To address inconclusive prior research, we conduct a comprehensive evaluation and systematic review of humor appeals' usefulness in health communication on message processing, attitudinal, and behavioral outcomes. Specifically, we investigate previously examined boundary conditions and intervening processes. Following PRISMA guidelines, this systematic review examines the state of knowledge based on 48 eligible articles presenting 62 experimental studies that manipulate humorous message appeals. We find that humor appeals influence attitudinal and behavioral message outcomes but caution against their use with certain audiences (e.g., youth and parents), severe or high-risk health conditions, or conditions that affect vulnerable populations. In addition, fear arousal, anxiety, argument strength, and reactance intervene in humor appeals' relationships with message processing and persuasion outcomes in health communication campaigns. Findings identify some advantages of humor appeals for public health message design strategies. First, humor appeals appear particularly useful among audiences who lack the motivation or ability to process health messages. Second, humor appeals help defuse emotional distress related to health conditions or treatments.

Cultural values shape consumer responses to advertising appeals. This study examines whether greater global media consumption and trade integration lead to cross-cultural convergence in rational and emotional appeals through a longitudinal content analysis of 7,505 US and Swedish advertisements. The United States and Sweden are well-suited to investigate global media consumption's influence as both routinely consume English-language media content on many US-based media platforms and are socio-economically similar but have several opposing cultural values. Although cultural value differences were reflected in more rational Swedish advertising but more emotional US advertising in the 2010s, we observed considerably more similarity across cultures by the mid-2020s. Binary logistic regression also demonstrates culture and decade main effects on positive and negative emotional appeals. We investigate prevalence and change in specific appeals (e.g. fear, guilt, humor, sex) and advance understanding of evolving industry practices in the US and Sweden related to these appeals.

This study provides a comprehensive assessment and synthesis of the literature on short-selling. It performs a lexicometric analysis, providing a quantitative review of 1093 peer-reviewed journal articles to identify and illustrate the main themes in short-selling research. Almost half the published literature on short-selling is thematically clustered around portfolio management techniques. Other key themes involve short-selling as it relates to risk management, strategic management, and market irregularities. Descending hierarchical classification examines the overall structure of the textual corpus of the short-selling literature and the relationships between its key terms. Similarity analysis reveals that the short-selling literature is highly concentrated, with most conceptual groups closely aligned and fitting into overlapping or conceptually similar areas. Some notable groups highlight prior short-selling studies of market dynamics, behavioral factors, technological advancements, and regulatory frameworks, which can serve as a foundation for market regulators to make more informed decisions that enhance overall market stability. Additionally, this study proposes a conceptual framework in which short-selling can be either a driver or an outcome by integrating the literature on its antecedents, consequences, explanatory variables, and boundary conditions. Finally, it suggests directions for future research.

While fear appeals often appear in health-oriented Public Service Announcements (PSAs), three experiments demonstrate that a positive appeal, hope, can be effectively used in PSAs to promote healthy eating when combined with an allusion, a type of figurative language. Specifically, Study 1 uses eye-tracking to establish that allusion moderates hope's encouragement of visual attention and engagement. Study 2 ' s experiment illustrates how allusion moderates hope's influence on message outcomes. Study 3 tests whether self-efficacy mediates the relationships between hope and allusion on message outcomes using Hayes PROCESS modeling. Results support self-efficacy's mediation of the hope-allusion interaction on message response outcomes. One contribution is the investigation of a multimodal allusion incorporating both visual and verbal elements and its ability to enhance message effectiveness. This study also advances the theoretical understanding of the use of positive emotional appeals and the power of self-efficacy to account for their effects in health promotion PSAs.

