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BACKGROUND: Despite the prevalence of over-the-counter medicine advertising (OTCA) in electronic and print media, scholarly focus has tended to concentrate on direct-to-consumer prescription medicine advertising (DTCA). OBJECTIVES: The purpose of this study is to examine the mechanisms through which attitudes toward OTCA in general and OTCA prompted behaviors are formed based on a consumer socialization framework. METHODS: An online survey was conducted as part of a larger medicine and pharmaceutical advertising project using the Qualtrics online panel. A total of 819 individuals who had taken a prescription medicine in the last six months participated in the survey and yielded 539 completed questionnaires (Completion rate: 65.8%). Of those, 304 responses from U.S. adults who had taken an OTC medicine and had seen an advertisement for OTC medicines in the past six months were analyzed to test the proposed model. A series of structural equation modeling analyses of the survey data was performed. RESULTS: The study results showed that consumers' use of mass media and professional interpersonal channels directly influenced attitudes toward OTCA and OTCA prompted behaviors. On the other hand, consumers' use of non-professional interpersonal channels indirectly influenced OTCA outcomes through their use of mass media and professional interpersonal channels. Younger respondents were more likely to obtain OTC medicine information from non-professional interpersonal and mass media sources whereas older respondents were more likely to obtain OTC medicine information from physicians and pharmacists. CONCLUSIONS: Application of the consumer socialization framework in the context of OTCA provides expanded understanding of the mechanisms through which responses to OTCA are formed. The findings of this study provide implications for pharmaceutical marketers, health professionals, and consumers of OTC medicines.

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Guided by the theoretical frameworks of the "health halo effect" and consumer expertise, this research was undertaken to determine how two individual factors, health consciousness and health literacy, differentially influence evaluations of nutrient-content claimed messaging for an unhealthy food (i.e., chocolate) and whether such evaluations are moderated by the reading of the food's Nutrition Facts Label displaying different serving sizes. The research found that health consciousness positively influenced evaluative responses to unhealthy food messaging, and that the positive influence persisted following the reading of a Nutrition Facts label listing a large quantity of unhealthy ingredients per serving size. In contrast, health literacy negatively influenced perceived healthiness and purchase intention when the nutrition label communicated a higher serving size, indicating that subjective and objective expertise work differently. The results advance understanding of the information processing of nutrient-claimed unhealthy foods, and suggest implications for food marketing communication and public health policy.

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Fast food restaurants have increasingly turned to healthier choices to counter criticisms of nutritionally poor menu offerings and to differentiate themselves from the competition. However, research has yet to specifically investigate how consumers respond to advertisements for these healthier foods. To address this knowledge gap, two experiments were conducted to examine how perceived brand healthiness, brand commitment, and health consciousness influence responses to nutrient-content claimed print advertisements for healthy foods. Findings indicate that consumer responsiveness varies across the three factors but is more positive for advertisements placed by perceivably healthy restaurant brands, and that brand commitment and health consciousness play significant roles in affecting how consumer respond to such advertising. Several theoretical and managerial implications of the findings are discussed.

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Given the importance of over-the-counter (OTC) drugs in the health care marketplace and lack of systematic research on OTC drug advertising (OTCA) effects, this study tested a theory-based, product category-specific OTCA effects model. Structural equation modeling analysis of data for 1 OTC drug category, analgesics, supported the proposed model, explaining the OTCA effect process from key consumer antecedents to ad involvement, from ad involvement to ad attention, from ad attention to cognitive responses, then to affective/evaluative responses, leading to the final behavioral outcome. Several noteworthy patterns also emerged: (a) Product involvement was directly linked to ad attention, rather than exerting an indirect influence through ad involvement; (b) ad attention was significantly related to both cognitive and affective/evaluative responses to different degrees, with stronger links to cognitive responses; and

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A 2 × 3 × 2 mixed factorial experimental design was used to examine how three message appeals (benefit-seeking vs. risk-avoidance vs. taste appeals), food healthiness (healthy vs. unhealthy foods), and consumer poverty status (poverty vs. nonpoverty groups) impact evaluative responses to nutrient-content claimed food advertisements. Subjects were partitioned into two groups, those below and those above the poverty line, and exposed to nutrient-content claimed advertisement treatments for healthy and unhealthy foods featuring the three appeals. The findings reaffirmed the interaction effects between perceivably healthy and unhealthy foods and different appeals reported in previous studies, and found interaction effects between consumer poverty level and response to the message appeals featured in the experimental food advertisements. Age, body mass index, current dieting status, education, and gender were examined as covariates.

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Using a model developed from the research literature, the authors compared consumers' attitudinal and behavioral responses to direct-to-consumer prescription drug advertising (DCTA) and over-the-counter nonprescription drug advertising (OTCA) of drugs. Adults 18 years of age and older who had taken any prescription drugs in the past 6 months completed online survey questionnaires. Variables measured included demographics (age, gender, race, education, and income), health-related characteristics (health status, prescription and over-the-counter drug use, health consciousness, and involvement with prescription or over-the-counter drugs), perceived amount of attention and exposure to DTCA and OTCA, attitudinal outcomes (skepticism toward DTCA/OTCA and attitude toward DTCA/OTCA), and behavioral outcomes triggered by DTCA and OTCA. The findings indicate that exposure to drug advertising is one of the most significant predictors of attitudinal and behavioral outcomes. Some audience factors such as health status, involvement with drugs, health consciousness, drug use, income, and age also were differentially associated with consumer responses to drug advertising.

