Portrayal of Women in Print Advertisements for Hormonal Contraceptives

Material Information

Portrayal of Women in Print Advertisements for Hormonal Contraceptives Using Qualitative Interviews and Focus Groups to Study Agency Professionals and Their Target Consumers
Ehrlich, Amanda
Place of Publication:
[Gainesville, Fla.]
University of Florida
Publication Date:
Physical Description:
1 online resource (108 p.)

Thesis/Dissertation Information

Master's ( M.Adv.)
Degree Grantor:
University of Florida
Degree Disciplines:
Journalism and Communications
Committee Chair:
Treise, Deborah M.
Committee Members:
Goodman, Jennifer R.
Villegas, Jorge
Graduation Date:


Subjects / Keywords:
Advertising campaigns ( jstor )
Advertising research ( jstor )
Birth control ( jstor )
Brands ( jstor )
Consumer advertising ( jstor )
Depth interviews ( jstor )
Focus groups ( jstor )
Gender roles ( jstor )
Research methods ( jstor )
Women ( jstor )
Journalism and Communications -- Dissertations, Academic -- UF
account, advertising, birth, contraceptives, dtc, focus, hormonal, pharmaceutical, planning
bibliography ( marcgt )
theses ( marcgt )
government publication (state, provincial, terriorial, dependent) ( marcgt )
born-digital ( sobekcm )
Electronic Thesis or Dissertation
Advertising thesis, M.Adv.


This thesis presents a pilot study regarding the portrayal of women in print advertisements for hormonal contraceptives. Utilizing the qualitative methods of one-on-one interviews and focus groups, this study interviewed both account planners and the target market of hormonal contraceptives. The goal of the study was to compare the responses of agency professionals and their consumers to determine whether or not the responses were congruent. The researcher utilized the grounded theory to develop and analyze the methods of qualitative interviews and focus group interviews. The participants were all Caucasian graduate students, ages 20-24, had lived in the United States for more than five years, and were not against birth control for any religious reasons. This study determined that account planners are largely aware of the needs of their target consumers, however, the portrayal of women in print advertisements for hormonal contraceptives still received a largely negative response from the focus group participants. This discrepancy is due, in part, to the gender of the account planners and their clients. If these agency professionals and their clients work together to avoid gender biases, the perception of these types of advertisements may garner a more positive reception in the future. ( en )
General Note:
In the series University of Florida Digital Collections.
General Note:
Includes vita.
Includes bibliographical references.
Source of Description:
Description based on online resource; title from PDF title page.
Source of Description:
This bibliographic record is available under the Creative Commons CC0 public domain dedication. The University of Florida Libraries, as creator of this bibliographic record, has waived all rights to it worldwide under copyright law, including all related and neighboring rights, to the extent allowed by law.
Thesis (M.Adv.)--University of Florida, 2009.
Adviser: Treise, Deborah M.
Statement of Responsibility:
by Amanda Ehrlich.

Record Information

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Rights Management:
Copyright Ehrlich, Amanda. Permission granted to the University of Florida to digitize, archive and distribute this item for non-profit research and educational purposes. Any reuse of this item in excess of fair use or other copyright exemptions requires permission of the copyright holder.
Resource Identifier:
665095442 ( OCLC )
LD1780 2009 ( lcc )


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2009 Amanda Ehrlich 2


To m y parents, Robert and Debra Ehrlich, and my brother, Scott Ehrlich, for their support, encouragement, and patience with my graduate education 3


ACKNOWL EDGMENTS The first acknowledgement of my gratitude goes toward my thesis chair, Dr. Debbie Treise, for having faith in me, despite my many protestations. Whenever I had questions or concerns (which was frequently), she was always readily available to assist and calm me. I would also like to thank my two committ ee members, Dr. Jorge Villegas and Dr. Robyn Goodman, for their guidance and support throughout the thesis process. Without my thesis committee, I never would have made it to the final stage. A special thank you is also due to my w onderful family and friends. My mother and father are owed my gratitude for always encourag ing me and putting everythi ng into perspective. I love them both so very much. I would also like to thank my brother for always being armed with a delightfully sarcastic comment to keep me laughing throughout the whole process. I would also like to thank all of my friends (yes, all of them). I thank them for putting up with me despite my whining, complaining, and frus tration. I am sure that at some point, all of them have felt the wrath of my thesis and I apologize. I thank them for inspiring laugher throughout the whole process. Finally, I wish to thank Todd for supporting me every step of the way and calming me down when I felt overwhelmed. He has been my number one fan throughout this process, and I could not have done it without him. 4


TABLE OF CONTENTS ACKNOWLEDGMENTS ...............................................................................................................4 ABSTRACT.....................................................................................................................................8 CHAPTER 1 INTRODUCTION................................................................................................................. ...9 Rationale/Significance of Study...............................................................................................9 Purpose...................................................................................................................................10 2 LITERATURE REVIEW.......................................................................................................12 Theories Applicable to the Study...........................................................................................12 Direct-to-Consumer Advertising............................................................................................15 Advertising Hormonal Contraceptives...................................................................................18 Portrayal of Women in Advertising........................................................................................20 Account Planning Process......................................................................................................26 Limitations of Previous Studies..............................................................................................29 3 METHOD....................................................................................................................... ........30 Research Questions............................................................................................................. ....30 Research Methods...................................................................................................................30 Qualitative Research........................................................................................................... ....30 Qualitative Interview.......................................................................................................... ....32 The Interview Guide (Appendix C).................................................................................34 Respondent Selection......................................................................................................35 Interview Process/Data Collection..................................................................................36 Focus Groups..........................................................................................................................37 Research Design..............................................................................................................39 Selection of Participants..................................................................................................39 Recruitment of Participants.............................................................................................41 Number of Groups...........................................................................................................42 Size of Groups.................................................................................................................42 Moderators Guide (Appendix F)....................................................................................43 Conducting the Focus Groups.........................................................................................44 Data Analysis..........................................................................................................................45 4 RESULTS...................................................................................................................... .........47 Qualitative Interviews......................................................................................................... ....47 The Differences between Advertising NonPrescription Drugs and Prescription Drugs.......48 Research, Research, Research.........................................................................................49 Focus Groups and One-On-Ones.....................................................................................50 5


