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Topical network of breast cancer information in a Korean American online community: a semantic network analysis.

01 Dec 2016-Information Research: An International Electronic Journal (Thomas D. Wilson. 9 Broomfield Road, Broomhill, Sheffield, S10 2SE, UK. Web site: http://informationr.net/ir)-Vol. 21, Iss: 4
TL;DR: The findings from this study demonstrate the complexity of health information-seeking behaviour and the subsequent vast spectrum of concerns in Korean Americans living in the USA.
Abstract: Introduction. Health information-seeking and sharing online has become immensely intertwined with day-to-day information-seeking of US immigrants with health concerns. Despite the consist recognition of unique health needs among different US immigrant communities, little is known about the distinctive patterns and extent of health information behaviour of Korean Americans, who are one of the most rapidly growing Asian immigrant populations in the USA. Method. The study uses online discussion forums whose participants are Korean Americans living in the USA. A mixed methodology of both content and semantic network analyses was used for data analysis. Results. It was revealed that forum participants discuss two dominant topics: breast cancer tests and treatment. Although breast cancer tests was the central topic, the emphasis was on diagnosis rather than prevention. Additionally, the data indicates that participants derive psychological or emotional support from breast cancer information-seeking and sharing. Moreover, concerns stemming from insurance and financial difficulties are the biggest causes of distress for those affected by breast cancer. Conclusions. The findings from this study demonstrate the complexity of health information-seeking behaviour and the subsequent vast spectrum of concerns. Online health information behaviour involving breast cancer is often copnnected not only with medical practices but also with social, financial and psychological challenges as well.

Content maybe subject to copyright    Report

VOL. 21 NO. 4, DECEMBER, 2016
Cont en ts | Aut hor in dex | Su bj ect in dex | Se ar ch | H om e
Topical network of breast cancer information in a Korean American
online community: a semantic network analysis
Min Sook Park and H ye j in Pa r k
Abstract
In t r o d u c t i o n . Health inform ation -seeking and sharing online has becom e
im m ensely intertw ined w ith day -to-day inform ation-seekin g of US im m igrants
w ith health concerns. Despite the con sist recogn ition of un ique health needs
am on g different US im m igrant com m unities, little is know n about the distin ctiv e
patterns and extent of health inform ation behaviour of Korean Am ericans, w ho
are one of the m ost rapidly grow ing Asian im m igrant populations in the USA.
M e t h o d . The study uses online discussion forum s w hose participants are
Korean Am ericans living in the USA. A m ixed m ethodology of both content an d
sem an tic netw ork analy ses w as used for data analy sis.
R e s u l t s . It w as revealed that forum participan ts discuss tw o dom inant topics:
breast cancer tests and treatm ent. Although breast cancer tests w as the central
topic, the em phasis w as on diagnosis rather than prevention. Additionally , the
data indicates that participants derive psy chological or em otional support from
breast cancer inform ation-seeking and sharing. Moreover, concerns stem m ing
from in surance and financial difficulties are the biggest causes of distress for
those affected by breast cancer.
Co n c l u s i o n s . The findings from this study dem on strate the com plexity of
health inform ation-seeking behaviour an d the subsequent vast spectrum of
concerns. Online health inform ation behaviour involving breast cancer is often
copnnected not only w ith m edical practices but also w ith social, fin ancial and
psy chological challenges as w ell.
Introduction
Health-related inform ation, including that about breast cancer, is
actively sought and shared through the participatory World Wide Web
(the Web) or social media. Indeed, the Web has become imm ensely
intertwined, particularly when it com es to day-to-day information-
seeking among imm igrants with health con cern s (
Kim and Yoon, 20 12;
Suarez et al., 20 0 0 ). The benefits that social m edia provides for health
information seekers should not be underestimated, particularly for
underrepresented groups such as im migrants. As it is for general
In ternet users, the Web is a useful resource for im migrants with health
concerns (
Caidi, Allard and Quirke, 20 10 ; Kim and Yoon, 2012; Suarez
et al., 20 0 0 ). Yet, the health information behaviour of different ethnic
groups has been understudied, despite the sheer diversity and growth of
US im m igrant com munities. Previous studies have consisten tly
recognised that different ethnic groups have distinctive patterns and
extent of health inform ation behaviour, which are impacted by various
change font

