Nadine Bol

Tailored information for cancer patients on the Internet: effects of visual cues and language complexity on information recall and satisfaction

OBJECTIVE This study was designed to investigate the effects of visual cues and language complexity on satisfaction and information recall using a personalised website for lung cancer patients. In addition, age effects were investigated. METHODS An experiment using a 2 (complex vs. non-complex language)×3 (text only vs. photograph vs. drawing) factorial design was conducted. In total, 200 respondents without cancer were exposed to one of the six conditions. RESULTS Respondents were more satisfied with the comprehensibility of both websites when they were presented with a visual cue. A significant interaction effect was found between language complexity and photograph use such that satisfaction with comprehensibility improved when a photograph was added to the complex language condition. Next, an interaction effect was found between age and satisfaction, which indicates that adding a visual cue is more important for older adults than younger adults. Finally, respondents who were exposed to a website with less complex language showed higher recall scores. CONCLUSION The use of visual cues enhances satisfaction with the information presented on the website, and the use of non-complex language improves recall. PRACTICE IMPLICATIONS The results of the current study can be used to improve computer-based information systems for patients.

Using cognitive and affective illustrations to enhance older adults’ website satisfaction and recall of online cancer-related information

This study examined the effect of adding cognitive and affective illustrations to online health information (vs. text only) on older adults’ website satisfaction and recall of cancer-related information. Results of an online experiment among younger and older adults showed that illustrations increased satisfaction with attractiveness of the website. Younger adults were significantly more satisfied with the comprehensibility of the website than older adults, whereas older adults were more satisfied with perceived emotional support from the website than younger adults. Being more emotionally satisfied with the website led to greater recall of information for older adults, but not for younger adults. Illustrations can be used to enhance older adults’ website satisfaction and consequently recall of online cancer-related information.

The effect of modality and narration style on recall of online health information: Results from a web-based experiment

Background Older adults are increasingly using the Internet for health information; however, they are often not able to correctly recall Web-based information (eHealth information). Recall of information is crucial for optimal health outcomes, such as adequate disease management and adherence to medical regimes. Combining effective message strategies may help to improve recall of eHealth information among older adults. Presenting information in an audiovisual format using conversational narration style is expected to optimize recall of information compared to other combinations of modality and narration style. Objective The aim of this paper is to investigate the effect of modality and narration style on recall of health information, and whether there are differences between younger and older adults. Methods We conducted a Web-based experiment using a 2 (modality: written vs audiovisual information) by 2 (narration style: formal vs conversational style) between-subjects design (N=440). Age was assessed in the questionnaire and included as a factor: younger (<65 years) versus older (≥65 years) age. Participants were randomly assigned to one of four experimental webpages where information about lung cancer treatment was presented. A Web-based questionnaire assessed recall of eHealth information. Results Audiovisual modality (vs written modality) was found to increase recall of information in both younger and older adults (P=.04). Although conversational narration style (vs formal narration style) did not increase recall of information (P=.17), a synergistic effect between modality and narration style was revealed: combining audiovisual information with conversational style outperformed combining written information with formal style (P=.01), as well as written information with conversational style (P=.045). This finding suggests that conversational style especially increases recall of information when presented audiovisually. This combination of modality and narration style improved recall of information among both younger and older adults. Conclusions We conclude that combining audiovisual information with conversational style is the best way to present eHealth information to younger and older adults. Even though older adults did not proportionally recall more when audiovisual information was combined with conversational style than younger adults, this study reveals interesting implications for improving eHealth information that is effective for both younger and older adults.

How Are Online Health Messages Processed? Using Eye Tracking to Predict Recall of Information in Younger and Older Adults

Little research has focused on what precedes the processing of health messages to predict recall of information and whether age matters in this regard. To address this gap, this study investigates the relationship between attention and recall among younger (<65 years) and older (≥65 years) adults. Using eye tracking, we exposed participants to a webpage consisting of text-only information, text with cognitive illustrations, or text with affective illustrations. When attention to text increased, older adults recalled more information, whereas younger adults did not. However, younger adults paid more attention to cognitive illustrations than older adults and recalled more information. These results reveal conditions under which health messages are effectively recalled by younger and older adults.

Exploring the role of health literacy on attention to and recall of text-illustrated health information

We use eye tracking to examine attention to online health information.Health literacy influences the attention-recall relationship.Attention to illustrations increases recall in limited health literacy groups.Attention to text increases recall in adequate health literacy groups. Although the use of illustrations is often recommended for audiences with limited health literacy, it is unclear how health literacy impacts the use of different online formats. The aim of this paper is therefore to investigate how health literacy influences attention to text and illustrations in online health information, and whether such attention is related to recall of information. Sixty-one participants were exposed to either text-only or text-illustrated information. Using eye tracking, we recorded attention patterns on a health webpage after which recall of information was assessed. Results showed that health literacy influenced the attention-recall relationship. For people with limited health literacy, attention to the illustrations was positively related to recall, whereas attention to the text improved recall of information in the adequate health literate group. As attention to different parts of online health information leads to different information processing routes for people with different levels of health literacy, effective health communication should consider both text and illustrations that attract attention and improve understanding of the health message.

