CONSUMER UNDERSTANDING AND USE OF HEALTH INFORMATION ON PRODUCT LABELS: MARKETING IMPLICATIONS FOR FUNCTIONAL FOOD

In recent years, the numbers of functional foods being developed and subjected to scientific evaluation have increased substantially. The main characteristic of functional foods that distinguishes them from conventional foods is the potential health benefit, which can be considered to be a credence attribute of product quality. Because this characteristic cannot be easily assessed even after consumption, an asymmetric information environment for health benefits has emerged where producers have more information than consumers. Thus the government intervenes by regulating the provision of health information on product labels in order to avoid potential market failures. The Food and Drug Administration (FDA) recently amended the way health claims on labels of conventional food and dietary supplements are managed. The new policy on qualified health claims allows claims to be made based on different levels of supporting scientific evidence. The policy goal is to encourage firms to make accurate, science-based claims about the health benefits of their products while helping consumers prevent disease and improve their health through sound dietary decisions using nutrition information. This marks a break from the previous environment where a lengthy approval process was argued to provide a road block for food firms wanting to market functional foods based on emerging evidence of diet to health links. This study has two objectives. First, to determine how consumers use health and nutrition information on food labels to form judgments about product quality, using the Elaboration Likelihood Model (ELM) as a theoretical framework. Second, to examine whether consumers can differentiate various levels of health claims, specifically the new qualified language, approved by FDA in 2003. It is interesting to determine whether consumers understand the different levels of scientific evidence supporting such claims and whether they can distinguish between the disclaimer languages used. Understanding how consumers use health and nutrition information on product labels has implications for both public policy and food manufacturers who use health claims as tools to market their products e.g., functional foods. This study used a still hypothetical functional food product a wheat cracker containing soy protein. It has been shown that soluble fiber and isoflavones, which can be found in wheat and soy products, respectively, independently help prevent the risk of several maladies including cancer and heart disease. A 5 (claim information on the front label a control condition and the four levels of qualified health claim) x 2 (information on Nutrition Facts) between-subjects factorial design was applied. Five versions of claim information were manipulated, including a control condition and four levels of qualified health claim. Each claim contained explicit relationships between nutrients and diseases i.e., isoflavones - heart disease and soluble fiber - cancers, but had different disclaimers explaining the level of scientific evidence supporting the claim. A report card was also included to inform consumers about the various claim levels, ranging from level A to D. Information on the Nutrition Facts panel was manipulated representing a "healthy" and an "unhealthy" version. Three hundred and seventy-two undergraduate students participated in the study, receiving extra credit for a Marketing class. Several multi-item scales are used as dependent variables, including attitude toward the product, buying intention, strength of evaluation about scientific studies to support claim, confidence about claim statement, perception of product's health benefit, and information search. A univariate analysis of variance (ANOVA) is conducted to test main and interaction effects among independent variables on a dependent variable. The results of this study suggest that consumers pay attention to information from all sources including the front label and Nutrition Facts panel. Even though it is shown that consumers react more positively to versions with health claims, there is no evidence to support the first hypothesis that consumers are more careful in evaluating product quality when health and nutrition information is present on the front package. Nevertheless, consumers are able to differentiate healthy products from unhealthy products, regardless of the presence of health and nutrition information on the front label. This study examines whether consumers understand and can distinguish various levels of qualified health claims. Although evidence suggests that consumers react differently to various claim levels, it is not clear whether people understand differences in the scientific support of these claims, as described in the disclaimer. Despite an increasing trend in attitude and purchase intention from the weakest claim (level D) to the strongest claim (level A), there is no statistically significant difference among claim levels when using measures of evaluation of strength of scientific studies, confidence about claim information, and perception of product's health benefit. From the public policy perspective, the results of this study can help determine how consumers evaluate health and nutrition information. It is shown that consumers do not overlook information from other parts of the label specifically the Nutrition Facts panel and that the presence of health and nutrition information on the front label is not likely to mislead consumers. The key issue here that needs further investigation is how to effectively provide information on the front label to consumers. FDA's goal is to permit the use of more, better, easily understood, and up-to-date scientific information about how dietary choices can affect consumers' health on food labels. It is important to identify optimal levels of qualified health claims, perhaps only two levels instead of four levels, so that consumers can distinguish and understand differences in terms of the scientific support for the claims and product benefits. As for the food industry, the results of this study can help food manufacturers decide what level of health and nutrition information they should provide to consumers. In addition to understanding the petitioning procedures for different claims, food firms must determine which, how, and when consumers understand and use health information in order to find the most efficient marketing communication channels.Health Economics and Policy,

Interventions to Assist Health Consumers to Find Reliable Online Health Information: A Comprehensive Review

