Email updates

Keep up to date with the latest news and content from BMC Complementary and Alternative Medicine and BioMed Central.

Open Access Highly Accessed Research article

Understanding the role of scientific evidence in consumer evaluation of natural health products for osteoarthritis an application of the means end chain approach

Teresa Tsui1, Heather Boon1*, Andreas Boecker2, Natasha Kachan1 and Murray Krahn1

Author Affiliations

1 Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada

2 Department of Food, Agricultural and Resource Economics, University of Guelph, Guelph, ON, Canada

For all author emails, please log on.

BMC Complementary and Alternative Medicine 2012, 12:198  doi:10.1186/1472-6882-12-198

Published: 30 October 2012

Abstract

Background

Over 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.

Methods

The 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.

Results

The 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.

Conclusions

The 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.

Keywords:
Natural health products; Decision-making; Means ends chain analysis; Osteoarthritis