Skip to main content

Advertisement

Log in

Improving Health Promotion to American Indians in the Midwest United States: Preferred Sources of Health Information and Its Use for the Medical Encounter

  • Original Paper
  • Published:
Journal of Community Health Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. 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.

    Article  PubMed  Google Scholar 

  2. 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.

    Article  PubMed  Google Scholar 

  3. Anderson, C. (2000). Health promotion in community pharmacy: The UK situation. Patient Education and Counseling, 39(2–3), 285–291.

    Article  PubMed  CAS  Google Scholar 

  4. 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.

    Article  PubMed  Google Scholar 

  5. Atkin, C. (2001). Theory and principles of media health campaigns. Public Communication Campaigns, 3, 49–67.

    Google Scholar 

  6. 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.

    Google Scholar 

  7. 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.

  8. Centers for Disease Control and Prevention. (2011). CDC Health disparities and inequalities report—United States, 2011. MMWR, 60, 116.

    Google Scholar 

  9. 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.

    Google Scholar 

  10. Cline, R., & Haynes, K. (2001). Consumer health information seeking on the Internet: the state of the art. Health Education Research, 16(6), 671.

    Article  PubMed  CAS  Google Scholar 

  11. 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.

    Article  PubMed  Google Scholar 

  12. 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.

    Article  PubMed  Google Scholar 

  13. 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.

    PubMed  Google Scholar 

  14. 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.

    Google Scholar 

  15. 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.

    Google Scholar 

  16. 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.

    Google Scholar 

  17. 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.

    Article  Google Scholar 

  18. DeWalt, D., Berkman, N., Sheridan, S., Lohr, K., & Pignone, M. (2004). Literacy and health outcomes. Journal of General Internal Medicine, 19(12), 1228–1239.

    Article  PubMed  Google Scholar 

  19. 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.

    Article  CAS  Google Scholar 

  20. Estey, A., Musseau, A., & Keehn, L. (1994). Patient’s understanding of health information: A multihospital comparison. Patient Education and Counseling, 24(1), 73–78.

    Article  PubMed  CAS  Google Scholar 

  21. Evans, W. (2006). How social marketing works in health care. British Medical Journal, 332(7551), 1207.

    Article  PubMed  Google Scholar 

  22. Eyerman, R., & Turner, B. S. (1998). Outline of a theory of generations. European Journal of Social Theory, 1(1), 91–106.

    Article  Google Scholar 

  23. Eysenbach, G. (2003). The impact of the internet on cancer outcomes. CA: A Cancer Journal for Clinicians, 53(6), 356–371.

    Article  Google Scholar 

  24. 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.

    Article  PubMed  Google Scholar 

  25. 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.

    Article  PubMed  Google Scholar 

  26. 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.

    Article  Google Scholar 

  27. Fox, S., & Jones, S. (2009). The social life of health information. Washington, DC: Pew Internet & American Life Project.

    Google Scholar 

  28. 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.

    Article  CAS  Google Scholar 

  29. Geana, M. V., & Greiner, K. A. (2011). Health information and the digital divide. Journal of Management & Marketing in Healthcare, 4(2), 108–112.

    Article  Google Scholar 

  30. 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.

    Article  PubMed  Google Scholar 

  31. 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).

  32. 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.

    Article  Google Scholar 

  33. 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.

    Article  PubMed  Google Scholar 

  34. 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.

    Article  PubMed  Google Scholar 

  35. 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.

    Article  PubMed  Google Scholar 

  36. 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.

    Article  PubMed  Google Scholar 

  37. 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.

    Article  PubMed  Google Scholar 

  38. Israel BA, E. E., Schulz, A. J., & Parker, E. A. (2005). Methods in community-based participatory research for health. San Francisco: Jossey-Bass.

    Google Scholar 

  39. 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.

    Google Scholar 

  40. 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.

    Article  PubMed  Google Scholar 

  41. 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.

    Article  Google Scholar 

  42. 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.