factors including cultural an d social frameworks (Caidi et al., 20 10 ;
Kim , Kreps and Shin, 2015). Also, im m igrant groups were often
reported to experience unique health needs yet disparity in inform ation
access (
Caidi et al., 20 10; Coronges, Sykes an d Valente, 200 7;
Marchionini, 1995
; Ruiz and Barnett, 2015).
The curren t study, therefore, intends to enhance the understandin g of
health in form ation behaviour of Korean Americans, which is on e of the
most rapidly growing Asian im migrant populations in the USA. These
individuals present distin ct socio-cultural values and lifestyles.
Particular consideration was given to identifying their unique health
information needs and shared information regarding breast cancer, as
well as the behavioural patterns emerging from the identified needs and
shared inform ation. This study focuses exclusively on in formation
relating to breast cancer in order to understand their online health
information behaviour patterns, particularly since breast cancer is a
leading cause of death for wom en (
Center for Disease Control and
Prevention, 20 13; National Center for Health Statistics, 20 11; Choi et al.,
2010 ; Oh, J un, Zhao, Kreps and Lee, 20 15).
In order to probe the patterns of major topics within questions and
replies in an onlin e comm unity specialised for Korean Am ericans, we
employed semantic network analysis along with content analysis. Breast
cancer may lead to a wide range of medical and other non-m edical
concerns, such as physical, psychological, social and financial changes,
sin ce it is a serious and complex disease. Previous studies regardin g
Korean Am ericans and breast cancer provide valuable information
about the diverse dim ensions of breast cancer amon g this study group,
yet they fell short in addressing relationships between the various
aspects of the disease. Semantic network analysis enabled the
researchers to capture the latent relationships between topics about
breast cancer so as to observe the un ique in form ation-seeking and
sharing behavioural pattern s of this com m unity.
Related literature
For those with health concerns, the Internet offers new m odes of health
information-seeking and sharing, including e-mail counselling, bulletin
boards and self-help (
Gooden an d Winefield, 20 0 7; Liberman and
Goldstein, 20 0 5; Winefield, Coventry, Pradhan, Harvey an d Lam bert,
200 0 ). Online information exchange affords users m ultiple benefits
including im mediate access to useful inform ation , searchable content,
easy tracking of health information, the opportunity to share
information, em otional support an d help with health-related decision-
making (
Oh et al., 20 15). Through online comm unication with other
patients, many people also receive critical psychological support, a need
that is often unfulfilled by doctors (
Lee an d Hawkins, 20 10). Online
discussion is on e of the most positive activities for those with chronic
disease (
Fox and Purcell, 20 10). This m edium offers opportun ities for
those with health concerns to engage in asynchronous written
interactions with others interested in the designated topic (
Gooden an d
Winefield, 20 0 7; Win efield et al., 20 00 ). Especially when it comes to
marginalised comm unities such as im migrants, these online interactions
often becom e an important alternative to tradition al caregiving or
support, particularly for those who feel dissatisfied with their current
circumstances, such as face-to-face peer, family and professional care
(
Winefield et al., 20 0 0 ; Caidi et al., 20 10). Thus, their sense of health

and wellbeing is enhanced. For im migrants who are often isolated due
to barriers like language and cultural differen ces, the Internet offers
culturally and linguistically supported information (
Caidi et al., 20 10;
Napier et al., 20 14; Savolainen, 20 0 8), along with other an array of
other benefits. As a result, many patients and caregivers actively seek
and share health inform ation online to cope with serious diseases, such
as breast cancer.
Im migran ts, including Korean Am ericans, however, often have difficulty
in locating and accessing in formation in mediums that are
understan dable and usable to them due to many challenges such as
language, and cultural and economic challenges, along with limited
interpersonal networks in the United States (
Caidi
et al., 20 10 ). The
most prevalent lim itations in clude language (
Oh, Kreps, J un an d
Ramsey, 2011; Park and Park, 20 14; Thomson and Hoffman, 20 0 9) and
lack of health in surance (
Choi et al., 20 10; Oh et al., 20 15). When
Korean Am ericans experience hardship in terms of accessing
information resources, they tend to use Korean Am erican onlin e
com mun ities. Providing health inform ation in the users' primary
language is identified as critical for the imm igrants (
Ahm ad et al., 20 0 4;
Thomson an d Hoffman, 20 0 9). The ability to exchange information in
their native language improves com m unication while reducing
misunderstanding (
Ahm ad et al., 20 0 4; Thomson and Hoffman, 20 0 9).
In dividual socioeconomic an d cultural realities along with distinctive
health needs in fluence imm igrants' patterns of health inform ation
behaviour (
Caidi et al., 20 10; Kim et al., 20 15). information-seekin g and
sharing reflect their knowledge, skills, attitudes and preferences within
the problem dom ain (
Marchionini, 1995; Savolainen , 20 0 8 ).
Furtherm ore, inform ation-seeking is shaped by group characteristics
and internalised behaviour which, in turn, is influenced by traits,
attitudes or cognitive styles (
Marchionini, 1995; Coronges, Stacy and
Valente, 200 7; Doerfel and Barnett, 1999). Am ong newcom ers to the
USA, the Asian population is a rapidly growing segm ent, which
increased by 46 per cent from 11.9 m illion to 17.3 million from 200 0 to
2014 (
U.S. Census Bureau, 20 15). Without question , this im migrant
sector is multifaceted an d enormous. Despite the typical research
practice of aggregating national health data of Asian s into one category,
the US-based Asian population is in fact heterogen eous. Asian groups in
the USA originate from fifty-two differen t countries and vary in culture,
traditions, native languages and disease incidence (
Asian Am erican
Health In itiative, 20 0 5). Within the Asian population, the Korean
population is the fourth fastest growin g as well as the fifth largest
population and has grown by 41 per cent since 20 0 0 (
U.S. Census
Bureau, 20 15).
When it comes to Korean Am ericans, however, there are some distinct
tren ds. They are hom ogenous in race as well as som e cultural traits.
They also dem onstrate the highest rate of non-English language usage
among Asian American subgroups (
Han, Kang, Kim, Ryu an d Kim ,
200 7; Shin, Song, Kim and Probst, 20 0 5), strong association prim arily
with their own ethnic social networks (
Min, 1995), and a high rate of not
being insured (Asian Am erican policy review, 2013; Kao, 20 10 ; Shin et
al., 20 0 5). These im portant attributes have great bearin g on their health
information behaviour.
Korean Am ericans' general health characteristics also affect their

