How message appeals and prior product use influence information processing, risk perceptions, trust, attitudes, and genetic test purchase intentions

PLOS ONE RESEARCH ARTICLE How message appeals and prior product use influence information processing, risk perceptions, trust, attitudes, and genetic test purchase intentions Matthew S. VanDyke ID1*, Nicole M. Lee ID2, Alan Abitbol3, Stephen W. Rush ID4 a1111111111 a1111111111 a1111111111 a1111111111 a1111111111 1 Department of Advertising & Public Relations, The University of Alabama, Tuscaloosa, Alabama, United States of America, 2 School of Social & Behavioral Sciences, Arizona State University, Phoenix, Arizona, United States of America, 3 Department of Communication, University of Dayton, Dayton, Ohio, United States of America, 4 Mike Curb College of Entertainment & Music Business, Belmont University, Nashville, Tennessee, United States of America * Abstract OPEN ACCESS Citation: VanDyke MS, Lee NM, Abitbol A, Rush SW (2023) How message appeals and prior product use influence information processing, risk perceptions, trust, attitudes, and genetic test purchase intentions. PLoS ONE 18(3): e0283102. https://doi.org/10.1371/journal.pone.0283102 Editor: Ali B. Mahmoud, St John’s University, UNITED STATES Received: April 4, 2022 Accepted: March 1, 2023 Published: March 15, 2023 Copyright: © 2023 VanDyke et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: All relevant data are within the manuscript and its Supporting Information files. Funding: Data collection was supported by the Lewis Research Fund in the Department of Advertising & Public Relations at The University of Alabama. There was no additional external funding received for this study. Competing interests: The authors have declared that no competing interests exist. Within the direct-to-consumer (DTC) genetic test industry, attracting customers can be difficult especially due to the highly sensitive nature of these products. How these tests are communicated to consumers may be one avenue in which companies can impact customer purchase intentions. A 2 (message sidedness: one-way vs. two-way refutational) x 2 (hedging: present vs. absent) between-subjects experiment was conducted to understand how message features and prior product use influence information processing, risk and trust perceptions, and attitude toward the genetic test, which in turn, may influence direct-to-consumer (DTC) genetic test purchase intentions. Results demonstrated that having used a genetic test in the past predicted participants’ trust in the company, information processing, and risk judgments; however, among those who used a genetic test, viewing a message that included hedging tended to increase their trust in the message. Trust in the message and company, information processing, and risk judgments significantly predicted participants’ attitudes toward genetic testing, which in turn predicted their purchase intentions. The results suggest that in the context of DTC genetic test messaging, practitioners should strive to increase consumer trust in the message and the company and facilitate information processing, and they should work to diminish perceived risk. These results suggest opportunities for identifying other message features that may influence message and company trust, information processing, risk judgments, and attitudes related to DTC genetic testing. Introduction Since hitting the market in the early 2000s, direct-to-consumer (DTC) genetic tests such as those produced by 23andMe and Ancestry.com have become increasingly popular. As of July 2019, 15% of U.S. adults had taken one or more DTC tests to obtain health and/or ancestral information [1]. As the prevalence of such tests has grown, so have concerns about the ability PLOS ONE | https://doi.org/10.1371/journal.pone.0283102 March 15, 2023 1 / 20 PLOS ONE Message appeals and prior use influence processing, perceptions, trust, attitudes, and genetic test purchase of consumers to understand and act upon the information provided [2]. In particular, medical professionals have expressed concerns about the clinical utility of DTC genetic tests [3] and about consumers making health decisions based on their results without guidance from a physician or genetic counselor [4, 5]. Test results indicating average or below average risk for a disease or condition may give consumers a false sense of security because tests only include specific genetic variants and do not account for other risk factors [6]. On the other hand, results indicating increased risk may cause unnecessary worry in instances where absolute risk (as opposed to relative risk) is still very low or when there are no additional screenings or treatments available for the condition, meaning the consumer cannot act on the information they receive. DTC genetic tests represent a unique communication context as companies are essentially selling a scientific product directly to consumers by collecting genetic samples and other sensitive information. Because of this, concerns have been raised regarding privacy and information security [7]. Thus, such companies need to balance traditional product promotion strategies with information communicating the science and risks associated with the product and services provided. Accordingly, this study was informed by the message sidedness literature—as message sidedness is a common variable used to compare the influence of promoting a position (e.g., “buy this genetic test!”) against promoting a position while also inoculating against an opposing position (e.g., “buy this genetic test, because it’s better than others!”)—and the hedging literature—to examine the impact of disclosing uncertainties and limitations inherent in DTC genetic test products. These variables afforded the opportunity to examine and compare the influence of traditional product promotion (message sidedness) and communication of scientific risk (hedging) in a DTC health product context. Previous research in this area analyzed social media content from 23andMe to understand how the popular DTC genetic testing company balances promotional and science content [8]. Still, scholars have called for more research examining communication strategies used in for-profit science communication [9] and there are opportunities to examine the processes and effects of how message strategies may influence consumers’ perceptions and purchase intentions related to DTC genetic testing. Pharmaceutical advertising has dominated most scholarly attention in the DTC communication space related to science, health, and risk. Researchers analyzed content of DTC prescription drug commercials and websites [10–12], the presentation of risk information on branded drug websites [13], the presence of third-person effects among older consumers [14], how consumer reliance on certain information channels associates with a (...truncated)