At the heart of the ethics debate regarding healthcare service advertising is the erosion of the trust bestowed upon physicians by patients and society at large. However, no study has empirically examined the relationship between advertising and trust in the medical profession. The current study addresses this gap using a survey of adults in a U.S. state. Contrary to some ethicists' assertions, exposure to healthcare service advertisements resulted in higher trust via a more positive attitude toward healthcare service advertising. At the same time, exposure to healthcare service advertisements was related to lower trust via a more positive attitude toward physicians who advertise: The more advertisements consumers saw, the more they liked physicians who advertised, resulting in lower trust in the medical profession. The ethics of healthcare service advertising should be understood in a broader context of access to healthcare and patient-provider relationships.

Patient portal use has been linked to increased patient engagement, improved relationships with healthcare providers, and higher patient satisfaction. The current study aimed to contribute to patient portal research by proposing the breadth of functions utilized and the breadth of healthcare entities connected as two novel ways to conceptualize and operationalize patient portal use, updating the research on the disparities in patient portal access, and examining differentiated use of patient portals beyond the dichotomy of access vs no access. We analyzed Health Information National Trends Survey (HINTS) 7 data with the full-sample person weights and replicate weights. More than two-thirds of the U.S. adult population had patient portal access, but the vast majority of them accessed patient portals less than once every two months on average. Making appointments, messaging providers, looking up test results, and viewing clinical notes were used by more than half of the U.S. adult population. Primary care providers were the most widely connected entities, with other providers, insurers, clinical labs, pharmacies, and hospitals showing a low level of connection to patients via portals. In the United States, both unequal access and differentiated use exist between sociodemographic groups, highlighting the need for continued monitoring and concerted efforts to address them. At the same time, a close examination of the factors that led to the higher access rates and beneficial uses by traditionally disadvantaged groups-women and people with poorer health-could offer effective strategies to close the gaps.

This study employed the theory of the stages of change model to assess consumers' attitudes toward farmers' markets and identify their stages of change from precontemplation, contemplation, preparation, to action. When the four stages were compared, progressively positive attitudes were observed in the order. Also, consumers in the latter three stages were consonant in their positive assessments of farmers' market foods while more divergent in their assessments of prices, ability to do all weekly grocery shopping, convenience of locations, and the impact on communities. Furthermore, consumers' attitude toward the entertainment value of farmers' markets was a differentiating factor between the precontemplation and contemplation stages. These findings shed new light on how different stages of consumer readiness influence consumer behavior toward farmers' markets. Moreover, they provide insights for developing marketing programs that address relevant consumer concerns and crafting communication message strategies tailored to each stage of farmers' market use.

Theoretical frameworks Resource-Based View (RBV) and competitive advantages have served as conceptual foundations for investigating the role of Google Maps in business success. This research has two key findings: First, an analysis of a dataset obtained by scraping local business information from Google Maps ( N = 9,445) shows that minority-owned businesses were less likely to be claimed on Google Maps and received fewer consumer review comments compared to their non-minority counterparts. Second, a comparison of Google Maps data collected before the outbreak of the COVID-19 pandemic in 2019 and follow-up data gathered in 2022 reveals higher survival rates among businesses that were claimed, utilized business attributes, or had more reviews. Together, these findings suggest that a stronger presence on Google Maps contributed to competitive advantages and business survival during the pandemic. This underscores the importance of Google Maps presence for the survival of businesses during a crisis.

