Biomedical Engineering Reference
In-Depth Information
In line with previous literature and our prediction that experienced parents'
decisions would be based upon behavioral inertia (Brown
2008
) motivated by a his-
tory of safe experiences with OTC-CCM, experienced parents (with older children in
addition to a child age 2 or younger) were far less likely to adhere to the FDA warning
relative to parents with only a child 2 or younger. That is, previous parental experience
with OTC-CCM was a signifi cant predictor of adherence, such that inexperienced (vs.
experienced) parents were almost 3 times more likely to adhere to the FDA warning.
In contrast, we found no signifi cant differences on any of the other measures (i.e.,
amount of warning information received, prevalence of side effects, trust in the FDA,
frequency of child's coughs and colds). Thus, the difference in adherence rate between
experienced and inexperienced parents could not be attributed to any of these factors.
However, amount of information did have a differential impact upon adherence within
the experience groups. Among inexperienced parents, amount of information did not
affect adherence rate. In contrast, among the experienced group, adherence to the
FDA warning was higher in parents who had received more information. Thus only
among experienced parents did amount of information received impact their decision
regarding whether to continue administering OTC-CCM to their children. Taken
together, these fi ndings indicate that future FDA communication efforts should target
households with many young children, as experienced parents are least adherent and
yet most receptive to additional information.
As above, trust of the government agency issuing the warning and prior safe
experience with the product appear to be key determinants of adherence. Indeed in
both the USA and the UK, adherence to warnings against administering OTC-CCM
to young children appears related to these variables. With regard to trust, it is star-
tling that approximately half of parents in a US study (Hanoch et al.
2010
) and a UK
study (Himmelstein et al.
2011
) did not trust the warning or were unsure what to
believe. Regarding experience, as with other medications (Barron et al.
2008
), pre-
vious safe experience with OTC-CCM in children over the age of 2 seems related to
poorer adherence (Miron-Shatz et al.
2010
). Based upon the marketing literature
previously reviewed, we propose alternative phrasing and targeting of future warn-
ings to help counter the barriers of low trust and safe past experience. We propose
promising directions for further research in applying marketing principles to the
design of pharmaceutical warnings and examining their impact on behavior and,
subsequently, health outcomes.
12.2.4
Recommendations for Further Improving
Warning Effectiveness
In this section we propose several directions for improving the effectiveness of pub-
lic announcements of governmental warnings, such as the one against OTC-CCM in
young children. These directions are based on our fi ndings, as well as the marketing
literature surveyed above.
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