BACKGROUND: Health information on the Internet is ubiquitous, and its use by health consumers prevalent. Finding and understanding relevant online health information, and determining content reliability, pose real challenges for many health consumers. PURPOSE: To identify the types of interventions that have been implemented to assist health consumers to find reliable online health information, and where possible, describe and compare the types of outcomes studied. DATA SOURCES: PubMed, PsycINFO, CINAHL Plus and Cochrane Library databases; WorldCat and Scirus ‘gray literature’ search engines; and manual review of reference lists of selected publications. STUDY SELECTION: Publications were selected by firstly screening title, abstract, and then full text.DATA EXTRACTION: Seven publications met the inclusion criteria, and were summarized in a data extraction form. The form incorporated the PICOS (Population Intervention Comparators Outcomes and Study Design) Model. Two eligible gray literature papers were also reported. DATA SYNTHESIS: Relevant data from included studies were tabulated to enable descriptive comparison. A brief critique of each study was included in the tables. This review was unable to follow systematic review methods due to the paucity of research and humanistic interventions reported. LIMITATIONS: While extensive, the gray literature search may have had limited reach in some countries. The paucity of research on this topic limits conclusions that may be drawn.CONCLUSIONS: The few eligible studies predominantly adopted a didactic approach to assisting health consumers, whereby consumers were either taught how to find credible websites, or how to use the Internet. Common types of outcomes studied include knowledge and skills pertaining to Internet use and searching for reliable health information. These outcomes were predominantly self-assessed by participants. There is potential for further research to explore other avenues for assisting health consumers to find reliable online health information, and to assess outcomes via objective measures

Information Systems and Healthcare XXII: Characterizing and Visualizing the Quality of Health Information

We all need ways to assess the quality of the information we look for, but this task is critically important when we are seeking health information. Healthcare consumers increasingly seek and use health information to address their health concerns. However, many health consumers lack the time and expertise required to make solid judgments about the quality of health information they encounter. A full range of quality appraisal methods for health information offer help, yet health consumers use those methods infrequently. Health consumers need better support to overcome barriers to efficiency, scalability, and transparency often associated with this breadth of valuable methods. Furthermore, they need ways to assess the quality of health information they find in the context of their own, individually situated needs. Our goals were to investigate the concept of health information quality and to explore how we can provide health consumers with better support by highlighting, rather than hiding, important aspects of health information quality. First, by reviewing and synthesizing criteria used by a broad range of quality appraisal methods for health information, we identified four focal characteristics of health information quality: content, reference, authorship, and publisher. Together, these four characteristics of intrinsic quality provide an organizing framework for health consumers to assess the quality of health information along multiple dimensions according to their own needs. Next, we used a user-center approach to design a prototype tool that concretely illustrates our framework by allowing the user to highlight multiple dimensions of health information quality. We present a usage case example of this illustrative tool, which visualizes the quality of MEDLINE search results. Our work provides a new perspective on health information quality by acknowledging and supporting consumers\u27 needs for transparency and flexibility as they take a prominent role in health information quality assessment

Are Health Videos from Hospitals, Health Organizations, and Active Users Available to Health Consumers? An Analysis of Diabetes Health Video Ranking in YouTube

Health consumers are increasingly using the Internet to search for health information. The existence of overloaded, inaccurate, obsolete, or simply incorrect health information available on the Internet is a serious obstacle for finding relevant and good-quality data that actually helps patients. Search engines of multimedia Internet platforms are thought to help users to find relevant information according to their search. But, is the information recovered by those search engines from quality sources? Is the health information uploaded from reliable sources, such as hospitals and health organizations, easily available to patients? The availability of videos is directly related to the ranking position in YouTube search. The higher the ranking of the information is, the more accessible it is. The aim of this study is to analyze the ranking evolution of diabetes health videos on YouTube in order to discover how videos from reliable channels, such as hospitals and health organizations, are evolving in the ranking. The analysis was done by tracking the ranking of 2372 videos on a daily basis during a 30-day period using 20 diabetes-related queries. Our conclusions are that the current YouTube algorithm favors the presence of reliable videos in upper rank positions in diabetes-related searches.Fernández Llatas, C.; Traver Salcedo, V.; Borrás Morell, JE.; Martinez-Millana, A.; Karlsen, R. (2017). Are Health Videos from Hospitals, Health Organizations, and Active Users Available to Health Consumers? An Analysis of Diabetes Health Video Ranking in YouTube. Computational and Mathematical Methods in Medicine. 2017:1-9. doi:10.1155/2017/8194940S19201

An Evaluation of Breast Cancer Website: Assessing the Readability of Breast Cancer Websites for The Public.

