Master of Science / Department of Journalism and Mass Communications / Soontae An / Since the Food and Drug Administration (FDA) relaxed regulations on broadcast DTC advertising in 1997, DTC advertising has become a prominent part of public health communication. The purpose of this study is to assess the stigma reducing components of DTC ads based on the attribution theory and recategorization theory. Taken together, the combination of these two health communication theories can provide a useful framework to assess whether DTC advertising has made a sufficient effort to reduce the barrier in an attempt to motivate people to take appropriate actions for their treatment. A content-analysis of the past ten years from 1998 to 2008 of DTC ads of stigmatized diseases was done to critically evaluate the practice of DTC ads. Results focus on the prevalence of onset controllability (e.g., whether contracting an illness is blamable or not), offset responsibility (e.g., whether people have efforts to cope with or not) and recategorization (e.g., in-group) as textual cues and visual cues in the ads. Only half of ads (57%) offered a stigma reducing strategy. The most prevalent for both textual cues and visual cues were recategorization. However, an unbalance of stigma reducing components implies a meaning that Corrigan and Penn (1999)’s strategy of interventions to reduce stigma could not effectively function. Therefore, it required appropriate adjustments by onset controllability, offset responsibility and recategorization.

OBJECTIVES: To identify the types of patients who talk with their physicians as a result of Direct-to-Consumer (DTC) advertising. METHODS: Data were taken from a national survey, "Public Health Impact of Direct-to-Consumer Advertising of Prescription Drugs, July 2001- January 2002", conducted by researchers from Harvard Medical School. Participants (n = 3000) were interviewed by telephone. We constructed a conceptual framework consisting of outcomes (3 types of physician visits), intervention (DTC experience) and five groups of explanatory factors (health beliefs, demographics, health status, socioeconomic status and market factors). Data were analyzed with three multivariate stepwise logistic regressions. The three dependent variables were whether an advertisement for a prescription drug had ever prompted the patient to: 1) visit to discuss prescription drug, 2) visit to discuss new condition, and 3) visit to discuss treatment change. RESULTS: Out of all independent variables, only six variables consistently showed significant effects on the three dependent variables after adjusting for other variables. They were: 1) taking medication on regular basis, 2) having anxiety, 3) having high advertisement attentiveness, 4) viewing media as the most important source prompting one to talk with physician, 5) believing that DTC advertisements increased awareness of new treatment, and 6) believing that DTC advertisements improved discussion with health professionals. The six variables were the strongest predictors for DTC-prompted physician visits.CONCLUSIONS: Our nationally representative study found multiple factors were associated with different types of physician visits prompted by DTC advertisements. This information could be used to target those patients most likely to talk to their physicians as a result of DTC advertisements.

Diante de discrepâncias na literatura sobre a recomendação de alguns modelos de propaganda de se emparelhar os apelos (racionais ou emocionais) à atitude do consumidor sobre o produto (predominantemente cognitiva ou predominantemente afetiva), o objetivo geral desta Tese foi avaliar tal recomendação. A revisão bibliográfica evidenciou algumas lacunas teóricas: 1) generalização indevida de resultados de estudos sobre formatos de propaganda para produtos de outras categorias; 2) não mensuração direta dos componentes cognitivo e afetivo da atitude do consumidor nos modelos de propaganda, que consideram apenas o tipo de necessidade que o produto satisfaz e o envolvimento do consumidor como determinante da atitude sobre o produto; 3) não consideração de outras características do consumidor, além do envolvimento, como determinante da atitude nos modelos de propaganda; 4) ausência da atitude do consumidor sobre o produto dentre os antecedentes da atitude do consumidor frente a anúncio. Procurando superar tais deficiências, foi empreendida pesquisa de campo contemplando: a) uma categoria de produto específica (medicamentos / medicamentos para emagrecer); b) a mensuração dos componentes cognitivo e afetivo da atitude; c) a avaliação de outras características do consumidor (estado de saúde / peso e experiência com o produto) que influenciam sua atitude; d) atitude do consumidor sobre o produto como possível antecedente da atitude dele frente a anúncio. A pesquisa empírica consistiu de três etapas. A primeira, sobre as particularidades da propaganda de medicamentos no Brasil, constatou maior uso de apelos emocionais. A segunda etapa, referente aos componentes cognitivo e afetivo da atitude do consumidor sobre medicamentos, encontrou predominância do componente cognitivo em pessoas saudáveis e de ambos os componentes em pessoas com problemas de saúde. A terceira etapa, acerca de atitude do consumidor sobre medicamentos para emagrecer e atitude e intenção comportamental do consumidor frente a anúncios racional e emocional, apontou predominância do componente cognitivo na atitude sobre o produto e atitude e intenção