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PubMed2003

Searching for and selecting a nursing facility.

In this study, the authors present findings from 306 resident interviews matched with 306 family member interviews examining factors associated with both the search for and selection of a nursing facility. For many elders transitioning into a nursing facility, the facility becomes their home, and the average cost of residing in that home is high. As such, searching for and selection of a facility has important consequences. The authors found that residents are not very influential in these processes. Second, they found very few proactive nursing facility choices were made by either residents or family members. Third, the choices made were seldom based on the quality of the facility. Fourth, prior knowledge of the chosen facility was limited. Finally, the authors also show that the time taken to choose a facility was in most cases extremely limited.

Aged↗
PubMed1998

Medicaid enrollment choice into managed care health plans.

Rural Aid to Families with Dependent Children (AFDC) Medicaid recipients were surveyed to identify factors that influenced their enrollment choice between two managed care health plans and the traditional Medicaid free-for-service plan. Bivariate and logistic regression analyses provided evidence that the Medicaid institutional information structure directly influenced recipient decision to enroll in managed care plans. Current smokers were more likely to choose a managed care plan in this sample. There was no evidence that health status, health service use patterns, marital status, or ethnicity was related to the enrollment decision. Of those who chose the traditional Medicaid fee-for-service plan, 41 percent reported that they did not understand what managed care was.

Adult↗
PubMed1987

Focus group interview: an underutilized research technique for improving theory and practice in health education.

The purpose of this article is to increase awareness about and stimulate interest in using focus group interviews, a qualitative research technique, to advance the state-of-the-art of education and learning about health. After a brief discussion of small group process in health education, features of focus group interviews are presented, and a theoretical framework for planning a focus group study is summarized. Then, literature describing traditional and health-related applications of focus group interviews is reviewed and a synthesis of methodological limitations and advantages of this technique is presented. Implications are discussed regarding: need for more inductive qualitative research in health education; utility of focus group interviews for research and for formative and summative evaluation of health education programs; applicability of marketing research to understanding and influencing consumer behavior, despite notable distinctions between educational initiatives and marketing; and need for professional preparation faculty to consider increasing emphasis on qualitative research methods.

Adolescent↗
PubMed1997

The telephone as a communication medium for health education.

The telephone is being widely used by the private sector as a communication medium for understanding and influencing consumer behavior. Coinciding with the growth of telephone use in the private sector is the expansion of telephone use in health care to include complex health promotion and disease prevention interventions aimed at initiating and maintaining health-related behavioral changes. While several studies have evaluated the impact of telephone interventions on a wide range of health behaviors, no published reports synthesizing current knowledge about using the telephone as a communication medium for health education were identified. In this article, the authors therefore (1) examine recent applications of telephone use in health education by describing three example interventions, (2) outline key features and alternatives in conceptualizing and designing health education using the telephone, (3) review advantages and disadvantages of using the telephone for health education, and (4) discuss implications for health education practice and research.

Communication↗
PubMed2002

Research and development of transgenic plants in Malaysia: an example from an Asian developing country.

In 2000, agriculture contributed 13% to the national gross domestic product of Malaysia. The country of 23 million people has created a competitive program coordinated by the Ministry of Science, Technology and the Environment, research institutions, and universities to undertake biotechnology research in several areas. Intensified research efforts are under way on oil palm, rubber, rice, papaya, and orchids. Although the most progress has been made in rice and papaya, no transgenic crop is ready for field trials. Nonetheless, preliminary steps have been taken to prepare for the trials, and detailed testing protocols are being developed.

Agriculture↗
PubMed2006

Consumer satisfaction with primary care provider choice and associated trust.

