Using the Stages of Change Model to Choose an Optimal Health Marketing Target

Background: In the transtheoretical model of behavior change, “stages of change” are defined as Precontemplation (not even thinking about changing), Contemplation, Preparation, Action, and Maintenance (maintaining the behavior change). Marketing principles suggest that efforts should be targeted at persons most likely to “buy the product.” Objectives: To examine the effect of intervening at different stages in populations of smokers, with various numbers of people in each “stage of change.” One type of intervention would increase by 10% the probability of a person moving to the next higher stage of change, such as from Precontemplation to Contemplation. The second type would decrease by 10% the probability of relapsing to the next lower stage, such as from Maintenance to Action, and also of changing from Never Smoker to Smoker. Nine hypothetical interventions were compared with the status quo, to determine which type of intervention would provide the most improvement in population smoking. Methods: Three datasets were used to estimate the probability of moving among the stages of change for smoking. Those probabilities were used to create multi-state life tables, which yielded estimates of the expected number of years the population would spend in each stage of change starting at age 40. We estimated the effect of each hypothetical intervention, and compared the intervention effects. Several initial conditions, time horizons, and criteria for success were examined. Results: A population of 40-year-olds in Precontemplation had a further life expectancy of 36 years, of which 26 would be spent in the Maintenance stage. In a population of former and current smokers, moving more persons from the Action to the Maintenance stage (a form of relapse prevention) decreased the number of years spent smoking more than the any other intervention. In a population of 40-year-olds that included Never Smokers, primary smoking prevention was the most effective. The results varied somewhat by the choice of criterion, the length of follow-up, the initial stage distribution, the data, and the sensitivity analyses. Conclusions: In a population of 40-year-olds, smokers were likely to achieve Maintenance without an intervention. On the population basis, targeting quitters and never-smokers was more effective than targeting current smokers. This finding is supported by some principles of health marketing. Additional research should target younger ages as well as other health behaviors

Characterization of N-acetyltransferase 1 and 2 polymorphisms and haplotype analysis for inflammatory bowel disease and sporadic colorectal carcinoma

<p>Abstract</p> <p>Background</p> <p>N-acetyltransferase 1 (NAT1) and 2 (NAT2) are polymorphic isoenzymes responsible for the metabolism of numerous drugs and carcinogens. Acetylation catalyzed by NAT1 and NAT2 are important in metabolic activation of arylamines to electrophilic intermediates that initiate carcinogenesis. Inflammatory bowel diseases (IBD) consist of Crohn's disease (CD) and ulcerative colitis (UC), both are associated with increased colorectal cancer (CRC) risk. We hypothesized that <it>NAT1 </it>and/or <it>NAT2 </it>polymorphisms contribute to the increased cancer evident in IBD.</p> <p>Methods</p> <p>A case control study was performed with 729 Caucasian participants, 123 CRC, 201 CD, 167 UC, 15 IBD dysplasia/cancer and 223 controls. <it>NAT1 </it>and <it>NAT2 </it>genotyping were performed using Taqman based techniques. Eight single nucleotide polymorphisms (SNPs) were characterized for <it>NAT1 </it>and 7 SNPs for <it>NAT2</it>. Haplotype frequencies were estimated using an Expectation-Maximization (EM) method. Disease groups were compared to a control group for the frequencies at each individual SNP separately. The same groups were compared for the frequencies of <it>NAT1 </it>and <it>NAT2 </it>haplotypes and deduced NAT2 phenotypes.</p> <p>Results</p> <p>No statistically significant differences were found for any comparison. Strong linkage disequilibrium was present among both the <it>NAT1 </it>SNPs and the <it>NAT2 </it>SNPs.</p> <p>Conclusion</p> <p>This study did not demonstrate an association between <it>NAT1 </it>and <it>NAT2 </it>polymorphisms and IBD or sporadic CRC, although power calculations indicate this study had sufficient sample size to detect differences in frequency as small as 0.05 to 0.15 depending on SNP or haplotype.</p

Typologies of post-divorce coparenting and parental well-being, parenting quality and children’s psychological adjustment

First published online: 30 October 2015The aim of this study was to identify post-divorce coparenting profiles and examine whether these profiles differentiate between levels of parents’ well-being, parenting practices, and children’s psychological problems. Cluster analysis was conducted with Portuguese heterosexual divorced parents (N = 314) to yield distinct postdivorce coparenting patterns. Clusters were based on parents’ self-reported coparenting relationship assessed along four dimensions: agreement, exposure to conflict, undermining/support, and division of labor. A three cluster solution was found and replicated. Parents in the highconflict coparenting group exhibited significantly lower life satisfaction, as well as significantly higher divorce-related negative affect and inconsistent parenting than parents in undermining and cooperative coparenting clusters. The cooperative coparenting group reported higher levels of positive family functioning and lower externalizing and internalizing problems in their children. These results suggested that a positive coparenting alliance may be a protective factor for individual and family outcomes after parental divorce

Implicit Assimilation and Explicit Contrast: A Set/Reset Model of Response to Celebrity Voice-Overs

An experiment reveals that the relationship between celebrity attitude and attitude toward brands paired with the celebrity's voice is moderated by identification of the celebrity but only when attitude is measured explicitly. Using explicit measures, celebrity attitude was positively (negatively) related to brand attitude change when the evaluator could not (could) identify the celebrity. This finding is attributed to "resetting," a correction of the perceived influence from irrelevant cues. On implicit measures, a positive relationship between celebrity and brand attitude was observed regardless of celebrity identification. The disassociation between the explicit and implicit results suggests that resetting requires explicit evaluation. (c) 2005 by JOURNAL OF CONSUMER RESEARCH, Inc..

