Nadine Bol

This wearable eye-tracking study investigated the social and clinical context in which patients’ and a clinician’s gaze and verbal behaviours occurred during medical consultations at an outpatient neurology clinic. We analysed gaze behaviour and instrumental and affective communication of patients and a neurologist in selected consultations (n = 12), representing different consultation compositions (i.e., the social context: one-on-one, one-on-two, one-on-many) and consultation activities (i.e., the clinical context: discussing scan results, performing a neurological examination). In-depth analyses of mutual and joint gaze in relation to verbal utterances were explored in a smaller subset (n = 3), providing detailed descriptions of patient-neurologist gaze and verbal communication while considering the social and clinical context of these consultations. Results showed that both patients and the neurologist predominantly gazed at each other’s faces but also looked at other locations and objects. Individual, mutual, and joint gaze patterns at faces, the screen, and companions varied across social and clinical contexts. Instrumental and affective communication were intertwined and co-occurred with patients’ and the neurologist’s mutual and joint gaze states. These findings underscore that doctor-patient communication is shaped by what is said and how attention is jointly managed within the broader social and clinical context of doctor-patient communication.

This essay proposes a conceptual framework that reconceptualizes scientific evidence as a process of public construction in contemporary media environments. In social media contexts, scientists, journalists, influencers, NGOs, lay publics and AI agents participate in the circulation and interpretation of evidential claims. The essay’s contribution is to explain how evidential status itself is publicly assembled, circulated, internalized, and fed back into further communication. We distinguish two analytically coupled layers of this process: amalgamated evidence , the publicly visible circulation and recombination of claims across posts, comments and shares, and internalized evidence , the individual representations through which users interpret and evaluate these claims. Their reciprocal “circle of evidence” is driven by three recurring communicative behaviours—consumption, participation and generation—and shaped by platform logics that amplify, recontextualize and remix information. Under these conditions, evidential status emerges from communicative interaction rather than solely from scientific procedures, creating potential divergences between scientific records and what publics perceive as evidence. By conceptualizing evidencing as a socio-technical and communicative process, the framework aims to stimulate debate and outlines a research agenda for examining how public circulation and individual internalization mutually shape the authority of science in digital media environments.

Purpose: Patient-reported outcome measures (PROMs) are increasingly used in oncology to support patient-centered care, yet their implementation in routine practice remains inconsistent. Using a communication-centered perspective which conceptualizes PROMs implementation as a process of meaning exchange between patients, clinicians, and implementation staff, this study examined PROMs implementation as a multi-stage process and explored how it unfolds in real-life oncology care, drawing on both patient and healthcare professional perspectives. Methods: A qualitative interview study was conducted in the Netherlands with patients with cancer ( n = 10) and healthcare professionals and implementation staff in oncology care ( n = 7). Semi-structured interviews were informed by a communication-centered framework conceptualizing PROMs implementation as a multi-stage process. Data were analyzed using hybrid inductive-deductive thematic analysis. Results: Six interrelated stages of PROMs implementation were identified: (1) selecting and organizing PROMs use, (2) establishing purpose and motivation, (3) experiencing PROMs as a task, (4) making sense of results together, (5) applying PROMs information in care, and (6) evaluating and improving PROMs implementation. Findings showed that experiences at different stages were interconnected: processes occurring earlier in the implementation influence how PROMs were later understood, discussed, and used in care. Across roles, participants recognized PROMs’ potential to support communication beyond clinical indicators, while also describing frustration when PROMs were collected but not meaningfully used. Patient and clinician engagement influenced one another across stages, reflecting the reciprocal nature of PROMs as a communication tool. Conclusion: PROMs implementation should be viewed as an interdependent, sequential process. Improving connections between stages is essential to realizing PROMs’ communicative and patient-centered potential in oncology care. Practical strategies such as personalizing PROMs invitations, completing the feedback loop between PROMs results and patients, and integrating supportive tools for clinicians can help translate PROMs data into meaningful patient-centered dialogue.