The Account Planning P rocess in Hormonal Contraceptives..........................................51 The Portrayal of Women in Hormon al Contraceptive Advertisements..........................53 Focus Groups..........................................................................................................................55 Category 1: Hormonal Contraceptiv es are Still Prescription Drugs...............................56 Subcategory 1: Frivolity...........................................................................................56 Subcategory 2: Wheres the beef?...........................................................................58 Subcategory 3: Transparency...................................................................................60 Category 2: Wheres the Birth Control in Birth Control Advertisements?....................62 Category 3: Motivation to Take Action...........................................................................64 Core Category: Portrayal of Women in Print Advertisements for Hormonal Contraceptives..............................................................................................................65 Subcategory 1: Unrealistic/fake...............................................................................66 Subcategory 2: Sexualized bimbos..........................................................................68 Subcategory 3: Relatable..........................................................................................69 5 DISCUSSION................................................................................................................... ......72 Answering the Research Questions and Generating Theory..................................................72 Practical Implications......................................................................................................... ....79 Limitations.................................................................................................................... ..........82 Suggestions for Future Research............................................................................................83 Conclusion..............................................................................................................................84 LIST OF REFERENCES...............................................................................................................86 APPENDICES A PRELIMINARY RESPONDENT E-MAIL...........................................................................91 B QUALITATIVE INTERVIEW GUIDE.................................................................................92 C FOCUS GROUP SCREENING EMAIL................................................................................93 D FOCUS GROUP SCREEN ING QUESTIONNAIRE............................................................94 E MODERATORS GUIDE......................................................................................................95 F FOCUS GROUP INFORMED CONSENT............................................................................98 G FOCUS GROUP TRANSCRIPT EXAMPLE........................................................................99 H YAZ PARTY PRINT AD.....................................................................................................101 I YAZ FIGHTING PRINT AD...............................................................................................102 J YAZ BALLOONS PRINT AD............................................................................................103 K SEASONIQUE PRINT AD..................................................................................................104 6


L NUVARING PRINT AD......................................................................................................105 M ACCOUNT PLANNER PROFILES....................................................................................106 BIOGRAPHICAL SKETCH.......................................................................................................107 7


Abstract of Thesis Presen ted to the Graduate School of the University of Florida in Partial Fulfillment of the Requirements for the Degree of Master of Advertising PORTRAYAL OF WOMEN IN PRINT ADVERTISEMENTS FOR HORMONAL CONTRACEPTIVES: USING QUALITATIV E INTERVIEWS AND FOCUS GROUPS TO STUDY AGENCY PROFESSIONALS AND THEIR TARGET CONSUMERS By Amanda Ehrlich May 2009 Chair: Debbie Treise Major: Advertising This thesis presents a pilot study rega rding the portrayal of women in print advertisements for hormonal contraceptives. U tilizing the qualitative methods of one-on-one interviews and focus groups, this study intervie wed both account planners and the target market of hormonal contraceptives. The goal of the st udy was to compare the responses of agency professionals and their consumers to determine wh ether or not the responses were congruent. The researcher utilized the grounded theory to develop and anal yze the methods of qualitative interviews and focus group interviews. The participants were all Caucasian graduate students, ages 20 had lived in th e United States for more than five years, and were not against birth control for any religious reasons. This study determined that account planners are largely aware of the ne eds of their target consumers, however, the portrayal of women in print advertisements for hormonal contraceptives still received a la rgely negative response from the focus group participants. This discrepancy is due, in part, to the gender of the account planners a nd their clients. If these agency professionals and their clients work together to avoid gender biases, the pe rception of these types of advertisements may garner a more positive reception in the future. 8


9 CHAPTER 1 INTRODUCTION Rationale/Significance of Study With a total expenditure of $4.5 billion in 2006, direct-to-consumer pharmaceutical advertising1 (DTC) is a major player in the advertising game (Kelly, 2007, pg.14). In fact, DTC is now the fastest growing healthcare expe nse (Findlay, 2002, pg. 21). Within the booming, yet controversial industry of DTC is the equally controversial area of hormonal contraceptive2 advertising. In a study conducted by the CDC in 2002, the leading method of contraception was found to be the oral contraceptive, a type of hormonal contraceptive, used by over 11.6 million women, ages 15-44. In this same study, a st aggering 82% of women who have ever had intercourse reported using the oral contraceptiv e pill. By the year 2002, it was reported that 44.5 million women ages 15 had ever used the contraceptive pill (Mosher, Martinex, Chandra, Abma, & Wilson, 2002, pg. 1). Thus, the amount of money and women invested in hormonal contraceptives is tremendous. While the investment in hormonal contracep tives is significance enough, consider that hormonal contraceptives are one of the few pr escription drugs available only to women. Therefore, the manner in which DTC advertisers c hoose portray their sole target market is of great interest. Additionally, research indicates, women appear slightly more inclined to pay attention to DTC advertisement messages than ma les (Joseph, Stone, Japer, Stockwell, Johnson, 1 DTC prescription drug advertising is defined as any promotional effort by a pharm aceutical company to present prescription drug information to the general public through the lay media, i.e., newspapers, periodicals, television and radio (Shah, Holmes, Desselle, 2003, pg.23). 2 Hormonal Contraceptives include any drug designed to act on the hormonal system to provide for the intentional prevention of conception or impregnation in a sexually active female. These drugs can be taken orally, vaginally, transdermally, or through injections or implants.