information behaviour. Breast cancer is a leading cause of death and one
of the m ost com mon ly diagnosed cancers am ong wom en (Centers for
Disease Control and Preven tion, 20 13; Choi et al., 20 10 ). The average
ann ual per centage increase of breast cancer incidence was the highest
for Korean wom en of all Asian groups in the USA from 1972 to 20 0 7
(
Liu, Zhang, Wu, Pike and Deapen, 20 12). Although early detection of
the incidence through breast cancer screening tests (e.g.,
mamm ography) im proves the chances of survival (
Smith, Cokkinides
and Brawley, 20 0 9), Asian women , including Koreans, in the United
States are less likely to be screen ed than white wom en (
American
Cancer Society, 20 13). For Korean Americans health and lifestyle have
profound im pacts on their health inform ation-seeking and sharing.
The curren t body of research has shed light on the distinct health-
related landscape pertaining to Korean Americans. Notwithstanding,
research on their online health information behaviour regarding cancer
is limited. On ly a few studies focused on understanding inform ation
needs.
Kim and Yoon (20 12) exam ined the use of an online health form
by Korean American women through content analysis of question s. The
findings in dicate that users' health in formation needs consisted main ly
of seeking recomm endations for hospitals and doctors, causes of
symptoms experienced or treatmen t methods.
Kim (20 15) and his
colleagues examined Korean Americans' information-seekin g behaviour
in the context of social support in social media. Along with social ties
such as family, friends and religious organizations, Kim's study
identified major topics in their in formation-seeking: specifically,
recomm endations regarding hospitals or doctors, preventive care,
diagnosis, diet and exercise and m edications, as well as comfort with
language an d sense of belongin g.
Several studies about Korean Americans' behaviour regarding cancer
information involve users' offline health inform ation behaviour.
Oh et
al. (20 11) examined the types of cancer information searches, cancer
information-seeking experien ces and the awareness of major cancer
information sources am ong 254 Korean Am ericans through a cross-
sectional, com munity-based survey. The results suggest that they had a
lower rate of cancer information-seeking and lim ited awareness of
cancer information sources. Addition ally, these users' experiences in
seeking cancer information were som ewhat negative. A separate study
by
Oh et al. (2015) identified the most trustworthy can cer information
sources according to Korean American women . The researchers
examined perceived usefulness and limitations of cancer in formation
sources in seven focus group interviews with thirty-four wom en and a
survey of 152 women. The data pinpoint that these wom en viewed
health care professionals as the most trusted can cer information source.
The Internet and Korean ethnic media were also popular cancer
information sources in term s of language, cultural and economic
significance.
Regarding studies pertaining to non-disease-specific, health
information-seeking behaviour,
Oh et al. (2011) explored the
relationship between exposure to mass m edia and health information
seeking behaviour for Korean Americans. The study focused on
dem ographic characteristics, variations in exposure to differen t health
information, as well as trust in health information sources am ong 254
respondents. The researchers found that those with lower language
proficiency, income and education were m ore likely to seek health