comportamental mais favoráveis frente a anúncio racional. Em vista do objetivo geral da Tese, do lado dos anunciantes, os resultados da pesquisa de campo não confirmaram a recomendação de emparelhar os apelos da propaganda à atitude do consumidor sobre o produto. Apelos emocionais são mais utilizados (primeira etapa da pesquisa), enquanto a atitude dos consumidores sobre esse tipo de produto é predominantemente cognitiva (segunda etapa da pesquisa). Os apelos utilizados na propaganda de medicamentos podem não estar sendo os mais adequados. Do lado dos consumidores, a recomendação de emparelhamento foi confirmada, pois a atitude dos consumidores sobre medicamentos para emagrecer é predominantemente cognitiva e eles tiveram atitude e intenção comportamental mais favoráveis frente ao anúncio racional. Os resultados trazem algumas implicações gerenciais. Do lado dos anunciantes, há insights para uma maior efetividade da propaganda e o alinhamento dela com as exigências legais. Parece ser mais adequado informar do que simplesmente tentar persuadir com apelos emocionais. Os benefícios funcionais do produto influenciam mais a formação da atitude sobre medicamentos. Sendo tais benefícios abordados na propaganda (apelos racionais), é provável que ela seja mais persuasiva. Do lado do governo, os resultados podem auxiliar às autoridades no seu objetivo de modernizar e atualizar o regulamento da propaganda de medicamentos, bem como na implementação de políticas de educação e conscientização da população sobre os perigos da auto-medicação. Pois sendo apelos racionais mais persuasivos, não significa que eles não possam gerar uso indevido de remédios ou auto-medicação. A tese termina expondo suas limitações e propondo lineamentos para pesquisas futuras. / There are discrepancies in the literature about the recommendation, of some advertising models, toward matching the appeals (rational or emotional) to the product consumer\'s attitude (predominantly cognitive or predominantly affective). In this context, the main objective of this Dissertation was to evaluate such recommendation. The literature review evidenced some theoretical gaps: 1) improper generalization of results from studies on advertising formats on one product category to other categories; 2) no direct measurement of the cognitive and affective components of the consumer\'s attitude in advertising models, that just consider the type of need that the product satisfies and the consumer\'s involvement as determinants of the product attitude; 3) no consideration of other consumer\'s characteristics, beyond the involvement, as determinants of attitude in advertising models; 4) absence of the consumer\'s product attitude among the antecedents of the consumer?s advertisement attitude. Trying to overcome such deficiencies, field research was undertaken regarding: a) a specific product category (medicines / medicines to lose weight); b) the measurement of the cognitive and affective components of attitude; c) the evaluation of other consumer\'s characteristics (health condition / weigh and experience with the product) that influence attitude; d) the consumer\'s product attitude as possible antecedent of attitude toward advertisement. The empiric research consisted of three stages. The first, about the particularities of medicines advertising in Brazil, confirmed larger use of emotional appeals. The second stage, regarding the cognitive and affective components of consumer\'s attitude toward medicines, found predominance of cognitive component in healthy people and of both components in people with health problems. The third stage, concerning the consumer\'s attitude toward medicines to lose weight and attitude and behavioral intention toward rational and emotional ads, pointed out predominance of cognitive component in attitude toward product, and attitude and behavioral intention more favorable toward rational ad. In light of the general objective of the Thesis, from the point of view of advertisers, the results of the field research didn\'t confirm the recommendation of matching the appeals of the advertising to the consumer\'s product attitude. Emotional appeals are more used (first stage of the research), while the consumers\' attitude on that product type is predominantly cognitive (second stage of the research). Perhaps the appeals used in medicines advertising aren?t the most appropriate. From the point of view of consumers, the matching recommendation was confirmed. While the consumers\' attitude toward medicines to lose weight is predominantly cognitive, they had attitude and behavioral intention more favorable toward rational ad. Results bring some managerial implications. To advertiser, there are insights for better effectiveness of advertising and alignment with legal restrictions. There seems to be more appropriate to inform than just try to persuade with emotional appeals. The functional benefits of the product influence more the attitude formation toward medicines. Being such benefits approached in advertising (rational appeals), it is probable grater persuasiveness. Results of this Dissertation can help authorities to modernize and to update the regulation of medicines advertising, as well as the implementation of an educational policy about the dangers of self-medication. Especially because the use of rational appeals doesn\'t mean that they cannot generate improper use of medicines or self-medication. The Dissertation ends with the limitations and directions for future researches.