and Huckaby, 2005, pg. 242). Therefore, advertisem ents for hormonal contraceptives hold a great deal of persuasive power over females. Because several studies on gender stereot yping suggest that advertisements profoundly influence how people perceive and relate to one another, understandi ng the level to which women are portrayed in these hormonal contraceptiv e advertisements (whether stereotypically or not) is of great social importa nce (Plous and Neptune, pg. 628) To understand how women are portrayed in hormonal contracep tive ads means to understand how women are socially perceived in a category that is based only on their needs. A dditionally, the interest of this study is not only to uncover how advertisers and thei r agencies view their target market, but also to unveil how their target market views themse lves. Thus, understanding their se lf-perceptions will provide for an extremely interesting and who lly original line of research. Surprisingly, despite the tremendous amount of money involved in DTC pharmaceutical advertising and the social signif icance of understanding gender portr ayals, few studies have been conducted analyzing the portrayals of women in DTC advertisements. Additionally, virtually no research exists regarding the portrayal of women in advertis ing for hormonal contraceptives, whether in print or on television. Because adve rtisements for hormonal contraceptives have become so ubiquitous in advertising today, espe cially in womens magazines, this lack of research is highly surprising. Finally, no study on the portrayal of females in advertising has ever explored the portrayal of the female from the perspective of a dvertising professionals themselves. Purpose In an area as controversial and financially si gnificant as DTC, the dearth of information and research available on gende r portrayals in DTC advertising allows for a compelling, yet 10


widely untouched area of study. Through researc h, insights into areas where few have been developed have em erged. The portrayal of women in cu rrent print advertisements for hormonal contraceptives was examined in this study via qualitative pers onal interviews and focus groups. Print advertisements were selected as the medium beca use studies suggest that magazines provide the most effective format for DTCA; consumers find ads for prescription drugs in magazines the most memorable and are more likely to ask physic ians about products advertised in magazines than in other media (Shah, Holmes, and Desse lle, 2003, pg. 27). Following a selection of the most common print advertisements for hormonal c ontraceptives, those agencies responsible for the development of the print advertisements we re contacted and interv iewed regarding their account planning process. Specific a ttention was paid to the types of research and insights that led the account planners to recomm end that the females in the a dvertisements be portrayed in their selected manner. After unde rstanding the portrayal of wome n from the agency side, the largest users of hormonal contraceptives, wome n ages 20, were interviewed in a focus group format (Mosher et. al, 2004). Through these interviews, this study was able to determine whether or not the manner in which the target fe male consumer perceives the female model in the advertisements and the manner in which the agency perceives the female model in the advertisements is congruent. The level of congruency of the agen cy to the consumer has led to a discussion of the theoretical implications of th e findings and to the development of theoretical reasoning to explain the findings. 11


12 CHAPTER 2 LITERATURE REVIEW This literature review will present previ ous research performe d on all aspects of information relevant to the study. Through thes e summaries, the role of the study within currently available research will become apparent The literature review will begin with theories that are relevant to the area of study. It will next continue wi th a general overview of the DTC industry and its relationship to the main topic. Following a discussion of DTC, a more specific examination of one aspect of DTC will be discussed, that of hormonal contraceptives. Because there has been little prior rese arch conducted on current hormonal contraceptive advertising, this section will deal primarily with th e history of oral contraceptive advertising. In the next section, the subjects of DTC and hormonal contraceptiv e advertising will be bridged together by a summation of information available regarding the portrayal of women in print advertisements. Finally, a discussion of the account planning proc ess will reveal how prin t advertisements are developed from research to c onceptualization to execution. Theories Applicable to the Study Grounded Theory: Typical research studies work in a deductive fashion, using existing theories to craft hypotheses and us ing a quantitative research met hod to test the merit of these hypotheses. However, qualitative research is not entirely typical Qualitative research works in the opposite manner of quantitative research, in an inductive fashion, developing theory from the research method. However, if theories are to be attained inductively from qualitative studies, these studies must be guided by some system of rules in order to legitimize the research. That is, quantitative research follows th e scientific method, a long-estab lished pattern of scientific research. Because qualitative research is an atypi cal form of research, in order to gain validity as a method, grounded theory was developed to pr ovide necessary guidelines and structure.


Grounded theory was developed in 1967 by Barney G. Glaser and Anselm L. Strauss in an effort to provide a strategic framework to qualit ative research and to he lp legitimize it among the research community. In their text, Glaser and St rauss define grounded theory as the process of purposeful systematic generation of new theo ries from the data of social research (1967, pg.28). Glaser and Strauss argue that grounded theory in qualitat ive research can actually be superior to quantitative research as quantitative research is merely concerned with the testing of hypotheses and little else. That is, quantitative research uses preexisting theories to develop hypotheses and then all effort is made to eith er accept or deny these hypotheses. Any other information that is generated in the study is larg ely ignored, as it is secondary to the testing of hypotheses. Thus, a focus on testing can thus eas ily block the generation of a more rounded and more dense theory (pg. 27). Grounded theory, on the other hand, can prove to be a much more productive form of research, stimulating a vari ety of research and study, constantly exciting students (pg. 4). Thus, while grounded theory is intimately connected to the data from which it is produced, the theories developed from such a method of research, inspire researchers to develop further methods of testing such theories or attempts to work with and modify the theory generated. Furthermore, unlike hypothesis testing where the hypothesis can be negated, theory based on data can usually not be completely refu ted by more data or replaced by another theory. Since it is too intimately linked to data, it is destined to last despite its inevitable modification and reformulation (pg. 4). While there are certainly many benefits of utilizing grounded theor y, these benefits can only prevail if the guidelines of grounded theory are properly followed. An important aspect in grounded theory is theoretical sampling or the pr ocess of data collection for generating theory whereby the analyst jointly collects, codes, and anal yzes his data and decides what data to collect 13


