The author presents a value-based model of consumer involvement and preventive health care behavior. Through in-depth interviews, consumer views were elicited on three health care policy issues—health information use, the patient-physician relationship, and health compliance. Value maps are developed that explain the motivations and desired outcomes underlying consumer health care involvement and behavior. The author discusses the dynamics of control, empowerment, and trust and introduces a value-based conceptual model of health care involvement and preventive behavior incorporating these values. He concludes by offering implications for enhancing comsumer involvement in social marketing health care programs.
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References
1.
AndreasenAlan R. (1977), “A Taxonomy of Consumer Satisfaction/Dissatisfaction Measures,” in Conceptualization and Measurement of Consumer Satisfaction and Dissatisfaction, HuntH. K., ed. Cambridge, MA: Marketing Science Institute.
2.
AndreasenAlan R. (1991), “Consumer Behavior Research and Social Policy,” in Handbook of Consumer Behavior, RobertsonT., and KassarjianH., eds. Englewood Cliffs, NJ: Prentice-Hall, Inc.,459–506.
3.
AndrewsJ. Craig, DurvasulaSrinivas, and AkhterSyed H. (1990), “A Framework for Conceptualizing and Measuring the Involvement Construct in Advertising Research,”Journal of Advertising, 19(4), 27–40.
4.
AntilJohn H. (1984), “Conceptualizing and Operationalization of Involvement,” in Advances in Consumer Research, 11, KinnearT., ed. Provo, UT: Association for Consumer Research,203–209.
5.
BakerKenneth R. (1992), “Law: Pharmacists’ Liability and OBRA 90,”Drugstore News for the Pharmacist, 2(December 14), 143–49.
6.
BaricLeo (1969), “Recognition of the “At Risk” Role: A Means to Influence Health Behavior,”International Journal of Health Education, 12, 24–34.
7.
BaronJohn A., GleasonRay, CroweBernadette, and MannJ. I. (1990), “Preliminary Trial of the Effect of General Practice Based Nutritional Advice,”British Journal of General Practice, 40(April), 137–41.
8.
BeardenWilliam O., NetemeyerRichard G., and MobleyMary F. (1993), Handbook of Marketing Scales.Newbury Park, CA: Sage Publications.
9.
BeckerMarshall H. (1985), “Patient Adherence to Prescribed Therapies,”Medical Care, 23(May), 539–55.
10.
BettmanJames R., PayneJohn, and StaelinRichard (1986), “Cognitive Considerations in Designing Effective Labels for Presenting Risk Information,”Journal of Public Policy and Marketing, 5, 1–28.
11.
BlackstonMax (1992), “Building Brand Equity by Managing the Brand's Relationships,”Journal of Advertising Research, 32(May/June), 79–83.
12.
BozinoffLorne, RothVictor, and MayColin (1989), “Stages of Involvement With Drugs and Alcohol: Analysis of Drug and Alcohol Abuse Advertising,” in Advances in Consumer Research, 16, SrullT., ed. Provo, UT: Association for Consumer Research,215–20.
13.
BrennerLynn (1992), “OBRA: It's the Law,”American Druggist, 207(December), 26–33.
14.
BurnsAlvin C. (1992), “The Expanded Health Belief Model as a Basis for Enlightened Preventive Health Care Practice and Research,”Journal of Health Care Marketing, 12(September), 32–45.
15.
CalnanM. (1984), “The Health Belief Model and Participation in Programmes for the Early Detection of Cancer: A Comparative Analysis,”Social Science Medicine, 19, 823–30.
16.
CohenJoel B. (1983), “Involvement and You: 1000 Great Ideas,” in Advances in Consumer Research, 10, BagozziR. P., and TyboutA. M., eds. Ann Arbor, MI: Association for Consumer Research,325–28.
17.
CohenEric P. (1990), “Are Pharmaceutical Ads Good Medicine?”Business and Society Review, 2(Spring), 8–10.
18.
CookT. D. (1975), “Sesame Street” Revisited.New York: Russell Sage Foundation.
19.