An Interpretive Frame Model of Identity-Dependent Learning: The Moderating Role of Content-State Association

Although it is well known that advertising can momentarily activate specific consumer identities and thereby influence preference for identity-relevant products, the influence of such identity activation on consumer memory is undocumented. Identity activation encourages consumers to link advertising content to their identity during encoding, and these links facilitate subsequent recognition if the identity is again activated at retrieval. This identity-dependent processing produces different recognition outcomes for information that is strongly related, moderately related, and unrelated to the identity. Identity activation at both encoding and retrieval improved recognition of advertising content moderately related to the identity but had no effect on recognition of unrelated content. Identity activation at retrieval improved recognition of strongly related content, regardless of whether identity was primed externally at encoding. These results support an interpretative frame process at encoding and suggest that content-state association is a critical moderator of state-dependent learning.

When Is Honesty The Best Policy? The Effect of Stated Company Intent on Consumer Skepticism

Prior research suggests that consumers evaluate firms more negatively if they attribute the firm's business practices to firm-serving motivations rather than to motivations that serve the public good. The authors propose an alternative hypothesis: firm-serving attributions lower evaluation of the firm only when they are inconsistent with the firm's expressed motive. As such, the negative effect of consumer skepticism regarding a firm's motives can be inhibited by public acknowledgment of the strategic benefits to the firm. The power of this inhibition procedure was demonstrated in an experiment that manipulated the salience of firm-serving benefits and the firm's publicly stated motive. Consumer evaluation of the sponsoring firm was lowest in conditions when firm-serving benefits were salient and the firm outwardly stated purely public-serving motives. This experiment also revealed that the potential negative effects of skepticism were the most pronounced when individuals engaged in causal attribution prior to company evaluation. Finally, this study measured the different effects on attribution and evaluation of two distinct forms of skepticism: situational skepticism--a momentary state of distrust of an actor's motivations--and dispositional skepticism--an individual's ongoing tendency to be suspicious of other people's motives.

Riding Coattails: When Co-Branding Helps versus Hurts Less-Known Brands

New brands often partner with well-known brands under the assumption that they will benefit from the awareness and positive associations that well-known brands yield. However, this associations-transfer explanation may not predict co-branding results when the expected benefits of the co-branded product are presented simultaneously with the co-branding information. In this case, the results of co-branding instead follow the predictions of adaptive-learning theory which posits that consumers may differentially associate each brand with the outcome as a result of cue interaction effects. Three experiments show that the presence of a well-known brand can weaken or strengthen the association between the less-known brand and the co-branding outcome depending on the timing of the presentation of product benefit information. When this information was presented simultaneously with co-branding information (at a delay after co-branding information), the presence of a well-known brand weakened (strengthened) the association of the less-known brand with the outcome and thereby lowered (improved) evaluation of the less-known brand. N ew brands face many obstacles including the need to generate awareness in an often crowded marketplace and to build unique brand associations that can help meaningfully differentiate the brand. To jumpstart the creation of these associations, new brands often leverage external entities (other brands, events, causes, countries, people, etc.) that already possess valued associations in the hope that these desired associations will transfer to the new brand (Keller 2003). The widely accepted explanation for why such secondary associations would transfer to the new brand is derived from associative network models of memory tha

Riding Coattails: When Co-Branding Helps versus Hurts Less-Known Brands

New brands often partner with well-known brands under the assumption that they will benefit from the awareness and positive associations that well-known brands yield. However, this associations-transfer explanation may not predict co-branding results when the expected benefits of the co-branded product are presented simultaneously with the co-branding information. In this case, the results of co-branding instead follow the predictions of adaptive-learning theory which posits that consumers may differentially associate each brand with the outcome as a result of cue interaction effects. Three experiments show that the presence of a well-known brand can weaken or strengthen the association between the less-known brand and the co-branding outcome depending on the timing of the presentation of product benefit information. When this information was presented simultaneously with co-branding information (at a delay after co-branding information), the presence of a well-known brand weakened (strengthened) the association of the less-known brand with the outcome and thereby lowered (improved) evaluation of the less-known brand. N ew brands face many obstacles including the need to generate awareness in an often crowded marketplace and to build unique brand associations that can help meaningfully differentiate the brand. To jumpstart the creation of these associations, new brands often leverage external entities (other brands, events, causes, countries, people, etc.) that already possess valued associations in the hope that these desired associations will transfer to the new brand (Keller 2003). The widely accepted explanation for why such secondary associations would transfer to the new brand is derived from associative network models of memory tha