next, and where to find them in order to develo p his theory as it emerges (pg. 45). Because data serves as the basis for grounded theory, its proper collection and sampling is pivotal. In grounded theory, sampling does not simply refer to acquiring the proper demographic group as an interview pool, but also refers to acquiring a de mographic that displays the concepts that are under study (pg. 9). Thus, once a concept has earned its way into a studythen its indicators should be sought in all subsequent interviews and observations (pg.9) Another area of procedural importance in ground ed theory is that of data collection. In grounded theory, data collection an d analysis are interrelated pro cesses (Corbin and Strauss, 1990, pg.6). Therefore, unlike in traditional qualitative research, where all data is collected before analysis, in grounded theory research, the analysis begins as soon as the first bit of data is collected (pg.6). Thus, the analysis that is captured from the data help s to guide further areas of research. It is for this reason that analysis ob tained from one qualitative interview will help to guide the questions that will be addressed durin g following qualitative interviews and during the focus groups (More specific information on data collection can be found in the Methods section of this study). The mixture of data collection and analysis is also sign ificant because only those concepts that are found to occur repeatedly in th e interviews or the focu s groups will earn their way into the theory (pg.7). Therefore, by no ting commonly addressed concepts early on in the interview process, questions can be adjusted in later interviews to better glean information on these repeating concepts. Other elements of grounded theory include coding methods and measures of analysis. These procedures will be discussed in the analysis section of this study. The key significance of grounded theory to this study is th at preexisting theory will not gui de this study. There are a few theories, to be discussed later, that help to further elaborate on the significance of the study, but 14


that do not dictate the research questions nor the research m et hod. Following the guidelines of grounded theory, this study will use the data collected to develop a theory based on key concepts discovered during the qualitativ e interviews and focus groups. Direct-to-Consumer Advertising Despite its multi-billion dollar advertising budge t, direct-to-consumer advertising is still relatively new. Pharmaceutical advertisements ha ve only been allowed in broadcast media since 1997, when the Food and Drug Administration (FDA) relaxed its guidelines on advertising pharmaceuticals (Kelly, 2007, pg. 14). Prior to th is relaxation by the FDA, pharmaceutical companies marketed their drugs to doctors and pharmacists through trade journals and conferences (Huh and Becker, 2005, pg. 442). Ho wever, once pharmaceutical manufacturers received the okay from the FDA to market direct to the consumer, the DTC industry was born. From the outset, however, DTC has encount ered controversy. The idea of selling prescription drugs straight to the consumer without a doctor or a pharmacist acting as an intermediary has irked many in the professional wo rld as well as many consumers. Much of the controversy involves the power of DTC ads to drive consumers into their doctors offices, demanding a prescription for a drug they saw advertised in print or on television. Many studies have been conducted on this driving power of DTC advertising. One study published in the British Medical Journal found that of their surveyed population, patients requested prescriptions in 12% of surveyed visits. Of these requests, 42% were for pr oducts advertised to consumers (Mintzes, Morris, and Kravitz, 2002, pg. 278). In a telephone survey conducted by the FDA, the results showed that three-quarters of those surveyed remembered seeing an ad for prescription drugs in the previous three months. Of these responde nts that recalled seeing an ad, 25% said they had asked their doctor about a cond ition referred to in the ad, and 13% asked for the specific drug (Findlay, 2002, pg. 22). In a nother telephone survey, this one conducted by 15


Prevention m agazine, out of ,222 consumers survey ed, 72 (6%) ended up with a prescription drug because they saw an advertisement for it (Findlay, 2002, pg. 22). As suggested by the results of these three studies, there is no conclusive response to the question of the persuasive power of DTC in terms of prescr iption requests. The bottom lin e: Most experts agree that no scientifically rigorous studies have yet quant ified the magnitude of the impact of DTC advertising on consumer behavior physician prescribing patterns, or public health (Findlay, 2002, pg.22). In addition to the controversy over DTCs pow er to drive unnecessary prescriptions based on the direct-to-consumer advertising of prescrip tion drugs, lies the controversy over whether or not DTC advertising increases sale s. That is, is the amount of money spent to promote a drug, correlated with the amount of sales earned from th at drug? There have been previous studies that link higher sales of heavily adve rtised drugs to increased adve rtisement spending on those same drugs (Joseph, Stone, Japer, Stockwell, Johnson, and Huckaby, 2005, pg. 235; Davis, 2000; Doucette and Schommer, 1998). However, the results are largely inconclusi ve as there are other factors involved. For example, th e higher sales levels could be due to the increase in the cost of prescription drugs. Most industry ex perts have attributed this rise in drug prices as the result of the high expenses for research and development in order to make advances in medial research and new miracle drugs (Joseph, Stone, Japer, Stockwell, Johnson, and Huckaby, 2005, pg. 235; Shields, 2003). However, those opposed to th e pharmaceutical industry would argue that the increase in drug prices is due to the greed a nd monopolization of power by the drug companies. The controversial nature of DTC, for all of the aforementioned reasons, has led many to go against the drug industry. Many consumers fi ght the drug companies by illegally obtaining their drugs from Canada. These consumers believe that the elevated prices of prescription drugs 16


are due to the high m arketing expenses of the dr ug companies. Others, including an academic from Duke University and an analyst for Consumer Reports fight the drug industry by speaking out against DTC during a panel held by the FDA in Washington, D.C. (McGuire, 2005, pg. 30). As recently as May 2007, the DTC industry was a ttacked by the Senate via a bill proposing a moratorium of up to two years on ads for new drugs (Arnold, 2007, pg. 9). The bill, proposed by Senator Roberts of Kansas, was ultimately voted down. Negative reactions from the Senate and Congress toward DTC have been raging for n early a decade and are likely to continue indefinitely. For example, it is possible that the recent election of democrat Barack Obama to the office of President could bring about further DTC regulations. While there is much to be said against DTC pharmaceutical advertising, there is also a great deal to be said in s upport of such an industry. For example, proponents of DTC advertising argue that DTC ads give consumers the information they need to discuss medical symptoms and treatment options with thei r physicians (Huh and Becker, 2005, pg. 442). In other words, it enable[s] them to take a more active role in interacting with health professionals (Choi and Lee, 2007, pg. 137). Additio nally, the information that is provided to the consumer allows the consumer to become ed ucated about medical conditions and treatments that they might not otherwise be aware. In a se nse, DTC advertising can be said to empower the average consumer (Huh and Becker, 2005, pg. 442). So how does this entire discussion of DTC pharmaceutical advertising fit into the advertising of hormonal contraceptives in print? First, like all other prescription drugs being advertised, hormonal contraceptives are only avai lable after consultation with a doctor. These contraceptives may be prescribed for birth c ontrol purposes or due to medical conditions. Because most hormonal contraceptives have been proven to reduce the duration of periods, the 17