Purpose: Research on direct-to-consumer health-care service advertising has not caught up with its noticeable and steady growth. In particular, there is very limited research exploring the perspectives of physicians and health-care marketers vis-a-vis consumers. To address the gap, this study aims to investigate the US physicians' and the US health-care marketers' attitudes toward health-care service advertising and their perceptions of information features in the advertisements. Design/methodology/approach: Cross-sectional surveys were conducted online in Nevada, generating a data set comprising 247 responses, 109 from physicians and 138 from health-care marketers. Independent samples t-tests were used to compare physicians and marketers in their perceptions of advertising features. Multiple linear regression was conducted to examine potential predictors of physician attitudes. Findings: Physicians exhibited negative attitudes toward advertising, whereas marketers showed positive attitudes. Physicians also showed a wider variation than marketers in their appreciation across 27 different advertisement information features, suggesting their discernment among the features that marketers did not share. Specifically, physicians rated access-related features the highest and service quality-related features the lowest, whereas marketers rated provider qualification the highest and all other features equivalently. Physicians' involvement in their organizations' advertising process was low. Younger physicians exhibited more positive attitudes. Originality/value: Stakeholder theory recommends collaboration between physicians and marketers as partners in the advertising process, and the partnership will benefit the medical profession, health-care organizations and consumers.

Marijuana use among U.S. college students is the highest since the mid-1980s. Because knowledge about marijuana and confidence in the knowledge are related to changing marijuana laws and marijuana-related messages ubiquitous in college students' information environment, we examined their relationships with use. The Structural Equation Modeling method was used to analyze the relationships using survey responses from 249 college students in an adult-use marijuana legal state. Marijuana health knowledge was related to less use, and law knowledge was related to more use. Both relationships were mediated by perceived risk. Confidence in knowledge was related to more use directly as well as indirectly via lower peer disapproval and lower perceived risk. Among various marijuana message channels, peers were the most influential, contributing to lower health knowledge and higher confidence in knowledge.

BACKGROUND:Peer support programs may be effective for supporting breastfeeding among diverse groups, and in reducing disparities. This study provides insight regarding the implementation and outcomes of a peer breastfeeding support program. RESEARCH AIMS:(1) to examine how participation affected the outcomes of breastfeeding motivation, confidence, and coping strategies; and (2) to evaluate satisfaction with the program. METHOD:This was a cross-sectional, retrospective study. Seven pilot sites in the United States uniquely implemented a federally-funded peer support program for low-income women. Data were collected using a survey and focus groups/interviews. Over 12 months, 1,296 women participated, comprising 615 peer support pairs. A total of 401 women responded to the survey. Twenty-three focus groups and 63 interviews were conducted across the seven sites. RESULTS:Participants who enrolled in the program during pregnancy: t (189) = -6.55, p < 0.001, and after the baby was born: t (170) = -2.59, p = 0.001, gained confidence in breastfeeding. More satisfied participants were more likely to breastfeed longer: F (7,352) = 12.75, p < 0.001, and cope with breastfeeding challenges: F (7,352) = 7.83, p < 0.001. CONCLUSION:Effective operation strategies of the peer breastfeeding support program have significantly influenced participant satisfaction. Introducing peer support for low-income women to share their breastfeeding experiences would be beneficial in enhancing breastfeeding rates. However, the generalizability of these findings may be limited to this U.S. federally-funded peer support program.

Patient-centered care and healthcare consumerism are dominant models of the patient-provider relationship. Positioning theory was applied to examine consumers' and physicians' positions on patient-centered care and healthcare consumerism, along with their attitudes toward direct-to-consumer healthcare service advertising and trust in the medical profession. Surveys were conducted with a convenience sample of consumers and physicians respectively. Patient-centered care was the only theoretical construct that both consumers and physicians unequivocally embraced. Both groups were either ambivalent or skeptical of the other three concepts. Between the two groups, physicians exhibited a stronger endorsement of patient-centered care and more negative attitudes toward advertising than consumers. When the relationships among the theoretical constructs were examined, a negative correlation between patient-centered care and consumerism was found among consumers. Also, patient-centered care and trust were negatively correlated in both groups. Implications of these findings are discussed for strategic communication, consumer and physician education, and future research.

