Examining the Role of Information Behavior in Linking Cancer Risk Perception and Cancer Worry to Cancer Fatalism in China: Cross-Sectional Survey Study

Abstract

Background: Reducing cancer fatalism is essential because of its detrimental impact on cancer-related preventive behaviors. However, little is known about factors influencing individuals' cancer fatalism in China.

Objective: With a general basis of the extended parallel process model, this study aims to examine how distinct cancer-related mental conditions (risk perception and worry) and different information behaviors (information seeking vs avoidance) become associated with cancer fatalism, with an additional assessment of the moderating effect of information usefulness.

Methods: Data were drawn from the Health Information National Trends Survey in China, which was conducted in 2017 (N=2358). Structural equation modeling and bootstrapping methods were performed to test a moderated mediation model and hypothesized relationships.

Results: The results showed that cancer risk perception and cancer worry were positively associated with online health information seeking. In addition, cancer worry was positively related to cancer information avoidance. Moreover, online health information seeking was found to reduce cancer fatalism, while cancer information avoidance was positively associated with cancer fatalism. The results also indicated that the perceived usefulness of cancer information moderated this dual-mediation pathway.

Conclusions: The national survey data indicate that cancer mental conditions should not be treated as homogeneous entities, given their varying functions and effects. Apart from disseminating useful cancer information to encourage individuals to adaptively cope with cancer threats, we advocate for health communication programs to reduce cancer information avoidance to alleviate fatalistic beliefs about cancer prevention.

Keywords: cancer fatalism; cancer risk perception; cancer worry; health information seeking; information avoidance.

Figure 1

Hypothesized model.

Figure 2

Final model with standardized path coefficients. Dotted lines indicate nonsignificant relationships. The covariances between all exogenous factors (eg, controls) and coefficients with control variables are not presented for the purpose of clarity. *P<.05, **P<.01, ***P<.001.

Figure 3

Moderating effect of perceived usefulness of online cancer information on the relationship between cancer risk perception and online health information seeking; the higher value is 1 SD above the mean, and the lower value is 1 SD below the mean.

Figure 4

Moderating effect of perceived usefulness of online cancer information on the relationship between cancer worry and online health information seeking; the higher value is 1 SD above the mean, and the lower value is 1 SD below the mean.

Figure 5

Moderating effect of perceived usefulness of online cancer information on the relationship between cancer worry and cancer information avoidance; the higher value is 1 SD above the mean, and the lower value is 1 SD below the mean.