intensity of cram ps, and the effects of other pre-menstrual symptoms, they can fit under a medically necessary umbrella. For example, many women choose to use a birth control pill because they suffer from debilitating cramps and wish to curb these symptoms with medical treatment. In this way, DTC advertising allows for women to find out information regarding the medicines on the market to help them with th eir medical issues. Additionally, DTC advertising allows women to discover new brands of hormona l contraceptives and th e new attributes that each new brand brings. However, there is growing concern as to whether providing females with information regarding treatments for their periods is helpful for their medical health or if it is a hindrance. For example, one oral contraceptive, Yaz, has been pr oven to reduce moderate acn e in clinical trials (Nurse Practitioner, 2007, pg. 58). In its DTC a dvertising of Yaz, Bayer Schering Pharma AG, make it a point to mention their products acne-f ighting power. As a result, many teenage girls have begun to utilize Yaz as a means to combat their acne. However, because Yaz is also a contraceptive, these youngsters may also feel that sexual intercourse at their age is acceptable because they are protected from getting pregnant. In this case, some would suggest that a benefit such as acne-prevention should be kept out of Yazs DTC advertis ements as it encourages those who may not have otherwise know n about the pills added benefit to ask their doctor for a prescription. Advertising Hormonal Contraceptives In the 1960s, the Searle pha rmaceutical company received FDA approval for the first ever birth control pill, known si mply as the Pill (Webmd, 2007) From that moment forward, the birth control industry was change d forever as oral contraceptives were born. At that point in time, the pill was only advertised to medical professionals. In the professional advertisements, the revolutionary nature of the drug was the key selling point while the ability of the drug to 18


em power women and rewrite the social order was severely downplayed (Tone, 2006, pg. 261). The women in these advertisements were consiste ntly depictedas passive patients in need of strong male and medical guidance (Tone, 2006, pg. 261). As a gender, the women of these advertisements were: Overwhelmingly middle-class, white, and married. Conservatively dressed, they wear tasteful lipstick hues and opaque pantyhose. They respect the social order. They are not the bra-burning feminists who operate underg round abortion clinics and demonstrate against the Vietnam War. (Tone, 2006, pg. 261-2) Thus, while the birth control pill was inte nded to liberate women from the burden of unwanted pregnancy, the advertisements portrayed the potential consumers of the product as anti-feminist and highly constrained. When pha rmaceutical advertising was allowed to be presented directly to the consumer in the late 1990s, the portrayal of women remained restrained. Once the public had access to contraceptive advertising, marke ting executives had to play a double gamesignal[ing] to women the liberatin g possibilities of their products without assaulting the sensibilities of t hose who still regarded contracep tives as sexually obscene (Tone, 2006, pg. 262). However, in the new millennium, the advert ising of hormonal contraceptives has become more common and more routine than in the nineties. Lately, new hormonal products have emerged on the market, altering the way hormo nal contraceptives are marketed. These new products seek to tackle a problem that has been plaguing women since the oral contraceptive was introducedremembering to take the pill: Once hailed as a breakthrough in efficacy and e fficiency, the pill has become an onerous nuisance for many women. When they get bus y with jobs, children and travel, some women forget to take their da ily tablet. As a result, though th e pill is 99%-effective in clinical trials, in the real world it fails 5% to 8% of the time. (Parker-Pope, 2002, pg. D1) The key issue that many women have with the oral contraceptive is the fact that it must be taken by mouth, daily, and at re latively the same time every da y. Thus, while it is celebrated 19


as a liberating wonder drug, the oral contraceptive can still be som ewhat restricting. In an effort to address these concerns, Ortho Evra, an a dhesive patch, NuvaRing, a vaginal insert, and Lunelle, an injection, have been developed recen tly. These three products allow for the dosage of pregnancy-preventing hormones to be given monthly, rather than daily. Thus, because these products allow for a less stringent dosing schedule, their advertising campaigns reflect their liberating abilities. Ortho Evras campaign focu ses on its once-monthly dosage with its copy: The patch has the effectiveness of the Pill and f its into my hectic schedule (Ortho Similarly, NuvaRings campaign emphasizes freedom with its tagline I broke free from the pack. These relatively new products ar e changing the face of hormonal contraceptive advertising by emphasizing liberatio n in ways not previously see n. In an effort to remain competitive with such products, oral contracepti ve manufacturers find themselves trying to emphasize product benefits that are not found in these non-oral contraceptives. Seasonique, for example, is an oral contraceptive that reduces the number of periods women experience from 12 per year to just four per year and touts its product as Birth Cont rol Plus Fewer Periods. Thus, the hormonal contraceptive market has gotten more advanced and more competitive since Tone (2006) concluded her study. W ith these new product benefits and a heightened level of competitiveness among hormonal contraceptive manufact urers, it will be of gr eat interest to see whether women in hormonal contraceptive print a dvertisements have become more relatable and the overall advertisement has become less pa tronizing than those from years past. Portrayal of Women in Advertising Throughout the years, there have been countless studies involving gender roles in advertising (Lindner 2004; Ford and LaTour 1996; Busby and Leichty 1993). The rationale behind these studies is primarily the fact that the images presented in advertisements act as socializing agents that influen ce our attitudes, values, beliefs, and behaviors (Lindner, 2004, pg. 20


