Incorporating Emotions into Healthcare Segmentation Research

September 22, 2003

Jon Morris, PhD Wes Michael

All healthcare decisions are made

Rationally Scientifically Non-emotionally Logically Technically

All healthcare decisions are made

Physicians Diagnose Prescribe Select treatments

Patients Request medications Build compliance Switch meds

….Without emotion entering into the picture.

Why does Amgen use this image with Rheumatologists?

                                                      

Not Exactly

Why does Pfizer show this to ED sufferers?

                                                      

Not Exactly

Why does Abbott show this to Pediatricians?

                                                      

Not Exactly

Why does Lilly show this to parents of kids with ADHD?

                                                      

Not Exactly

All decisions, even those of physicians and patients, incorporate some emotional components

Concept Development Segmentation Positioning Messaging Tracking

Market researchers, realizing the importance of emotions in messaging, incorporate various

projective techniques into qualitative research at the messaging stage of research

There is a critical need, however, to understand the emotions earlier, as we

define and prioritize segments

Healthcare segmentation research now can and should include another dimension: emotional response

Emotions

Demographics

Attitudes

Behaviors

Based on 3 fundamental dimensions of emotion:

The three dimensional approach provides greater diagnostic capabilities

AdSAM is a non-verbal, cross-cultural visual measure of emotional response

PleasureArousal Dominance

AdSAM®

Emotional Response Predicts Intentions and Interest

49%

28%

23%

Emotions

Knowledge And beliefs

Robust study of over 23,000 responses to 240 advertising messages

Emotion shown to dominate over knowledge and beliefs for predicting intentions

Unmeasured

“The Impact of Influencers on Consumer Healthcare Decision Making”

Focused on healthcare actions taken due to influence of non-healthcare people

Example: a study on Influencers

FAMILY -- Mother, Father, Sister, Brother, Son, Daughter

FRIENDS/NEIGHBORS/ COWORKERS

SPOUSE

Consumer quantitative study 1800 patients,

150 each with one of 12 specified conditions (diabetes, depression, migraine, prostate cancer, etc.)

Conducted via internet, March, 2003

The Impact of Influencers on Consumer Healthcare Decision Making

Sufferers who are influenced to take healthcare actions are often influenced by a spouse. An immediate female family member, or female friend/neighbor consistently make up the second most important group of influencers.

Spouse

Daughter

Female Friend/Neighbor

Mother

Sister

Son

Consistent across several measures:• People discussed condition with• People most involved in decision making• People most influential in decision making

Consistent across several measures:• People discussed condition with• People most involved in decision making• People most influential in decision making

Feelings about all these conditions are generally negative, especially obesity and

insomnia. Migraines are seen as intensely negative.

How do you feel about having your condition?

pleasure and arousal with dominance

1

2

34

5

6

7

8

910

11

12

ObesityCongestive Heart Failure

Prostate CancerDiabetes

OsteoarthritisErectile Dysfunction

Migraine

High BPOsteoporosis

High Cholesterol

InsomniaDepression

1

2

3

4

5

6

7

8

9

1 2 3 4 5 6 7 8 9

Arousal

Ple

as

ure

1

2

3

4

5

6

7

8

9

1 2 3 4 5 6 7 8 9

Arousal

Ple

as

ure

Emotions surrounding talking to a physician differ somewhat by condition. Obesity and erectile dysfunction suffers have more negative feelings while prostate cancer sufferers are more comfortable talking to their doctors about

their conditions.

How do you feel about talking to your doctor about your condition? 1

2

345

6

7

89

10

11

12

Obesity

Congestive Heart Failure

Prostate Cancer

DiabetesOsteoarthritis

Erectile Dysfunction

Migraine

High BPOsteoporosis

High Cholesterol

Insomnia Depression

pleasure and arousal with dominance

1

2

3

4

5

6

7

8

9

1 2 3 4 5 6 7 8 9

Arousal

Ple

as

ure

1

2

3

4

5

6

7

8

9

1 2 3 4 5 6 7 8 9

Arousal

Ple

as

ure

People suffering from any of these conditions are more relaxed about talking

with an influencer than with their physician.

How do you feel about your [person most involved]’s involvementin helping you make healthcare decisions about your condition?

1

2

34 5

6

7

8 9

1011

12

Obesity

Congestive Heart FailureProstate Cancer

DiabetesOsteoarthritis

Erectile Dysfunction

Migraine

High BPOsteoporosis

High CholesterolInsomnia

Depression

pleasure and arousal with dominance

1

2

3

4

5

6

7

8

9

1 2 3 4 5 6 7 8 9

Arousal

Ple

as

ure

1

2

3

4

5

6

7

8

9

1 2 3 4 5 6 7 8 9

Arousal

Ple

as

ure

But how do the results differ by segments?

Hybrid segmentation was conducted across all conditions using Attitudes Behaviors Emotions

A six segment solution was selected. AdSAM proved to contribute powerful and

unduplicated new information to the analysis.