BACKGROUND: Development of managed care, characterized by limited provider choice, is believed to undermine trust. Provider choice has been identified as strongly associated with physician trust. Stakeholders in a competitive healthcare market have competing agendas related to choice. The purpose of this study is to analyze variables associated with consumer's satisfaction that they have enough choice when selecting their primary care provider (PCP), and to analyze the importance of these variables on provider trust. METHODS: A 1999 randomized national cross-sectional telephone survey conducted of United States residential households, who had a telephone, had seen a medical professional at least twice in the past two years, and aged > or = 20 years was selected for secondary data analyses. Among 1,117 households interviewed, 564 were selected as the final sample. Subjects responded to a core set of questions related to provider trust, and a subset of questions related to trust in the insurer. A previously developed conceptual framework was adopted. Linear and logistic regressions were performed based on this framework. RESULTS: Results affirmed 'satisfaction with amount of PCP choice' was significantly (p < .001) associated with provider trust. 'PCP's care being extremely effective' was strongly associated with 'satisfaction with amount of PCP choice' and 'provider trust'. Having sought a second opinion(s) was associated with lower trust. 'Spoke to the PCP outside the medical office,' 'satisfaction with the insurer' and 'insurer charges less if PCP within network' were all variables associated with 'satisfaction with amount of PCP choice' (all p < .05). CONCLUSION: This study confirmed the association of 'satisfaction with amount of PCP choice' with provider trust. Results affirmed 'enough PCP choice' was a strong predictor of provider trust. 'Second opinion on PCP' may indicate distrust in the provider. Data such as 'trust in providers in general' and 'the role of provider performance information' in choice, though import in PCP choice, were not available for analysis and should be explored in future studies. Results have implications for rethinking the relationships among consumer choice, consumer behaviors in making trade-offs in PCP choice, and the role of healthcare experiences in 'satisfaction with amount of PCP choice' or 'provider trust.'

Adult↗
PubMed2005

Preferences for place of care and place of death among informal caregivers of the terminally ill.

OBJECTIVES: (1) To determine informal caregivers perceptions about place of care and place of death; and (2) to identify variables associated with a home death among terminally ill individuals who received in-home support services in a publicly funded home care system. PARTICIPANTS AND DESIGN: A total of 216 informal caregivers participated in a bereavement interview. Data collection included care recipient and informal caregiver characteristics, the use of and satisfaction with community services, and preferences about place of death. RESULTS: Most caregivers reported that they and the care recipient had a preferred place of death (77 and 68%, respectively) with over 63% reporting home as the preferred place of death. Caregivers had a greater preference for an institutional death (14%) than care recipients (4.7%). While 30% of care recipients did not die in their preferred location, most caregivers (92%) felt, in retrospect, that where the care recipient died was the appropriate place of death. Most caregivers reported being satisfied with the care that was provided. The odds of dying at home were greater when the care recipient stated a preference for place of death (OR: 2.92; 95% CI: 1.25, 6.85), and the family physician made home visits during the care recipients last month of life (Univariate odds ratios (OR): 4.42; 95% CI: 1.46, 13.36). DISCUSSION: The ethic of self-control and choice for the care recipient must be balanced with consideration for the well being of the informal caregiver and responsiveness of the community service system.

Aged↗
PubMed1990

The patients' view of life in a psychiatric hospital. A questionnaire study and associated methodological considerations.

In any assessment of hospital life, the patients' view is indispensable, but there is no generally accepted way of seeking it. In this study, the views of 258 patients in four 'traditional' English psychiatric hospitals were obtained by a questionnaire of 45 items supplemented by freehand comments. Their experience of fellow patients, the staff and the material and institutional aspects of hospital care were explored. Some of the benefits and problems of questionnaire use in this realm are discussed.

Anxiety↗
PubMed2004

Marketing drugs, marketing health care relationships: a content analysis of visual cues in direct-to-consumer prescription drug advertising.