Patients including breast cancer patients’ participation in the management of their health is now an important practice and they need information about their condition for them to make an informed decision about their health. This information can be sought through various media and internet has been found to be the most important medium even for cancer patients. Literature has shown the recommended readability level of online health consumers to be sixth grade level. Websites were selected by trying to mimic how the public search for breast cancer information on the internet. These websites were then evaluated using a readability tests. This study found out that readability is poor with all the websites written above the recommended grade level for health information. Information about breast cancer can be found on the internet by the public. The readability of online health information is a very serious issue. Keywords: Readability, Informed patient, health information online, internet

Three Essays on the Empowerment Role of Information Technology in Healthcare Services

Information technology (IT) is empowering consumers, service providers, and inventor teams with superior services. Various IT innovations are enabling diverse groups of people to search, exchange, and learn from information. In healthcare services, the context of the three essays of this dissertation, information resources are often not equally accessible to consumers, not transparent between patients and physicians, and hard to locate across technological domains that may be relevant to the development of breakthrough innovations. Focusing on empowering roles of IT in healthcare services, I develop a three-essay dissertation to study how IT can enable information access to (i) address health inequalities in developing regions of the world, (ii) strengthen the physician-patient relationship where patient trust in the physician has atrophied, and (iii) energize inventor teams in the development of medical device innovations. Essay 1 examines consumers’ awareness and use of mobile health that can empower consumers to access health advice information. Essay 2 investigates how online health consultation communities can empower physicians to build trust with patients, and gain social and economic advantages in competitive healthcare services. Essay 3 studies the role of digital capabilities to empower inventor teams in medical device companies by converting expertise of inventor teams into broad and deep knowledge capital and expanding knowledge production regarding medical device innovations. I adopt a pluralistic approach to collect data (surveys administered in multiple languages for Essay 1, scraping web data from online communities for Essay 2, and constructing a multisource archival panel dataset for Essay 3) and analyze data (multivariate analysis for Essay 1, multilevel modeling and econometrics for Essay 2 and Essay 3). The essays contribute to our understanding about the acceptance of empowering IT innovations, the empowering role of user-generated content in online communities for providers of credence services, and the empowering role of IT for inventor teams of healthcare innovations

Health consumers' knowledge learning in online health information seeking

With the increasing awareness of health consumers as active information seekers, the past decade has witnessed a shifting research interest from a physician-centered paradigm to a consumer-centered paradigm. Online health information seeking (OHIS) has become pervasive, with critical impacts on consumers' health. However, the inherent complexity and the uniqueness of health tasks pose new challenges to consumers in OHIS, such as a lack of adequate knowledge to formulate queries and evaluate the online resources with various qualities. OHIS is, by nature, a learning-oriented behavior, and knowledge learning is a critical component and outcome of consumers' OHIS. On the other hand, studies in the area of search as learning (SAL) have demonstrated that learning is a common phenomenon in the information-seeking process. However, the existing studies in OHIS mainly concentrated on viewing consumers' domain knowledge as a fixed value, even though consumers are involved in the knowledge learning in the OHIS. Therefore, this dissertation proposes a conceptual framework of health information search as learning (HearSAL) by linking the related models and prior studies from the two areas — OHIS and SAL — and conducts a systematic study to understand what, how, and how well health consumers can search and learn in online health information seeking, particularly for three increasing levels of learning objectives: Understand, Analyze and Evaluate. Two representative health consumer groups, laypeople and cancer patients, are targeted in this dissertation study because they share the common issue of facing barriers in searching and learning in OHIS, yet they are different due to prior topic knowledge, learning duration, and learning expectation. Following the conceptual framework HearSAL, four sub-studies are conducted with emphasis on different dimensions of health consumers' search as learning in OHIS, including the following: Study 1: a user study with laypeople that examines the method dimension (e.g., search behaviors and source selections); Study 2: an analysis of an ovarian cancer online health community that reveals the information dimension (e.g., types and amount of information); Study 3: interviews with laypeople; and Study 4: interviews with ovarian cancer patients and caregivers. The two complementary interviews highlight the outcomes of OHIS. Major results demonstrate that, (1) health consumers’ SAL behaviors and sources vary by different levels of learning objectives, and the variation is affected by the severity of health conditions; (2) Analyze is the most prevalent learning objective in the online health community, while the amount of informational support is the highest in the Evaluate level; (3) Though consumers’ prior knowledge of the Understand level is the highest, compared to higher levels, consumers still tend to achieve the most knowledge increase in the Understand level of learning; and (4) Receiving more informational support drives consumers to increase the level of learning objectives. This dissertation makes empirical, practical, theoretical and methodological contributions. The empirical studies of laypeople and ovarian cancer patients provide a deeper insight into health consumers' SAL behavior and performance in today's web environment. Based on the empirical results, practical implications are proposed for designing consumer-centered health information systems, which facilitate seeking and enhance learning. Finally, the HearSAL framework and its application in this study can serve as a theoretical and methodological basis for future explorations