    Article  Google Scholar 

  43. 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.

    Article  PubMed  CAS  Google Scholar 

  44. 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.

    Article  PubMed  Google Scholar 

  45. 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.

    Article  Google Scholar 

  46. 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.

    Article  Google Scholar 

  47. 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.

    Article  PubMed  Google Scholar 

  48. Macky, K., Gardner, D., & Forsyth, S. (2008). Generational differences at work: Introduction and overview. Journal of Managerial Psychology, 23(8), 857–861.

    Article  Google Scholar 

  49. 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.

    Article  PubMed  Google Scholar 

  50. Mintzes, B. (2002). For and against: Direct to consumer advertising is medicalising normal human experience: For. British Medical Journal, 324(7342), 908.

    Article  PubMed  Google Scholar 

  51. 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.

    Article  PubMed  Google Scholar 

  52. 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.

    Article  PubMed  Google Scholar 

  53. 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.

    Article  Google Scholar 

  54. Nardo, M., Saisana, M., Saltelli, A., & Tarantola, S. (2005). Tools for composite indicators building. EUR: European Commission-Joint Research Centre. 21682.

    Google Scholar 

  55. National Cancer Institute. (2007). Health Information National Trends Survey, from http://hints.cancer.gov/questions/allyears-chart.jsp?qid=761.

  56. 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.

    Article  PubMed  Google Scholar 

  57. 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.

    Article  PubMed  CAS  Google Scholar 

  58. 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.

  59. 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.

    Article  PubMed  Google Scholar 

  60. 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.

    Article  PubMed  Google Scholar 

  61. 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.

    Article  Google Scholar 

  62. Rimer, B., & Kreuter, M. (2006). Advancing tailored health communication: A persuasion and message effects perspective. Journal of Communication, 56, S184–S201.

    Article  Google Scholar 

  63. 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.

    Article  PubMed  CAS  Google Scholar 

  64. 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.

    Article  PubMed  Google Scholar 

  65. Satcher, D. (2001). American women and health disparities. Journal-American Medical Womens Association, 56(4), 131–132.

    CAS  Google Scholar 

  66. 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.

    Google Scholar 

  67. 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.

    Article  PubMed  Google Scholar 

  68. 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.

    Article  PubMed  CAS  Google Scholar 

  69. 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.

    PubMed  Google Scholar 

  70. 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.

    Google Scholar 

  71. Speros, C. (2005). Health literacy: Concept analysis. Journal of Advanced Nursing, 50(6), 633–640.

    Article  PubMed  Google Scholar 

  72. 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.

    Article  PubMed  Google Scholar 

  73. 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.

    Article  PubMed  CAS  Google Scholar 

  74. Stewart, M. (1995). Effective physician-patient communication and health outcomes: A review. Canadian Medical Association Journal, 152(9), 1423.

    PubMed  CAS  Google Scholar 

  75. Stokols, D. (1996). Translating social ecological theory into guidelines for community health promotion. American Journal of Health Promotion, 10, 282–298.

    Article  PubMed  CAS  Google Scholar 

  76. 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.

    Article  PubMed  Google Scholar 

  77. 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.

    Google Scholar 

  78. Walters, K., & Simoni, J. (2002). Reconceptualizing Native women’s health: An” indigenist” stress-coping model. American Journal of Public Health, 92(4), 520.

    Article  PubMed  Google Scholar 

  79. 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.

    PubMed  Google Scholar 

  80. Young, T. (1994). The health of Native Americans: Toward a biocultural epidemiology. USA: Oxford University Press.

    Google Scholar 

  81. Zarcadoolas, C., Pleasant, A., & Greer, D. (2005). Understanding health literacy: An expanded model. Health Promotion International, 20(2), 195.

    Article  PubMed  Google Scholar 

  82. 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.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Mugur V. Geana.

Rights and permissions

Reprints 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

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10900-012-9564-x

Keywords

Navigation