The recognition and valuing of patient knowledge: a way forward

The health care that patients receive, particularly in acute care settings, is mainly based in biomedical knowledge. The scientific method of investigating health conditions has directly contributed to the development of this knowledge. This has made a significant contribution to increased survival rates, reduced recovery periods and extending the duration of life. The influence of consumerism on health‐care management has led to an expectation of increased patient involvement when making decisions about their treatment options. This assumes that the provision of information helps improve patients' understanding of the diagnosed health condition and assists them to make ‘good’ decisions. Accordingly, there is a greater focus on providing information to patients. The information provided to patients mostly involves explanation about the biomedical aspects of their health condition. However, patients also desire information about how the health condition will affect their everyday life. We call the understanding of the implications of this information ‘everyday knowledge’. Provision of this information can assist patients by helping them realize their expectations and providing reassurance to both patients and their significant others. Unfortunately, everyday knowledge that assists patients to understand and manage their daily life has not been as systematically researched or examined. While biomedical knowledge has been extensively developed and promoted through funding regimes, everyday knowledge has not benefited from the same support. The interactions in health‐care settings are influential in the generation and use of knowledge. Practises that encourage sensitivity by health professionals to each patient's situation need to be identified and implemented. An increased focus on the inclusion of everyday knowledge alongside biomedical knowledge is likely to enhance the relevance of the information that patients currently receive.     

Value co‐creation in online healthcare communities: The impact of patients’ reference frames on cure and care

The gradual transition of health care toward businesses during the past 50 years has converted passive patients into active customers. In our digital society, patients increasingly use online health communities to satisfy complex needs that healthcare professionals leave unmet, including the creation of cure‐oriented (i.e., functional) and care‐oriented (i.e., emotion) value. This research investigates patients’ reference frames (self versus other) as an information processing mechanism and their impact on value creation in online communities. The analysis of 1,687 online postings of a leading healthcare platform shows that self‐referencing is typical for information obtained through an individualistic, patient–doctor encounter; other‐referencing emerges when patients focus on the needs of their peers. Information gathered through the patient–doctor encounter and processed with a self‐referencing frame accordingly enhances cure‐related value, but limits care‐oriented value co‐creation. Other‐referencing does exactly the opposite: it creates a barrier to cure‐related value, but stimulates care‐related value. A patient's experience with the community largely moderates the impact of both self‐ and other‐referencing on cure‐ and care‐related value. These findings show that online health communities can identify and address unmet patient needs, but healthcare professionals still play a critical role in terms of ensuring information quality in online health communities.     

Process Coordination Within a Health Care Service Supply Network

There are two manifestations of supply chains in health care. One involves the supply of equipment and materials used in health care delivery. The other supply chain involves the delivery of health care itself, wherein patients supply their physical conditions and service suppliers deliver health care services. This article considers the latter supply chain, analyzing a case study in which patients have comorbidities and thus require the services of a network of multiple health care providers. In the case study, we examine three schemes for coordination of care. In the first scheme, the patient herself is expected to manage the coordination. In the second scheme, physicians are expected to coordinate the care. In the third scheme, a third‐party coordinator manages care across network members. We examine these three possible coordination alternatives using a technique known as Process‐Chain‐Network (PCN) Analysis. PCN Analysis helps us document how coordination schemes are implemented and where they may fail. Our analysis of the case study leads us to the development of ex post theory about who should initiate coordination and how it should take place under conditions of comorbidities. Empirical data coming from the case study support the theory. We describe possible applications of the theory inside and outside of health care, and show how the PCN approach can guide process innovation.     

The Impact of the Internet on Professional Relationships: The Case of Health Care

This paper considers the impact of the internet on professional services, specifically healthcare services which have been characterised as asymmetrical in information and power distribution. For complex professional services the internet is primarily an information resource offering perceived parity with professionals. Based on interviews with healthcare professionals and website managers, this paper considers how professionals perceive the internet to be changing patterns of professional–consumer interaction and the nature of professional–consumer relationships. Manifest at service encounter level and health policy level, professionals perceived the evolving parameters of the consumer role to be generating a requirement for a fundamental revision of models of service delivery and professional roles.     

