., & Choi, W. S. (2009). Assessing the scientific accuracy, readability, and cultural appropriateness of a culturally targeted smoking cessation program for American Indians. Health Promotion Practice, 10(3), 386–393.
Daley, C. M., James, A. S., Ulrey, E., Joseph, S., Talawyma, A., Choi, W. S., Coe, M. K. (2010). Using focus groups in community-based participatory research: Challenges and resolutions. Qualitative Health Research, 20(5), 697–706.
Davis, T., Williams, M., Marin, E., Parker, R., & Glass, J. (2002). Health literacy and cancer communication. CA: A Cancer Journal for Clinicians, 52(3), 134–149.
DeWalt, D., Berkman, N., Sheridan, S., Lohr, K., & Pignone, M. (2004). Literacy and health outcomes. Journal of General Internal Medicine, 19(12), 1228–1239.
Dignan, M., Michielutte, R., Blinson, K., Wells, H., Case, L., Sharp, P., et al. (1996). Effectiveness of health education to increase screening for cervical cancer among eastern-band Cherokee Indian women in North Carolina. JNCI Cancer Spectrum, 88(22), 1670.
Estey, A., Musseau, A., & Keehn, L. (1994). Patient’s understanding of health information: A multihospital comparison. Patient Education and Counseling, 24(1), 73–78.
Evans, W. (2006). How social marketing works in health care. British Medical Journal, 332(7551), 1207.
Eyerman, R., & Turner, B. S. (1998). Outline of a theory of generations. European Journal of Social Theory, 1(1), 91–106.
Eysenbach, G. (2003). The impact of the internet on cancer outcomes. CA: A Cancer Journal for Clinicians, 53(6), 356–371.
Eysenbach, G., & Kohler, C. (2002). How do consumers search for and appraise health information on the World Wide Web? Qualitative study using focus groups, usability tests, and in-depth interviews. British Medical Journal, 324(7337), 573–577.
Eysenbach, G., & Köhler, C. (2002). How do consumers search for and appraise health information on the world wide web? Qualitative study using focus groups, usability tests, and in-depth interviews. BMJ, 324(7337), 573.
Fagerlin, A., Ubel, P., Smith, D., & Zikmund-Fisher, B. (2007). Making numbers matter: Present and future research in risk communication. American Journal of Health Behavior, 31(supp), 47–56.
Fox, S., & Jones, S. (2009). The social life of health information. Washington, DC: Pew Internet & American Life Project.
Friedman, D., Hoffman-Goetz, L., & Arocha, J. (2006). Health literacy and the World Wide Web: Comparing the readability of leading incident cancers on the Internet. Informatics for Health and Social Care, 31(1), 67–87.
Geana, M. V., & Greiner, K. A. (2011). Health information and the digital divide. Journal of Management & Marketing in Healthcare, 4(2), 108–112.
Geana, M. V., Kimminau, K. S., & Greiner, K. A. (2011). Sources of health information in a multiethnic, underserved, urban community: Does ethnicity matter? Journal of Health Communication, 16(6), 583–594.
Geana, M. V., Daley Makosky C., Nazir, N., Cully, L., Etheridge, J., Bledowski, C., Choi, W. S., Greiner, K. A. (2011). Use of Online Health information Resources by American Indians and Alaska Natives. Journal of Health Communication (in press).
Henwood, F., Wyatt, S., Hart, A., & Smith, J. (2003). ‘Ignorance is bliss sometimes’: constraints on the emergence of the ‘informed patient’in the changing landscapes of health information. Sociology of Health & Illness, 25(6), 589–607.
Hesse, B., Nelson, D., Kreps, G., Croyle, R., Arora, N., Rimer, B., et al. (2005). Trust and sources of health information: The impact of the Internet and its implications for health care providers: Findings from the first Health Information National Trends Survey. Archives of Internal Medicine, 165(22), 2618.
Hesse, B. W., Nelson, D. E., Kreps, G. L., Croyle, R. T., Arora, N. K., Rimer, B. K., et al. (2005). Trust and sources of health information. Archives of Internal Medicine, 165(22), 2618–2624.
Hourihan, F., Krass, I., & Chen, T. (2003). Rural community pharmacy: A feasible site for a health promotion and screening service for cardiovascular risk factors. Australian Journal of Rural Health, 11(1), 28–35.
Houts, P., Doak, C., Doak, L., & Loscalzo, M. (2006). The role of pictures in improving health communication: A review of research on attention, comprehension, recall, and adherence. Patient Education and Counseling, 61(2), 173–190.
Huhman, M., Potter, L., Wong, F., Banspach, S., Duke, J., & Heitzler, C. (2005). Effects of a mass media campaign to increase physical activity among children: Year-1 results of the VERB campaign. Pediatrics, 116(2), e277–e284.
