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Aikin KJ, Sullivan HW, Caporaso A, Hoverman V, Yan T, Williams D, Crafts J. Attention to risk information in direct-to-consumer prescription drug print ads: An eye-tracking study. Pharmacoepidemiol Drug Saf 2023; 32:312-320. [PMID: 35864719 DOI: 10.1002/pds.5511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 06/22/2022] [Accepted: 07/16/2022] [Indexed: 11/11/2022]
Abstract
PURPOSE FDA regulations state print ads for prescription drugs must provide a true statement of information "in brief summary" describing "side effects, contraindications and effectiveness." To fulfill these requirements, these ads typically display risk information both as important safety information (ISI) on the "main" ad page with the product claims and on a separate "brief summary" page. The ISI can be lengthy and may repeat brief summary content. METHODS The authors tested two versions of the ISI (short versus long) and the presence or absence of a brief summary in direct-to-consumer prescription drug print ads for two medical conditions: overactive bladder (N = 181) and rheumatoid arthritis (N = 179). Attention was measured with eye-tracking and self-report methods. Risk retention and perceptions were self-reported. RESULTS Participants spent more time viewing ads with a long ISI or a brief summary and in some instances, recalled more risks. The combination of a long ISI and a brief summary did not increase or decrease attention to or retention of risk information. CONCLUSION A long ISI and a brief summary may perform similar functions.
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Affiliation(s)
- Kathryn J Aikin
- US Food and Drug Administration, Office of Prescription Drug Promotion, Silver Spring, Maryland, USA
| | - Helen W Sullivan
- US Food and Drug Administration, Office of Prescription Drug Promotion, Silver Spring, Maryland, USA
| | | | | | - Ting Yan
- Westat, Rockville, Maryland, USA
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Giombi K, Thompson J, Wines C, Haughney R, Sullivan HW, Betts KR. A scoping review of empirical research on prescription drug promotion. Res Social Adm Pharm 2023; 19:859-872. [PMID: 36931982 DOI: 10.1016/j.sapharm.2023.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 03/04/2023]
Abstract
BACKGROUND Pharmaceutical spending on prescription drug promotion is considerable, and exposure to advertising can influence demand and behavior. The U.S. Food and Drug Administration (FDA) provides industry guidance to help ensure that communications to consumers and health care providers about prescription drug promotion are truthful, balanced, and accurately communicated. As empirical research has accelerated on this topic in the past decade, an understanding of the current landscape of the science will help inform future research. OBJECTIVES Using systematic methods, this rigorous scoping review of the literature over the past decade (2012-2021) (1) examined the extent to which prescription drug promotion has been empirically investigated with consumers, patients, and health care providers; (2) examined the extent to which content and features of prescription drug promotion have been empirically investigated; and (3) identified themes across the literature to better understand the current landscape of prescription drug promotion. METHODS Databases searched include PubMed, Web of Science, CINAHL, APA PsycInfo, Business Source Corporate, Communication Source, Cochrane Library, and ClinicalTrials.gov for original research published in English from January 1, 2012, through November 10, 2021, using terms related to direct-to-consumer advertising, prescription drugs, and outcomes of interest (e.g., attitudes, perceptions, intentions, behaviors). RESULTS Of 804 screened references, 151 studies addressed the first research question, and 40 studies addressed the second. The most common theme across the body of evidence focused on testing of features and content in prescription drug promotional materials (84), followed by studies examining attitudes, perceptions, and behaviors toward prescription drug promotion more generally (43). Some (27) studies focused on targeted populations, such as patients, the elderly, non-English speaking people or individuals of a non-white race/ethnicity. Twenty-four studies assessed influence of exposure to prescription drug promotion on actual clinical outcomes, while 11 studies examined emerging technologies around prescription drug promotion. Seven studies evaluated the extent to which prescription drug promotion complied with existing guidelines and requirements. CONCLUSIONS Findings from this scoping review suggest there has been an increase in the number of empirical studies conducted on prescription drug promotion over the past decade. Potential areas that warrant further study include examination of emerging technologies, an expanded focus on targeted populations, and construct measurement.