Diante de discrepâncias na literatura sobre a recomendação de alguns modelos de propaganda de se emparelhar os apelos (racionais ou emocionais) à atitude do consumidor sobre o produto (predominantemente cognitiva ou predominantemente afetiva), o objetivo geral desta Tese foi avaliar tal recomendação. A revisão bibliográfica evidenciou algumas lacunas teóricas: 1) generalização indevida de resultados de estudos sobre formatos de propaganda para produtos de outras categorias; 2) não mensuração direta dos componentes cognitivo e afetivo da atitude do consumidor nos modelos de propaganda, que consideram apenas o tipo de necessidade que o produto satisfaz e o envolvimento do consumidor como determinante da atitude sobre o produto; 3) não consideração de outras características do consumidor, além do envolvimento, como determinante da atitude nos modelos de propaganda; 4) ausência da atitude do consumidor sobre o produto dentre os antecedentes da atitude do consumidor frente a anúncio. Procurando superar tais deficiências, foi empreendida pesquisa de campo contemplando: a) uma categoria de produto específica (medicamentos / medicamentos para emagrecer); b) a mensuração dos componentes cognitivo e afetivo da atitude; c) a avaliação de outras características do consumidor (estado de saúde / peso e experiência com o produto) que influenciam sua atitude; d) atitude do consumidor sobre o produto como possível antecedente da atitude dele frente a anúncio. A pesquisa empírica consistiu de três etapas. A primeira, sobre as particularidades da propaganda de medicamentos no Brasil, constatou maior uso de apelos emocionais. A segunda etapa, referente aos componentes cognitivo e afetivo da atitude do consumidor sobre medicamentos, encontrou predominância do componente cognitivo em pessoas saudáveis e de ambos os componentes em pessoas com problemas de saúde. A terceira etapa, acerca de atitude do consumidor sobre medicamentos para emagrecer e atitude e intenção comportamental do consumidor frente a anúncios racional e emocional, apontou predominância do componente cognitivo na atitude sobre o produto e atitude e intenção comportamental mais favoráveis frente a anúncio racional. Em vista do objetivo geral da Tese, do lado dos anunciantes, os resultados da pesquisa de campo não confirmaram a recomendação de emparelhar os apelos da propaganda à atitude do consumidor sobre o produto. Apelos emocionais são mais utilizados (primeira etapa da pesquisa), enquanto a atitude dos consumidores sobre esse tipo de produto é predominantemente cognitiva (segunda etapa da pesquisa). Os apelos utilizados na propaganda de medicamentos podem não estar sendo os mais adequados. Do lado dos consumidores, a recomendação de emparelhamento foi confirmada, pois a atitude dos consumidores sobre medicamentos para emagrecer é predominantemente cognitiva e eles tiveram atitude e intenção comportamental mais favoráveis frente ao anúncio racional. Os resultados trazem algumas implicações gerenciais. Do lado dos anunciantes, há insights para uma maior efetividade da propaganda e o alinhamento dela com as exigências legais. Parece ser mais adequado informar do que simplesmente tentar persuadir com apelos emocionais. Os benefícios funcionais do produto influenciam mais a formação da atitude sobre medicamentos. Sendo tais benefícios abordados na propaganda (apelos racionais), é provável que ela seja mais persuasiva. Do lado do governo, os resultados podem auxiliar às autoridades no seu objetivo de modernizar e atualizar o regulamento da propaganda de medicamentos, bem como na implementação de políticas de educação e conscientização da população sobre os perigos da auto-medicação. Pois sendo apelos racionais mais persuasivos, não significa que eles não possam gerar uso indevido de remédios ou auto-medicação. A tese termina expondo suas limitações e propondo lineamentos para pesquisas futuras. / There are discrepancies in the literature about the recommendation, of some advertising models, toward matching the appeals (rational or emotional) to the product consumer\'s attitude (predominantly cognitive or predominantly affective). In this context, the main objective of this Dissertation was to evaluate such recommendation. The literature review evidenced some theoretical gaps: 1) improper generalization of results from studies on advertising formats on one product