Israel BA, E. E., Schulz, A. J., & Parker, E. A. (2005). Methods in community-based participatory research for health. San Francisco: Jossey-Bass.
Kim, K., & Kwon, N. (2009). Racial differences in source awareness, trust, selection and information competence among cancer patients who sought cancer information: A preliminary analysis of HINTS 2007. Proceedings of the American Society for Information Science and Technology, 46(1), 1–8.
Koch-Weser, S., Bradshaw, Y. S., Gualtieri, L., & Gallagher, S. S. (2010). The Internet as a health information source: Findings from the 2007 Health Information National Trends Survey and implications for health communication. Journal of Health Communication, 15(Suppl 3), 279–293.
Kreuter, M., Lukwago, S., Bucholtz, D., Clark, E., & Sanders-Thompson, V. (2003). Achieving cultural appropriateness in health promotion programs: Targeted and tailored approaches. Health Education & Behavior, 30(2), 133.
Kreuter, M., & Wray, R. (2003). Tailored and targeted health communication: strategies for enhancing information relevance. American Journal of Health Behaviour, 27(Supplement 3), 227–232.
Larson, C. O., Nelson, E. C., Gustafson, D., & Batalden, P. B. (1996). The relationship between meeting patients’ information needs and their satisfaction with hospital care and general health status outcomes. International Journal for Quality in Health Care, 8(5), 447.
Legaspi, A., & Orr, E. (2007). Disseminating research on community health and well-being: A collaboration between Alaska Native villages and the academe. American Indian and Alaska Native Mental Health Research, 14, 24–43.
Lemire, M., Pare, G., Sicotte, C., & Harvey, C. (2008). Determinants of Internet use as a preferred source of information on personal health. International Journal of Medical Informatics, 77(11), 11.
Leung, L. (2003). Impacts of Net-generation attributes, seductive properties of the Internet, and gratifications-obtained on Internet use. Telematics and Informatics, 20(2), 22.
Longo, D. (2005). Understanding health information, communication, and information seeking of patients and consumers: A comprehensive and integrated model. Health Expectations, 8(3), 189–194.
Macky, K., Gardner, D., & Forsyth, S. (2008). Generational differences at work: Introduction and overview. Journal of Managerial Psychology, 23(8), 857–861.
McMullan, M. (2006). Patients using the Internet to obtain health information: How this affects the patient-health professional relationship. Patient Education and Counseling, 63(1–2), 24–28.
Mintzes, B. (2002). For and against: Direct to consumer advertising is medicalising normal human experience: For. British Medical Journal, 324(7342), 908.
Mintzes, B., Barer, M., Kravitz, R., Kazanjian, A., Bassett, K., Lexchin, J., et al. (2002). Influence of direct to consumer pharmaceutical advertising and patients’ requests on prescribing decisions: Two site cross sectional survey. British Medical Journal, 324(7332), 278.
Murray, E., Lo, B., Pollack, L., Donelan, K., Catania, J., Lee, K., et al. (2003). The impact of health information on the Internet on health care and the physician-patient relationship: National US survey among 1.050 US physicians. Journal of Medical Internet Research, 5(3), e17.
Murray, E., Lo, B., Pollack, L., Donelan, K., & Lee, K. (2004). Direct-to-consumer advertising: Public perceptions of its effects on health behaviors, health care, and the doctor-patient relationship. Journal of the American Board of Family Medicine, 17(1), 6.
Nardo, M., Saisana, M., Saltelli, A., & Tarantola, S. (2005). Tools for composite indicators building. EUR: European Commission-Joint Research Centre. 21682.
National Cancer Institute. (2007). Health Information National Trends Survey, from http://hints.cancer.gov/questions/allyears-chart.jsp?qid=761.
Nelson, D., Kreps, G., Hesse, B., Croyle, R., Willis, G., Arora, N., et al. (2004). The health information national trends survey (HINTS): Development, design, and dissemination. Journal of Health Communication, 9(5), 443–460.
Ngoh, L., & Shepherd, M. (1997). Design, development, and evaluation of visual aids for communicating prescription drug instructions to nonliterate patients in rural Cameroon. Patient Education and Counseling, 30(3), 257–270.
Office of Minority Health. (2009). American Indian/Alaska Native Profile Retrieved July 1, 2010, from http://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlID=52.
Paasche Orlow, M., Parker, R., Gazmararian, J., Nielsen Bohlman, L., & Rudd, R. (2005). The prevalence of limited health literacy. Journal of General Internal Medicine, 20(2), 175–184.
Peters, E., Hibbard, J., Slovic, P., & Dieckmann, N. (2007). Numeracy skill and the communication, comprehension, and use of risk-benefit information. Health Affairs, 26(3), 741.