The accuracy and completeness of drug information in Google snippet blocks

Introduction: Consumers commonly use the Internet for immediate drug information. In 2014, Google introduced the snippet block to programmatically search available websites to answer a question entered into the search engine without the need for the user to enter any websites. This study compared the accuracy and completeness of drug information found in Google snippet blocks to US Food and Drug Administration (FDA) medication guides. Methods: Ten outpatient drugs were selected from the 2018 Clinical Drugstats Database Medical Expenditure Panel Survey. Six questions in the medication guide for each drug were entered into the Google search engine to find the snippet block. The accuracy and completeness of drug information in the Google snippet block were quantified by two different pharmacists using a scoring system of 1 (less than 25% accurate/complete information) to 5 (100% accurate/complete information). Descriptive statistics were used to summarize the scores. Results: For five out of the six questions, the information in the Google snippets had less than 50% accuracy and completeness compared to the medication guides. The average accuracy and completeness scores of the Google snippets were highest for “What are the ingredients of [the drug]?” with scores of 3.38 (51–75%) and 3.00 (51–75%), respectively. The question on “How to take [drug]?” had the lowest score with averages of 1.00 (<25%) for both accuracy and completeness. Conclusion: Google snippets provide inaccurate and incomplete drug information when compared to FDA-approved drug medication guides. This aspect may cause patient harm; therefore, it is imperative for health care and health information professionals to provide reliable drug resources to patients and consumers if written information may be needed

Behaviors and Perceptions Concerning Online Nutrition Information Among Young Adult Midwest University Students

Since the inception of the Internet, Americans have become increasingly dependent upon this medium for gleaning information, with each new generation being more apt to seek information online. This general trend has affected, among many other things, the search for health and nutrition information. While the Internet can provide a wealth of beneficial information for users, it can pose a myriad of dangers, as well, if users do not know how to look for credible information. The objectives of this study were to determine where university students search for nutrition information and what criteria they use when seeking nutrition information online. The population sampled was from a Midwest University. Participants were selected via convenience sampling methods. Students were invited to participate in an online survey available campuswide. Data was analyzed using SPSS statistical software. This study found that 73% of students surveyed indicated they use the Internet to search for nutrition information online. Government websites and product websites were shown to be chosen most often as being visited for nutrition information. The credibility criteria most often chosen as being important included date of publication or update of information, the information’s being authored by a medical doctor, and the web address ending in “.gov.” The results of this study identified that the majority of university students sampled used the Internet when searching for nutrition information and identified several criteria that students use when determining online nutrition information’s credibility. These results can be used to help health professionals, and registered dietitians in particular, know how best to provide and promote online health and nutrition information for consumers. Young adults are leading the trend of searching for health and nutrition information online, and registered dietitians need to provide timely, and understandable information for the public in order to best meet their needs.Brenda MoecklyLynn DurrFerng-Kuo, Shiaw-FenFlorence UruakpaMaster of ScienceDepartment Not ListedCunningham Memorial Library, Terre Haute, Indianab State University.201205MastersTitle from document title page. Document formatted into 49p. : ill

A Qualitative Study

Background: Social media is frequently used by consumers and health care professionals; however, our knowledge about its use in a professional capacity by pharmacists is limited. Objective: Our aim was to investigate the professional use of social media by pharmacists. Methods: In-depth semistructured interviews were conducted with practicing pharmacists (N=31) from nine countries. Interviews were recorded, transcribed verbatim, and thematically analyzed. Results: Wikipedia, YouTube, and Facebook were the main social media platforms used. Professional use of social media included networking with peers, discussion of health and professional topics, accessing and sharing health and professional information, job searching, and professional promotion. Wikipedia was the participants’ first choice when seeking information about unfamiliar topics, or topics that were difficult to search for. Very few pharmacy-related contributions to Wikipedia were reported. YouTube, a video-sharing platform, was used for self-education. University lectures, “how-to” footage, and professionally made videos were commonly watched. No professional contribution was made to YouTube. Facebook, a general social networking site, was used for professional networking, promotion of achievements, and job advertisements. It also afforded engagement in professional discussions and information sharing among peers. Conclusions: Participants used social media in a professional capacity, specifically for accessing and sharing health and professional information among peers. Pharmacists, as medicines experts, should take a leading role in contributing to health information dissemination in these user-friendly virtual environments, to reach not only other health care professionals but also health consumers. J Med Internet Res 2016;18(9):e258 doi:10.2196/jmir.570