Proponents and opponents of direct-to-consumer advertising (DTCA) of prescription drugs argue that it promotes greater participation in health care by consumers with significant implications for public health and health care outcomes. This article (a). proposes a social cognitive theoretical framework to explain DTCA's effects, and (b). reports the first in a series of studies on DTCA's observational learning functions that may influence consumer behavior and the physician-patient relationship. This investigation addresses visual features of print DTCA. Results focus on the prevalence and nature of models featured in the ads and how visual cues may offer identity and relational motivators while reinforcing the value of prescription drug treatments. Further, DTCA may market disenfranchising images that increase disparity in health care information and access, despite their argued educational function.

Advertising↗
PubMed1992

Assessing the quality of health care: a consumerist approach.

Recent investigations show that nontechnical interventions influence patients' ratings of the quality of health care, and that these aspects of the medical encounter are as important to the patient as the technical aspects; perhaps more important. This paper adopts a consumerist approach and measures patients' perceptions of health care quality using a scale adapted from the consumer behavior literature (SERVQUAL). The study measures health care quality as well as five of its individual dimensions. The findings indicate that, for the whole sample, patients' ratings of overall quality as well as the ratings of four of the five dimensions of care are negative. Further analysis indicates that many individual aspects (scale items) are rated negatively by each of two age groups (25-65 and over 65 years old), but the gap between perceptions of the younger group and their expectations is greater than that of the senior group. The two dimensions of "assurance" and "empathy" are found to be the most discriminating dimensions between the two groups. Other analyses indicate that age, annual household income, and work status significantly relate to overall quality rating. Marketing and strategic planning implications of the results are discussed.

Adult↗
PubMed1993

Health demography comes of age.

The U.S. health care industry has been hampered in the development of a mature marketing function in part due to characteristics unique to the industry. These characteristics include a lack of market data, poorly developed market research techniques, and a poor understanding of consumer behavior within the industry. Some of the deficiencies are being addressed through the development of an emerging field that is being referred to as "health demography." Health demography and those who have begun to refer to themselves as health demographers are drawing from the fields of demography, epidemiology, biostatistics, and the social sciences to formulate a new discipline uniquely related to the needs of today's health care marketers and planners. Those involved with health demography are developing databases and models for application to concrete problems in health care delivery. The development of this field is contributing to the advancement of the state of marketing in health care and serving to reduce many of the barriers that have retarded the development of a mature marketing function within the health care industry.

Catchment Area, Health↗
PubMed1993

Investigating differences in choice decisions for physicians, dentists and lawyers.

This paper presents findings from a study investigating differences in the importance of nineteen criteria in the choice of professionals from three professional groups--physicians, dentists, and lawyers. Knowledge is the most important for all three groups but is less so for doctors. Discussions about the problem and its treatment are both less important for dentists. Six characteristics of professional service providers are used to explain differences.

Adolescent↗
PubMed2001

Determinant attributes in nursing home choice: profiling attribute segments.

The majority of research of nursing home choice focuses on attribute importance. In comparison, this study identifies attributes that determine choice. Utilizing dual-questioning methodology, 177 nursing home decision-makers rated not only the importance of ten attributes to their choice, but also how different they perceived nursing homes to be on those attributes. When compared, determinant attributes were different from importance attributes. Respondents reported that cleanliness, location, and reputation were most determinant in nursing home choice. However, depending on profile characteristics such as income and relationship of the decision maker to the patient, determinant attributes differed. Therefore, profile characteristics influence determinant attributes.

Aged↗
PubMed2003

From attitude formation to behavioral response in organ donation: using marketing to increase consent rates.

This article presents a theoretical analysis of attitude formation and the relationship to stated behavioral intentions as it relates to the decision to donate organs. This analysis reveals the presence of three distinct paths to behavior of potential donors, groups differing in their involvement with organ donation. Promotional objectives and campaign strategies designed to influence attitudes and behaviors should differ according to the behavioral path in operation and the involvement of the audience. Mass media campaigns are likely to reach high involvement groups only. Therefore, personal selling, underutilized in previous donation campaigns, should be brought into the donation strategy to appeal to low involvement groups. By recognizing differences in audience involvement and implementing different strategies, overall donation rates could substantially increase.

Attitude to Health↗