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Affiliation(s)
| | | | - Candi Wines
- RTI International, Research Triangle Park, NC, USA
| | | | - Helen W Sullivan
- U.S. Food and Drug Administration, Office of Prescription Drug Promotion, Silver Spring, MD, USA
| | - Kevin R Betts
- U.S. Food and Drug Administration, Office of Prescription Drug Promotion, Silver Spring, MD, USA
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Sullivan HW, Chen WH, Betts KR. Assessing the Inclusion of Foil Items in a Scale to Measure Recognition of Health Messages. COMMUNICATION METHODS AND MEASURES 2021; 15:10.1080/19312458.2020.1768520. [PMID: 34616499 PMCID: PMC8488547 DOI: 10.1080/19312458.2020.1768520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Researchers frequently measure recognition of information in health messages by presenting participants with statements that were or were not in a message and then asking them to identify which were presented and which were not. Recognition scales are then calculated by summing the correct responses to both the true items and foils, or by summing the correct responses to the true items only. We used a sequence of psychometric analyses, including factor analysis and item response theory (IRT) analysis, to evaluate two recognition measures of this type, using data from previously published studies. We found that foils are less associated with true items than true items are with one another, or more practically, that foils are less associated with the underlying dimension of interest. These results provide researchers with insight into how recognition items function, as well as a better analytic approach for use in future studies.
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Affiliation(s)
- Helen W Sullivan
- U.S. Food and Drug Administration, 10903 New Hampshire Ave, Silver Spring, MD 20993-0002
| | - Wen-Hung Chen
- U.S. Food and Drug Administration, 10903 New Hampshire Ave, Silver Spring, MD 20993-0002
| | - Kevin R Betts
- U.S. Food and Drug Administration, 10903 New Hampshire Ave, Silver Spring, MD 20993-0002
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Waters EA, Maki J, Liu Y, Ackermann N, Carter CR, Dart H, Bowen DJ, Cameron LD, Colditz GA. Risk Ladder, Table, or Bulleted List? Identifying Formats That Effectively Communicate Personalized Risk and Risk Reduction Information for Multiple Diseases. Med Decis Making 2020; 41:74-88. [PMID: 33106087 DOI: 10.1177/0272989x20968070] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Personalized medicine may increase the amount of probabilistic information patients encounter. Little guidance exists about communicating risk for multiple diseases simultaneously or about communicating how changes in risk factors affect risk (hereafter "risk reduction"). PURPOSE To determine how to communicate personalized risk and risk reduction information for up to 5 diseases associated with insufficient physical activity in a way laypeople can understand and that increases intentions. METHODS We recruited 500 participants with <150 min weekly of physical activity from community settings. Participants completed risk assessments for diabetes, heart disease, stroke, colon cancer, and breast cancer (women only) on a smartphone. Then, they were randomly assigned to view personalized risk and risk reduction information organized as a bulleted list, a simplified table, or a specialized vertical bar graph ("risk ladder"). Last, they completed a questionnaire assessing outcomes. Personalized risk and risk reduction information was presented as categories (e.g., "very low"). Our analytic sample (N = 372) included 41.3% individuals from underrepresented racial/ethnic backgrounds, 15.9% with vocational-technical training or less, 84.7% women, 43.8% aged 50 to 64 y, and 71.8% who were overweight/obese. RESULTS Analyses of covariance with post hoc comparisons showed that the risk ladder elicited higher gist comprehension than the bulleted list (P = 0.01). There were no significant main effects on verbatim comprehension or physical activity intentions and no moderation by sex, race/ethnicity, education, numeracy, or graph literacy (P > 0.05). Sequential mediation analyses revealed a small beneficial indirect effect of risk ladder versus list on intentions through gist comprehension and then through perceived risk (bIndirectEffect = 0.02, 95% confidence interval: 0.00, 0.04). CONCLUSION Risk ladders can communicate the gist meaning of multiple pieces of risk information to individuals from many sociodemographic backgrounds and with varying levels of facility with numbers and graphs.
