For all informants, their beliefs in product benefits did not come simply from interpretation of the claims. Their views were shaped as a result of their exposure to other marketing sources and information. In the following sections, we examine RQ3 by describing the search practices of our informants and specifically the sources in which they focused their efforts and trust. Our findings again highlight how driving motivations for health improvement and motivated goals (RQ4) may lead to unintended consequences during this process.
Motivated to Search, but Directed toward Sellers
While our informants were primarily motivated by directional goals to improve health, they did not completely avoid accuracy goals. Both types of goals can be seen through information search efforts beyond the basic product claim messages. It appears that the vagueness of the legal structure–function claim piques curiosity about product benefits. When first exposed to new claims related to personal health concerns, our informants faced a dilemma as to whether they would immediately purchase the product. A few individuals indicated that they would sometimes buy supplements based on claims “to give them a try,” but usually they attempted to learn about the product prior to purchase. All individuals expressed an interest in knowing more about the supplement upon seeing a relevant claim, even if it was postpurchase. As a result of this curiosity, they consulted either a variety of sources or, in some cases, just one particularly trusted source. The following quotes highlight this desire to learn more upon exposure to a health claim:
So if a claim piques my curiosity I will ask [the retailer]…If a new product comes out you really can't find anything in a book. You want to read product literature on it. You want to ask someone there [at the store] if they know anyone who has tried it or if they’ve tried it themselves and what kind of results they’ve had. #12, female, 45 yrs.
Usually I don't know what to buy because the descriptions on the bottles aren't very good. It's a roundabout way of what Ginseng does or what Melatonin does. It doesn't really tell you what good effects it'd have…Most of the people that work there [nutrition store] know a lot more about herbal products. #22, male, 24 yrs.
I usually research some of these supplements a little bit more than what is on the label… Magazines and books, the Vitamin Bible or something that you might have seen…it's kind of an educated thing I do with supplements, an educated guess. #26, male, 63 yrs.
Recognizing the limited information from claims, informants appear to be motivated by accuracy goals to some extent and seek out more information. However, as the above informants demonstrate, this search is often directed toward sources that provide positive information consistent with their directional goals. Rather than having a “healthy skepticism” toward sellers' messages, reflective of directional goals, our informants revealed a propensity to seek and readily accept retailer- and seller-related information. In addition to information seeking, several informants developed a trusted relationship with the seller/provider of their supplements. All informants used seller-provided factual information (i.e., ingredients lists, usage directions, return guarantees), but as the following quotes indicate several individuals extend this trust to sellers' subjective assessments and assurances:
I don't go out and research. It's just what they [a group of alternative providers/sellers] tell me. And I trust them completely. Because from what I’ve seen so far, they’ve done nothing but help me in everything they’ve given me. So it's just based on what they believe is good for me or what they think is right. #23, female, 23 yrs.
I try to buy from reliable sources, order from good laboratories, and trust them…There are three laboratories [direct marketing firms] that I order from and I have ordered from them for a year. I am feeling fine so I think what they’re doing for me is honest. #16, female, 80 yrs.
I research it [a supplement] off the Internet and in the books…I research it, I read it, then I bring it to John [a retailer] and ask what he thinks. He’ll say “oh yeah, I’ve heard of this. It's good.”…If he doesn't know anything about it then he’ll go and look it up. He’ll tell us “yeah, you can have this or no you should stay away from that.”#29, male, 28 yrs.
I figure that if it [an herb] is in there [her multi-vitamin], it's good. Why do I think that? Because they [the manufacturer] wouldn't put it in there if you didn't need it. I trust the manufacturer [a popular brand]. #24, female, 35 yrs.
Our informants looked to sellers as trusted authorities. Seller-sponsored information was considered legitimate support for product effectiveness and safety, sometimes despite label warnings. Information policies based on the premise that the average consumer will question seller material when evaluating persuasive messages as a result of “healthy skepticism” (Friestad and Wright 1994) may presume an overly optimistic and unrealistic characterization of many consumers who are motivated by directional goals (even during search). Once seller trust is firmly established and activation of directional goals is strong, regulatory messages and involvement may be misunderstood.
A Distrust of Regulation and Regulators
Some individuals understood that the FDA's regulatory oversight of supplements was limited. However, this lack of oversight did not raise questions about product efficacy or safety or about the lack of testing. Some informants with strong directional goals demonstrated indifference, or even gratitude, to the disclaimer's message. These informants tended to believe that FDA scrutiny was not important and increased oversight could threaten product availability. The following quotes highlight these views:
Personally, I think it's better [the limited oversight]. Because I think if the FDA did get involved with supplements there would probably be better quality products out there, but there would be less of a choice. #3, male, 32 yrs.
I don't really care what the FDA says. I don't think they’re 100% accurate…If it's working for me, it's working. Who cares, I don't think it's causing me any problems. It's natural. #23, female, 23 yrs.
I don't mind if a committee of people within the natural health field and various companies together really try to oversee and have a certain expected level of quality. That's fine, but as far as the FDA coming in, then straight away you have to get prescriptions to get supplements. It just becomes pathetic. #15, female, 30 yrs.