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Considerable knowledge on food advertising has been generated by research on consumers' psychological reactions to food advertising messaging using either students or nonstudents as subjects. Building on past research, this article investigates the methodological question of whether students are appropriate surrogates for nonstudents in food advertising studies. Following exposure to print advertisements featuring healthy and unhealthy foods with two different nutrient attribute-based message appeals, student and nonstudent subjects were asked to complete five standard evaluative response measures to the food ads: claim believability, attitude-toward-the ad, attitude-toward-the-product, attitude-toward-the-brand, and purchase intention. Among the findings, students were found to react differently and more negatively to identical food advertisements than nonstudents. Overall, the message sent to health communication researchers, policy officials, and practicing professionals is - unless certain criteria are satisfied - students should be considered inadequate subjects to represent all age groups of the general population in food advertising research. Thus, conclusions drawn from student-based research about advertising processing and effects should be questioned and broad generalizations avoided.

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This study examined Korean Americans' prescription drug information seeking, evaluation and use of different information sources, and communication with physicians, and compared the findings with those from the White American population. The results suggest that although Korean and White Americans were similar in extent of drug information seeking, Korean Americans tended to experience relatively greater difficulty finding information. Regarding perceived source usefulness, Korean Americans were significantly more likely to perceive higher usefulness in mass media and direct-to-consumer advertising sources than were Whites. Korean Americans were also more likely to use fewer sources, and less likely to use mass media and printed materials in drug information seeking. However, the hypothesized in-group source preference by Korean Americans was not found.

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This experiment examined the interaction effects of message framing and counterfactual thinking on attitudes toward binge drinking and behavioral intentions. Data from a 2 (message framing: gain vs. loss) × 2 (counterfactual thinking priming: additive vs. subtractive) between-subjects factorial design showed that a gain-framed message resulted in lower binge drinking intentions than did a loss-framed message after subjects engaged in additive counterfactual thinking. The effects of a loss-framed message on binge drinking intentions occurred when subtractive counterfactual thinking was induced. Theoretical and practical implications for anti-binge drinking public service announcements are discussed.

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This study examined Korean Americans' evaluation and use of online advertising and non-advertising sources of prescription drug information and compared the findings to those of white Americans. A mail survey was conducted with a disproportionate stratified sample of 600 adults (300 general population and 300 Korean Americans) who have ever taken or are currently taking prescription drugs regularly and reside in a metropolitan area in the Midwestern United States. While both Korean and white Americans evaluated online non-advertising sources more positively than advertising sources, the 2 groups were similar in their evaluation of both online advertising and non-advertising sources. White Americans tended to use more online advertising sources than did Korean Americans, but both groups were equally likely to use non-advertising sources. Evaluation and use of online advertising and non-advertising sources by Korean and white Americans were associated with different predictors.

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This study examines frequencies and types of promotion techniques featured in five decades of cigarette advertising relative to five major smoking eras. Analysis of 1,133 cigarette advertisements collected through multistage sampling of 1954 through 2003 issues of three youth-oriented magazines found that 7.6% of the analyzed ads featured at least one promotion technique. Across smoking eras the proportion of promotion in the ads steadily increased from 1.6% in the "pre-broadcast ban era" to 10.9% in the "the pre-Master Settlement Agreement (MSA) era" and 9% in "post-MSA era." The increased use of sponsorships/events in cigarette ads for youth-oriented brands warrants more attention from tobacco control experts and government regulators.

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This study investigates source selection in prescription drug information seeking and influencing factors on selection and seeking behaviors applying a modified Comprehensive Model of Information Seeking in an American context. Survey results suggest consumers engage in prescription drug information search before and after visiting a doctor, but search is not extensive. Consumers turn to the Internet, pharmacists, and doctors most frequently for prescription drug information. Information-seeking behaviors are rather universal across demographic and health-related characteristics; however, higher income consumers are more likely to search. Although our study shows some support for the modified Comprehensive Model of Information Seeking, the results indicate influencing factors vary by information source types examined, suggesting the model is more complex than predicted. The study advances research on health communication, information-seeking behaviors, and prescription drug decision making.

