Consumer responses to framing statements preceding the major risk statement in prescription drug DTC TV ads.

BACKGROUND: Research on the major risk statement in direct-to-consumer (DTC) prescription drug television ads has shown that risk severity and actionability can affect consumers' risk comprehension and perceptions. A framing statement presented just before the major risk statement may serve as a cue that directs attention to the risk statement that follows, or it may guide consumers' interpretation of the severity of the risks that follow. OBJECTIVE: Examine how the use of different framing statements (severe, life-threatening; serious; or basic) that precede the major risk statement in DTC television ads affect consumers' risk perceptions, risk recognition, benefit perceptions, interest in the drug, and other relevant outcomes. METHODS: An online experiment was conducted using a 1 × 3 between-subjects design to compare three different framing statements, which was replicated across three different DTC television ads that focused on different medical conditions (arthritis, lung cancer, and type 2 diabetes). A sample of US adults (N = 1961) was randomly assigned to view one of nine television ads and asked to respond to a questionnaire. RESULTS: The type of framing statement had significant effects on perceived risk severity, perceived utility of risk and benefit information, fear of risks, and perceived likelihood of explicit and implicit benefits. CONCLUSIONS: Consumers pay attention to and use cues to process and interpret the risk information presented to them in DTC television ads. Using lead-in language that describes risk severity, particularly for products with severe, life-threatening risks, may better allow consumers to make evaluative judgments on risk severity in DTC ads than stating the drug can cause serious reactions or simply that reactions are possible. More work is needed to examine the factors that affect people's understanding of the nature of risk severity, particularly with regard to risk recognition.

The role of patient-clinician information engagement and information seeking from nonmedical channels in fruit and vegetable intake among cancer patients.

Previous research suggests positive effects of health information seeking on prevention behaviors such as diet, exercise, and fruit and vegetable consumption. The present study builds upon this research and strengthens causal claims from it by examining the lagged effect of patient-clinician information engagement on fruit and vegetable consumption as well as the indirect effect on the outcome through seeking information from nonmedical channels. The results are based on data collected from a randomly drawn sample of breast, prostate, and colorectal cancer patients from the Pennsylvania Cancer Registry who completed mail surveys in the Fall of 2006 and 2007. There was a 65% response rate for baseline subjects (resulting n = 2,013); of those, 1,293 were interviewed 1 year later, and 1,257 were available for our analyses. Results show a positive lagged main effect of patient-clinician information engagement at baseline on fruit and vegetable consumption at follow-up (B = 0.26, SE = 0.10, p = .01). The mediation analysis shows that patient-clinician information engagement leads to increased fruit and vegetable consumption among cancer patients, in part through patients' information seeking from nonmedical channels. Implications of these findings for the cancer patient population and for physicians are discussed.

Navigating the cancer information environment: The reciprocal relationship between patient-clinician information engagement and information seeking from nonmedical sources.

Prior theory has argued and empirical studies have shown that cancer patients rely on information from their health care providers as well as lay sources to understand and make decisions about their disease. However, research on the dynamic and interdependent nature of cancer patients' engagement with different information sources is lacking. This study tested the hypotheses that patient-clinician information engagement and information seeking from nonmedical sources influence one another longitudinally among a representative cohort of 1,293 cancer survivors in Pennsylvania. The study hypotheses were supported in a series of lagged multiple regression analyses. Baseline seeking information from nonmedical sources positively predicted subsequent patient-clinician information engagement at 1-year follow-up. The reverse relationship was also statistically significant; baseline patient-clinician information engagement positively predicted information seeking from nonmedical sources at follow-up. These findings suggest that cancer survivors move between nonmedical and clinician sources in a dynamic way to learn about their disease.

An analysis of the association between cancer-related information seeking and adherence to breast cancer surveillance procedures.

BACKGROUND: Breast cancer surveillance is important for women with a known history of breast cancer. However, relatively little is known about the prevalence and determinants of adherence to surveillance procedures, including associations with seeking of cancer-related information from medical and nonmedical sources. METHODS: We conducted a longitudinal cohort study of breast cancer patients diagnosed in Pennsylvania in 2005. Our main analyses included 352 women who were eligible for surveillance and participated in both baseline (~1 year after cancer diagnosis) and follow-up surveys. Outcomes were self-reported doctor visits and physical examination, mammography, and breast self-examination (BSE) at 1-year follow-up. RESULTS: Most women underwent two or more physical examinations according to recommended guidelines (85%). For mammography, 56% of women were adherent (one mammogram in a year) while 39% reported possible overuse (two or more mammograms). Approximately 60% of respondents reported regular BSE (≥ 5 times in a year). Controlling for potential confounders, higher levels of cancer-related information seeking from nonmedical sources at baseline was associated with regular BSE (OR, 1.52; 95% CI, 1.01-2.29; P, 0.046). There was no significant association between information-seeking behaviors from medical or nonmedical sources and surveillance with physical examination or mammography. CONCLUSIONS: Seeking cancer-related information from nonmedical sources is associated with regular BSE, a surveillance behavior that is not consistently recommended by professional organizations. IMPACT: Findings from this study will inform clinicians on the contribution of active information seeking toward breast cancer survivors' adherence to different surveillance behaviors.

Applying Quantitative Approaches to the Formative Evaluation of Antismoking Campaign Messages.

This article shares an in-depth summary of a formative evaluation that used quantitative data to inform the development and selection of promotional ads for the antismoking communication component of a social marketing campaign. A foundational survey provided cross-sectional data to identify beliefs about quitting smoking that campaign messages should target, as well as beliefs to avoid. Pretesting draft ads against quantitative indicators of message effectiveness further facilitated the selection and rejection of final campaign ads. Finally, we consider lessons learned from the process of balancing quantitative methods and judgment to make formative decisions about more and less promising persuasive messages for campaigns.

Patient-clinician information engagement improves adherence to colorectal cancer surveillance after curative treatment: results from a longitudinal study.

Introduction. Follow-up surveillance after curative treatment for colorectal cancer (CRC) patients is recommended to detect early cancer recurrences and improve survival outcomes. However, a substantial proportion of CRC patients do not undergo cancer surveillance. Several demographic and disease-related factors have been associated with cancer surveillance adherence. Thus far, patient-centered communication has not been studied as a determinant for undergoing cancer surveillance. The purpose of this study is to determine whether patient-clinician information engagement (PCIE) influences patients' self-reported adherence to recommended CRC surveillance procedures. Methods. The study was a longitudinal survey among Pennsylvanian patients diagnosed with CRC in 2005. CRC patients who were eligible for surveillance and participated in both the baseline and 1-year follow-up surveys were included in this analysis (n = 305). The main outcome measure was self-reported adherence to physical examination, carcinoembryonic antigen testing, and colonoscopy according to recommended guidelines. Results. Controlling for potential confounders, higher PCIE at baseline predicted a higher odds for CRC patients reporting adherence to recommended surveillance 1 year later by 2.8 times. Other significant predictors of adhering to recommended surveillance were a higher education level and having received systemic therapy. Discussion. In this longitudinal study among CRC patients who received curative treatment, greater patient engagement with clinicians about cancer-related information was found to improve patients' subsequent adherence to recommended surveillance. This finding provides support for encouraging greater patient-physician communication among CRC patients.