Age-related use and perceptions of eHealth in men with prostate cancer: a web-based survey

Background Men with prostate cancer require ample information and support along the continuum of care, and eHealth is one way to meet such critical information and support needs. Currently, evidence about how age influences use and perceptions about prostate cancer eHealth information and support is lacking. Objective The aim of this paper is to explore use and perceptions about eHealth among men living with prostate cancer. Specifically, we aimed to analyze men with prostate cancer by age-specific cohorts to identify potential age-related differences in use and perceptions about prostate cancer eHealth information. Methods We used survey methodology to examine how men under 65 years old with prostate cancer differ from those aged 65 years old or older in use and perceptions about prostate cancer eHealth information and support (n=289). Results We found that men in the younger cohort used the Internet more often to be informed about treatment options (P=.04) and to learn more about staging/grading (P=.01) than men in the older cohort. Results also showed comparatively greater use of online prostate cancer information for emotional support and encouragement by the younger as compared to the older cohort (P=.001). Furthermore, the older cohort reported more negative psychosocial effects of eHealth (eg, more anxious, depressed) than younger men (P=.002). We also found that as a result of more frequent Internet use, younger men experienced more positive psychosocial effects (eg, more informed, in control) from accessing information about prostate cancer through eHealth channels (b=-0.10, 95% CI -0.28 to 0). Conclusions Men with prostate cancer have different information and support needs; our findings suggest that these needs might vary by age. Future research is needed to unravel age-related factors underlying these differences to be better able to tailor prostate cancer eHealth information to men’s information and support needs.

An Overview of How Eye Tracking Is Used in Communication Research

Eye tracking gives communication scholars the opportunity to move beyond self-reported measures by examining more precisely how much visual attention is paid to information. However, we lack insight into how eye-tracking data is used in communication research. This literature review provides an overview of how eye tracking is used in communication research by examining published articles from the top-25 ranked communication journals between 2005 and 2015. Our results showed that most eye-tracking research was employed in the field of advertising. Furthermore, most studies used eye tracking to measure (visual) attention and used this as the study’s dependent variable. A wide variety of eye-tracking measures were reported, including fixation time, fixation count, and visual shifts, and a wide variety of eye-tracking devices were used. Our results highlight opportunities for using eye tracking as well as identify other ways of using eye tracking to maximize its potential in communication research.

Does Web Design Matter? Examining Older Adults' Attention to Cognitive and Affective Illustrations on Cancer-Related Websites through Eye Tracking

This study examines how adults pay attention to cognitive and affective illustrations on a cancer-related webpage and explores age-related differences in the attention to these cognitive and affective webpages. Results of an eye-tracking experiment n = 20 showed that adults spent more time attending to the illustrations on the cognitive webpage than the illustrations on the affective webpage. Furthermore, older adults spent about 65% less time fixating the webpages than younger adults. Whereas older adults had less attention for illustrations on the cognitive webpage then younger adults, they spent equal time viewing the illustrations on the affective webpage as younger adults.

How Tailoring the Mode of Information Presentation Influences Younger and Older Adults’ Satisfaction with Health Websites

Although older adults are increasingly using online health information, many websites are not senior-friendly, which might lead to user-problems and dissatisfaction among older people. It has been suggested that websites targeted at older adults should take into account age-related abilities and limitations, for example by providing the opportunity to adjust the modality (i.e., “mode”) of information presentation based on visual and auditory capabilities. This study investigates the effects of a mode-tailored website, allowing users to self-tailor the mode of information presentation, on younger and older adults’ satisfaction with health websites. The results from a 5 (condition: tailored vs. text, text with visuals, text with audiovisual, combination) × 2 (age: younger [25–45] vs. older [≥ 65] adults) experimental study (N = 563) show that mode tailoring positively influenced satisfaction with the attractiveness and comprehensibility of the website, as compared to non-tailored conditions. These effects on website satisfaction were not different for younger and older adults. The current study provides relevant insights for researchers and practitioners in the field of digital health communication.

Het effect van personalisatie en leeftijdscongruentie in narratieve communicatie op website satisfactie en recall van online gezondheidsinformatie

The effect of personalization and age congruency on website satisfaction and recall of information was tested in a 2 (personalization: personalized vs. nonpersonalized video) × 2 (age congruency: congruent vs. incongruent) experimental design (n = 275). Personalization was found to be an effective communication tool to predict recall of information. Age congruency had an effect on satisfaction with the emotional support from the website. Narrative engagement predicted both website satisfaction and recall of information, but did not mediate the relationship between personalization and the outcomes. However, significant conditional mediation effects revealed that age congruency plays a moderating role in explaining the effects of personalization on website satisfaction and recall of online health information via narrative engagement. This study provides practical implications for developing online health messages for older adults.