Abstract: A Cross-National Comparison Examining Major Determinants of Health Information Seeking Experiences in the U.S. and Germany

◆ Elena Link, Hanover University of Music, Drama and Media
◆ Fabian Czerwinski, Hanover University of Music, Drama and Media
◆ Eva Baumann, Hanover University of Music, Drama and Media
◆ Magdalena Rosset, Hanover University of Music, Drama and Media
◆ Ralf Suhr, Stiftung Gesundheitswissen
◆ Gary L. Kreps, George Mason University

Health information seeking is essential for improving individuals’ health empowerment, reducing health information inequalities, and promoting health (Johnson & Case, 2012; Kreps, 2008; 1988). Achieving important health goals requires access to high-quality health information and effective seeking experiences. To improve users’ seeking experiences and successful information acquisition, determinants of problems experienced when searching for information need to be identified. It is known that social and health-related determinants are important factors that influence health information use and health self-efficacy (e.g. Sarkar et al., 2007; Niederdeppe, 2008). Moreover, national and cultural aspects can be important factors too. Cross-country comparisons revealing similarities and differences in health information access and use can help increase understanding about country-specific causes of information-related problems and help to identify strategies for reducing these problems (Kreps et al, 2017). Based on differences in the health care systems and prevalent health and social inequalities, we focus on comparisons between the U.S. and Germany (Jürges, 2006). The aim of this study is to explore how social and health-related determinants are linked to problems with health information seeking in these two countries.
To answer this research question the study compares data from the first wave of HINTS Germany (n=2,902; telephone survey, 2018) with HINTS U.S. data gathered from HINTS 5, Cycle 1 (n=3,285, mail survey, 2017). We used these data to predict the amount of problems respondents experienced during their last search for health information (Arora et al., 2007). Predictor variables related to social determinants include sex, age, socioeconomic status (SES) and migration background. Health-related determinants were measured by self-reported health status, Patient Health Questionnaire (PHQ-4), health-related self-efficacy and satisfaction with the quality of health care. We conducted separate block-wise multiple linear regression models using Jackknife estimates of variance in the U.S. and in Germany and compared the results.
The findings show markedly different effects of social determinants in the cross-country comparison. In the U.S., social determinants seem to play a minor role for the respondents’ perceived problems in information seeking. In Germany, higher SES is associated with fewer problems, while respondents with a migration background and male respondents reported more problems while searching for health information. With regard to health-related factors, we find similar influencing patterns for both countries. Whereas self-reported health status is not a significant predictor, higher scores on the PHQ4-scale and lower satisfaction with the quality of care increase information-related problems. Overall, the model explains 11.3% of the total variance of the amount of problems experienced by respondents during their last search for health information for the U.S. and 10.3% of the variance for Germany.
The findings underline similarities and differences between the countries and the importance of taking social and health-related determinants into account when explaining information-related problems. Further the results reveal the need to enhance health information seeking skills in specific target groups. However, some limitations like slightly different measures or different modes of data collection need to be considered. Implications from these findings are explored for guiding development of health promotion interventions in both countries.