information in Korean ethnic magazines and newspapers, while those
with higher English proficiency and income were m ore likely to seek
information onlin e. Similarly, a 20 13 cross-sectional study by
Oh et al.
explored the influence of immigration status on Korean Americans' trust
in health inform ation sources and health information-seeking behaviour
com pared to native Koreans. Her results showed that Korean
im migrants livin g in the USA were more likely to trust health
information from newspapers or magazin es than native Koreans.
The aforem entioned studies cen tred on a comm on seeking behaviour
among Korean Americans, focusing on question ing activities cancer-
related in formation-seeking in general. Questions are often
conceptualised as a represen tation of health information needs to fill
gaps in a state of knowledge (
Belkin, Oddy an d Brooks, 198 2; Dervin,
198 3). To this en d, an im portant benefit of using the In ternet for health-
related in formation lies in the ability to interact with many others who
share sam e or similar interests and to pose question s with m inim al risk
or consequen ces. Although it is im portant to identify whether seekers
received replies which adequately addressed the area they wanted to
understan d, no studies identified relationships between question s
(in formation needs) and replies (shared information). The research
milieu has not addressed the link between online health-related
question s and an swers, specifically as it pertains to Korean Am ericans.
An im portant concern of cancer inform ation-seeking is unmet needs as
a result of inconsistencies between desired and obtain ed information
(queries and replies). This disparity may lead to negative outcomes,
such as increased levels of anxiety (
Garvin
et al., 20 0 3). In online
settings, answers are viewed as a form of information sharin g behaviour
(
Adam ic, Zhang, Bakshy and Ackerman, 20 0 8; Wang, Wang, Abrahams
and Fan, 20 15). In this respect, the curren t study en compasses topics in
shared inform ation, which are manifested as an swers in on line forums.
Furtherm ore, can cer information-seeking behaviour is a much more
nuanced and multidim ensional behaviour (
Germ eni, Bianchi,
Valcarenghi and Schulz, 20 15), where one factor impacts an other.
Most studies have examined health-related in formation behaviour using
quantitative methods, such as a survey, or a qualitative method, such as
focus groups or interviews. None of the examined studies used an in-
depth analysis method, such as sem antic network analysis, that enables
one to understand the relationships amon g the m ajor needs and shared
information. Nor have previous studies used the sem antic network
analysis technique, a relatively new relation al content analysis method,
which is prom oted as a dynam ic methodological approach that enables
researchers to capture the pattern of major topics in m essages, including
question s and replies in online forum s. To fill the gaps, this study
focuses on understanding the patterns and relationships between
Korean Am ericans' health information-seekin g and sharing in the social
media setting, focusing on breast cancer.
Method
Rese a r ch quest ions
With the purpose of identifying Korean Americans' main information
needs and inform ation they share online as well as their behavioural
patterns, the following research questions guided the current study:

Citations
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TL;DR: There is a need for cancer information from health professionals, and thus for patient-centered training materials, and a survey system to evaluate consumers' cancer information needs should be developed.
Abstract: Objective This study was a scoping review of research on cancer-related health information seeking and needs of patients, survivor, non-patients, and caregivers. Methods This study used the COSI model to search for articles published from 2007 to 2017. Results In total, 117 articles with titles and abstracts including the following terms were selected: cancer, health, information, seeking. Non-patients obtained information from the Internet, doctors, and media, whereas patients obtained information from doctors, the Internet, and media. Information needs were the highest for treatment, prognosis, and psychosocial support. Patients had the highest need for information on prognosis and treatment, whereas non-patients had the highest need for general cancer information, prevention, and cancer examination. Caregivers sought information about treatment, psychosocial support, and prevention. Conclusion This study revealed an increase in the number of research articles identifying cancer patients’ information needs. Cancer patients rely on health professionals for information; thus, relevant materials are needed. Furthermore, not only medical but also psychosocial support information is needed. Practice implications There is a need for cancer information from health professionals, and thus for patient-centered training materials. Furthermore, a survey system to evaluate consumers’ cancer information needs should be developed.

