The Effects of Risk Disclosure in Direct-to-Consumer Prescription Drug Advertising

174 Pages·2017·2.59 MB·English

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Doctoral Dissertations Graduate School
8-2014
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Ilwoo Ju
University of Tennessee - Knoxville, [email protected]
Follow this and additional works at: https://trace.tennessee.edu/utk_graddiss
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Ju, Ilwoo, "The Effects of Risk Disclosure in Direct-to-Consumer Prescription Drug Advertising (DTCA):
Prominence, DTCA Regulatory Knowledge, and Perceived Attention. " PhD diss., University of Tennessee,
2014.
https://trace.tennessee.edu/utk_graddiss/2891
This Dissertation is brought to you for free and open access by the Graduate School at TRACE: Tennessee
Research and Creative Exchange. It has been accepted for inclusion in Doctoral Dissertations by an authorized
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[email protected].
To the Graduate Council:
I am submitting herewith a dissertation written by Ilwoo Ju entitled "The Effects of Risk
Disclosure in Direct-to-Consumer Prescription Drug Advertising (DTCA): Prominence, DTCA
Regulatory Knowledge, and Perceived Attention." I have examined the final electronic copy of
this dissertation for form and content and recommend that it be accepted in partial fulfillment
of the requirements for the degree of Doctor of Philosophy, with a major in Communication and
Information.
Jin Seong Park, Major Professor
We have read this dissertation and recommend its acceptance:
Ronald E. Taylor, Mariea G Hoy, Daniel J. Flint
Accepted for the Council:
Carolyn R. Hodges
Vice Provost and Dean of the Graduate School
(Original signatures are on file with official student records.)
The Effects of Risk Disclosure in Direct-to-Consumer Prescription Drug Advertising
(DTCA): Prominence, DTCA Regulatory Knowledge, and Perceived Attention

A Dissertation Presented for the
Doctor of Philosophy
Degree
The University of Tennessee, Knoxville