Patients require important information when prescribed medications. For example, the U.S. Food and Drug Administration (FDA) requires that promotional information includes a fair balance of risks and benefits. This study evaluates how well legitimate online pharmacies (LOPs) and illegitimate online pharmacies (IOPs) comply with the spirit of the FDA’s fair balance guidelines by examining the extent and equivalence of risk and benefit information on their websites. This study analyzed the content of 307 online pharmacy websites. Most (90.3%) communicated drug benefits, while 84.7% provided risks. Both risk and benefit information was moderately extensive. Presentation of risks and benefits differed between online pharmacy types. Compared to LOPs, IOPs were more likely to present risk information but also exaggerate benefits. Four in ten online pharmacies presented a fair balance of risks and benefits. However, LOPs (47.4%) were more likely to present a fair balance than IOPs (36.5%). Interestingly, IOPs were more likely to disclose instructions for use and overdose information than LOPs. These findings underscore the need for regulatory guidelines to encourage online pharmacies to present a fair balance of benefit and risk information. Also, pharmacists should develop online approaches to better fulfill their professional responsibility as drug information providers while maintaining their integrity and objectivity.

This systematic review of 54 cross-disciplinary peer-reviewed causal empirical studies helps public health officials, researchers, and healthcare professionals better comprehend the effects of fear appeals in vaccine promotional campaigns on message processing, persuasion, vaccination attitudes, and vaccination intentions. This review documents inconsistent findings across studies, which it attempts to clarify by considering differences in research designs, sample populations, and outcomes measured. In general, we find that fear appeals increase risk perceptions, message involvement, and vaccination attitudes. However, fear appeals have less influence on vaccination intentions, especially among female and general adult populations or populations from the U.S. and other Western cultures. On the other hand, the effect of fear appeals on vaccination intentions is stronger among student populations and those from China (People’s Republic of China and Hong Kong) and other non-Western cultures. Also, fear appeals are less persuasive when promoting COVID-19 vaccines and boosters than they are for other vaccines (e.g., HPV, influenza, MMR). Future research should compare fear appeal effectiveness in messages across vaccines or when combined with other executional elements, such as the endorser or type of evidence provided. Finally, future studies should explore other methodological approaches and measure underexplored message outcomes, such as vaccine uptake behavior, in more naturalistic settings.

Objective: Consumers increasingly buy pharmaceuticals online. No scoping review has been carried out to summarize and synthesize the studies that have identified drivers of consumers’ purchase intention and behavior from online pharmacies. Thus, we conducted a scoping review to explore the extent to which prior research has studied consumer purchase intentions and behavior related to online pharmacies, the drivers previously identified to explain consumers’ online pharmacy purchase intentions and behavior, and how these antecedents differ between OTC and prescription medications. Then, we identified gaps in the published literature to form a comprehensive theory-based agenda for future research.Methods: We searched PubMed, Web of Science, and Scopus to retrieve relevant studies published in English in peer-reviewed journals. The search strategy identified forty-eight eligible studies.Results: We identified twelve types of factors influencing purchase intentions and behaviors from online pharmacies: demographics, convenience, availability, price, evaluations of the purchase environment, information sources, internet usage, prior experience, perceived risk, health insurance, privacy, and product. Our analysis also revealed differences between OTC and prescription medications in drivers of purchase intentions and behaviors.Conclusion: While demographic factors tended to be the most often measured influences on intentions and behavior, their role was generally inconsistent, with many contradictory results. However, other factors (e.g., convenience, availability, lower prices, and favorable evaluations toward the purchase environment) more consistently enhanced online medication purchase intentions and behavior. An extensive agenda for future research is advanced.

As the COVID-19 pandemic continues and transitions to an endemic stage, booster vaccines will play an important role in personal and public health. However, convincing people to take boosters continues to be a key obstacle. This study systematically analyzed research that examined the predictors of COVID-19 booster vaccine hesitancy. A search of PubMed, Medline, CINAHL, Web of Science, and Scopus uncovered 42 eligible studies. Globally, the average COVID-19 booster vaccination hesitancy rate was 30.72%. Thirteen key factors influencing booster hesitancy emerged from the literature: demographics (gender, age, education, income, occupation, employment status, ethnicity, and marital status), geographical influences (country, region, and residency), adverse events, perceived benefit/efficacy, perceived susceptibility, perceived severity, prior history of COVID-19 infection, vaccination status, vaccination recommendations, health status, knowledge and information, skepticism/distrust/conspiracy theories, and vaccine type. Vaccine communication campaigns and interventions for COVID boosters should focus on factors influencing booster confidence, complacency, and convenience.

