title: Class, race and ethnicity and information avoidance among cancer survivors.
abstract: BACKGROUND
  Information seeking may increase cancer survivors' ability to make decisions and cope with the disease, but many also avoid cancer information after diagnosis. The social determinants and subsequent communication barriers that lead to avoidance have not been explored. The purpose of this study is to examine the influence of social determinants on information avoidance among cancer survivors.
  
  
  METHODS
  We examined how health information avoidance is associated with structural and individual factors in a mail-based survey of 519 cancer survivors. Factor analysis was conducted to determine barriers to obtaining cancer information, and multivariable logistic regression models by gender were run to analyze social determinants of avoidance from an intersectional approach.
  
  
  RESULTS
  Participants who were younger, female, had greater debt and lower income, and had difficulty finding suitable information were more likely to avoid information. The probability of information avoidance increased when survivors reported barriers to information use or comprehension.
  
  
  CONCLUSIONS
  These results indicate that survivors' information avoidance may be driven, in part, by social determinants, particularly among those at the intersection of multiple social status categories. Customized strategies are needed that maximize the likelihood that information will be used by vulnerable groups such as those from a lower socioeconomic position.
authors.affiliation: Harvard School of Public Health, Boston, MA, USA. Rachel_Faulkenberry@dfci.harvard.edu
authors.forename: R F
authors.initials: RF
authors.lastname: McCloud
authors.forename: M
authors.initials: M
authors.lastname: Jung
authors.forename: S W
authors.initials: SW
authors.lastname: Gray
authors.forename: K
authors.initials: K
authors.lastname: Viswanath
mesh_terms: D000328:Adult; D000368:Aged; D001362:Avoidance Learning; D003144:Communication Barriers; D005006:Ethnicity / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D058980:Information Literacy; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000208:ethnology / Q000523:psychology; D044469:Racial Groups / Q000523:psychology / Q000706:statistics & numerical data*; D012923:Social Class; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data