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Affiliation(s)
- Erika A Waters
- Department of Surgery, Division of Public Health Sciences, Washington University in St. Louis, Saint Louis, MO, USA
| | - Julia Maki
- Department of Surgery, Division of Public Health Sciences, Washington University in St. Louis, Saint Louis, MO, USA
| | - Ying Liu
- Department of Surgery, Division of Public Health Sciences, Washington University in St. Louis, Saint Louis, MO, USA
| | - Nicole Ackermann
- Department of Surgery, Division of Public Health Sciences, Washington University in St. Louis, Saint Louis, MO, USA
| | - Chelsey R Carter
- Department of Surgery, Division of Public Health Sciences, Washington University in St. Louis, Saint Louis, MO, USA
| | - Hank Dart
- Department of Surgery, Division of Public Health Sciences, Washington University in St. Louis, Saint Louis, MO, USA
| | | | | | - Graham A Colditz
- Department of Surgery, Division of Public Health Sciences, Washington University in St. Louis, Saint Louis, MO, USA
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Alkazemi MF, Van Stee SK. Electronic direct-to-consumer advertising of pharmaceuticals: an assessment of textual and visual content of websites. HEALTH EDUCATION RESEARCH 2020; 35:134-151. [PMID: 32144424 DOI: 10.1093/her/cyaa004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Accepted: 02/07/2020] [Indexed: 06/10/2023]
Abstract
Considering the important role of the Internet in health information seeking by consumers, it is critical to examine the health information that is available to them through the Internet. This study contributes to existing knowledge by employing a content analysis to examine visual and textual information on prescription medication websites. A stratified random sample was selected from a list of the 100 most-prescribed medications in the United States. Findings point to under-utilization of audiovisual components on the homepage of prescription medication websites as well as a lack of racial diversity in people pictured. Medications for chronic conditions were more likely to have homepages with a positive emotional tone than those for acute conditions. Further, more depictions of women on homepages predicted a greater number of prescriptions filled. This study includes implications for health education and healthcare professionals, patients and the Food and Drug Administration.
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Affiliation(s)
- Mariam F Alkazemi
- Department of Public Relations, Robertson School of Media & Culture, 901 W Main Street, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Stephanie K Van Stee
- Department of Communication, 571 Lucas Hall, University of Missouri - St. Louis, One University Boulevard, St. Louis, MO 63121, USA
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Effectiveness of Knowledge Translation Strategies in Audiovisual Language Compared With Other Languages to Improve Health Outcomes in Individuals and the General Population: Systematic Review. ACTA ACUST UNITED AC 2019; 48:105-126. [PMID: 30981325 DOI: 10.1016/j.rcp.2017.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 05/24/2017] [Accepted: 07/10/2017] [Indexed: 01/12/2023]
Abstract
BACKGROUND Knowledge translation (KT) not only encompasses a series of final actions in areas of dissemination, but also the identification of strategies for the implementation of this process. OBJECTIVE To evaluate the effectiveness of KT strategies in audiovisual language compared with other languages to improve health outcomes in the general population. METHODS We performed a search in MEDLINE, CENTRAL, PsycARTICLES, the WHO International Clinical Trials Registry Platform, EMBASE and LILACS. RESULTS We included 63 studies encompassing a broad range of study populations, languages that were compared to audiovisual language and measurement scales for outcomes. These studies presented a high risk of bias and the quality of evidence was not sufficient to draw conclusions about the effectiveness of the evaluated languages for knowledge translation. CONCLUSIONS We identified different languages that could be used in knowledge translation. The knowledge and the effects produced as a result of the strategy diminish as time progresses, regardless of the type of language used. This is an important point to consider when implementing this type of strategy.
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Catalan-Matamoros D, Peñafiel-Saiz C. The Use of Traditional Media for Public Communication about Medicines: A Systematic Review of Characteristics and Outcomes. HEALTH COMMUNICATION 2019; 34:415-423. [PMID: 29252009 DOI: 10.1080/10410236.2017.1405485] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
A systematic review was conducted to identify, appraise, and synthesize data from original research investigating the use of traditional media for public communication about medicines. Databases were searched for studies conducting quantitative or qualitative analyses between the years 2007 and 2017. Data extraction and assessment of the quality of the resulting studies was conducted by one reviewer and checked for accuracy by a second reviewer. A total of 57 studies met the inclusion criteria. Studies were grouped as follows: "newspapers and other print media" (n = 42), "television" (n = 9), and "radio and a combination of media" (n = 6). Content analysis (n = 34) was the most frequent research design, followed by surveys or interviews (n = 14) and randomized controlled trials (RCTs) (n = 9). Advertising, public awareness, and health administration were the most common themes, and the medicines most analyzed were vaccines, particularly human papillomavirus (HPV) and influenza. Studies conducted in the United States were the most frequent, followed by other high-income countries such as Canada and the United Kingdom. The lack of consistent studies of the effects of media campaigns stresses the importance of the use of standardized research methodologies. Theoretical and practical implications of the findings for further research are discussed.
