Direct-To-Consumer Advertisements and Medical Services Utilization Among Adult Dermatology ...

304 Pages·2016·5.01 MB·English

Walden University
ScholarWorks
Walden Dissertations and Doctoral Studies
Walden Dissertations and Doctoral Studies
Collection
2016
Direct-To-Consumer Advertisements and Medical
Services Utilization Among Adult Dermatology
Patients in the United States
Heribert Zouetchou
Walden University
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Walden University

School of Health and Human Services

This is to certify that the doctoral dissertation by

Heribert Zouetchou

has been found to be complete and satisfactory in all respects,
and that any and all revisions required by
the review committee have been made.

Review Committee
Dr. Mountasser Kadrie, Committee Chairperson, Health Services Faculty
Dr. Raj Singh, Committee Member, Health Services Faculty
Dr. Scott McDoniel, University Reviewer, Health Services Faculty

Chief Academic Officer
Eric Riedel, Ph.D.

Walden University
2015
Abstract

Direct-To-Consumer Advertisements and Medical Services Utilization Among Adult
Dermatology Patients in the United States
by
Heribert Zouetchou

MBA, ESSEC-University of Douala, 2004
MA, University Yaoundé I, 1998
BA, ESSEC-University of Douala, 2001
BA, University Yaoundé I, 1995

Dissertation Submitted in Partial Fulfillment
of the Requirements for the Degree of
Doctor of Philosophy
Health Sciences

Walden University
February 2016
Abstract
Pharmaceutical product claim and help-seeking advertisements have prompted the types
and purposes of medical dermatology service(s) that patients have used in the United
States. Indeed, researchers have demonstrated that 94% of working nurse practitioners
affirmed receiving from their patients a request for a cancer drug advertised. However,
adult dermatology patients members of Saint Nicholas Catholic Church or/and patients at
MedStar Clinic in Houston, Texas, have not been of interest for any study so far. The
purpose of this quantitative study was to assess the relationship between product claim,
help-seeking, types, and purposes of medical dermatology services used amongst males
and females aged at least18 years. Prospect theory (PT) was the theoretical framework
used to analyze the purpose of this study. A cross-sectional survey approach permitted to
collect primary data from 120 participants who were members of Saint Nicholas Catholic
Church or/and patients at MedStar Clinic. The results, based on a forced entry multiple
regression analysis at 95% confidence interval, indicated that product claim and help-
seeking significantly explained (p ≤ .05) the variances of certain types and purposes of
medical dermatology services used. Thus, product claim and help-seeking predicted the
types and purposes of medical services used by the study population. Pharmaceutical
announcers may benefit from the results of this study by using the study results to create
new direct-to-consumers advertisements for the dermatology health promotion. The study
population may benefit healthy skin, hairs, and nails by using medical dermatology
services after exposure to the new pharmaceutical direct-to-consumer advertisements.
Direct-To-Consumer Advertisements and Medical Services Utilization Among Adult
Dermatology Patients in the United States
by
Heribert Zouetchou

MBA, ESSEC-University of Douala, 2004
MA, University Yaoundé I, 1998
BA, ESSEC-University of Douala, 2001
BA, University Yaoundé I, 1995

Dissertation Submitted in Partial Fulfillment
of the Requirements for the Degree of
Doctor of Philosophy
Health Sciences

