School of Social Work, The University of Memphis, 226 McCord Hall, Memphis, TN 38152, USA.
Department of Social Welfare, University of Seoul, 163 Seoulsiripdaero, Dongdaemun-gu, Seoul 02504, South Korea.
Patient Educ Couns. 2019 Mar;102(3):416-423. doi: 10.1016/j.pec.2018.11.002. Epub 2018 Nov 6.
To test the hypothesized paths for Online Health Information Seeking (OHIS) behaviors in developing health literacy, leading to colorectal cancer (CRC) screening among Korean Americans (KAs) using Health Literacy Skills Frameworks (HLSF) and Cognitive Mediation Model (CMM).
A total of 433 KAs aged 50 through 75 in a metropolitan area in the Southeastern U.S. completed a cross-sectional survey regarding sociodemographics, OHIS behaviors, information overload, health literacy, decisional balance, and CRC screening history. Path analyses were implemented to assess the hypothesized causal models by examining the relationships among these variables.
OHIS was positively associated with information overload and health literacy; information overload was negatively associated with health literacy. Health literacy was positively associated with decisional balance; decisional balance was positively associated with uptake of sigmoidoscopy and colonoscopy.
The findings supported both theoretical frameworks, HLSF and CMM, for OHIS to develop health literacy, leading to CRC screening. These findings highlight the significant roles of information overload and attitudes and beliefs about screening in enhancing health literacy and CRC screening among KAs.
Practice efforts for facilitating CRC screening among medically underserved older KAs should target improving access to and use of OHIS and culturally-tailored health information delivery.
利用健康素养技能框架（HLSF）和认知中介模型（CMM），检验在线健康信息搜索（OHIS）行为对韩国裔美国人（KAs）健康素养发展以及结直肠癌（CRC）筛查的假设路径，该路径假设是基于 OHIS 行为而产生的。
在美国东南部一个大都市地区，共有 433 名年龄在 50 至 75 岁之间的 KAs 完成了一项关于社会人口统计学、OHIS 行为、信息过载、健康素养、决策平衡和 CRC 筛查史的横断面调查。通过检验这些变量之间的关系，实施路径分析来评估假设的因果模型。
OHIS 与信息过载和健康素养呈正相关；信息过载与健康素养呈负相关。健康素养与决策平衡呈正相关；决策平衡与乙状结肠镜和结肠镜检查的采用呈正相关。
这些发现支持了 OHIS 发展健康素养、进而促进 CRC 筛查的两个理论框架，即 HLSF 和 CMM。这些发现强调了信息过载和对筛查的态度和信念在提高 KAs 健康素养和 CRC 筛查中的重要作用。
为促进医疗服务不足的老年 KAs 进行 CRC 筛查，应努力改善他们获取和使用 OHIS 以及接受文化上量身定制的健康信息的机会。
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