Reyna, V., & Brainerd, C. (2007). The importance of mathematics in health and human judgment: Numeracy, risk communication, and medical decision making. Learning and Individual Differences, 17(2), 147–159.
Rimer, B., & Kreuter, M. (2006). Advancing tailored health communication: A persuasion and message effects perspective. Journal of Communication, 56, S184–S201.
Roubideaux, Y., Moore, K., Avery, C., Muneta, B., Knight, M., & Buchwald, D. (2000). Diabetes education materials: Recommendations of tribal leaders, Indian health professionals, and American Indian community members. The Diabetes Educator, 26(2), 290.
Rutten, L., Arora, N., Bakos, A., Aziz, N., & Rowland, J. (2005). Information needs and sources of information among cancer patients: A systematic review of research (1980–2003). Patient Education and Counseling, 57(3), 250–261.
Satcher, D. (2001). American women and health disparities. Journal-American Medical Womens Association, 56(4), 131–132.
Satterfield, D., Burd, C., Valdez, L., Hosey, G., & Shield, J. (2002). The “in-between people”: Participation of community health representatives in diabetes prevention and care in American Indian and Alaska Native communities. Health Promotion Practice, 3(2), 166.
Schillinger, D., Grumbach, K., Piette, J., Wang, F., Osmond, D., Daher, C., et al. (2002). Association of health literacy with diabetes outcomes. JAMA, 288(4), 475.
Schooler, C., Chaffee, S., Flora, J., & Roser, C. (1998). Health Campaign Channels Tradeoffs Among Reach, Specificity, and Impact. Human Communication Research, 24(3), 410–432.
Schunemann, H., Best, D., Vist, G., & Oxman, A. (2003). Letters, numbers, symbols and words: How to communicate grades of evidence and recommendations. Canadian Medical Association Journal, 169(7), 677.
Shah, D. V., Kwak, N., & Holbert, L. R. (2001). “Connecting” and “disconnecting” with civic life: Patterns of internet use and the production of social capital. Political Communication, 18, 21.
Speros, C. (2005). Health literacy: Concept analysis. Journal of Advanced Nursing, 50(6), 633–640.
Sprague, D., LaVallie, D., Wolf, F., Jacobsen, C., Sayson, K., & Buchwald, D. (2010). Influence of graphic format on comprehension of risk information among American Indians. Medical Decision Making, 31(3), 437–443.
Stevenson, F., Barry, C., Britten, N., Barber, N., & Bradley, C. (2000). Doctor-patient communication about drugs: The evidence for shared decision making. Social Science and Medicine, 50(6), 829–840.
Stewart, M. (1995). Effective physician-patient communication and health outcomes: A review. Canadian Medical Association Journal, 152(9), 1423.
Stokols, D. (1996). Translating social ecological theory into guidelines for community health promotion. American Journal of Health Promotion, 10, 282–298.
Stokols, D., Grzywacz, J., McMahan, S., & Phillips, K. (2003). Increasing the health promotive capacity of human environments. American Journal of Health Promotion, 18(1), 4–13.
Varcoe, C., Bottorff, J., Carey, J., Sullivan, D., & Williams, W. (2010). Wisdom and influence of elders: Possibilities for health promotion and decreasing tobacco exposure in First Nations communities. Canadian Journal of Public Health, 101(2), 154. Revue canadienne de santé publique.
Walters, K., & Simoni, J. (2002). Reconceptualizing Native women’s health: An” indigenist” stress-coping model. American Journal of Public Health, 92(4), 520.
Wong, F., Huhman, M., Asbury, L., Bretthauer-Mueller, R., McCarthy, S., Londe, P., et al. (2004). VERB™—a social marketing campaign to increase physical activity among youth. Preventing Chronic Disease, 1(3), A10.
Young, T. (1994). The health of Native Americans: Toward a biocultural epidemiology. USA: Oxford University Press.
Zarcadoolas, C., Pleasant, A., & Greer, D. (2005). Understanding health literacy: An expanded model. Health Promotion International, 20(2), 195.
Zuckerman, S., Haley, J., Roubideaux, Y., & Lillie-Blanton, M. (2004). Health service access, use, and insurance coverage among American Indians/Alaska Natives and Whites: What role does the Indian Health Service play? American Journal of Public Health, 94(1), 53.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Geana, M.V., Greiner, K.A., Cully, A. et al. Improving Health Promotion to American Indians in the Midwest United States: Preferred Sources of Health Information and Its Use for the Medical Encounter. J Community Health 37, 1253–1263 (2012). https://doi.org/10.1007/s10900-012-9564-x
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10900-012-9564-x