This scoping review presents the extent and nature of the body of literature on illicit online pharmacies (IOPs) and identifies research gaps. Using the five-step framework developed by Arksey and O’Malley, we searched PubMed, Web of Science, EMBASE, CINAHL, Science Direct and PsycInfo to retrieve relevant studies published in English in peer-reviewed journals. The search strategy identified forty-three articles that met the inclusion criteria. Ten themes were identified and categorized into five clusters: patient risk, healthcare providers, marketing and supply chain, public health and society, and policy and regulation. Research into these clusters has evolved over time and has focused increasingly on issues related to specific drugs rather than the overall phenomenon. Data collection has been dominated by convenience sampling, online searches, content analysis and surveys. Data analysis remains primarily descriptive. Gaps within the extant literature suggest an agenda for future research into regulation and enforcement; public health awareness and education; healthcare services; risks to patients and public health; patient-, price- and product-related issues; website design; social media promotion; and supply chains and logistics. We conclude that IOPs are vastly understudied and suggest an urgent need for further empirical and conclusive research.

Consumers increasingly use online pharmacies. However, illicit online pharmacies endanger consumer welfare with unapproved and counterfeit drugs. By linking Food and Drug Administration (FDA) warning letter content with observations of the 1108 websites cited in those letters, we identify factors associated with FDA requested compliance and active/inactive website status. One in five online pharmacies failed to comply with FDA recommendations. Findings support the cost/benefit, social norm, and instrumental theories of compliance. Compliance declines with cost (e.g., when the FDA requests changes to more drug categories). Organized crime's social norms encourage law breaking; thus, illicit pharmacies comply less than other online pharmacies. Instrumental theory suggests perceived severity and certainty of penalties influences compliance. In support, when political will and attention focused on the opioid crisis, the FDA cited primarily opioid-related violations and these opioid-related letters increased compliance and website closures. Finally, we recommend improved consumer protection efforts to address internet pharmaceutical distribution challenges.

Female and male endorsers, both young and old, are often featured in B2B advertisements. However, our current understanding of gender and age effects in B2B advertising is limited. In this research, the authors explore the effects of endorser gender and age on attention, recall, endorser-brand fit, and brand attitudes among organizational purchase decision-makers. An exploratory content analysis and three experiments were conducted—the content analysis established the varied gender depictions of models in popular business magazine ads. In Study 1, eye tracking established gaze behaviors of business professionals viewing a B2B ad featuring a man, a woman, or no person. Study 2 supports the hypothesis that gender-based endorser-brand fit mediates the relationship between endorser’s gender in B2B ads and utilitarian attitudes towards the brand. Study 3 showed no appreciable difference in endorser-brand fit perceptions or attitudes towards the brand attributable to whether the endorser was young or old.

