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Abstract
BackgroundOver 30% of individuals use natural health products (NHPs) for osteoarthritis-related pain. The Deficit Model for the Public Understanding of Science suggests that if individuals are given more information (especially about scientific evidence) they will make better health-related decisions. In contrast, the Contextual Model argues that scientific evidence is one of many factors that explain how consumers make health-related decisions. The primary objective was to investigate how the level of scientific evidence supporting the efficacy of NHPs impacts consumer decision-making in the self-selection of NHPs by individuals with osteoarthritis.MethodsThe means-end chain approach to product evaluation was used to compare laddering interviews with two groups of community-dwelling Canadian seniors who had used NHPs to treat their osteoarthritis. Group 1 (n=13) had used only NHPs (glucosamine and/or chondroitin) with “high” scientific evidence of efficacy. Group 2 (n=12) had used NHPs (methylsulfonylmethane (MSM) and/or bromelain) with little or no scientific evidence supporting efficacy. Content analysis and generation of hierarchical value maps facilitated the identification of similarities and differences between the two groups.ResultsThe dominant decision-making chains for participants in the two scientific evidence categories were similar. Scientific evidence was an important decision-making factor but not as important as the advice from health care providers, friends and family. Most participants learned about scientific evidence via indirect sources from health care providers and the media.ConclusionsThe Contextual Model of the public understanding of science helps to explain why our participants believed scientific evidence is not the most important factor in their decision to use NHPs to help manage their osteoarthritis.
Highlights
Over 30% of individuals use natural health products (NHPs) for osteoarthritis-related pain
No statistically significant differences were found between participants in the high and low scientific evidence categories with respect to gender, age, ethnicity, education level, net household income, presence of extended health insurance, duration of using NHPs, perceived importance of scientific evidence, overall perceptions of health, or pain severity (See Table 1)
The dominant chain that includes scientific evidence, described in the section below, captures the concepts used for product evaluation which relate to our central research question
Summary
Over 30% of individuals use natural health products (NHPs) for osteoarthritis-related pain. The Contextual Model argues that scientific evidence is one of many factors that explain how consumers make health-related decisions. The primary objective was to investigate how the level of scientific evidence supporting the efficacy of NHPs impacts consumer decision-making in the self-selection of NHPs by individuals with osteoarthritis. Natural health products (NHPs) are defined in Canada as products made from ingredients found in nature sold over-the-counter for medical purposes [1] including herbal medicines, vitamins and minerals. It is an estimated 3 billion dollar industry annually in North America [2]. The widespread selfmanagement of OA leads one to question how consumers choose which products to purchase
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