Preferences for Performance versus Potential in Promotion Recommendations

As high-performing employees with high potential (or superstars) are rare in the workplace, practitioners often face a performance–potential trade-off when deciding who to promote. We use regulatory focus theory as a framework to examine whether Canadian managers (n = 58) and human resource (HR) professionals (n = 121) show a preference for performance or potential when making near-term promotion recommendations. We show that respondents generally had a preference for performance versus potential when making their recommendations, and HR professionals versus managers accorded greater weight to potential. We discuss the implications of the relative emphasis on performance versus potential in promotion recommendations and when this may contribute to organizational inefficiencies.     

Vaping Viewpoints: A Multi‐Segment Understanding of E‐Cigarette Risk Perceptions

Electronic cigarettes (e‐cigarettes) are battery‐operated devices used to deliver nicotine by vapor and are positioned as a safer alternative to traditional tobacco cigarettes. As a recent entrant to the market, little is known about how consumers perceive the health risks of these devices, raising the question of whether consumers are making informed product adoption and use choices. Study 1 evaluates different consumer usage segments (vapers, smokers, dual users, and nonusers) in terms of their level of perceived risk. Study 2 examines how different groups of consumers' risk perceptions are influenced by on‐ad warning labels. Results show that vapers operate as a distinct consumer segment with lower perceptions of harm than other segments, although illustrate greater likelihood to respond to health messaging and on‐ad warning information.     

Exploring word‐of‐mouth influences on travel decisions: friends and relatives vs. other travellers

Travel research consistently shows the importance of word‐of‐mouth (WOM) information sources in the travel decision‐making process. Friends and relatives have been identified as organic image‐formation agents, and it has been emphasized that this WOM information is one of the most relied‐upon sources of information for destination selection. While there has been recognition of the importance of WOM information sources on consumer behaviour in tourism, little has been performed to understand more specifically how and what behaviour is influenced. This study examined the differing influences of friends and relatives vs. other travellers on the travel choices and behaviours of 412 visitors to the North Queensland Region in Australia. More specifically, the present study compared the following four groups of respondents: those who indicated that they obtained travel information from friends/relatives and other travellers (n = 70); those who obtained information from friends/relatives only (n = 121); those who obtained information from other travellers only (n = 105); and those who obtained information from neither (i.e. no WOM) (n = 116). The results indicated that there were significant differences across the four groups with respect to demographic characteristics, other information sources used, accommodation and transportation used, and travel activities in the destination. However, the groups did not differ in their image of the destination.     

Estimating the effects of nutrition label use on Canadian consumer diet‐health concerns using propensity score matching

The overarching goal of nutrition labelling is to transform intrinsic credence attributes into searchable cues, which would enable consumers to make informed food choices at lower search costs. This study estimates the impact of nutrition label usage on Canadian consumers’ (n = 8,114) perceived diet‐health concerns using alternative propensity score matching (PSM) techniques. We apply a series of tests and sensitivity analyses to overcome issues of endogeneity and selection bias frequently found in studies of diet‐health behaviour and to validate the impact of exposure to nutrition facts labels for users vs. non‐users. Our results support the notion that consumer uncertainty and related food‐health concerns are linked to their information behaviour, but not in straightforward manner. Dominant subjective food attributes, such as taste, convenience and affordability, may in fact outweigh the benefits of information about healthier, alternative food choices. In order to change dietary health behaviour, food manufacturer and policy makers alike need to adopt communication instruments that better account for differences in preferences, shopping habits and overall usage patterns of nutrition labelling information.     

