Term of Award

Fall 2017

Degree Name

Doctor of Public Health in Public Health Leadership (Dr.P.H.)

Document Type and Release Option

Dissertation (restricted to Georgia Southern)

Copyright Statement / License for Reuse

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


Jiann-Ping Hsu College of Public Health

Committee Chair

Joanne Chopak-Foss

Committee Member 1

Yelena Tarasenko

Committee Member 2

Stuart Tedders


The purpose of this study was to examine the relationship between Internet information seeking and adherence to screening guidelines for breast and cervical cancers among women in the U.S. using data from the 2013-2014 cycles of the Health Information National Trends Survey (HINTS). The Andersen’s model provided the theoretical framework for examining the relationship between predisposing, enabling, and need factors, Internet information seeking and adherence to cancer screening guidelines for both breast and cervical cancers.

All descriptive and bivariate analyses were completed using Stata SE 14 and multivariable analysis to estimate prevalence ratios were completed using SAS-Callable SUDAAN. Binary logistic regression analyses were used to test the unadjusted and adjusted associations between predisposing, enabling, and need factors, Internet information seeking and guidelines adherence.

Study results indicate adjusting for need factors, the prevalence of guideline adherent cervical cancer screening was significantly higher among women who used the Internet (aPR = 1.16; 95% CI: 1.01 – 1.33) compared to women who did not (p = 0.036). Similar findings were found in the breast cancer screening subpopulation: adjusting for need factors, women who used the internet had a higher probability of being adherent to breast cancer screening (aPR = 1.10; 95% CI: 1.00 – 1.21) than women who did not use the internet (p = 0.033). The adjusted prevalence of guideline adherent breast cancer screening was significantly higher in women who looked for cancer information controlling for predisposing factors (aPR = 1.09; 95% CI: 1.00 – 1.18) and need factors (aPR = 1.12; 95% CI: 1.03 – 1.22). As the search for cancer information online increases, it is important to understand how to use internet information seeking as a tool to drive increased cancer screening adherence among women.

Research Data and Supplementary Material