Analyzing paths from online health information seeking to colorectal cancer screening using health literacy skills frame and cognitive mediation model

Objective: To test the hypothesized paths for Online Health Information Seeking (OHIS) behaviors in developing health literacy, leading to colorectal cancer (CRC) screening among Korean Americans (KAs) using Health Literacy Skills Frameworks (HLSF) and Cognitive Mediation Model (CMM). Methods: A total of 433 KAs aged 50 through 75 in a metropolitan area in the Southeastern U.S. completed a cross-sectional survey regarding sociodemographics, OHIS behaviors, information overload, health literacy, decisional balance, and CRC screening history. Path analyses were implemented to assess the hypothesized causal models by examining the relationships among these variables. Results: OHIS was positively associated with information overload and health literacy; information overload was negatively associated with health literacy. Health literacy was positively associated with decisional balance; decisional balance was positively associated with uptake of sigmoidoscopy and colonoscopy. Conclusion: The findings supported both theoretical frameworks, HLSF and CMM, for OHIS to develop health literacy, leading to CRC screening. These findings highlight the significant roles of information overload and attitudes and beliefs about screening in enhancing health literacy and CRC screening among KAs. Practice Implications: Practice efforts for facilitating CRC screening among medically underserved older KAs should target improving access to and use of OHIS and culturally-tailored health information delivery