Abstract Social media have emerged as a promising communication channel for promoting breastfeeding among a new generation of mothers. Yet, there is no published study reporting the effects of a large‐scale social media intervention on key breastfeeding‐related perceptions, attitudes, and behaviors. As a component of its breastfeeding promotion campaign, the Women, Infants, and Children (WIC) program implemented a 12‐month intervention using Facebook and Instagram and subsequently evaluated the outcomes by surveying WIC‐participating women (N = 832) twice, immediately before and after the intervention. Based on their level of exposure to the intervention messages, the women were retrospectively classified into two groups, resulting in a two‐group (no–low exposure vs. medium–high exposure) quasi‐experiment. Women in the medium–high exposure group, in comparison with women in the no–low exposure group, exhibited higher campaign awareness (p < .001), visits to the campaign website (p < .001), and engagement with the website content (p < .001). They also reported more positive breastfeeding attitudes (M = 17.26 vs. M = 16.51, p < .05), self‐efficacy (M = 54.48 vs. M = 49.94, p < .01), and social support (M = 27.37 vs. M = 25.11, p < .001). But they did not differ from women in the no–low exposure group in breastfeeding initiation (p > .05) and duration (p > .05). In conclusion, a social media‐based intervention resulted in more positive breastfeeding attitudes, higher self‐efficacy, and higher perceived social support. Future studies need to investigate the optimal level of intervention message dosage that prompts significant behavioral changes.

본 연구는 국내의 연기교육 방법론 확대방안의 일환으로 리차드 셰크너(Richard Schechner, 1934- )의 ‘라사박스(rasaboxes)' 연기 훈련법을 소개하는 데 있어 그 원리와 미학을 고찰하는 연구로써 실질적으로 교육현장에서 연기교육 방법론의 하나로 활용할 수 있을지에 대한 논의이다. 현재까지 미국 중심의 발전된 연기법을 겨우 답습하는 가운데 국내에서는 특히 다채로운 미디어콘텐츠나 현대공연예술에 발맞춘 새로운 연기교육 방법의 연구가 전혀 이뤄지지 못하는 실정이다. 이는 우리나라의 연기교육환경 자체가 열악하고 그에 관련한 연구가 뚜렷하지 못하며, 전문적인 연기 교육자가 부재한 현실의 폐해 때문이다. 또한, ‘신체적 행동 방법론'을 정립하며 신체의 활용을 강조한 스타니슬랍스키의 후기 연기교육이 그의 초기 연기이론이었 던 ‘정서 기억법' 비해 국내에 제대로 파급되지 못하고 제자리에 머물러있다. 급변화하는 시대를 반영하지 못하고 체계적이고 다양성이 추구되는 연기훈련이 수반되지 않은 연기는 배우에게 발전 가능성을 가져다줄 수 없다. 그 결과, 국내의 연기예술은 발전과 혁신을 기대하기 어려운 상태로 머무르게 될 것이다. 이에 대한 대안으로 연구자가 국내에 소개하려는 연기교육 방법론은 동양의 시학이라 불리는 인도의 󰡔나티아 사스트라󰡕에 제시된 라사미학을 토대로 미국 아방가르드 연극계와 이후로도 연기훈련을 선도한 라사박스 연기 훈련법이다. 셰크너와 미국의 동부 연안 예술가그룹으로부터 고안된 라사박스 연기 훈련법은 배우의 정서 반응을 기초로 하는 스타니슬랍스키의 이론과는 반대로 배우가 감정을 즉각적으로 자유롭게 조절하여 재현하는 방법을 지향한다. 또한, 이는‘진실’과 같은 요소를 사용하지 않고도 다양한 표정이나 표현까지 풍부하게 발전시킬 수가 있는 효과를 말한다. 신체적 체현이나 표현에 중점을 두고 이루어지기 때문에 라사박 스 트레이닝의 결과로 인간의 감정적 관련 사항들을 스스로 발견해내는 능력을 강화 해주는 훈련이 되는 것이다. 따라서 본 연구는 이렇게 기존과 다른 연기 훈련법을 국내의 교육현장에 소개하는 과정을 통해 연기교육의 방법론을 확장을 시도한다.