South African consumers' opinions and consumption of soy and soy products

Interest in soy foods has increased with consumer awareness of its health benefits, especially with soy‐related ingredients being utilized as one of the major sources of high‐protein fortification. The aim of the present study was to assess South African (SA) consumers' opinion of soy and soy products through different statements on consumption, taste, protein value and healthiness. The respondents (n = 3001) for this randomized cross‐sectional study were randomly selected from metropolitan and rural areas in South Africa. Trained fieldworkers administered questionnaires by conducting face‐to‐face interviews. Fourteen statements from four sections of the questionnaire (consisting of 17 food‐related topics in total), probing information on consumers' opinion on soy and soy products, were used. Data on 81% of the respondents (n = 2437), who had heard of soy before, were used for statistical analyses. The data were weighted to be representative of the total SA population based on gender, age and race. No practically significant differences among metropolitan and rural respondents' opinion, gender or age variables regarding any statement were found. A practically significant higher percentage (>60%) of respondents in the total population and within all race groups were positive about soy and agreed that soy is a good source of protein, has many health benefits, associated soy with meat substitutes, were aware of a number of meat substitutes and agreed that soy can replace meat in their diet. Medium to large practically significant differences were found between racial groups regarding certain statements. More Blacks and Indians (76% and 68% respectively) than Whites (25%) use soy. Almost two‐thirds of Indians (65%) and Blacks (64%) eat or drink soy products, compared with only 22% for Whites, indicating that the potential target market for soy products should be chosen accordingly. Higher percentages of Blacks than Whites also indicated that they liked the taste of soy, would use more soy if it was readily available and if a bigger product range existed and would replace cow's milk with soy milk, confirming that Blacks are more positive about soy and would use even more soy if a bigger range of soy products were available. The findings from the current study indicated that more than 70% of SA consumers believe that soy has many health benefits and more than 60% already use soy. Insight gained from this first study of its kind in SA provided valuable information to developers and marketers, and signified that consumer segmentation should be taken into consideration to focus on developing more acceptable soy products that appeal to these consumer segments that are more positive towards the taste of soy and might consume soy regularly. Within the discipline of Consumer Science, efforts to inform consumers about the advantages of soy in terms of its health benefits, and to support it in terms of a greater availability of more acceptable soy products at reasonable prices, would support the ideal of informed, responsible buying decisions across all socio‐economic groups.     

Independent decision making of adolescents regarding food choice

The adolescence period is the stage in the life cycle in which individuals begin to develop independent decision making related to their social environment including their dietary intake. The period is fundamental in the development of longer term eating habits that may be reflected in adulthood. This study aimed to investigate the decision‐making process of adolescents and their dietary behaviour in the achievement of a balanced diet and to determine the underlying factors that may affect these choices. To meet this aim, a three phase data collection was utilized. In phase 1, a baseline questionnaire (n = 239) measured factors affecting dietary behaviour and the barriers in the achievement of a balanced diet. Phase two employed and measured respondents’ (n = 235) independent decision making by rating nineteen menu choices which reflected all options of dietary guidelines. This was analyzed through conjoint analysis. In phase three a subsample (n = 55) from the first two phases completed a food map which determined underlying reasons for food decisions and choice behaviour. Results revealed that when adolescents are given free choice they tend to follow an unbalanced diet with some diets raising concerns for their current and future health. Fifty‐seven percent of respondents displayed serious concerns in their dietary choice of which 18% were identified as requiring immediate intervention. The most noticeable factors affecting dietary choice were the desire to eat foods high in fat and carbohydrates and low in fruit and vegetable consumption. Food‐mapping indicated prior knowledge and attitudes had no effect on the choices made but that that behaviour of parents in the preparation of meals at home and peers in the selection of snack choices had the most influence on the unbalanced diet.     

Is bank staff interaction associated with customer saving behavior in banks?

Major changes are underway in the U.S. retail banking sector toward heavy investments in technology and fewer in personnel. Using the 2017 survey of household economics and decision‐making (SHED) (n = 11,359), we examine the relationship between saving behavior related to emergency, long‐term and periodic expenses and personal, technological, and hybrid bank account access methods. Binary logistic regression models were used to estimate the odds of reporting various saving behaviors in relation to various banking access methods. Findings suggest that the personal access method is positively associated with savings behavior for periodic expenses for the general population, and negatively associated with emergency savings in people with lower education attainment. Technology is associated with all types of saving behavior, while the hybrid access method is associated only with saving for periodic expenses. As investments in self‐service technology increase, the importance of access methods to savings behavior must be considered.     