CroogSidney H., LevineSol, TestaMarcia, BrownByron, BulpittChristopher J., David JenkinsC., KlermanGerald L., and WilliamsGordon H. (1986), “The Effects of Antihypertensive Therapy on Quality of Life,”New England Journal of Medicine, 314(26), 1657–64.
20.
DeLongisAnita, CoyneJames C., DakofGayle, FolkmanSusan, and LazarusRichard S. (1982), “Relationship of Daily Hassles, Uplifts, and Major Life Events to Health Status,”Health Psychology, 2, 119–36.
21.
DePauloPeter J., RubinMary, and MilnerBrenton (1987), “Stages of Involvement With Alcohol and Heroin: Analysis of the Effects of Marketing on Addiction,” in Advances in Consumer Research, 14, WallendorfM., and AndersonP., eds. Provo, UT: Association for Consumer Research,521–25.
22.
FallowfieldL. J., RodwayA., and BaumM. (1990), “What Are the Psychosocial Factors Influencing Attendance, Non-Attendance and Re-Attendance at a Breast Screening Centre?”Journal of the Royal Society of Medicine, 83(September), 547–51.
23.
FrancisVida, KorschBarbara M., and MorrisMarie J. (1969), “Gaps in Doctor-Patient Communication,”New England Journal of Medicine, 280(March 6), 535–40.
24.
GarroLinda C. (1986), “Intracultural Variation in Folk Medical Knowledge: A Comparison Between Curers and Noncurers,”American Anthropologist, 88(2), 351–70.
25.
GerhardtUta (1990), “Qualitative Research on Chronic Illness: The Issue and the Story,”Social Science Medicine, 30(11), 1149–59.
26.
GouldStephen J. (1988), “Consumer Attitudes Toward Health and Health Care: A Differential Perspective,”Journal of Consumer Affairs, 22(1), 96–118.
27.
GouldStephen J., ConsidineJudith M., and OakesLeslie S. (1993), “Consumer Illness Careers: An Investigation of Allergy Sufferers and Their Universe of Medical Choices,”Journal of Health Care Marketing, 13(Summer), 34–48.
28.
GreenacreMichael J. (1984), Theory and Application of Correspondence Analysis.London: Academic Press.
29.
GutmanJonathan (1982), “A Means-End Chain Model Based on Consumer Categorization Processes,”Journal of Marketing, 46(2), 60–72.
30.
GutmanJonathan, and ReynoldsThomas J. (1986), “Coordinating Assessment to Strategy Development: An Advertising Assessment Paradigm Based on the MECCAS Model,” in Advertising and Consumer Psychology, 3, OlsonJ., and SentisK., eds. New York: Praeger,242–258.
31.
HarrellGilbert D., and ForsMatthew F. (1985), “Marketing Ambulatory Care to Women: A Segmentation Approach,”Journal of Health Care Marketing, 5(Spring), 19–28.
32.
HendersonAlice M. (1986), “The CBS Consumer Model,”Journal of Pharmaceutical Marketing & Management, 1(Winter), 7–11.
33.
HenryWalter A. (1976), “Cultural Values Do Correlate with Consumer Behavior,”Journal of Marketing Research, 13(May), 121–27.
34.
HoffmanDonna L., and FrankeGeorge R. (1986), “Correspondence Analysis: Graphical Representation of Categorical Data in Marketing Research,”Journal of Marketing Research, 23(August), 213–27.
35.
HolmesT. H., and RaheR. H. (1967), “The Social Readjustment Rating Scale,”Journal of Psychosomatic Research, 11, 213–18.
36.
HoranMichael J. (1989), “Implications for Research and Policy in the Treatment of Hypertension,”Hypertension, 13(May), I-164–66.
37.
HuebnerVicky Diamond, HuyckNorma I., and BissonnetteAdele (1989), “Social Marketing of Nutrition Education to Cardiac Patients in Acute Care,”Journal of the American Dietetic Association, 89(4), 540–42.
38.
HymanHerbert H., and SheatsleyPaul B. (1947), “Some Reasons Why Information Campaigns Fail,”Public Opinion Quarterly, 2, 412–23.
39.