Given the importance of a healthy lifestyle for cancer patients' health outcomes and quality of life, this study aimed to synthesize the literature on factors (perceived as) hindering or facilitating healthcare providers' provision of lifestyle information in oncology. Based on this synthesis, we additionally derived recommendations to improve this practice, which were independently validated by experts. A systematic literature review was conducted. PubMed, Web of Science, CINAHL Ultimate, and PsycINFO were searched. We screened titles and abstracts, aided by ASReview, and full texts. Peer-reviewed articles published from 2007-2022 were included, reporting non-interventional studies on factors that HCPs associated with lifestyle information provision to adult cancer patients. We identified 20,176 unique articles, of which 108 articles were included. Most articles studied factors related to information provision about physical activity, smoking, or a combination of lifestyle behaviors. Factors associated with lifestyle information provision fell into four main groups; factors related to the (1) HCP (e.g., knowledge), (2) patient (e.g., interest), (3) relationships between HCPs, patients, and stakeholders (e.g., support), and (4) organization (e.g., resources). The factors were linked to whether, how, and when information is provided. The review provides an overview of factors associated with communication about different lifestyle behaviors across HCPs and cancer types. Based on the findings, we formulated recommendations for future research and for clinical practice, which were validated via interviews with nine oncology HCPs, confirming feasibility with minor adjustments. Overall, lifestyle information provision as a whole and associated factors deserve more attention in clinical practice and scientific research.

A healthy lifestyle can have various health benefits for cancer survivors, including positive effects for their general health and cancer-specific outcomes

Digital inequality research shows that certain sociodemographic groups (e.g., older persons) experience fewer benefits from using digital technologies (e.g., not finding useful information). While disadvantage is typically conceptualized as not experiencing benefits, users also experience online harms (e.g., unauthorized access to personal information), which have been largely ignored. Better understanding of systematic differences in online experiences can contribute to understanding mistrust in online companies and chilling effects (i.e., inhibiting certain digital behaviors). Using Bayesian inference to analyze data of a preregistered survey-based study (N = 1,410), we find confirming and contradicting results for digital inequalities. While older and less educated persons experience fewer online benefits and women and older persons tend to inhibit their digital behaviors more, no inequalities regarding harmful privacy experiences were found (older persons even reported fewer harmful experiences). Generally, mistrust and self-inhibition are higher when people experience online harms and lower when they experience online benefits. We discuss these findings in relation to structural disadvantages, intersectionality, and potential solutions.

A healthy lifestyle, particularly having a balanced diet, regular physical activity, and abstaining from alcohol and smoking, is important for the recovery process of cancer survivors. The extent and form in which lifestyle information is provided by healthcare providers varies substantially, which could leave many patients with unmet information needs. To better understand current practices and areas for improvement in communicating about these health behaviors, we explored survivors' experiences and preferences regarding communication. Using deductive and inductive content analysis, we analyzed questionnaire responses from survivors with various types of cancers. The results revealed the experiences with information provision, and barriers and facilitators to adhere to treatments. Respondents reported having to search for information themselves, which could lead to negative feelings and neglecting vulnerable groups of patients. Most respondents preferred a multimodal distribution of information and receival of recommendations at the beginning of treatment. Additionally, respondents preferred personalized and non-coercive messages about their lifestyle. The results of this study provide insights into current shortcomings and points for improvement of healthy lifestyle communication practices in oncology. Understanding patients' communication preferences and ways in which they can be implemented could lead to adherence to health behaviors, potentially improving long-term survivorship outcomes. Future research could explore whether tailoring recommendations to individual needs and delivering information at critical stages can enhance patient satisfaction and engagement.

Insights from tailoring research have been useful in enhancing online health communication efforts. User-initiated customisation (UIC) is a novel tailoring approach that involves the self-tailoring of information. This study examined the strength and the mechanisms underlying UIC effects to further understand the suitability of UIC as a method of persuasion for online health communication efforts. Using a web-based experiment (N = 178), the effects of UIC on attitudes via sense of control, attention, and elaboration were assessed, including the moderating role of behaviour type (i.e., detection vs. prevention). The results demonstrate that UIC (vs. generic webpages) was significantly more effective at increasing sense of control, which consequently enhanced attention and elaboration of information, resulting in stronger positive attitudes toward health behaviours. These effects were stable across different behavioural contexts. The findings suggest that the online communication efforts of governments can be enhanced through the embedment of a UIC webpage feature.