Communicating health decisions: an analysis of messages posted to online prostate cancer forums

• Published in: Health expectations : an international journal of public participation in health care and health policy 2014-04, Vol.17 (2), p.244-253
• Main Authors: Sillence, Elizabeth, Mo, Phoenix K. H.
• Format: Article
• Language: English
• Subjects: Adult; Clinical decision making; Clinical outcomes; Communication; Consumer Health Information - methods; Decision analysis; Decision Making; Decision Support Techniques; Health education; Health information; Health status; Heuristic methods; Humans; Internet; Lay conceptions; Male; Men; Messages; Middle Aged; narratives; Original Research Papers; patient experience; Patient Participation - methods; Patient Participation - psychology; Prostate; Prostate cancer; Prostatic Neoplasms - psychology; Prostatic Neoplasms - therapy; Public health; Social Support; Treatment preferences; Websites
• ISSN: 1369-6513; 1369-7625
• DOI: 10.1111/j.1369-7625.2011.00745.x

Background  Experiential websites such as message forums and blogs allow Prostate Cancer (PCa) patients to communicate their health decisions to peers. The issues surrounding this form of indirect involvement in public health are little understood. Objective  This paper explores the types of decision‐making processes that people are exposed to on PCa online message boards. The kinds of treatment choices patients are making and the reports of their decision‐making processes to peers through an online environment are examined in the context of the Heuristic Systematic Model. Method  Messages about treatment decision making were collected from four PCa websites. In total, 137 messages were selected from blogs and online forums and their decision‐making processes coded. Results  Men looking online for information about treatment options for PCa are exposed to a range of decision‐making processes. Just under half (49.6%) of the messages reported non‐systematic decision processes, with deferral to the doctor and proof of cancer removal being the most common. For systematic processing (36.5%), messages most commonly considered treatment outcomes and side‐effects. Processes did not vary between the blogs and online forums. Discussion and conclusion  Compared to previous studies far fewer messages reported non‐systematic decision processes and only a small number of messages reflected lay beliefs or misbeliefs about PCa treatment. Implications for men and their clinicians of seeking health information online are discussed.