Ilwoo Ju
August 2014
ii
Copyright © 2014 by Ilwoo Ju
All rights reserved.
iii
Dedication
I dedicate this dissertation to my family who has shared every moment and given me
worthy opportunities for growth. This work could not have been completed without their love
and prayer.
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Acknowledgements
I would like to express my gratitude to a number of people who have influenced my
dissertation. I could complete this intellectual journey with their wisdom, assistance, and
contribution.
In the course of this research, I would especially like to appreciate Dr. Jin-seong Park's
rigorous guidance as my academic advisor. His insightful guidance, support, and patience for the
last three years have improved my scholarship. In addition, I would like to thank Dr. Ronald E.
Taylor, my mentor and former academic advisor. He is a great mentor and one of the most
respected advertising educators in the States. Dr. Daniel Flint, Regal Entertainment Group
Professor of Marketing, should also be acknowledged for his insightful comments and precious
time as my committee member. Especially, I do not know how to express my thanks to Dr.
Catherine Luther who is the Associate Dean of the College of Communication and Information,
my mentor, my advisor, and my sincere friend. Without her support, I could not compete this
though journey.
I would like to thank my other mentors who have shared valuable insight and experience
with me. First, Dr. David Schumann who is a legendary consumer researcher and well-known for
his ELM contribution has provided me with an invaluable philosophical foundation for my
educational career and emotional support as a human being. He is a great teacher who taught me
about the teacher-scholar model in the context of higher education. In addition, my MA study
advisors, Dr. Spencer Tinkham, Dr. Karen King, and Dr. Leara Rhodes, at the University of
Georgia, were also great emotional and academic supporters. In the same token, Dr. Eric Haley
was a very influential mentor during my PhD study. His succinct and insightful comments were
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always useful. I cannot forget Dr. Margaret Morrison who is a former director of UTK
Advertising during my PhD study. Her decisive and considerate advising was impressive. I thank
Dr. Tae-hyun Baek (University of Kentucky Faculty) and Dr. Ho-joon Choi (University of
Houston Faculty), my trustworthy friends. They have shared many things with me during my
graduate study in the States. I would like to express many thanks to my boon companions, Jong-
han Hyun (Kent State Faculty), Kang-bok Lee (Auburn University Faculty), and Shawn Starcher
(University of Akron Faculty). Plus, I cannot forget my American daddy Glenn Hawes. His
emotional support and life experience shared with me were much more valuable than any theory
and method that I know.
My special thanks go to my family, especially my wife (Dr. Eun-ju Rho), son (Daniel Ju),
mother (Bong-im Cho), father (So-ja Ju), sister (Joung-a Ju), elder brother-in-law (Soohyun
Jung), father-in-law (Gyeong-seob Rho), mother-in-law (Keun-ki Lee), and sister-in-law (Hye-
ran Rho). My career as a doctoral student was not possible without their devotion and sacrifice.
Last, but not least, I truly and deeply thank my living God for giving me strength in the
midst of trials, for being with us and helping us, for letting me know the joy of walking with
Him, and for all of His gifts.
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Abstract
Fair balance of benefit and risk information in consumer prescription drug advertising
(DTCA) has received much research attention. In this regard, it has been well-documented that
varying levels of risk disclosure prominence have disproportional effects on consumer response
to the DTC ad. However, little research has examined how the prominence effects can be
maximized or minimized depending on consumers’ varying levels of knowledge of the FDA’s
regulatory role for DTCA. In a similar vein, rare research has been conducted to investigate how
such regulatory knowledge directly affects consumers’ risk disclosure coping strategies.
Drawing on consumer information processing perspectives, this research employs an
experimental approach to examine one manipulated categorical variable, one measured
continuous variable, and their interactive effects on consumer response to the ad, while
controlling for potential covariates. Specifically, two levels of risk disclosure prominence are
manipulated (high vs. low) and coded as a dummy variable, and DTCA regulatory knowledge is
measured as a continuous variable. Further, based on the persuasion knowledge model (PKM)
framework, DTCA regulatory knowledge is tested as a moderator of the prominence effects.
Consumer memory such as unaided-recall and aided-recognition of the health risks of the
medicine presented in the ad as well as self-reported perceived attention to risk disclosure are
addressed as criterion variables.
The major findings are summarized as follows: (1) both higher DTCA regulatory
knowledge and higher prominence enhanced perceived attention to risk disclosure; (2) both
higher DTCA regulatory knowledge and higher prominence enhanced consumer recognition of
risk information; (3) DTCA regulatory knowledge moderated the prominence effects on
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perceived attention to risk disclosure; (4) the main DTCA regulatory knowledge effects and the
main prominence effects on consumer recall and recognition were mediated through perceived
attention to risk disclosure; (5) However, the moderated mediation effect analyses revealed that
the effects of prominence on recall and recognition were mediated through perceived attention
among low DTCA regulatory knowledge consumers, whereas the mediating effects were
minimal among high DTCA regulatory knowledge consumers.
The overall findings support the current study’s conceptual framework. The theoretical,
managerial, and consumer education/public health implications of this research are discussed.
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Table of Contents
CHAPTER 1: INTRODUCTION ................................................................................................... 1
Research Problem ....................................................................................................................... 1
Purpose of the Study ................................................................................................................... 4
The Organization of Dissertation ................................................................................................ 6
CHAPTER 2: LITERATURE REVIEW ........................................................................................ 8
The DTCA Market ...................................................................................................................... 8
The Context of DTCA ................................................................................................................ 9
Previous Research on DTCA .................................................................................................... 12
The Fair Balance Requirement of DTCA ................................................................................. 14
Risk Disclosure in DTCA ......................................................................................................... 16
Consumer Information Processing and DTCA Disclosure Prominence ................................... 18
Cognitive Fluency and Risk Disclosure Processing ................................................................. 20
The Influence of Cognitive Structure ....................................................................................... 22
DTCA Regulatory Knowledge and Risk Disclosure Prominence ............................................ 23
The Framework of Dissertation .................................................................................................... 25
Conceptualization of Risk Disclosure Prominence in the Literature ........................................ 25
The FDA’s Conceptualization of Risk Disclosure Prominence in DTCA ................27
The Study .................................................................................................................................. 29
Risk Disclosure Prominence as a Message Factor (Main Effects) ............................29