JachukS. J., BrierlyH., JachuckS., and WilcoxP. M. (1982), “The Effects of Hypotensive Drugs on the Quality of Life,”Journal of the College of General Practitioners, 32, 103–105.
40.
JanzNancy K., and BeckerMarshall H. (1984), “The Health Belief Model: A Decade Later,”Health Education Quarterly, 11(Spring), 1–47.
41.
JenkinsC. David, StantonBabette-Ann, SavageauJudith A., DenlingerPhilip, and KleinMichael D. (1983), “Coronary Artery Bypass Surgery: Physical, Psychological, Social, and Economic Outcomes Six Months Later,”Journal of the American Medical Association, 250(6), 782–88.
42.
JöreskogKarl G., and SörbomDag (1989), LISREL 7: A Guide to the Program and Applications.Chicago: SPSS.
43.
KahleLynn R., BeattySharon E., and HomerPamela (1986), “Alternative Measurement Approaches to Consumer Values: The List of Values (LOV) and Values and Life Style (VALS),”Journal of Consumer Research, 13(December), 405–409.
44.
KaslStanislav V., and CobbSidney (1966), “Health Behavior, Illness Behavior and Sick Role Behavior,”Archives of Environmental Health, 12(February), 246–66.
45.
KelmanHerbert C., and WarwickDonald P. (1978), “Ethics of Social Intervention: Goals, Means, and Consequences,” in The Ethics of Social Intervention, BermantG., KelmanH. C., and WarwickD. P., eds. Washington, DC: Hemisphere Publishing Co.,3–33.
46.
KesslerDavid A., and PinesWayne L. (1990), “The Federal Regulation of Prescription Drug Advertising and Promotion,”Journal of the American Medical Association, 264(November 14), 2409–15.
47.
KotlerPhilip, and RobertoEduardo L. (1989), Social Marketing: Strategies for Changing Public Behavior.New York: Free Press.
48.
LaBarberaPriscilla A., and MazurskyDavid (1983), “A Longitudinal Assessment of Consumer Satisfaction/Dissatisfaction: The Dynamic Aspect of the Cognitive Process,”Journal of Marketing Research, 20(November), 393–404.
49.
LauRichard R., and WareJohn E.Jr. (1981), “Refinements in the Measurement of Health-specific Locus-of-Control Beliefs,”Medical Care, 19(November), 1147–58.
50.
MaheswaranDurairaj, and Meyers-LevyJoan (1990), “The Influence of Message Framing and Issue Involvement,”Journal of Marketing Research, 27(August), 361–67.
51.
MaisiakRichard, KoplonSandra, and HeckLouisJr. (1989), “Users of a Public Arthritis Information Service and Their Needs,”The Journal of Rheumatology, 16(11), 1474–79.
52.
MarkJennifer Susan, and SpiroHoward (1990), “Informed Consent for Colonoscopy: A Prospective Study,”Archives of Internal Medicine, 150(April), 777–80.
53.
MassonAlison, and RubinPaul H. (1985), “Matching Prescription Drugs and Consumers,”New England Journal of Medicine, 313(August 22), 513–15.
54.
MassonAlison, and RubinPaul H. (1986), “Plugs for Drugs,”Regulation, 10(September/October), 37–43, 53.
55.
MeyerowitzBeth E., and ChaikenShelly (1987), “The Effects of Message Framing on Breast Self-Examination Attitudes, Intentions, and Behavior,”Journal of Personality and Social Psychology, 52(3), 500–510.
56.
MiniardPaul W., BhatlaSunil, LordKenneth R., DicksonPeter R., and Rao UnnavaH. (1991), “Picture-based Persuasion Processes and the Moderating Role of Involvment,”Journal of Consumer Research, 18(June), 92–107.
57.
MoormanChristine, and MatulichErika (1993), “A Model of Consumers’ Preventive Health Behaviors: The Role of Motivation and Health Ability,”Journal of Consumer Research, 20(September), 208–228.
58.
MorrisLouis A., TabakEllen R., and OlinsNancy J. (1992), “A Segmentation Analysis of Prescription Drug Information-Seeking Motives Among the Elderly,”Journal of Public Policy and Marketing, 11(2), 115–25.