Purpose With the increasing dependence on market-based distribution of health-care resources in the USA, spending on health-care service advertisements directly targeting consumers has also increased. Previous research has shown that the ads fail to deliver information deemed essential by regulators. Nevertheless, the attitude of consumers toward health-care service advertising has been more positive than negative. The purpose of this study is to create a taxonomy of advertising information features to better describe the relationships between information features in the advertisements and consumer attitudes toward them. Design/methodology/approach A cross-sectional survey was conducted with 128 health-care consumers in a western state in the USA. Findings Factor analysis generated seven groups of information features. Among them, information features about access, cost and quality of care were rated as most helpful, whereas providers’ clinical qualifications and communication were rated least helpful. The advertising attitude measure was validated to contain two subscales, one regarding health-care service advertising and the other regarding physicians who advertise. People who highly rated the consumerism features had more positive attitudes toward health-care service advertising and people who highly rated provider clinical qualification features had more negative attitudes toward advertising physicians. Originality/value This study made methodological improvements in health-care service advertising research that would be crucial for its theoretical development. It also shed light on consumer characteristics and perceptions about information features that could influence their attitudes toward health-care service advertising.

During the COVID-19 pandemic, health experts emerged to deliver crisis messaging to a public that needed information to understand the nature of the mega-crisis and to know how to mitigate the risk of infection. Some of the public health experts were immigrants who drew attention to healthcare disparities in the U.S. and called for systemic reform of healthcare delivery. This study critically examines the health equity discourse of immigrant public health leaders (IPHLs). Employing a critical application of the IDEA Model of crisis messaging, the study interrogates how three IPHLs navigated and disrupted their stereotyped identities as “model minorities” who were medical experts and advocates of equitable healthcare.

Direct-to-consumer advertisements for healthcare services constitute a rare channel of public communication where consumers see and hear directly from their local providers and healthcare organizations. Although spending on these advertisements has increased drastically during the past decades, research on their content and effects remains rare. To fill this gap, we analyzed primetime television advertisements for healthcare services directly targeting consumers. The advertisements were collected from the two largest media markets in Nevada for one month. In total, 795 advertisements were identified, and 106 of them were non-duplicates. Analysis revealed that the advertisements focused on patients' good health outcomes by showing them smiling, going out and about, having fun with others, and enjoying rigorous physical activities. On the other hand, the advertisements focused less on the providers. Although the advertisements often showed providers in clinical settings, basic information about their professional degrees was often missing. Mentions of providers' other qualifications and professional experiences were even scarcer. Also, a substantial number of advertisements failed to show providers interacting with patients. Additional analysis of patient and provider characteristics revealed under-representation of racial or ethnic minority and older adult patients. Representation of women and minorities as providers was even more uncommon. We discussed the implications of these findings from the perspective of patient expectation and made suggestions to help providers improve their direct-to-consumer advertisements.

Patient-centered care and healthcare consumerism are the two most dominant ideas about the relationship between patients and providers in the United States. To identify providers’ positions between the two perspectives, we analyzed the content of direct-to-consumer healthcare service advertisements. The advertisements were collected in the state of Nevada ( N = 323) and their landing pages were analyzed for provider attributes, patient experience features, and terms referring to patients and providers. The results showed that the advertisements fully embraced the notion of patient-centeredness by commonly claiming patient-centered care and frequently using the term “patient.” The advertisements also contained multiple indicators of healthcare consumerism, although they avoided using the terms “consumer/customer/client” closely associated with consumerism. Contrary to the prominence of patient experience features, provider attributes were not common. An additional analysis of inter-specialty differences in advertising features confirmed the strong consumerism position of cosmetic surgery providers. Application of the healthcare service advertising analytic scheme developed for this study could help providers and healthcare administrators recognize how their advertising messages may reflect their values.

Gender differences in the risk and protective factors of marijuana use among college students were explored by analyzing online survey responses from 464 undergraduates. Women perceived higher risk and used marijuana less than men, with no gender difference in peer disapproval. In addition, women had higher objective knowledge regarding the health effects of marijuana, although they exhibited lower confidence in their knowledge. In subsequent regression analyses, health knowledge, confidence in knowledge, perceived risk, and peer disapproval predicted women's marijuana use, whereas only confidence in knowledge and perceived risk predicted men's use. These findings can help devise effective intervention strategies.

