http://hints.cancer.gov

briefs

NUMBER 18

Implementation of

HINTS in Puerto Rico

In 2009, a demonstration project was conducted in Puerto

Rico using existing Behavioral Risk Factor Surveillance System

(BRFSS) infrastructure to assess the feasibility of adapting the

national HINTS survey to a local setting to facilitate local

data collection and cancer control planning.The University of

Puerto Rico Comprehensive Cancer Center (UPRCCC), in

collaboration with the Puerto Rico Behavioral Risk Factor

Surveillance System (PR-BRFSS), fielded the 2008 HINTS

instrument in Puerto Rico. Data collection was conducted

through the PR-BRFSS telephone research center using

random digit dialing (RDD) and computer-assisted telephone

interview (CATI). All interviews were conducted by

experienced bilingual Puerto Rican interviewers.

Collection of HINTS data in Puerto Rico provides an

opportunity to better understand the health information 

and education needs of the population in Puerto Rico. In 

this HINTS Brief, we explore health information seeking in

Puerto Rico.

“The most recent time you looked for

information on health or medical topics,

where did you go first?”1

Asked of those seeking health information only

56%

■ Internet

■ Printed Materials

■ Health Care

Professional

■ Other

28%

13%

3%

1 Data from HINTS Puerto Rico (2008).

Study Documents

Generally Positive

Information Seeking

Experiences 

Health information seeking experiences reported in Puerto Rico

generally positive, with some frustration and concerns about quality

In an analysis of HINTS Puerto Rico data published in

2010, investigators examined health and cancer information

seeking behaviors and experiences among the population in

Puerto Rico. Approximately one-third of the population

had ever sought health or medical information from any

source.Those looking for health or medical information

characterized their most recent health information seeking

experience as generally positive. However, 17.7% indicated

that it took a lot of effort to get the information that they

needed, 11.1% expressed feeling frustrated during their last

search, 19.8% had concerns about information quality, and

16.3% agreed that the information they obtained was

difficult to understand.

Quick Facts

• Internet penetration in Puerto Rico is fairly low, with

only 32.7% of respondents indicating that they use the

Internet compared with 68.5% of the mainland U.S.

population.

• The percentage of respondents seeking health or

medical information from any source also remains low,

with 32.9% saying they had looked for health information

compared with 61% of the mainland U.S. population.

• The most trusted sources of health and medical

information in Puerto Rico are health care providers and

government health agencies.

• Only 24.4% of the population in Puerto Rico indicate

that they trust the Internet ‘‘a lot’’ as a source of

medical and health information.

In this HINTS Brief, we explore health information seeking practices in Puerto Rico.
Health Information Seeking in Puerto Rico:

Differences by Gender and Education

Differences in health information seeking practices in Puerto Education

Rico were observed by gender and education. Frequency of individuals reporting health information seeking

increased with education level.While 15.1% of persons with less Gender than a high school education reported ever having sought health Health information seeking occurred more frequently among or medical information, 56.4% of those with a college degree females (41.8%) than males (22.6%).This difference remained had ever sought health information.This difference remained significant in a multivariate model testing for independent significant in a multivariate model testing for independent associations wherein females were nearly 3 times more likely associations wherein college graduates were over 7 times more than males to seek health information. likely than those with less than a high school education to

report ever having sought health information.

How Can This Inform Your Work?

Data from HINTS Puerto Rico illustrate how HINTS questions

fielded within a local context can sharpen the focus of health

planning efforts over relying on data from the U.S. national

sample alone:

• Trusted sources of health information in Puerto Rico,

including health care providers and government health

agencies, are ideal channels for relaying important health

messages to the public.

• Overall, Internet penetration is low in Puerto Rico, but of those

who are actively looking for information, the Internet is an

important first stop. Investment of resources to improve Internet

access might improve the reach of online health information.

• Women and those with college educations reported looking

for health information more frequently than other groups.

Consideration should be given to how these two groups can

be used as “connectors” or “promotoras” when planning to

reach the rest of the population.

% Trust Information Source “a lot”1

Health Care Provider

Government Health Agencies

Charitable Organizations

Television

Internet

Family

Magazine or Newspapers

Religious Organizations

Radio

76.5

47.7

25.1 24.5 24.4 23 22.8 22.2

17.9

1 Data from HINTS Puerto Rico (2008).

About HINTS

http://hints.cancer.gov

The National Cancer Institute (NCI) fielded the first Health Information National Trends Survey (HINTS) in 2002 and 2003,

surveying 6,369 Americans. Subsequent surveys followed in 2005 (5,586 Americans surveyed) and 2008 (7,674 Americans surveyed).

HINTS was created to monitor changes in the rapidly evolving field of health communication.The survey data can be used to

understand how adults 18 years and older use different communication channels to obtain health information for themselves and

their loved ones and to create more effective health communication strategies across populations.

HINTS Briefs provide a snapshot of noteworthy research findings.They introduce population-level estimates for specific questions in

the survey and summarize significant research findings that result from analyzing how certain demographic characteristics influence

specific outcomes. Many Briefs summarize research findings from recent peer-reviewed journal articles using HINTS data.

For More Information on Cancer

• Call the NCI Cancer Information Service at 1-800-4-CANCER

• Visit http://cancer.gov

• Order NCI publications at https://cissecure.nci.nih.gov/ncipubs/

References Used in This HINTS Brief

Tortolero-Luna G, Finney Rutten LJ, Hesse BW, Davis T, Kornfeld J,

Sanchez M, et al. Health and cancer information seeking practices and

preferences in Puerto Rico: creating an evidence base for cancer

communication efforts. J Health Commun. 2010;15(1): 30-45.

April 2011