Ann M. Mirabito

Transforming Consumer Health

The 2010 Patient Protection and Affordable Care Act is intended to transform the U.S. health care system. Its success will require the transformation of consumers’ views about health and their willingness to participate in healthful behaviors. Focusing on three barriers to consumers’ engagement in healthful behaviors, the authors review the research literature and suggest opportunities for further research. Using a social marketing perspective, they suggest actions for health care providers, marketers, and policy makers to help overcome these barriers.

Partnering for Prevention with Workplace Health Promotion Programs

Progressive, well-managed, responsible companies are primed to become prevention partners with the medical community. The business community needs the medical community to integrate wellness into the workplace. However, the medical community also needs the business community. Payers compensate medical providers for diagnostic and treatment care. Employers’ health promotion programs emphasize behavioral change, which is undercompensated in the medical community but pays off in the business community. A business-medical partnership opens a new path to achieving a greater balance between prevention and treatment of disease. Wellness is the common goal

You Say You Want a Revolution? Drawing on Social Movement Theory to Motivate Transformative Change

Personal well-being of service employees and others is declining, yet well-being is likely to influence on-the-job productivity. Workplace wellness programming (WWP) is prevalent among service organizations, but is controversial with critics questioning the appropriateness and efficacy of employer involvement in personal health. To understand how employers engage employees in personal wellness, we conducted a qualitative field study of WWP in 10 diverse organizations. We found lower employee engagement and higher resentment in firms that relied primarily on wellness training, incentives, and impersonal communications. Employee engagement was higher in firms that collaborated with wellness-minded employees to (1) tap into long-standing, deeply held belief systems to forge an inspirational wellness ideology, (2) leverage social capital to recruit participants and resources, and (3) modify the physical environment to signal the importance of healthful behaviors and to reduce obstacles to healthful choices. The three strategies are pillars of social movement (SM) organization. Drawing on the rich SM literature and our fieldwork, we developed and tested an SM-inspired model for cultural and behavioral change. The findings have implications for internal marketing and social marketing theory and for managers seeking to create a culture of health and improve employee productivity and effectiveness in serving customers.

From Use to Abuse: When Everyday Consumption Behaviours Morph Into Addictive Consumptive Behaviours

Addiction does not begin with the harmful effects of being dependent on a particular consumption behaviour such as smoking, alcohol, or illegal drugs. Instead it starts with everyday seemingly benign behaviours that, through psychological, biophysical, and/or environmental triggers, can become harmful and morph into an addiction. We develop a framework based on harm and dependence that can help researchers better understand how consumers could become addicted to various types of everyday benign consumption behaviours (e.g., texting, shopping, plastic surgery, and other types of normally acceptable behaviours). Furthermore, the conceptual framework is based on expanding the concept of addiction to include the pre-addiction process with a focus on this continuum of benign to harmful behavioural consumption. This framework describes how consumers progress from a normal state of consumption into a state of addictive abuse and dependence. The framework discusses key issues and future research that can aid public policy researchers, practitioners, and marketers to better understand the entire pre-addiction process.

Lessons That Patient-Centered Medical Homes Can Learn From the Mistakes of HMOs

Patient-centered medical homes (PCMHs) have been endorsed by primary and specialty care medical associations, payers, and patient groups as an innovative structure for transforming health care delivery. The cornerstone principle of the PCMH is the primary care physicians coordination of a patients use of health care services, including visits to specialists, to improve effectiveness and efficiency. This principle aligns with the vision behind the creation of HMOs, managed care organizations that were once embraced by physicians, patients, and policy analysts but have since lost much of their luster. Many patients and physicians rejected HMOs as too restrictive, objecting particularly to the concept of gatekeeping. This article reviews the HMO experience and identifies lessons applicable to PCMHs that build on the strengths of HMOs while avoiding their mistakes.

The Stigma Turbine: A Theoretical Framework for Conceptualizing and Contextualizing Marketplace Stigma

Stigmas, or discredited personal attributes, emanate from social perceptions of physical characteristics, aspects of character, and “tribal” associations (e.g., race; Goffman 1963). Extant research has emphasized the perspective of the stigma target, with some scholars exploring how social institutions shape stigma. Yet the ways stakeholders within the sociocommercial sphere create, perpetuate, or resist stigma remain overlooked. The authors introduce and define marketplace stigma as the labeling, stereotyping, and devaluation by and of commercial stakeholders (consumers, companies and their employees, stockholders, and institutions) and their offerings (products, services, and experiences). The authors offer the Stigma Turbine as a unifying conceptual framework that locates marketplace stigma within the broader sociocultural context and illuminates its relationship to forces that exacerbate or blunt stigma. In unpacking the Stigma Turbine, the authors reveal the critical role that market stakeholders can play in (de)stigmatization, explore implications for marketing practice and public policy, and offer a research agenda to further understanding of marketplace stigma and stakeholder welfare.