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Direct-to-Consumer Advertising and Health and Risk Messaging  

Kimberly A. Kaphingst

Direct-to-consumer advertising of prescription drugs (DTCA) is a multibillion-dollar industry in the United States, affecting the health-care landscape. DTCA has been controversial, since a major increase in this type of advertising resulted from re-interpretation of existing regulations in the late 20th century. Health and risk communication research can inform many of the controversial issues, assisting physicians, policymakers, and the public in understanding how consumers respond to DTCA. Prior research addresses four major topics: (1) the content of DTCA in different channels, (2) consumers’ perceptions of and responses to DTCA, (3) individual-level factors that affect how consumers respond to DTCA, and (4) message factors that impact consumers’ responses. Such research shows that the presentation of risk and benefits information is generally not balanced in DTCA, likely affecting consumers’ attitudes toward and comprehension of the risk information. In addition, despite consumers’ generally somewhat negative or neutral perceptions of DTCA, this advertising seems to affect their health information seeking and communication behaviors. Finally, a wide range of individual-level and message factors have been shown to have an impact on how consumers process and respond to DTCA. Consumers’ responses, including how they process the information, request prescription drugs from providers, and share information about prescription drugs, have an important impact on the effects of DTCA. The fields of health and risk communication therefore bring theories and methodologies that are essential to better understanding the impact of this advertising.

Article

Scientific Uncertainty in Health and Risk Messaging  

Stephen Zehr

Expressions of scientific uncertainty are normal features of scientific articles and professional presentations. Journal articles typically include research questions at the beginning, probabilistic accounts of findings in the middle, and new research questions at the end. These uncertainty claims are used to construct clear boundaries between uncertain and certain scientific knowledge. Interesting questions emerge, however, when scientific uncertainty is communicated in occasions for public science (e.g., newspaper accounts of science, scientific expertise in political deliberations, science in stakeholder claims directed to the public, and so forth). Scientific uncertainty is especially important in the communication of environmental and health risks where public action is expected despite uncertain knowledge. Public science contexts are made more complex by the presence of multiple actors such as citizen-scientists, journalists, stakeholders, social movement actors, politicians, and so on who perform important functions in the communication and interpretation of scientific information and bring in diverse norms and values. A past assumption among researchers was that scientists would deemphasize or ignore uncertainties in these situations to better match their claims with a public perception of science as an objective, truth-building institution. However, more recent research indicates variability in the likelihood that scientists communicate uncertainties and in the public reception and use of uncertainty claims. Many scientists still believe that scientific uncertainty will be misunderstood by the public and misused by interest groups involved with an issue, while others recognize a need to clearly translate what is known and not known. Much social science analysis of scientific uncertainty in public science views it as a socially constructed phenomenon, where it depends less upon a particular state of scientific research (what scientists are certain and uncertain of) and more upon contextual factors, the actors involved, and the meanings attached to scientific claims. Scientific uncertainty is often emergent in public science, both in the sense that the boundary between what is certain and uncertain can be managed and manipulated by powerful actors and in the sense that as scientific knowledge confronts diverse public norms, values, local knowledges, and interests new areas of uncertainty emerge. Scientific uncertainty may emerge as a consequence of social conflict rather than being its cause. In public science scientific uncertainty can be interpreted as a normal state of affairs and, in the long run, may not be that detrimental to solving societal problems if it opens up new avenues and pathways for thinking about solutions. Of course, the presence of scientific uncertainty can also be used to legitimate inaction.

Article

Health-Related Warning Message Processing  

Christopher B. Mayhorn and Michael S. Wogalter

Warnings are risk communication messages that can appear in a variety of situations within the healthcare context. Potential target audiences for warnings can be very diverse and may include health professionals such as physicians or nurses as well as members of the public. In general, warnings serve three distinct purposes. First, warnings are used to improve health and safety by reducing the likelihood of events that might result in personal injury, disease, death, or property damage. Second, they are used to communicate important safety-related information. In general, warnings likely to be effective should include a description of the hazard, instructions on how to avoid the hazard, and an indication of the severity of consequences that might occur as a result of not complying with the warning. Third, warnings are used to promote safe behavior and reduce unsafe behavior. Various regulatory agencies within the United States and around the globe may take an active role in determining the content and formatting of warnings. The Communication-Human Information Processing (C-HIP) model was developed to describe the processes involved in how people interact with warnings and other information. This framework employs the basic stages of a simple communication model such that a warning message is sent from one entity (source) through some channel(s) to another (receiver). Once warning information is delivered to the receiver, processing may be initiated, and if not impeded, will continue through several stages including attention switch, attention maintenance, comprehension and memory, beliefs and attitudes, and motivation, possibly ending in compliance behavior. Examples of health-related warnings are presented to illustrate concepts. Methods for developing and evaluating warnings such as heuristic evaluation, iterative design and testing, comprehension, and response times are described.