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Affiliation(s)
- Daniel Catalan-Matamoros
- a Department of Journalism and Communication , University Carlos III of Madrid , Getafe , Spain
- b Research Group of Health Sciences CTS-451 , University of Almeria , Almería , Spain
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Southwell BG, Parvanta SA, Johnson MM, O'Donoghue AC, Sullivan HW, Ray SE, Soloe CS, Davis CN, McKenna N. Assessing hearing and cognition challenges in consumer processing of televised risk information: Validation of self-reported measures using performance indicators. Prev Med Rep 2018; 11:145-147. [PMID: 30003013 PMCID: PMC6039885 DOI: 10.1016/j.pmedr.2018.06.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 05/23/2018] [Accepted: 06/13/2018] [Indexed: 11/28/2022] Open
Abstract
Public health researchers face important challenges if they wish to include measures of hearing or cognitive ability in risk communication studies. We sought validity evidence for self-report measures of hearing and cognitive ability by comparing those measures to performance-based measures and risk information recall. We measured hearing ability (with audiologist-assisted assessment and self report), cognitive ability (with an established performance task and self report), and reactions to direct-to-consumer prescription drug promotion with adults 18 and older (n = 1064) in North Carolina, USA, in 2017. We found moderate correspondence between self-reported hearing loss and audiologist-assessed hearing loss. Both measures also showed a small negative association with recall of presented risk information. Cognitive ability results suggested less substantial correspondence between self report and performance task and the measures differed in predicting risk recall. Our results suggested a moderately efficient measure for hearing ability for research on risk information exposure and retention, and yet also suggested the need for caution regarding future use of self-reported cognitive ability as a substitute for a performance-based measure.
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Affiliation(s)
- Brian G Southwell
- RTI International, USA.,Duke University, USA.,University of North Carolina at Chapel Hill, USA
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Babar ZUD, Siraj AM, Curley L. A review of DTCA techniques: Appraising their success and potential impact on medication users. Res Social Adm Pharm 2018; 14:218-227. [DOI: 10.1016/j.sapharm.2017.04.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 04/04/2017] [Indexed: 11/28/2022]
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Stone ER, Reeder EC, Parillo J, Long C, Walb L. Salience Versus Proportional Reasoning: Rethinking the Mechanism Behind Graphical Display Effects. JOURNAL OF BEHAVIORAL DECISION MAKING 2018. [DOI: 10.1002/bdm.2051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | | | | | | | - LeeAnn Walb
- Wake Forest University; Winston-Salem NC USA
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Melnick ER, Probst MA, Schoenfeld E, Collins SP, Breslin M, Walsh C, Kuppermann N, Dunn P, Abella BS, Boatright D, Hess EP. Development and Testing of Shared Decision Making Interventions for Use in Emergency Care: A Research Agenda. Acad Emerg Med 2016; 23:1346-1353. [PMID: 27457137 DOI: 10.1111/acem.13045] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 06/30/2016] [Accepted: 07/07/2016] [Indexed: 11/30/2022]
Abstract
Decision aids are evidenced-based tools designed to increase patient understanding of medical options and possible outcomes, facilitate conversation between patients and clinicians, and improve patient engagement. Decision aids have been used for shared decision making (SDM) interventions outside of the ED setting for more than a decade. Their use in the ED has only recently begun to be studied. This article provides background on this topic and the conclusions of the 2016 Academic Emergency Medicine consensus conference SDM in practice work group regarding "Shared Decision Making in the Emergency Department: Development of a Policy-Relevant, Patient-Centered Research Agenda." The goal was to determine a prioritized research agenda for the development and testing of SDM interventions for use in emergency care that was most important to patients, clinicians, caregivers, and other key stakeholders. Using the nominal group technique, the consensus working group proposed prioritized research questions in six key domains: 1) content (i.e., clinical scenario or decision area), 2) level of evidence available, 3) tool design strategies, 4) risk communication, 5) stakeholders, and 6) outcomes.
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Affiliation(s)
- Edward R. Melnick
- Department of Emergency Medicine; Yale University School of Medicine; New Haven CT
| | - Marc A. Probst
- Department of Emergency Medicine; Icahn School of Medicine at Mount Sinai; New York NY
| | | | - Sean P. Collins
- Department of Emergency Medicine; Vanderbilt University; Nashville TN
| | | | | | - Nathan Kuppermann
- Department of Emergency Medicine; University of California; Davis School of Medicine; Sacramento CA
| | - Pat Dunn
- Patient and Healthcare Innovations and Center for Health Technology and Innovation; American Heart Association; Dallas TX
| | - Benjamin S. Abella
- Department of Emergency Medicine; University of Pennsylvania; Philadelphia PA
| | - Dowin Boatright
- Department of Emergency Medicine; Yale University School of Medicine; New Haven CT
- Robert Wood Johnson Clinical Scholar Program; Yale University School of Medicine; New Haven CT
| | - Erik P. Hess
- Department of Emergency Medicine; Mayo Clinic College of Medicine; Rochester MN
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