59.
MuehlingDarrel D., LaczniakRussell N., and Craig AndrewsJ. (1993), “Defining, Operationalizing, and Using Involvement in Advertising Research: A Review,”Journal of Current Issues and Research in Advertising, 15(Spring), 22–57.
60.
NickensHerbert (1989), “The Physician-Patient Dyad: An Important Unit for Analysis,”Academic Medicine, 64(November), 664–65.
61.
OliverRichard L. (1980), “A Cognitive Model of the Antecedents and Consequences of Satisfaction Decisions,”Journal of Marketing Research, 17(November), 460–69.
62.
OparilSuzanne (1993), “Antihypertensive Therapy—Efficacy and Quality of Life,”New England Journal of Medicine, 328(13), 959–61.
63.
PaykelE.S., RaoB.M., and TaylorC. N. (1984), “Life Stress and Symptom Pattern in Out-Patient Depression,”Psychological Medicine, 14, 559–68.
64.
PettyRichard E., CacioppoJohn T., and SchumannDavid (1983), “Central and Peripheral Routes to Advertising Effectiveness: The Moderating Role of Involvement,”Journal of Consumer Research, 10(September), 135–46.
65.
PierlootR. A. (1983), “Different Models in the Approach to the Doctor-Patient Relationship,”Psychotherapy and Psychosomatics, 39, 213–24.
66.
Porter/Novelli (1988), Seminar Results: Fear as a Persuasion Technique.Washington, DC: Porter/Novelli and The National Heart, Lung and Blood Institute.
67.
RabkinJudith G., and StrueningElmer L. (1976), “Life Events, Stress, and Illness,”Science, 194, (3 December), 1013–20.
68.
RaheR. H. (1968), “Life Change Measurement as a Predictor of Illness,”Proceedings of the Royal Society of Medicine, 61, 1124–26.
69.
RaheR. H., and LindE. (1971), “Psychosocial Factors and Sudden Cardiac Death: A Pilot Study,”Journal of Psychosomatic Research, 15, 19–24.
70.
ReynoldsThomas J., and GutmanJonathan (1984), “Advertising is Image Management,”Journal of Advertising Research, 24(February/March), 27–37.
71.
ReynoldsThomas J., and GutmanJonathan (1988), “Laddering Theory, Method, Analysis, and Interpretation,”Journal of Advertising Research, 28(February/March), 11–31.
72.
RobinsonIan (1990), “Personal Narratives, Social Careers and Medical Course: Analysing Life Trajectories in Autobiographies of People with Multiple Sclerosis,”Social Science Medicine, 30(11), 1173–86.
73.
RogersEverett M. (1983), Diffusion of Innovations.New York: The Free Press.
74.
RokeachMilton J. (1968), Beliefs, Attitudes and Values.San Francisco: Jossey Bass.
75.
RoseRobert M., David JenkinsC., and HurstMichael W. (1978), “Health Change in Air Traffic Controllers: A Prospective Study,”Psychosomatic Medicine, 40(2), 142–65.
76.
RosenstockIrwin M. (1966), “Why People Use Health Services,”Milbank Memorial Fund Quarterly, 3, Part 2 (July), 94–127.
77.
RosenstockIrwin M., StrecherVictor J., and BeckerMarshall H. (1988), “Social Learning Theory and the Health Belief Model,”Health Education Quarterly, 15(Summer), 175–83.
78.
SarasonIrwin G., JohnsonJames H., and SiegelJudith M. (1978), “Assessing the Impact of Life Changes: Development of the Life Experiences Survey,”Journal of Consulting and Clinical Psychology, 46(5), 932–46.
79.
SchainWendy S. (1990), “Physician-Patient Communication About Breast Cancer,”Surgical Clinics of North America, 70(4), 917–35.
80.
SchwenkThomas L., MarquezJohn T., Dale LefeverR., and CohenMarian (1989), “Physician and Patient Determinants of Difficult Physician-Patient Relationships,”The Journal of Family Practice, 28(January), 59–63.
81.