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TL;DR: Various interwoven personal and environmental factors reflect efforts of people with MCCs to obtain more personalized information, conveying the specific queries and needs of this population.
Abstract: The health-information-seeking behaviors of people affected by multiple chronic conditions (MCCs) who use social media to obtain information was explored The contextual factors and latent relationships that shape the unique information-seeking behaviors of this population, focusing on commonly co-occurring chronic conditions: high blood pressure, high cholesterol, diabetes, cardiovascular disease, and obesity were investigated Using a similarity matrix and co-occurrence network techniques 9,980 Yahoo!Answers questions posted by individuals concerned about MCCs were analyzed Findings demonstrate the interactive nature of health-information-seeking among people with MCCs Various interwoven personal and environmental factors reflect efforts of people with MCCs to obtain more personalized information, conveying the specific queries and needs of this population Findings may help facilitate interactions between people living with MCCs and health care providers, as well as aid providers and health-information resource designers in providing more tailored and accessible resources, expanding upon user-centered approaches to health information service

6 citations

Book ChapterDOI
24 Sep 2018
TL;DR: The mixed methods seem to have generated the most comprehensive approach for studying OHISB in all its variety and complexity, however, this design was in fact least used in the analysed studies compared to quantitative and qualitative research.
Abstract: The aim of this paper is to establish the approaches preferred in studies focusing on online health information seeking behaviour (OHISB). Based on the content analysis of 70 articles on OHISB retrieved from EBSCOhost databases, five larger groups of studies were identified: (1) quantitative approach (39%), (2) qualitative research (25%), (3) mixed methods design (9%), (4) meta-analysis and bibliometric aspect (10%) and (5) other studies (e.g., theoretical aspect, online health information quality). Thus, quantitative research does dominate, but only to a degree. The qualitative aspect has grown considerably over time. Subject to the analysed literature, it may be concluded that the mixed methods seem to have generated the most comprehensive approach for studying OHISB in all its variety and complexity. However, this design was in fact least used in the analysed studies compared to quantitative and qualitative research.

1 citations

Journal ArticleDOI
TL;DR: Wang et al. as mentioned in this paper examined 150 text-based online medical consultation (OMC) cases that involve empathic interaction between doctors and patients/caregivers in the Chinese context.
Abstract: Empathy is believed to play a key function in clinical consultations. As online medical consultation (OMC) has become increasingly popular in the past decade, studies addressing empathic communication in the OMC context have started to attract research interest. However, previous studies have mainly addressed empathic communicative acts by online doctors. There is still a research gap as regards exploring online empathic communication from both doctors’ and patients’ perspectives, particularly in the context of China where there is a promising growth in OMC activities. The present study examines 150 text-based OMC cases that involve empathic interaction between doctors and patients/caregivers in the Chinese context. Adopting a theme-oriented discourse analysis approach, the paper aims to identify empathic communication sequences. Four types of sequence organization are identified, and these are discussed with relevant examples. The findings illustrate that OMC communication involves dynamic empathic sequential patterns, which can be optimally drawn upon by health professionals and medical students to practise their empathic communication skills.
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TL;DR: This study uncovered the coexistence of antithetical representations about organ donation in China—the longing for survival and the fear of death serves as the foundation of Chinese people's ambivalence.
Abstract: Background Organ donation has been claimed as a prosocial behavior to prolong the recipient's life and deliver great love. However, the supply-demand ratio of organs in China is highly unbalanced. Being entangled with multiple factors derived from individual and supra-individual levels, organ donation in China is important but sensitive. Previous scholars usually depended on obtrusive approaches to explore the facilitators and hindrances of organ donation, which is hard to discover genuine perceptions toward organ donation. Besides, relatively limited scholarly attention has been paid to what hampers organ donation in China. Objective We intended to excavate the diversified social representations and perceived barriers to organ donation in China over the past decade. Method Two kinds of text analysis methods—semantic network analysis and conventional content analysis, were applied to 120,172 posts from ordinary users on the Sina Weibo platform to address the research questions. Results Regarding social representations, the “hope, understanding, and acceptance” of organ donation was the most pronounced one (34% of the whole semantic network), followed by “family story” (26%), “the procedure of organ donation in NGOs” (15%), “the practical value of organ donation” (14%), and “organ donation in the medical context” (11%). Regarding perceived barriers, a four-layer framework was constructed, including (1) the individual level, mainly about the fear of death and postmortem autopsy; (2) the familial level, which refers to the opposition from family members; (3) the societal level, which alludes to distrust toward medical institutions and the general society; (4) the cultural level, which covers religious-cultural concerns about fatalism. Conclusion In concordance with prior works on social representations regarding organ donation, the current study also uncovered the coexistence of antithetical representations about organ donation—the longing for survival and the fear of death. This representation pair serves as the foundation of Chinese people's ambivalence. Besides, family-related narratives were dispersed over various representations, demonstrating the critical position of family support in organ donation. Moreover, the four-layer framework concerning donation barriers affords a reference for future empirical studies. The practical implications of this work are further discussed.
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"Topical network of breast cancer in..." refers background in this paper

  • ...The degree centrality (CD) is the number of ties that a given a node has (Borgatti, 2005; Hanneman and Riddle, 2005)....

    [...]

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    [...]

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