409). In other words, the constant viewing of such stim uli throughout our lifetime acts as a force in shaping our ideals of masculinity and femi ninity (Lindner, 2004, pg. 409) It is no wonder, then, that studying gender roles is of great importance to social research. The majority of interest in women in advert ising comes from a desire to address what are considered wholly unfair and unna tural depictions of women. These depictions are not only potentially debilitating and demeaning, but they are also inaccurate (Lazier and Kendrick, pg. 200). These portrayals, while demeaning, also lead to behavioral issues between men and women. Because even brief exposure to an image affects audience percepti ons of social reality immediately after exposure and even brief expo sure to advertisements that rely on gender stereotypes reinforces stereot ypes about gender roles, it is apparent that gender roles in advertising can affect behavior (Lafky, Du ffy, Steinmaus, and Berkowitz, 1996, pg.385). For example, studies have demonstrated that the increased level of attractiveness of females in advertising has led to an eleva tion of expectations for ones pa rtners attractiveness (Kendrick, Gutierres, and Goldberg 1989; Reichert, LaT our, Lambiase, Adkins, 2007). Another study shows that male interviewers who had watche d sexist television comm ercials later judged a female job applicant as less competent (Pl ous and Neptune, 1997; Rudman & Borgida, 1995). Clearly, the effects of female portrayals in advertising have pointed to negative effects on social behavior. However, how does one measur e such elements as attractiveness or sexiest imagery in female portrayals? Numerous resear chers have attempted to quantify depictions according to self-designed scales (Erving Goffman 1979; Butler-Paisley 1974; Pingree et al 1976; Sexton and Haberman 1974). Erving Goffman, considered a pi oneer in the analysis of women in advertising, placed the portrayals of fe males in advertising into six categories: size relative to men, feminine touch, family-oriented, function ranking, infe riority, and withdrawn 21


wom en (Goffman, 1979). In terms of feminine touch, Goffman found that womens hands were used to outline or cradle a product, or that the female was touching herself (not necessarily in a sexual manner). In the category of withdrawn women, Goffman found that women were distant psychologically and ther efore were dependant on men for protection (Goffman, 1979). The overall theme of Goffmans analysis was that females and males were involved in a parentchild relationship in advertis ing, where men were the parents and women were the children (Goffman, 1979, pg. 9). The Sexton and Haberman rating system also investigates the de pictions of women, analyzing the relationship of the woman to the pr oduct, her physical appe arance, and whether her role is traditional or nontrad itional (Sexton and Haberman, 1974) Another important scale, The Butler-Paisley Consciousness Scale of Sexism, later elaborated by Pingree et al (1976), contains five varying levels of female depictions in advertisements. The scale works on an increasing level, from the most stereotypical and sexist de piction, woman as a sex object (Level 1) to the most non-stereotypic (Level 5), where the woman is not judged by sex (Pingree et al, 1976). These scales have been used in research, specifica lly in quantitative content analyses to aid with coding. One of the more famous studies that ma kes use of both Pingree et als scale and Sexton and Habermans scale, is a content analysis of Ms. Magazine (Ferguson, Kreshel, and Tinkham, 1990). The researchers, using th e scales and the images within Ms. determined that Ms contained numerous sexist images despite th eir stance as a feminist magazine (Ferguson, Kreshel, and Tinkham, 1990, pg. 48). Most research conducted rega rding the portrayals of women in advertising seems to agree with the primary categories into which the portr ayals tend to fall. Generally, womens images fall into three categories: women as sexual objects, women as beautiful foreground or 22


background for selling a product, and wom en as dependent on men (Busby and Leichty, 1993, pg. 249; Venkatesan and Losco, 1975; Sexton and Haberman, 1974; Wagner and Banos, 1973). Another category to consider is woman as hom emaker (Courtney and Lockeretz, 1971; Wagner and Banos, 1973). A study analyzing the change in depictions of women in advertisements from 1951-1971 found that the trends over two decades di d not appear to have moved very far from a limited picture of women as social people appear ing in a predictable environment (Sexton and Haberman, 1974, pg. 45). Throughout the 1980s and 1990s, advertisements continued to depict women in a limited manner, only evolving slightly as the decades progressed. A study conducted in 1983, which analyzed the portrayal of women in mag azine advertisements from 1974, found that advertisers were portraying wome n more often in career and non-traditional settings than they had before (Ford and LaTour, 1996, pg. 82; Lys onski, 1983). However, in this same study, women were still found to be shown as homem akers (Ford and LaTour, 1996). Another study, which analyzed advertisements in Playboy, Ms. and Newsweek between 1972, found that women were indeed being shown in more modernized settings (Ford and LaTour, 1996, pg. 82; Klassen, Jasper, and Schwartz, 1993). Yet, based on other studies conducted around the same time, this evolution in the portrayal of women did not come without a price. A 1988 study by Sullivan and OConnor found that advertisements in 1983 reflected women in a more accurate manner, portraying them in a variety of roles, i.e. in the workplace or more everyday settings outside the home. However, this advancement was counteracted by an increase in women portrayed in purely decorativ e and sexualized roles (Li ndner, 2004, pg. 410; Sullivan and OConnor, 1988). In other words, 23


wom en might be portrayed more often as prof essionals, for example, but at the same time there is also a remarkable increase in sexuali zed images of women or images that show them as mentally removed from the si tuation at large. (Lindner, 2004, pg. 411) Another study analyzing wome n in advertisements from the 1950s-1980s confirms these results (Busby and Leichty, 1993). According to this study, womens roles as decorative objects in advertising have continued to increase over time, despite social changes brought about by the feminist movement (Busby and Leic hty, 1993, pg. 258). In the process of making women decorative objects, many of the advertis ements studied relied on indeterminate locations or backdrops. The st udy hypothesizes that these plain backdrops have been put into use in advertisements because of the confus ion generated by the feminist movement over appropriate gender roles for females whereby advertisers are floundering in their efforts to properly position the new woman in a dvertising (Busby and Leichty, 1993, pg. 258). Even one of the more current studies of wo men in advertisements has unfortunately found similar results. In a study of advertisements in fashion magazines from 1955-2002, the researcher found that % of the magazine ad vertisements portrayed women stereotypically (Lindner, 2004, pg. 419). Overall, the results of the study .revealed that the extent to which wo men were shown in stereotypical roles has remained fairly constant throughout the year s. This is a rather surprising finding considering that the changes in the actual roles women occupy in real life that have occurred since the Womens Movement and the subsequent trends toward equality, especially with regard to the business world. (Lindner, 2004, pg. 419). Therefore, while womens roles have evol ved socially in the past 50 years, most advertisements fail to pick up on this evolution. Instead, many advertisements stick to their traditional stereotypes of women, even in the new millennium. However, this lack of evolution in womens roles may not be entirely due to resi stance to change on the pa rt of advertisers. Some research suggests that 24