SheffetMary Jane, and KoppSteven W. (1990), “Advertising Prescription Drugs to the Public: Headache or Relief?”Journal of Public Policy and Marketing, 9, 42–61.
82.
ShugarGerald R. (1986), “Mixed Opinions on Direct-to-Consumer Advertising,”Medical Marketing & Media, 21(August), 36–41.
83.
SlovicPaul, FishhoffBaruch, and LichtensteinSarah (1978), “Accident Probabilities and Seat Belt Usage: A Psychological Perspective,”Accident Analysis and Prevention, 10, 281.
84.
SullivanGary L., and JoyceMary L. (1981), “The Impact of Preventive Health Education Programs on Beliefs, Attitudes and Behavioral Intentions: Experimental Investigation of a Breast Self-Examination Program,”Journal of Health Care Marketing, 1(Summer), 32–43.
85.
TannerJohn F.Jr., HuntJames B., and EpprightDavid R. (1991), “The Protection Motivation Model: A Normative Model of Fear Appeals,”Journal of Marketing, 55(July), 36–45.
86.
TanouyeElyse (1992), “Drug Firms Start ‘Compliance’ Programs Reminding Patients to Take Their Pills,”Wall Street Journal (March 25) B1, B5.
87.
TanouyeElyse (1993), “Similar Drugs Vary in Effect on Well-Being,”Wall Street Journal (April 1)B1, B6.
88.
TestaMarcia A., AndersonRichard B., NackleyJohanna F., HollenbergNorman K., and the Quality-of-Life Hypertension Study Group (1993), “Quality of Life and Antihypertensive Therapy in Men: A Comparison of Catopril and Enalapril,”New England Journal of Medicine, 328(13), 907–13.
89.
TestaMarcia A., HollenbergNorman K., AndersonRichard B., and WilliamsGordon H. (1991), “Assessment of Quality of Life by Patient and Spouse During Antihypertensive Therapy with Atenolol and Nifedipine Gastrointestinal Therapeutic System,”American Journal of Hypertension, 4(4), 363–73.
90.
TestaMarcia A., SudilovskyAbraham, RippeyRobert M., and WilliamsGordon H. (1989), “A Short Form for Clinical Assessment of Quality of Life Among Hypertensive Patients,”American Journal of Preventive Medicine, 5(2), 82–89.
91.
UusitaloLiisa (1982), “Environmental Impact of Changes in Consumption Styles,”Journal of Macromarketing, 2(2), 16–30.
92.
Valette-FlorencePierre, and RapacchiBernard (1991), “Improvements in Means-End Chain Analysis Using Graph Theory and Correspondence Analysis,”Journal of Advertising Research, 31(February/March), 30–45.
93.
VenkatramanMeera P. (1988), “Investigating Differences in the Roles of Enduring and Instrumentally Involved Consumers in the Diffusion Process,” in Advances in Consumer Research, 15, HoustonM. J., ed. Provo, UT: Association for Consumer Research,299–303.
94.
VinokurA., and SelzerM. L. (1975), “Desirable Versus Undesirable Life Events: Their Relationship to Stress and Mental Distress,”Journal of Personality and Social Psychology, 32, 329–37.
95.
VinsonDonald E., ScottJerome E., and LamontLawrence M. (1977), “The Role of Personal Values in Marketing and Consumer Behavior,”Journal of Marketing, 41(April), 44–50.
96.
WellerSusan C. (1984), “Consistency and Concensus Among Informants: Disease Concepts in a Rural Mexican Village,”American Anthropologist, 86, 966–75.
97.
WessonDonald R., and SmithDavid E. (1990), “Prescription Drug Abuse—Patient, Physician, and Cultural Responsibilities,”Western Journal of Medicine, 152(May), 613–16.
98.
WrightPeter, and WeitzBarton (1977), “Time Horizon Effects on Product Evaluation Strategies,”Journal of Marketing Research, 14(November), 429–43.
99.
WylerA. R., MasudaM., and HolmesT. H. (1971), “Magnitude of Life Events and Seriousness of Illness,”Psychosomatic Medicine, 33, 115–22.
