Exploiting the fact that hypertension is diagnosed when a person’s blood pressure reading exceeds a medically specified threshold (90 mmHg for diastolic blood pressure or 140 mmHg for systolic blood pressure), this study estimates the effect of a first-ever hypertension diagnosis on Chinese adults’ alcohol consumption using a two-dimensional regression discontinuity design. Analyzing data on 10,787 adults from the China Health and Nutrition Survey, our estimation reveals that hypertension diagnoses based on diastolic blood pressure readings exert a number of desirable effects. Hypertensive adults’ drinking frequency and the incidence of excessive drinking among them were reduced by 1.2 times/week and 17.9 percentage points, respectively, about three years after the diagnosis. Meanwhile, their beer and Chinese spirits (Baijiu) intakes were reduced by 518.6 ml/week and 194.8 ml/week, respectively. Interestingly, we also found modest evidence that hypertension diagnoses based on diastolic blood pressure readings increase Chinese adults’ wine intake, suggesting a substitution pattern upon hypertension diagnoses. In contrast, based on systolic blood pressure readings, no significant effects of hypertension diagnoses on alcohol consumption were found.

Unhealthy diets are a major threat to population health and are especially prevalent among those with a low socioeconomic status (SES). Health promotion initiatives often rely on nutrition information interventions (NIIs), but are usually less effective among adults with a low SES than in their high-SES counterparts. Explanations for this lower effectiveness are set out in extant studies. These have been conducted across a wide range of disciplines and subject fields and using a variety of methodological approaches. We have therefore conducted a scoping review to identify and synthesise the following: (1) explanations suggested in studies carried out in high-income countries for why NIIs are (in)effective among adults with a low SES and (2) whether these suggested explanations were studied empirically. Eight databases were searched for relevant studies published since 2009 across various disciplines. This identified 4951 papers, 27 of which were included in our review after screening. Only fifteen of these proposed an explanation for the (in)effectiveness of NIIs among adults with a low SES. The following four main themes were uncovered: health literacy, economic resources, social resources and convenience. Ten studies tested their explanations empirically, but the results were inconsistent. The reasons why NIIs are (in)effective among low-SES adults are therefore still largely unclear. Also, current literature predominantly relies on individualistic explanations, most notably focusing on psychological and economic attributes. Consequently, if the effectiveness of NIIs among low-SES populations is to be improved, future studies should examine a wider range of explanations and test them systematically and empirically.

In October 2015, the International Agency for Research on Cancer (IARC) released a report classifying processed meat as a type 1 carcinogen. The report prompted headlines and attracted immediate public attention, but the economic impacts remain unknown. In this paper, we investigate the impacts of the IARC report on selected processed meat prices and purchases using retail scanner data from US grocery stores. We compare changes in prices and sales of selected processed meat products to a constructed synthetic control group (using a convex combination of nonmeat food products). We find a significant decrease in bacon prices in the wake of the IARC report release, but we find no evidence of a sales reduction. We find no significant changes in price and sales for ham and sausage. The pattern of price and quantity changes are consistent with downward shifts in demand and outward shifts in supply for bacon and sausage following the release of the IARC report.

Multiple sclerosis (MS) is a chronic, typically progressive immune-mediated disease characterized by inflammation and demyelination in the central nervous system (CNS), and is associated with a wide range of neurological, physical, and psychosocial effects. For people living with MS, access to relevant, timely, and accessible health information and resources may contribute to effective illness management, psychosocial health, and quality of life (QOL). In this study, we sought to increase understanding of the specific types of information most wanted by people with MS, as well as the sources and effects of this information. Specifically, we surveyed 748 adults with MS about (a) the sources from which they obtain information about MS, (b) the type of information that is most important in terms of improving their QOL, and (c) specific topics about which they would like to have more information, services, or resources. Content analysis of the qualitative results demonstrated the diversity of information sources accessed by people with MS and the importance of providing information through different formats and media. The participants prioritized information related to new MS medications and treatments, physical and mental health and wellness, and local opportunities for support. Implications for practicing rehabilitation counselors are discussed.

Although handwashing is an effective way to prevent infections, there is scarce evidence on predictors of handwashing during a pandemic. This paper aims to identify behavioural and demographic predictors of handwashing. The study surveyed 674 adults in Malaysia in May 2020 regarding whether the time spent on social media predicted handwashing contingent on gender and number of children. More time spent on social media was positively associated with handwashing for males with three or more children. However, for males without children, social media use was negatively associated with handwashing. The association was not significant for males with one or two children. For females, more time spent on social media was significantly linked to more handwashing only for females with one child. Gender, a traditional predictor of handwashing, was a useful predictor only for those who spent more than three hours per day on social media and had at most one child. Number of children was a novel negative predictor for males who did not use social media and who averaged one hour per day on social media, a positive predictor for males who spent lots of time on social media, but not a predictor for females. In sum, social media use predicts handwashing, and is thus a helpful variable for use in targeted health communication during a pandemic – particularly through social media. Further, more conventional predictors like gender and number of children exhibit contingency effects with social media use.

