Spheres of influence: Reconfiguring identity in ehealth communication targeting minority and urban communities

Background: Integrating culture in health communication targeted to minority groups has shown effectiveness in health behavior change. Therefore, this strategy is used in ehealth communication to target these same groups. While effective off line, reliance on culture in targeting ehealth can be reductive to communities and to health experience. Objective: To evaluate what group memberships and other identities are operative in perceptions and use of ehealth. Methods: This presentation is a synthesis of findings from 1) a content analysis of web-based health portals, 2) 32 individual interviews (African American females; lower income) addressing substance use prevention online, and 3) 9 focus groups (4-12 participants; 74 African Americans; male and female; lower income) investigating smoking cessation online. All interviews were 2 hours, audio taped and involved use of the web. Data were analyzed through an integrated framework using The Comprehensive Model of Information Seeking and the Communication Theory of Identity .Results: Cultural identification is not always salient, especially as it interacts with a class-based identity and the use of ehealth. Participants reveal that role and relational identities are salient when seeking ehealth and fluctuate according to the health issue and prior health experiences. Findings further reveal identities are interconnected and affect perceptions of the internet for health as well as the utility of ehealth. Conclusions: Identities represent spheres of influence in ehealth consumption. This presentation advances the Model of Communicated Identities in eHealth; and demonstrates its application in the development of a web-based smoking cessation intervention targeting inner-city African American smokers.