School of Medicine and Health Management, Huazhong University of Science & Technology, Wuhan, Hubei, 430030, China.
School of Nursing, Hong Kong Polytechnic University, Hung Hom, Kowloon, HK SAR, China.
Public Health. 2023 Oct;223:50-56. doi: 10.1016/j.puhe.2023.07.025. Epub 2023 Aug 18.
Cervical cancer is one of the leading causes of cancer mortality in women, yet routine screenings lead to early detection and sometimes even prevention. Screening is an effective way to prevent cervical cancer, and it has been implemented in many countries and regions worldwide, especially in developed countries. However, the incidence of cervical cancer remains a public health problem due to screening disparities in the population. Social media engagement and overloading of online health information may be the cause of this disparity.
Cross-sectional study.
Data from the Health Information National Trends Survey (a national survey conducted by the National Cancer Institute) was used to characterise cervical cancer screening into two dimensions; namely, high-frequency screening and guideline-concordant screening. The differences between these two screening frequency behaviours were compared by applying ordered logistic regression and binary logistic regression, and the mechanisms of guideline-concordant screening were explored.
The factors influencing high-frequency screening and guideline-concordant screening were different. Only self-efficacy (odds ratio [OR] = 1.16; 95% confidence interval [CI] = 0.98, 1.37) had a significant positive association with the high-frequency screening behaviour. Social media engagement (OR = 0.57; 95% CI = 0.33, 0.96) was shown to have a significant negative impact on guideline-concordant screening. A theory-based mechanism of screening behaviour found that traditional health perception factors no longer influence guideline-concordant screening behaviour, whereas environmental factors (e.g., social media) significantly reduce guideline-concordant screening behaviour.
The results from this study indicate that while the internet has become the main channel through which women acquire health resources, and social media has become a main platform for people to obtain health information, online information cannot guide people to engage in appropriate healthy behaviours. Overloading of online health information and the digital divide may lead to excessive screening. Consequently, it is important to address the screening disparity caused by health behaviours as a result of environmental factors and the digital divide.
宫颈癌是导致女性癌症死亡的主要原因之一，但常规筛查可实现早期发现，甚至有时还可预防宫颈癌。筛查是预防宫颈癌的有效方法，已在世界许多国家和地区实施，尤其是在发达国家。然而，由于人群筛查差异，宫颈癌的发病率仍然是一个公共卫生问题。社交媒体参与度和网络健康信息量过载可能是造成这种差异的原因。
横断面研究。
利用国家癌症研究所进行的全国健康信息趋势调查（Health Information National Trends Survey）的数据，将宫颈癌筛查分为两个维度，即高频筛查和符合指南的筛查。通过应用有序逻辑回归和二项逻辑回归比较这两种筛查频率行为之间的差异，并探讨符合指南的筛查机制。
影响高频筛查和符合指南的筛查的因素不同。只有自我效能感（比值比[OR] = 1.16；95%置信区间[CI] = 0.98，1.37）与高频筛查行为呈显著正相关。社交媒体参与度（OR = 0.57；95% CI = 0.33，0.96）对符合指南的筛查行为有显著的负向影响。基于理论的筛查行为机制发现，传统的健康感知因素不再影响符合指南的筛查行为，而环境因素（如社交媒体）显著降低了符合指南的筛查行为。
本研究结果表明，虽然互联网已成为女性获取健康资源的主要渠道，社交媒体已成为人们获取健康信息的主要平台，但网络信息无法引导人们采取适当的健康行为。网络健康信息量过载和数字鸿沟可能导致过度筛查。因此，解决由环境因素和数字鸿沟导致的健康行为引起的筛查差异非常重要。