repla cing traditional images with more modern or liberated ones may create new effectiveness problems. More progressive portrayals may be in appropriate to the particular product category or brand advertised, may be in effective with some consumer segments, or may strike irritating and offensive chords even with seemingly progressive target segments. (Whipple and Courtney, 1984, pg. 4; Whipple and Courtney, 1983) Therefore, progressive portrayals of women may not be accepted into advertising, not because of unwillingness on the part of the advertisers, but rather on the part of the consumer. It is especially important to consider th e evolution of the portrayal of woman in a discussion about advertisements for hormonal c ontraceptives. Because the goal of hormonal contraceptives is to prevent pregnancy as well as reduce symptoms associated with menstruation, it appears that hormonal contraceptives provide their users with a sense of freedom and elimination of many burdens, which until 1960 were entirely unavoidable. Therefore, one would expect that advertisements for hormonal contraceptives would pres ent females as liberated and in control. However, as discussed previously, past advertisements, before prescription drugs were allowed to be marketed directly to the consum er, presented women as repressed and respectful (Tone, 2006, pg. 262). Therefore, it is of great inte rest as to whether or not the coming of DTC has allowed for a change in the portrayal of women in these advertisements. Based on two ads for hormonal contraceptives found in 2001 in ma gazines, Andrea Tone proclaims that in contrast to the neurotic and passive women who appeared in medical advertisements in the 1960s, this new generation of Pill users are cheerful, energetic, take-charge women. They can control their environment and look beautiful. (Tone, 2006, pg. 262) These two advertisements from 2001 may indicate the beginning of change in the way in which women are portrayed in hormonal c ontraceptive ads, a change that hopefully has continued into 2008. It will be interesting to explore how both agency professionals and their target consumers are reacting to this change. 25


Account Planning Process The exploration of the sp ecific account plan ning process behind a pr int advertisement for hormonal contraceptives can provi de insight into why certain cr eative decisions were made in regards to the portrayal of women. This section will detail how this process works so that the results of the account planner inte rviews can be better understood in regards to their relevance to the portrayal of women in hormonal contraceptive advertisements. While the term account planning can refer to ei ther a title or to a department, it has become an essential fixture in American adver tising agencies. Account planning serves as the bridge between the creative, accoun t, and research sectors of an advertising agency (Kelley and Jugenheimer, 2006, pg. 4). However, this does not mean that account planning/planners serves only as means of liaison between departments: account planning is about understanding the needs, wants, and mind of the consumer in order to produce more targeted and effective advertising messages. Chris Cowpe, an accoun t planner at Boase Massimi Pollitt, described planners as the architects and guardians of their clients bran ds, the detectives who uncovered long-hidden clues in the data and gently coerced consumers into re vealing their inne r secrets, and the warriors who stood up and fought for the inte grity of their strategic vision (Steel, 1998, pg. 37). Similarly, Wells, Moriarity, and Burnett (2006) define account plan ning as the researchand-analysis process used to gain knowledge and understanding of the consumer, understanding that is expressed as a key consumer insight into how people relate to a brand or product (pg 195). This consumer insight is then used to [ help] the creative people on their way. (Steel, 1998, pg. 36). Thus, the research and analysis in to the mind of the consumer allows for the agency to work together to [match] the right audience to the right message and present it in the right medium to reach that audience (We lls, Moriarty, and Burnett, 2006, pg. 194). 26


The first means of delivering this right message is by developing a situation analysis for the client. In this analysis, the account pl anner researches the client history, competition, industry, and any other relevant background information to glean insights into the business. Then, using these findings, the account planner can better understand th e market for the product or service that is to be advertised, and therefore better unders tand the target consumer to receive the advertising communication. In order to better understand the consumer the account planner can make use of secondary research or conduct hi s/her own primary research th rough qualitative or quantitative means. The account planner can conduct fo cus groups, personal interviews, or even ethnographic research in which a trained re searcherspends time with a small group of customers in their homes or wherever they might be using the pr oduct and observes and questions the customers about a range of t opics (Kelley and Jugenheimer, 2006, pg. 30). In many respects, account planners are social anth ropologists who are in touch with cultural and social trends and understand how they take on re levance in peoples lives (Wells, Moriarty, and Burnett, 2006, pg. 195). Account planners also can act as social anthropologists by conducting quantitative research, including surveys. This re search is a little less effective at gaining personal consumer insight, though it does provide concrete numbers from which the account planner can work. After conducting their qualitative and quantitat ive research, account planners can work to identify their target consumers, or to whom [they] should dir ect [their] marketing efforts (Kelley and Jugenheimer, 2006, pg. 38). Once the ta rget is chosen, the account planner will create a target market profile or a communication th at is a personal, almost story-like description of the target consumer. A target market profil e gives the target consumer a name, age, and a 27


history. This profile provides for a m eans to which the creative and media teams can better identify with the target consumer (pg. 45). The final step in the account planning pro cess is the creation of the communications brief or creative brief. The goal of this communication is to e xplain the consumer insight and summarizes the basic strategy decisions (posi tioning, targeting objectiv es, brand strategy) (Wells, Moriarty, and Burnett, 2006, pg.198). In this briefing process, one of the key tasks of the planner and other team members is to begin to translate client langua ge for the benefit of those who are writing the ads and those who will be ultimately be addressed by them (Steel, 1998, pg. 145). In other words, this brief is the result of all of the acc ount planners research and decision-making displayed in a simple, easyto-understand format for the benefit of the creative team and the media planners. While ev ery agency has its own creative brief template, for the most part, creative briefs contain six el ements: the marketing objectives, the product, the target audience, the promise and support, the brand personality, and th e strategy statement (pg.198). This brief should not be so simple that it is bland; however, as the goal of the account planner is to use the brief to inspire the creative group (Kelley and Jugenheimer, 2006, pg. 95). This creative brief is the connection between the account planners and the creative team and thus, the final creative product beco mes as much the work of the cr eative team as it is the work of the account planners. Behind a successful creative execution is a good account planning team. Based on this description of the account planning process, one can understand that account planning is essentially th e thought process behind any a dvertising campaign. Thus, one print advertisement would be the result of count less hours of research a nd critical thinking. Because the account planning process has become su ch a fixture in todays advertising industry, it is correct to assume that behind a print a dvertisement for a hormonal contraceptive, there 28