category to other categories; 2) no direct measurement of the cognitive and affective components of the consumer\'s attitude in advertising models, that just consider the type of need that the product satisfies and the consumer\'s involvement as determinants of the product attitude; 3) no consideration of other consumer\'s characteristics, beyond the involvement, as determinants of attitude in advertising models; 4) absence of the consumer\'s product attitude among the antecedents of the consumer?s advertisement attitude. Trying to overcome such deficiencies, field research was undertaken regarding: a) a specific product category (medicines / medicines to lose weight); b) the measurement of the cognitive and affective components of attitude; c) the evaluation of other consumer\'s characteristics (health condition / weigh and experience with the product) that influence attitude; d) the consumer\'s product attitude as possible antecedent of attitude toward advertisement. The empiric research consisted of three stages. The first, about the particularities of medicines advertising in Brazil, confirmed larger use of emotional appeals. The second stage, regarding the cognitive and affective components of consumer\'s attitude toward medicines, found predominance of cognitive component in healthy people and of both components in people with health problems. The third stage, concerning the consumer\'s attitude toward medicines to lose weight and attitude and behavioral intention toward rational and emotional ads, pointed out predominance of cognitive component in attitude toward product, and attitude and behavioral intention more favorable toward rational ad. In light of the general objective of the Thesis, from the point of view of advertisers, the results of the field research didn\'t confirm the recommendation of matching the appeals of the advertising to the consumer\'s product attitude. Emotional appeals are more used (first stage of the research), while the consumers\' attitude on that product type is predominantly cognitive (second stage of the research). Perhaps the appeals used in medicines advertising aren?t the most appropriate. From the point of view of consumers, the matching recommendation was confirmed. While the consumers\' attitude toward medicines to lose weight is predominantly cognitive, they had attitude and behavioral intention more favorable toward rational ad. Results bring some managerial implications. To advertiser, there are insights for better effectiveness of advertising and alignment with legal restrictions. There seems to be more appropriate to inform than just try to persuade with emotional appeals. The functional benefits of the product influence more the attitude formation toward medicines. Being such benefits approached in advertising (rational appeals), it is probable grater persuasiveness. Results of this Dissertation can help authorities to modernize and to update the regulation of medicines advertising, as well as the implementation of an educational policy about the dangers of self-medication. Especially because the use of rational appeals doesn\'t mean that they cannot generate improper use of medicines or self-medication. The Dissertation ends with the limitations and directions for future researches.

Thesis advisor: John J. Michalczyk / The internet is changing health care right under out very noses. In doing so, it may have great impact on the physician-patient relationship. This relationship exists along a continuum, with paternalism at one end and total patient autonomy at the other. Various aspects of web-based health care (eHealth) are pushing the equilibrium one way or the other. Aspects of eHealth considered include: general health information websites, internet pharmacies, health communication infrastructures (as in physician-patient email and electronic medical records), and finally web-brokered organ transplantation. While there is obviously much to be aware of in terms of quality on the internet, it is concluded that an integration of eHealth into traditional medicine (thus creating cybermedicine) may not only help to mitigate the managed care crisis, but may also change the physician-patient relationship—hopefully for the better. / Thesis (BS) — Boston College, 2005. / Submitted to: Boston College. College of Arts and Sciences. / Discipline: College Honors Program.