Alzheimer's disease (AD) is a major health concern as the world population ages. Yet, few studies have examined what the public over the age of 50 knows about AD. This qualitative study, based on 40 in-depth interviews, examines the knowledge of AD by Flemish people between 50 and 80 years old and their cross-source engagement with information sources. Building on AD media representations and theories on media complementarity and health information behaviour, we find that respondents mostly encounter AD information non-purposively via traditional mass media and interpersonal communication, while the internet is occasionally used to purposefully seek information. Novels, personal experiences/social proximity, public figures and particularly film stand out as channels and sources of AD information, suggesting that fictional narratives, personal experiences and being able to identify with others leave lasting impressions and help to communicate and disperse AD information. However, common misconceptions and gaps in knowledge persist, including AD being considered part of the normal ageing process and old age as well as confusing AD with Parkinson's disease. The biomedical perspective and the tragedy discourse prevail among the majority of respondents, who describe AD in terms of decline, loss and death and as ‘the beginning of the end’. Only a few, typically female respondents, appear aware of the role of individual health behaviour and lifestyle choices to prevent dementia or delay its onset. The misconceptions of AD and gaps in knowledge, as well as the fact that a third of all cases of dementia might be delayed or prevented by managing lifestyle and other risk factors, stress the importance of public educational programmes and the need to emphasise and raise awareness of preventative behaviour. Overall, the findings from this study can be of help to public health communicators and dementia-awareness campaigns, as well as AD training programmes for health-care professionals and family care-givers.

The Internet has become a major source of health and nutrition information. Little is known about the type of consulted websites (institutional v. non-institutional) and the tendency to discuss with a healthcare professional (HCP) the information found on the Internet. The aim of this cross-sectional study was to investigate health- and nutrition-related Internet use in a large French population-based study. Data were collected in 2013 using self-administered, web-based questionnaires from 42 113 participants of the NutriNet-Santé study (mean age=51·2 years, 76 % women). Unconditional multivariate logistic regression analyses and χ2 tests were used for comparisons. In total, 85·1 % of the subjects used the Internet to search for health and/or nutrition information, and 23·6 % used the Internet to read or post messages on health/nutrition forums. Only 16·0 % discussed with a HCP the information found online. This proportion was lower in subjects with lower educational level (OR 0·77; 95 % CI 0·72, 0·82) and lower computer skills (OR 0·70; 95 % CI 0·65, 0·76). In total, 8038 health/nutrition websites were cited, with institutional websites representing only 12·9 % of that number. Only one institutional website was present in the top 10. Older subjects (OR 1·49; 95 % CI 1·28–1·74), those with lower educational level (OR 2·08; 95 % CI 1·75, 2·50) and lower nutritional knowledge (OR 1·33; 1·12, 1·59) were more likely to cite non-institutional websites. This large population-based study showed that institutional websites were infrequently accessed and that a few participants discussed the information found online with their HCP. This particular trend was especially visible among individuals who were more vulnerable regarding misleading information. This supports the need to increase awareness of high-quality websites providing reliable health/nutrition information.

The problems of poor or biased information and of misleading health and well-being advice on the Internet have been extensively documented. The recent decision by the Internet Corporation for Assigned Names and Numbers to authorize a large number of new generic, top-level domains, including some with a clear connection to health or healthcare, presents an opportunity to bring some order to this chaotic situation. In the case of the most general of these domains, “.health,” experts advance a compelling argument in favor of some degree of content oversight and control. On the opposing side, advocates for an unrestricted and open Internet counter that this taken-for-granted principle is too valuable to be compromised, and that, once lost, it may never be recovered. We advance and provide evidence for a proposal to bridge the credibility gap in online health information by providing provenance information for websites in the .health domain.

‘Cyberchondria’ describes the phenomenon of searching for health information online exacerbating health anxiety. This study explores health anxious individuals’ experiences of searching for health information online to further understand ‘cyberchondria’. Semi-structured interviews were used to explore participants’ (N = 8) experiences of searching for health information online. Transcripts were analysed using Interpretative Phenomenological Analysis. Four themes emerged: ‘information is power’, ‘novelty of Internet searching’, ‘need for strategies to navigate the search: Google, authority and cross-checking’, and ‘cyberchondria: short-term gain but long-term pain’. Participants’ accounts suggested they sought health information online as a form of problem solving: to understand their problem and decide on a strategy for solving it, to feel better about having the problem by having ‘done something’ about it, or to share others’ similar experiences. Seeking online health information was prompted by negative expectations of healthcare professionals, yet was not seen as a replacement for medical consultations. Participants noted the accessibility of the Internet and were aware that information is sometimes inaccurate or irrelevant. Thus participants used strategies to filter and validate information. The findings are considered in relation to what they tell us about the purpose, methods and impact of seeking health information online among individuals with health anxiety.

Background: In the days following a disaster/public health emergency, there is great effort to ensure that everyone receives appropriate care and lives are saved. However, evacuees following a disaster/public health emergency often lack access to personal health information that is vital to receive or maintain quality care. Delayed treatment and interruptions of medication regimens often contribute to excess morbidity and mortality following a disaster/public health emergency. This study sought to define a set of minimum health information elements that can be maintained in a personal health record (PHR) and given to first responders/receivers within the first 96 hours of a disaster/public health response to improve clinical health outcomes.

Methods: A mixed methods approach of qualitative and quantitative data gathering and analyses was completed. Expert panel members (n = 116) and existing health information elements were sampled for this study; 55% (n = 64) of expert panel members had clinical credentials and determined the health information. From an initial set of six sources, a step-wise process using a Likert scale survey and thematic data analyses, including interrater reliability and validity checks, produced a set of minimum health information elements.

Results: The results identified 30 essential elements from 676 existing health information elements, a reduction of approximately 95%. The elements were grouped into seven domains: identification, emergency contact, health care contact, health profile –past medical history, medication, major allergies/diet restrictions, and family information.

Conclusions: Leading experts in clinical disaster preparedness identified a set of minimum health information elements that first responders/receivers must have to ensure appropriate and timely care. If this set of elements is used as the fundamental information for a PHR, and automatically updated and validated during clinical encounters and medication changes, it is conceivable that following large-scale disasters clinical outcomes may be improved and more lives may be saved.

(Disaster Med Public Health Preparedness. 2012;6:303-310)