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Tobacco studies indicate that health-related information in cigarette advertising leads consumers to underestimate the detrimental health effects of smoking and contributes to their smoking-related perceptions, beliefs, and attitudes. This study examined the frequencies and kinds of implicit health information in cigarette advertising across five distinct smoking eras covering the years 1954-2003. Analysis of 1,135 cigarette advertisements collected through multistage probability sampling of three popular consumer magazines found that the level of implicit health information (i.e., "light" cigarette, cigarette pack color, verbal and visual health cues, cigarette portrayals, and human model-cigarette interaction) in post-Master Settlement Agreement [MSA] era ads is similar to the level in ads from early smoking eras. Specifically, "light" cigarettes were frequently promoted, and presence of light colors in cigarette packs seemed dominant after the probroadcast ban era. Impressionistic verbal health cues (e.g., soft, mild, and refreshing) appeared more frequently in post-MSA era ads than in pre-MSA era ads. Most notably, a majority of the cigarette ads portrayed models smoking, lighting, or offering a cigarette to others. The potential impact of implicit health information is discussed in the contexts of social cognition and Social Cognitive Theory. Policy implications regarding our findings are also detailed.

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Direct-to-consumer advertising has changed the way prescription drugs are marketed in the United States. This article traces the history of direct-to-consumer advertising of prescription and over-the-counter medications and describes how drug advertising is regulated and by whom. It also discusses the controversies that surround direct-to-consumer marketing of prescription drugs.

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This survey was conducted to determine and compare how Anglo and Hispanic Americans evaluate and use interpersonal, advertising, and mediated sources of prescription drug information. Findings suggest the following: (1) Hispanics rely on doctors, Internet advertising sources, and direct-to-consumer advertising (DTCA), while Anglos frequently use health-related websites and health care professionals; (2) Anglos are more likely to use health-related websites such as WebMD, although Anglos and Hispanics do not appear significantly different in Internet source usefulness evaluation; (3) Hispanics rely on television (TV) and DTC TV advertising more than Anglos, and this tendency is stronger for strong than weak Hispanic identifiers; (4) Hispanics evaluate TV news stories and TV advertising as more useful than Anglos; (5) Hispanics evaluate DTCA more positively and with less skepticism than Anglos; and (6) Hispanic ethnic identification level is positively related to preferences for Spanish-language media and health care professionals.

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This study investigates advertising skepticism in the context of consumers' prescription drug information seeking behavior. Results of a telephone survey found that: (a) the overall level of direct-to-consumer advertising (DTCA) skepticism among consumers was neutral; (b) DTCA skepticism was unrelated to age, positively related to education and income, and varied by race; (c) however, when all the antecedent variables were considered concurrently, only education emerged as a significant predictor (consumers with higher education were more skeptical of DTCA); (d) DTCA skepticism was not significantly related to perceived importance of prescription drug information; (e) DTCA skepticism was not associated with use of advertising and interpersonal sources of prescription drug information; and (f) DTCA skepticism was negatively related to perceived usefulness of advertising sources but unrelated to perceived usefulness of professional interpersonal sources (i.e., physicians and pharmacists). The article concludes with a discussion of findings and directions for future research.

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This study was conducted to provide additional evidence on how consumers behave following direct-to-consumer (DTC) advertising exposure and to determine if there are differences in ad-prompted acts (drug inquiry and drug requests) between different age groups (i.e., older, mature, and younger adults). The results suggest that younger, mature, and older consumers are all moved to act by DTC drug ads, but that each age group behaves in different ways. Somewhat surprisingly, age was not predictive of ad-prompted behavior. DTC advertising was no more effective at moving older consumers to behave than their younger counterparts. These results suggest that age does not matter that much when it comes to the "moving power" of prescription drug advertising, even though research indicates that older consumers are more vulnerable to the persuasive effects of communication.

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Despite growing concerns about the quality and accuracy of Internet-based prescription drug information, there has been very little empirical research on consumers' perceptions of the trustworthiness of on-line drug information. In this article, we report on a study modeled after that of Menon, Deshpande, Perri, and Zinkhan (2002) in Health Marketing Quarterly that reexamines how key demographic, predispositional, and media factors are associated with consumer trust in on-line prescription drug information and the impact of trust in on-line drug information on ad-promoted behavior following exposure to direct-to-consumer (DTC) advertising. Four major findings are reported: (1) on-line drug information is not highly trusted; (2) trust in on-line drug information is not differentially affected by consumer demographic or predispositional characteristics; (3) trust in the traditional media of DTC advertising is predictive of trust in on-line drug information; and (4) trust in on-line drug information is associated directly with specific types of ad-promoted behavior following exposure to DTC advertising. Implications and recommendations are offered based on the results.

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In this article, we report the results of a study conducted to determine consumer perceptions of the media credibility and informativeness of direct-to-consumer prescription drug advertising (DTC advertising) and to examine how those perceptions are influenced by consumer predispositions and demographic characteristics, especially consumer age. This study specifically surveyed older consumers, who are the most significant market segment for prescription drugs and particularly susceptible and vulnerable to commercial persuasion. Older consumers' perceptions of DTC advertising were found to be neutral but their evaluation of informativeness was found to be more positive. Attitude toward DTC advertising and DTC advertising familiarity predicted perceived credibility across various media and attitude toward DTC advertising was the most prominent predictor of perceived informativeness. Age and usage of different media were also found to predict credibility and informativeness of DTC advertising in certain types of media. This study's findings provide insight into how older consumers evaluate various DTC advertising media as an information source.

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