Information search in health care decision-making: a study of word-of-mouth and internet information users

This paper investigates how individual consumers may differ in their information search behavior in health care decision-making. Results indicate that most consumers still use word-of-mouth as a primary information source for health care decisions. However, usage of the Internet is increasing. The results of this study indicate that consumers who are most likely to use the Internet for health care information are single, younger, and less educated, whereas consumers who are most likely to use word-of-mouth are middle-aged, married, with higher income and higher education. Surprisingly, no significant gender difference was found in information search behavior for health care decision-making. The results also suggest that consumers with the highest tendency to use word-of-mouth are also the lowest users of the Internet in health care decision-making. Implications of these findings are discussed.     

‘I send the wife to the doctor’– Men's behaviour as health consumers

This paper explores men's behaviour and attitudes in relation to health matters. While there has been some practical and research progress in engaging with users of health services, there is less development in the area of engaging non‐users. In effect, all members of the society can be the consumers/users of health promotion, though not all are. This paper reports on the first stage of a wider project aimed at increasing the effectiveness of skin cancer awareness messages aimed at men. The project focuses on men over 50 from an area of socio‐economic disadvantage, since these men tend to have the lowest life expectancies in general, and the highest incidences of mortality for skin cancer both at a national and international level. The research was conducted through community‐based focus groups and while the sample was relatively, small it produced some interesting outcomes in terms of how this cohort audited and responded to public health promotion campaigns; how they perceive cancer and health issues in general; how they respond to health issues; and how they view both the public health service in Ireland and the ways health professionals relate to them. It confirms many theories about how men view their health and how they respond to health promotion campaigns. Among other points, it raises questions about the possible mixed benefits of testimonial‐based advertising. It also indicates that there may be further layers of complexity connected to identity, fatalism, problem solving and respectful treatment that have not been sufficiently articulated in the literature. It points to the need for greater engagement by service planners and providers with the needs of their target audience, which may require a more encompassing definition of service user.     

Complementary and alternative medicine: Consumers in search of wellness or an expression of need by the sick?

The provision of health care in Western societies is examined in relation to the arrival of complementary and alternative medicine (CAM) as a serious provider in the latter half of the 20th century. This article examines the underlying components of the increasing uptake of CAM and attempts to cluster health‐care consumers according to their attitudes and motivation toward the use of health‐care products and services. The analysis does not support the idea of a widespread uptake of CAM practitioner treatments on the part of the general public except for particular segments of that public, including the seriously ill. There is also little evidence of exclusive use of CAM for personal health care. On the other hand, there is significant evidence for an uptake of non‐practitioner‐based CAM by wider segments of the population. The findings raise issues regarding the evidence for the efficacy of CAM and the methodology for testing it. These are discussed. © 2004 Wiley Periodicals, Inc.     

Use of and satisfaction with managed health care benefits: a comparison by gender

Abstract: This study examines whether the use of and satisfaction with managed health care benefits differs for men and women. The findings indicate that there are significant differences in both use of and satisfaction with managed care. Further analysis shows income level is a mediating factor in how men and women fare in their experience with managed care with regard to access and cost of care. Although access to health care appears to be linked to both gender and income, problems with care received are linked to income level rather than gender.     

Marketing Novel Fruit Products: Evidence for Diverging Marketing Effects Across Different Products and Different Countries

The purpose of this study was to compare the influence of four different marketing claims and price information on consumers’ product choices for novel fruits and novel fruit products, using a choice experiment. In total, 1,652 people in Greece (n = 400), the Netherlands (n = 419), Poland (n = 423), and Spain (n = 410) participated in the study. The marketing claims entailed (1) information about scientific findings concerning health benefits, (2) social norm information, (3) information about the products’ naturalness, and (4) information about the products’ time-until-expiration. The results showed that all four marketing claims and price information influenced consumer choice, but the effect of naturalness depended on the specific novel fruit product being advertised, and the effect of time-until-expiration depended on both country and fruit product. These results suggest that marketing communications should be tailored to different national markets and to specific fruit products.