The six influencer segments

1 Forrest Gump (15%)• Open, relaxed with physician• Discuss Rx with physician• Open to advice from others• Optimistic• Fewest conditions, least

affected

2 Taxi Driver (22%)• Take fewest healthcare

actions• Distrustful of Rx and OTC• Distrustful of pharma ads• Distrustful of self• Distrustful of friends and

family

3 Ad Lovers (18%)• Get information from

pharma ads• Prefer Rx treatments• Optimistic about condition• Will ask physician about Rx• Shortest duration of

condition

4 Castaway (18%)• Least involved social network• Doesn’t share info with

family, physician• Doesn’t trust physician• Doesn’t want advice• Pessimistic

5 My Big Fat Greek Wedding (9%)

• Largest family connections• Most involved social network• Share with family• Takes most healthcare

actions• Open to Rx solutions

6 Home Alone (19%)• Fewest family connections• Prefer OTC over Rx• I know as much as the

doctor about my condition• Longest condition duration• Most treatments used• Seek information

Let’s look at two segments4 Castaway (18%)

• 51 yrs.• 52% female• Lowest income (11% $80,000+)• 21% rural, small MSA• 72% live with spouse• 43% 3+ household members• More likely to have: Depression, ED, Insomnia,

Obesity• 4.1 conditions• Moderate severity (53%)• Discussed condition with spouse (75%), mother

(32%), female friend (30%); mother-in-law (5%)• 95% have discussed condition with family

members, 54% with non-family members• Discussed with 3.1 people (least)• 57% used Rx for condition, 39% currently (least)• Least involved social network• Doesn’t share info with family, physician• Doesn’t trust physician• Doesn’t want advice• Takes fewest healthcare actions due to influence• Pessimistic

5 My Big Fat Greek Wedding (9%)• 49 yrs.• 60% female• High income (26% $80,000+)• 88% live with spouse (highest)• 56% 3+ household members (highest)• 28% rural, small MSA• More likely to have: Diabetes, Migraine,Congestive

Heart Failure• 4.4 conditions• Moderate severity (48%)• Discussed condition with spouse (93%), mother

(69%), female friend (64%), mother-in-law (64%), etc.

• 100% have discussed condition with family members, 93% with non-family members

• Discussed with 9.6 people (most)• 90% used Rx for condition, 77% currently using

(most)• Most involved social network• Share with family• Takes most healthcare actions due to influence• Open to Rx solutions

Segments 4 (Castaway) and 5 (Greek Wedding) feel similarly negative about having their conditions.

How do you feel about having your condition?

Each position in the three dimensional emotional space (pleasure-arousal-dominance) is associated with emotion adjectives, from Prominent Emotions Index© database, and related to each segment.

How do you feel about having your condition?

Segments 4 (Castaway) and 5 (Greek Wedding) also feel equally ambivalent about taking Rx medication for their condition.

How do you feel about taking prescription medication to treat your condition?

Segment 5 (Greek Wedding) members feel more positive about talking to their physician; Segment 4 (Castaway) feels very negative and not empowered.

How do you feel about talking to your doctor about your condition?

All segments feel more positive about talking with their influencer about their decisions than talking with their physician. Segment 5 (Greek Wedding) feels very positive, while Segment 4 (Castaway) is the most negative, and least empowered.

How do you feel about your [person most involved]’s involvement in helping you make healthcare decisions about your condition?

The emotion adjectives vary greatly between Segment 4 (Castaway) and Segment 5 (Greek Wedding) on feelings of involvement.

How do you feel about your [person most involved]’s involvement in helping you make healthcare decisions about your condition?

AdSAM® Prominent Emotions Index©

Feelings About Talking To Your DoctorAbout Your Condition

CastawaySegment 4

stressedaggravated

fearfulfrustratedembattled

My Big Fat Greek Wedding Segment 5

relaxedprotectedleisurelysecure

respectfulgrateful

appreciative

Feelings About Persons Involvement In Helping You MakeHealthcare Decisions About Your Condition

Segment 4protectedserenemodest

nonchalantaloof

My Big Fat Greek Wedding Segment 5

securerelaxed

untroubledrespectful

kindjoyfulloving

Castaway

AdSAM® Prominent Emotions Index©

Influencer Research Implications

DTC advertisers can motivate Segment 5 consumers (Greek Wedding) by also targeting their influencers, especially family members.

Segment 4 (Castaway) represent a difficult segment to motivate. Pharma companies should attempt to reduce the stress these consumers experience in talking with their physician to increase their likelihood to take action.

Conclusions

Emotional response provided valuable dimensions in framing the segmentation

Emotional profiling of segments helps to uncover motivators and barriers of key segments prior to messaging research

Identifying the feelings associated with each segment helps direct positioning

AdSAM provides an effective way of incorporating emotional response into segmentation research

DTC advertisers have an opportunity to incorporate influencers, (primarily spouses) as targets in addition to patients in developing and testing

messages. It is time to look beyond just the sufferer. Treatment choice and compliance could

be impacted by broadening beyond just the sufferer and the physician. There is no one “rule” however, that applies across all conditions.

DTC advertising is still evolving – consumer goods have long understood the influence of others in the decision making process. Packaged goods, fashion, computers, cars etc. are all successful targeting more than just the primary users/buyer and also vary the message by target.

Cereals – target parents for health, children for taste. Clothing stores – target parents for value, children for fashion. Cars – target one family member for image the other for safety. Computers – target parent for functionality, users (teenager) for “coolness”

DTC advertising that successfully targets both the sufferer and the influencer will result in a change in “action’ especially if the advertising is impactful enough to provoke the influencer to initiate the conversation.

More needs to be done to understand the role of the influencer – their attitudes and emotions towards the sufferers condition, their understanding of the available options and where they, in turn, go to for education on the condition.

Conclusions….