Walden University
February 2016
Dedication
I dedicate this achievement to the following people:
To my daughter, mademoiselle Aaliyah Chris Zouetchou, for her constant
presence, love, wisdom, and the sharp interest in education through her dedication to her
current Preschool program.
To my father, Tagni Joseph Ngandji, the Ngandji’s family teacher, and role model
of the academic perseverance.
To my mother, Magni Marie Yanou Ngandji, for the values of rigor, Catholic
faith, education, honesty, discipline, and leadership conveyed, with her loving husband,
to us, their loving 10 children. Those values have been so critical to my success in the
past and in this Ph.D. journey.
To my late spiritual father, Fr David Kamani, lovingly known as Père Roi, who
joined the holy kingdom of God on November 1st, 2011 in Cameroon. His multiple
supports and prayers, since my childhood, prepared me to access today to this terminal
level of education.
To my adopted daughter Lysa Celeste Nkemgna Nganji who just honored the
family by completing her Bachelor Degree successfully in Biochemistry in Cameroon.
Finally, to my younger sister, Inés-Aimée Feuba Ngondji, who honored the
family with her graduation from her program of Bachelor of Sciences of Nursing in
Cameroon on September 30th, 2015.
Acknowledgments
My gratitude goes to my dissertation committee members. Dr. Mountasser
Kadrie, committee chair, demonstrated long patience, guidance, and constant scrutiny of
the drafts and finals of this dissertation. Dr. Raj Singh, the methodology expert, showed
constant methodology scrutiny. The University Research Reviewer, Dr. Scott McDoniel,
kept this work in alignment with Walden University academic standards.
I would like to thank the two community partners. I am thankful to the Saint
Nicholas Church of Houston, Texas, through the reverend (Rv.) father (Fr.) Desmond
Ohankwere and Rev. Fr. Gorge Okeahiahalan who were pastors at that parish. My sincere
gratitude goes to the second community partner, the MedStar Primary Care Clinic,
through doctor (Dr.) Rachel Kientcha-Tita. As the medical director of the Clinic, Dr.
Rachel approved the use of the clinic as the study site. She provided pieces of advice and
words of encouragement during the data collection.
I do acknowledge Mimi Brooks and MD Anderson of Houston, Texas’ support.
I do acknowledge my 10 siblings’ constant supports and encouragements, mostly
the eldest son, Raymond Kouetchou. Raymond has been there for years supporting our
academic progress or education.
I extend my gratitude to my wife, Stephanie Bangoup Zouetchou, for her proper
way of support and love in this journey, since she joined me in the United States in 2010.
Many friends, peers at Walden University, and Fr. Martial Oya, pastor at Saint
Matthews the Evangelist Catholic Church in Houston, Texas; constantly have been close
and helpful to me during this academic journey.
Table of Contents
List of Tables ................................................................................................................... viii
List of Figures ......................................................................................................................x
Chapter 1: Introduction to the Study ....................................................................................1
Introduction ....................................................................................................................1
Analysis of the Concept of DTCA .......................................................................... 1
Analysis of the Concept of Utilization of Medical Services................................... 5
Conclusion of the Section and Contents of Chapter 1 ............................................ 7
Background of the Study ...............................................................................................8
PhRMA Influence ................................................................................................... 8
Evidence in Favor of the Correlation Between DTCAs and the Utilization
of Medical Services..................................................................................... 9
Gap From the Literature and the Need of This Study ........................................... 10
Problem Statement .......................................................................................................12
Purpose of the Study ....................................................................................................13
Research Questions and Hypotheses ...........................................................................15
Main Research Question and Hypothesis ............................................................. 15
Secondary Research Questions and Hypotheses ................................................... 15
Theoretical Framework for the Study ..........................................................................17
Theory Identity and Origin: Prospect Theory (PT)............................................... 17
PT Theoretical Foundations/Assumptions ............................................................ 18
PT Connection to This Study ................................................................................ 19
i
Nature of the Study ......................................................................................................19
Definitions (Operational) .............................................................................................21
Concepts Definitions ............................................................................................. 22
Operational Definitions ......................................................................................... 23
Assumptions .................................................................................................................32
Scope and Delimitations ..............................................................................................33
Limitations ...................................................................................................................35
Significance..................................................................................................................37
Summary ......................................................................................................................39
Chapter 2: Literature Review .............................................................................................41
Introduction ..................................................................................................................41
Background, Problem and Gap ............................................................................. 41
Literature Review Method and Chapter’s Content ............................................... 43
Resource Identification Method ...................................................................................43
Theoretical Framework of the Study: PT .....................................................................44
Origin ................................................................................................................... 44
Characteristics ....................................................................................................... 46
Limitations ............................................................................................................ 48
Contemporary Applications of P T ....................................................................... 49
Matching With This Study .................................................................................... 51
Analysis of the Independent Variables: Product Claim and Help-Seeking
Advertisements ................................................................................................52
ii
Product Claim Advertisement’s Regulatory Agency ............................................ 52
Product Claim Advertisement’s Legal Content .................................................... 55
DTCAs Typology.................................................................................................. 56
Product Claim and Help-Seeking Advertisements Cons Debate .......................... 57
Product Claim and Help-Seeking Advertisements Pros Debate ........................... 61
Product Claim and Help-Seeking Advertisements’ Regulatory Debate ............... 64
Product Claim and Help-seeking Advertisements Spending Debate .................... 71
Analysis of the Dependent Variables: Types and Purposes of Utilization of
Medical Services ..............................................................................................74
Types of Medical Services Utilization After Exposure to a Product Claim
Advertisement ........................................................................................... 74
Types of Medical Services Utilization After Exposure to Help-Seeking
Advertisement ........................................................................................... 75
Purposes of Medical Services Utilization After Exposure to a Product
Claim Advertisement ................................................................................ 76
Purposes of Medical Services Utilization After Exposure to Help-Seeking
Advertisement ........................................................................................... 76
Analysis of the Dependent Variables: the Dermatology Services Context .................76
Types of Medical Services Utilized After Exposure to Dermatology
Product Claim Advertisement ................................................................... 77
Types of Medical Services Utilized After Exposure to Dermatology Help-
Seeking Advertisement ............................................................................. 78
iii