Complementary and alternative medicine consist of variety of health care approaches such as the use of natural products (e.g. dietary supplements and herbal medicine) or mind-body practices (e.g. acupuncture, chiropractic care) (NIH 2018). The 2012 National Health Interview Survey reveals that 30 percent of adults and 12 percent of children use nonconventional medical care; with Americans spending 30.2 billion U.S. dollars for adults and 1.9 billion U.S. dollars for children on complementary health care services (NIH 2016). Despite growing trends in CAM consumption, the extant marketing literature in the area is limited and narrowly focused on health claims, information processing, or consumer values (e.g. Bolton 2008; Homer and Mukherjee 2019; Mason and Scammon 2011). The goal of the current research is to explore practitioner-based CAM offerings and their use by consumers from a provider’s perspective. What benefits and value do CAM providers believe they are offering, compared to conventional medical services? What types of consumers do they target and how do they go about it? What insights can they provide about these consumers? Exploratory expert interviews with prominent CAM providers in a mid-sized East Coast U.S. city offer preliminary answers to these questions. Based on CAM provider experiences and perceptions, patients seek CAM services because their needs are not being met by conventional medical services. These unmet needs are not only due to shortcomings related to interpersonal factors (communication, time with doctor) but also to technical shortcomings (undiagnosed or unsolved medical problems). CAM providers in this study describe their patients as proactive, engaged, well-informed, and having unmet needs. A new and surprising finding is that CAM providers cherry-pick patients who are likely to be compliant with recommendations of diagnostics, diets, exercise, and herbal supplements; and who can afford all these products and services, which are likely neither regulated nor tested for efficacy. Conventional healthcare providers seem to be failing at meeting the needs of a growing segment of consumers.

Purpose Two studies investigate how different structural properties of images – symmetry (vertical and horizontal) and image contrast – affect social media marketing outcomes of consumer liking and engagement. Design/methodology/approach In Study 1’s experiment, 361 participants responded to social media marketing images that varied in vertical or horizontal symmetry and level of image contrast. Study 2 analyzes field data on 610 Instagram posts. Findings Study 1 demonstrates that vertical or horizontal symmetry and high image contrast increase consumer liking of social media marketing images, and that processing fluency and aesthetic response mediate these relationships. Study 2 reveals that symmetry and high image contrast improve consumer engagement on social media (number of “likes” and comments). Research limitations/implications These studies extend theory regarding processing fluency’s and aesthetic response’s roles in consumer outcomes within social media marketing. Image posts’ structural properties affect processing fluency and aesthetic response without altering brand information or advertising content. Practical implications Because consumer liking of marketing communications (e.g. social media posts) predicts persuasion and sales, results should help marketers design more effective posts and achieve brand-building and behavioral objectives. Based on the results, marketers are urged to consider the processing fluency and aesthetic response associated with any image developed for social media marketing. Originality/value Addressing the lack of empirical investigations in the existing literature, the reported studies demonstrate that effects of symmetry and image contrast in generating liking are driven by processing fluency and aesthetic response. Additionally, these studies establish novel effects of images’ structural properties on consumer engagement with brand-based social media marketing communications.

This systematic review of cross-disciplinary peer-reviewed quantitative research into pharmaceutical marketing ethical issues from 1990 to 2021 reveals a focus on direct-to-consumer advertising and physician-directed promotion. This review documents inconsistent findings across studies due to discrepancies and limitations in research designs, study populations, sampling procedures, and analytical approaches as well as discipline-specific biases and normative ethical ideologies. We present a comprehensive taxonomy of ethical issues from the systematic review, additional scholarly and industry publications, and expert interviews. We recommend that future research test causal inferences, use rigorous research designs, explore under-researched topics, resolve conflicting findings, and incorporate ethical theories.

Purpose The purpose of this paper is to investigate masculinity in Chinese social media marketing for global luxury fashion brands through two studies. Design/methodology/approach Study 1 compares physical characteristics of males in visually oriented US (Instagram) and Chinese (Weibo) social media posts promoting global luxury fashion magazine brands (e.g. Vogue, Cosmopolitan, GQ and Esquire ). Study 2 examines the prevalence of and Chinese consumers’ responses (reposts, comments and likes) to different masculinities depicted in luxury fashion brand-sponsored Weibo posts. Findings Male portrayals for Chinese audiences feature more characteristics associated with emerging East Asian hybrid masculinities – “Little Fresh Meat” (LFM) and “Old Grilled Meat” (OGM) – than associated with global or regional hegemonic masculinity (i.e. the scholarly Wén and action-oriented Wu). Wén remains common in social media posts for luxury fashion goods, but LFM and OGM engender more consumer responses. Practical implications Chinese luxury fashion marketing depicts masculinity more similarly to other East Asian marketing than to Western marketing. Some luxury fashion brands are struggling for acceptance among Chinese youth. Luxury fashion marketers should incorporate hybrid rather than hegemonic masculinities to prompt more favorable responses among Chinese consumers, especially younger female target markets. Originality/value Growing female occupational and consumer power and shifting male employment from blue-collar to white-collar jobs have influenced media portrayals of masculinity. Social media marketing for luxury fashion brands demonstrates the prevalence and appeal of hybrid masculinities in China.