These informants' appreciation for relaxed regulatory oversight related to perceptions that the FDA might try to limit the availability of the supplements that they deemed central to health enhancement. They also expressed doubts about the FDA's ability to provide high-quality information in general. As evidence, they cited past examples of FDA-approved drugs which later were found to be harmful. They perceived the FDA as being careless in permitting products to enter the market without extensive testing. They did not associate these errors with the general nature of emerging scientific evidence, but specifically with errors stemming from the FDA and as such questioned the agency's competence or expertise. Other individuals perceived the FDA's evidence to be outdated and questioned the agency's credibility because of its failure to update views despite new evidence. The following quotes illustrate informants' concerns with the FDA's ability to regulate health products and their subsequent reliance on other sources:
Phen-Phen has killed people. Viagra has killed people. Oh, this one really gets me. It's the drug males use for hair loss. The disclaimer is that no pregnant woman should even touch the pill. My questions is if no pregnant woman should touch the pill then what is it doing to the guy… the FDA thinks it's great to have bovine growth hormone in your milk and milk products. Now research is coming out saying that BGH is causing problems, causing cancer…I get on the Internet and they [websites found through search] tell what the FDA doesn't know - this works. #10, female, 30 yrs.
My husband and I wanted to get it [his cholesterol level] down so he wouldn't have to go on medication. It just doesn't sound good. The medication you take for it [high cholesterol], it ruins your liver…Sometimes the FDA, the stuff that they approve is horrible. I don't know if they know anything about it. #8, female, 54 yrs.
The Food and Drug Administration, which is slow as cold tar on evaluating medicines, has not supported the claims that these makers made. But that doesn't mean that private research or research in Europe or someplace else might not support the same claims. So it comes down to whether you trust your government or not, and I don't necessarily trust them. #26, male, 63 yrs.
Motivated reasoning suggests that when faced with contradictory information, individuals motivated by directional goals will more closely scrutinize this conflicting message or in this case the source of the information. While informants consistently trusted sellers and heeded their product advice with little hesitation, regulatory authorities received significant scrutiny and questions about their credibility. Given the evolving nature and pace of the information environment, evaluations of source expertise may be more fluid and open to debate than traditionally conceptualized. Over time and through various channels, the information environment communicated a pattern of the FDA providing inaccurate information. Our informants accessed this knowledge to construct doubt about its credibility in this area when confronted with unfavorable messages. As the previous quotes suggest, informants turned to alternative sources in response to a growing disillusionment about the knowledge and control that regulatory institutions held. These alternative sources and sellers are more likely to provide information consistent with directional goals.
Additional concerns of FDA trustworthiness were voiced with respect to its relationship with the medical community. Informants did not view the FDA as an impartial, independent agency, but rather as having a vested interest in the medical community. As such, the FDA, which bases its actions on medical studies, was viewed as unable to be objective about product assessments. This questioning of larger underlying motives provided additional support for avoiding and refuting the agency's messages. The following quotes highlight some informants' perceived association between the FDA and medical community that further magnified their doubts about regulatory oversight:
Doctors, it [supplements] doesn't fit their system. It's not what they studied in school…And if you don't understand the system and what's going on, it is confusing. It's very confusing because on the one hand the people that promote herbs are saying it's so good for you and on the other hand the FDA and doctors are saying this is garbage. But fortunately the trend is going toward more information [from sellers] and less of this misinformation. #17, female, 56 yrs.
[I'm skeptical of] the government, absolutely, absolutely, especially in this industry. They really are trying to shut it down and have been for a very, very long time. It used to be that herbs had absolutely no validity and now you even see pharmaceutical companies coming out with their own St. John's Wort or Saw Palmetto…The FDA is making a conscious effort now to make it law so only pharmaceutical companies can manufacture them. #12 female, 45 yrs.
In general, questioning the FDA and medical information is a healthy practice for consumers. However, questioning other sources of information, particularly when they sell the product, is also important. Many informants did not do this. While our informants were motivated to seek information and were information-sensitive (modifying behaviors based on messages), contrary to regulatory assumptions, they were not information-discriminating. Motivations related to product use led informants to be predisposed to certain sources and messages as well as to construct arguments to refute information sources that threatened their directional goals.
Some informants' expectation of protection and disregard for regulatory legitimacy was so pervasive that even when experiencing product ineffectiveness, they did not consider that it might be due to unsubstantiated claims (as inferred by the disclaimer). They associated unsuccessful results with a particular brand, an isolated production allotment or not working for them individually but being effective for others. The following quotes highlight this desire to believe in products working as claimed:
I'd been really manic so I tried using Valerian. I tried one pill and nothing, two pills and nothing. I tried four pills and still nothing. It's like a bad batch. Either a bad batch or I’ve had it in the cupboard too long. I probably won't buy that brand again. #19, female, 33 yrs.
I took a supplement for about 45 days and I didn't feel anything. Maybe it was working. I had a lot of faith in the company that put it out. A lot of people were saying they were getting great benefits out of it, but it didn't really do anything for me.#3, male, 32 yrs.
I took bilberry for the eyes, and I didn't think it worked. It made me feel a little sick so I stopped…Then I tried taking it every other day…I don't think that I took enough. If you took it 2 or 3 times a day it would probably work better. #8, female, 54 yrs.
When confronted with confusing, inconsistent information (i.e., the claim and disclaimer, touted benefit and product ineffectiveness), individuals held fast to beliefs that supplements were effective despite contradictory evidence. The hoped for outcomes and directional goals remained; doubts were constructed around personal usage behaviors, not the product.
In summary, our research suggests that consumers may be susceptible to biased behaviors due to unique motivations driving them to the marketplace, lack of experience with unfamiliar information or a lack of discrimination with regard to messages and sources. In our study, claims and disclosures resulted in a desire by consumers for more information, but their motivations for product use led them to be particularly sensitive to certain sources and messages. Although informants' motivations played prominently throughout product use and information search, differences in consumer motivation are not likely to be included in deliberations about needed consumer protection remedies. Disclosures are designed with a “typical” information-discriminating consumer in mind and any unintended consequences of the remedies are typically viewed as a communication problem. Current regulatory efforts, which then tend to focus upon improving message content for typical consumers, will likely have little effect on those with strong motivation biases.