Objectives: This study explored the relationships between marijuana knowledge, confidence in knowledge, and information efficacy and marijuana use. Furthermore, the effects of the knowledge-related variables were examined on intention to use, resistance efficacy, and intention to vote for legalization. Participants: Undergraduate students (N = 215) were surveyed in Fall 2018. Methods: Data were collected online and analyzed through a series of regression analyses. Results: Higher knowledge was related to less use via higher perceived risk whereas higher confidence in knowledge was related to more use. Marijuana use was related to higher future intention to use, lower resistance self-efficacy, and intention to vote for legalization. Information efficacy was related to intention to vote for legalization only. Conclusions: Students with more knowledge were less likely to use marijuana, whereas students who considered themselves well-informed were more likely to use it. Future intervention efforts will benefit from counteracting students' misplaced confidence in their knowledge.

Background In the 1970s, the Federal Trade Commission declared that allowing medical providers to advertise directly to consumers would be “providing the public with truthful information about the price, quality or other aspects of their service.” However, our understanding of the advertising content is highly limited. Objective To assess whether direct-to-consumer medical service advertisements provide relevant information on access, quality and cost of care, a content analysis was conducted. Method Television and online advertisements for medical services directly targeting consumers were collected in two major urban centres in Nevada, USA, identifying 313 television advertisements and 200 non-duplicate online advertisements. Results Both television and online advertisements reliably conveyed information about the services provided and how to make an appointment. At the same time, less than half of the advertisements featured insurance information and hours of operation and less than a quarter of them contained information regarding the quality and price of care. The claims of quality were substantiated in even fewer advertisements. The scarcity of quality and cost information was more severe in television advertisements. Conclusion There is little evidence that medical service advertising, in its current form, would contribute to lower prices or improved quality of care by providing valuable information to consumers.

For more than two decades, health communication educators and practitioners have been working toward establishing a competency model to guide health communication education. This article reports the results of a survey to identify competencies for health communication specialists with master's degrees. To prepare the survey, a working group drafted a competency list through reviewing the literature and soliciting feedback from attendees at a professional society meeting, resulting in lists of items reflecting 18 knowledge domains, 11 skill sets, and 14 application bundles labeled "abilities." The survey asked participants to rate the 43 items in terms of their importance and provide their opinions about the preparation of health communication specialists. The survey was disseminated online through professional associations and completed by 142 participants (74 educators and 68 practitioners). Nearly all of the 43 items were rated "somewhat important" or higher. The lists were reduced to 10 knowledge domains, three skill sets, and five abilities through factor analyses. Replication of the findings and triangulation with studies employing different research methods will help advance this line of inquiry.

Purpose There is an increasing need for a better understanding of healthcare service marketing in social media. This paper aims to examine Under the framework of positioning theory, popular Instagram posts related to #plasticsurgery and their accounts were analyzed and the relationships between the posts' attributes and the number of user comments and likes were examined. Design/methodology/approach A total of 272 posts associated with #plasticsurgery and their account profiles were analyzed. Findings Plastic surgery procedures were positioned on Instagram primarily by doctors and celebrity patients who were motivated by self-promotion. Doctors often omitted their medical credential information from their account profile and posts while featuring their vanity photos, emojis and consultation solicitations. They showed patients as the objects of surgery. On the other hand, patients positioned themselves as individuals with the agency by showing their faces rather than focusing on their body parts. Instagram users responded better to the doctors who positioned themselves more as business owners than medical professionals by soliciting consultations, offering discounts, displaying surgery photos and using emojis. In responding to patient posts, Instagram users liked under-dressed images more than fully clothed images and commented more on before-and-after photos than others. Social implications In Instagram, doctors positioned themselves as self-interested providers of plastic surgery services, whereas patients positioned themselves as active consumers. Medical professionals' social media activities should be more closely monitored to protect patient safety and the trust between patients and doctors. Originality/value This study shed light on how doctors and patients position themselves on social media and how they are received by social media users in the context of #plasticsurgery on Instagram.