Despite widespread use in advertising, scholars have not been able to agree if taboo themes have a positive effect on advertising outcomes. The conflicting findings in prior research are further complicated from using self-report and indirect attention measures. The current study includes responses to 23 actual advertisements using a combination of eye-tracking and self-report data to understand attention and recall effects relating to the brand-identifying elements in ads. Findings indicate that taboo positively affects recall and attention, and attention to brand-identifying information also influences recall. The results demonstrate that taboo increases time to first fixation and fixation count for both product images and brand logos. Thus, taboo seems to encourage processing of brand- identifying information. Additionally, high ad complexity mitigated the effects of taboo on attention. Together, the results suggest a holistic approach to considering how attention is allocated to different areas of the ad.

Despite ease of processing from greater prior knowledge and expertise, high-familiarity consumers often fail to process product-specific information more than low-familiarity consumers. This paradox of familiarity makes reaching consumers particularly difficult for new brands of familiar products. A creative execution corollary proposes that sufficiently engaging executions should motivate advertising engagement such that high-familiarity consumers' experience and well-developed associative networks permit them to locate and retain relevant information better than low-familiarity consumers. Two experiments demonstrate that sufficient creative executions (i.e., humor and/or athlete endorsers) enhance attention, processing, and recall of brand-relevant information for a familiar versus unfamiliar product, but no difference when advertisements feature insufficient or no creative executions.

Purpose Government policy mandates information disclosure in financial communications to protect consumer welfare. Unfortunately, low readability can hamper information disclosures' meaningful benefits to financial decision making. Thus, this experiment tests the product evaluation and decision satisfaction of Korean consumers with less or more subjective knowledge and with or without personal finance education. Design/methodology/approach A between-subjects experiment examined responses of a nationally representative sample of 400 Korean consumers toward a Korean-language credit card advertisement. Findings Financial knowledge improves financial product evaluation and decision satisfaction. More readable disclosures improved evaluation and satisfaction among less knowledgeable consumers. Less readable disclosures did not. Consumers without financial education exhibited lower evaluations and decision satisfaction regardless of readability. More knowledgeable consumers and those with financial education performed equally well regardless of disclosure readability. Practical implications Financial service providers seeking more accurate evaluations and better decision satisfaction among their customers should use easier-to-read disclosures when targeting consumers with less prior financial knowledge. Social implications One-size-fits-all financial communications are unlikely to achieve public policy or consumer well-being goals. Government-mandated information should be complemented by augmenting financial knowledge and providing personal finance training. Originality/value Although almost a quarter of the world's population lives in East Asia, this is the first examination of readability in disclosures written in East Asian characters rather than a Western alphabet. Previous readability research on Asian-originating financial disclosures has been conducted on English-language texts. This study extends knowledge of readability effects to growing East Asian markets.

We compare six taxonomies (including some not previously tested) that systematically categorize visual rhetorical figures (RFs) on their domain coverage, reliability, parsimony, and predictive validity to determine which is best for advertisers and researchers. All taxonomies showed increased effectiveness with RFs than without RFs in a sample of 952 copy-tested advertisements. However, one taxonomy-that of McQuarrie and Mick -demonstrated the best balance of the criteria for a useful taxonomy including predictive validity. Ads containing RFs from each of their visual RF categories improved ad effectiveness measures related to Starch Noted, Associated, and Read Most scores as predicted by theory.