[What can you do to not be influenced?] / Wat kunt u doen om niet beïnvloed te worden?

OBJECTIVES: To identify persuasion strategies in paper-based marketing materials about medicines, sent to general practices. DESIGN: Observational study. METHOD: Twenty Dutch general practices collected all mail from pharmaceutical companies during one month. These materials were assessed by researchers with backgrounds in pharmacy and marketing for the presence of seven persuasion strategies, described by Cialdini. The researchers also identified the marketed medicines. RESULTS: The general practitioners collected 68 unique marketing materials involving 37 different medicines with a median introduction year of 2012 (range 1966-2022). Factor Xa inhibitors, glucagon-like peptide-1 analogues, and sodium-glucose co-transporter-2 inhibitors were the most marketed drugs. All persuasion strategies described by Cialdini were observed: liking (65% of all materials), authority (29%), social proof (18%), unity (15%), scarcity (13%), reciprocity (12%), and consistency/commitment (3%). Emotional pressure was identified as a new strategy (31%). This strategy leverages the prescriber's professional responsibility by appealing to the physician's duty to do what is best for the patient. CONCLUSION: General practitioners regularly receive paper-based marketing materials about new medicines that attempt to influence the recipient. In the context of rational use of medicines, it is recommended to be vigilant about such persuasion strategies and to make physicians (both practicing and in training) aware of these strategies, including possible mechanisms to resist them whenever possible.

When Similarity Beats Expertise-Differential Effects of Patient and Expert Ratings on Physician Choice: Field and Experimental Study.

BACKGROUND: Increasing numbers of patients consult Web-based rating platforms before making health care decisions. These platforms often provide ratings from other patients, reflecting their subjective experience. However, patients often lack the knowledge to be able to judge the objective quality of health services. To account for this potential bias, many rating platforms complement patient ratings with more objective expert ratings, which can lead to conflicting signals as these different types of evaluations are not always aligned. OBJECTIVE: This study aimed to fill the gap on how consumers combine information from 2 different sources-patients or experts-to form opinions and make purchase decisions in a health care context. More specifically, we assessed prospective patients' decision making when considering both types of ratings simultaneously on a Web-based rating platform. In addition, we examined how the influence of patient and expert ratings is conditional upon rating volume (ie, the number of patient opinions). METHODS: In a field study, we analyzed a dataset from a Web-based physician rating platform containing clickstream data for more than 5000 US doctors. We complemented this with an experimental lab study consisting of a sample of 112 students from a Dutch university. The average age was 23.1 years, and 60.7% (68/112) of the respondents were female. RESULTS: The field data illustrated the moderating effect of rating volume. If the patient advice was based on small numbers, prospective patients tended to base their selection of a physician on expert rather than patient advice (profile clicks beta=.14, P<.001; call clicks beta=.28, P=.03). However, when the group of patients substantially grew in size, prospective patients started to rely on patients rather than the expert (profile clicks beta=.23, SE=0.07, P=.004; call clicks beta=.43, SE=0.32, P=.10). The experimental study replicated and validated these findings for conflicting patient versus expert advice in a controlled setting. When patient ratings were aggregated from a high number of opinions, prospective patients' evaluations were affected more strongly by patient than expert advice (meanpatient positive/expert negative=3.06, SD=0.94; meanexpert positive/patient negative=2.55, SD=0.89; F1,108=4.93, P=.03). Conversely, when patient ratings were aggregated from a low volume, participants were affected more strongly by expert compared with patient advice (meanpatient positive/expert negative=2.36, SD=0.76; meanexpert positive/patient negative=3.01, SD=0.81; F1,108=8.42, P=.004). This effect occurred despite the fact that they considered the patients to be less knowledgeable than experts. CONCLUSIONS: When confronted with information from both sources simultaneously, prospective patients are influenced more strongly by other patients. This effect reverses when the patient rating has been aggregated from a (very) small number of individual opinions. This has important implications for how to present health care provider ratings to prospective patients to aid their decision-making process.

Signalling product healthiness through symbolic package cues: Effects of package shape and goal congruence on consumer behaviour.

Three studies show that product packaging shape serves as a cue that communicates healthiness of food products. Inspired by embodiment accounts, we show that packaging that simulates a slim body shape acts as a symbolic cue for product healthiness (e.g., low in calories), as opposed to packaging that simulates a wide body shape. Furthermore, we show that the effect of slim package shape on consumer behaviour is goal dependent. Whereas simulation of a slim (vs. wide) body shape increases choice likelihood and product attitude when consumers have a health-relevant shopping goal, packaging shape does not affect these outcomes when consumers have a hedonic shopping goal. In Study 3, we adopt a realistic shopping paradigm using a shelf with authentic products, and find that a slim (as opposed to wide) package shape increases on-shelf product recognition and increases product attitude for healthy products. We discuss results and implications regarding product positioning and the packaging design process.

Strategies and motives for resistance to persuasion: an integrative framework.

Persuasion is an important element of human communication. But in many situations, we resist rather than embrace persuasive attempts. Resistance to persuasion has been studied in many different disciplines, including communication science, psychology, and marketing. The present paper reviews and connects these diverse literatures, and provides an organizing framework for understanding and studying resistance. Four clusters of resistance strategies are defined (avoidance, contesting, biased processing, and empowerment), and these clusters are related to different motivations for resisting persuasion (threat to freedom, reluctance to change, and concerns of deception). We propose that, while avoidance strategies may be triggered by any of these motivations, contesting strategies are linked primarily to concerns of deception, while empowerment and biased processing strategies are most common when people are reluctant to change.