would be som e sort of account planning process. This does not suggest that every agency has a designated account planner positi on, but rather that the proce ss of understanding the consumer and bringing that understanding to the attention of the creative team is an inherent one in any successful agency. Limitations of Previous Studies In an area as widely researched as women in advertising, it is surprising that so few studies have been conducted in recent years. The majority of studies come from the mid to late eighties or early nineties (F ord and LaTour 1996; Busby and Leichty 1993; Lafky, Duffy, Steinmaus, and Berkowitz, 1996; Plous and Ne ptune, 1997; Rudman & Borgida, 1995; MacKay and Covell 1997; Ferguson, Kreshel, and Tinkha m, 1990; Busby and Leichty, 1993; Sullivan and OConnor, 1988). While these studies are somewh at dated, they also primarily analyze advertisements on a general basis, ignoring specif ic product categories. Therefore, it would be of interest to social science re search to conduct a study that analy zes current advertisements in a category as unexplored and niche as hormonal contraceptives. Add itionally, there has yet to be a study outside of an agency setting that seeks to match the manner in which an agency sees the consumer to the manner in which the consumer s ees himself or herself. Most forms of focus group research are conducted pr ior to the creation of the a dvertisement and any sort of qualitative data gleaned prior to a campaigns ru n is merely for the purposes of copy-testing and understanding the response to the advertisement, rather than to gauge the opinions of the target consumer. Furthermore, there has only been one study that has explored the portrayal of women in hormonal contraceptive advertising (Tone 2006) and that study concluded in 2006, just as new hormonal contraceptives technologies were being unveiled. 29


CHAP TER 3 METHOD The information contained in the literature review has led to the development of three research questions elaborated below. Following a discussion of the research questions, this section explores the two research methods util ized in this studyquali tative interviews and focus group interviews. Research Questions This study is concerned with understandi ng the portrayals of women in print advertisements for hormonal contraceptives. As such, the research questions are as follows: (RQ1): What do account planners think is the most advantageous manner to portray women in print advertisements for hormonal contraceptives? (RQ2): How do the target females for hormonal contraceptives feel about the manner in which a female is portrayed in the print advertisement? (RQ3): Is the manner with which the account planning team chose to portray females in print advertisements for hormonal contraceptiv es congruent with the manner in which the target audience for hormonal cont raceptives view themselves? Research Methods In order to obtain the proper data needed to answer the above research questions, there were two methods involved in this study: qual itative or active interviews and focus groups. Information obtained in the qualitative interviews helped to direct the nature of the focus groups. Because the qualitative interviews occurred prior to the focus groups they will be discussed first, following a discussion of qualitative research in general. Qualitative Research While quantitative research seeks to find pattern s based on statistical analysis, qualitative research seeks to uncover patterns based on extensive observation and interviewing to understand the nature or structure of attitudes and motivations ra ther than their frequency or 30


distribution (Davis, 1997, pg. 195). It can be fu rther defined as the nonnum eric examination and interpretation of observation, for the pur pose of discovering underl ying meanings and patterns of relationships (Babbie, 2007, pg. G9). The data that are analyzed to uncover these patterns of relationships come from intensive observation or inte rviewing of a small number of individuals to acquire detailed, in -depth insights into their attitudes, beliefs, motivations, and lifestyles (Davis, 1997, pg. 195). Qu alitative research is superior to quantitative research when the goal is not to obtain statisti cs, but to understand why certain attitudes or behaviors exist. However, because qualitative research involve s hands-on techniques with an interviewer or moderator, there is always the danger that the moderator can have great influence on the direction of the study: Despite all the methodological controls, the research and its fi ndings are unavoidably influenced by the interests and the social and cultural backgrounds of those involved. These factors influence the formulation of res earch questions and hypotheses as well as the interpretation of data an d relations. (Flick, 1998, pg. 4) In addition to influencing the nature of the study, the researcher can also influence those who are participating in the study. For example, when people know they are being studied or analyzed, they might modify their behavior or th eir attitudes to appear more socially acceptable or respectable (Babbie, 2007, pg. 290). It is not simply the moderator that may influence the validity or reliability of qualitative research, but the very nature of qualitative resear ch itself. In order to provide for validity and reliability in qualitative research, there are several measures that can be taken during the qualitative research process. One measure of obtai ning reliable data is by keeping the quality of the documentation at a very high level. Thus, there should be some level of standardization among the note taking, moderators guides, and interview questions. Additionally, the genesis of the data needs to be explicat ed in a way that makes it possible to check what is a statement of 31


the subject on the one hand and where the research ers interpretation begins on the other (Flick, pg. 224). Thus, even though qualitative research is less strict than its quantitative brother, those evaluating the research, the data, and the analysis m ust be able to unders tand the thought process of the researcher and reach similar conclusions based on the information provided in the study, in order for the study to be of worth. This ability of the researcher to ma ke their thought process obvious to their audience also helps to increase the validity of the study. In the case of this study, the best way to assure reliability and va lidity was to follow the practices of grounded theory, a concept highly explicat ed in the literature review. Additionally, within the specific research methods of qualitative interviews and fo cus groups are guidelines to obtain a measure of reliability and validity, such as member checks, where the researcher, on synthesizing their data, re-contacts the research respondent s and confirms that the data matches the respondents initial sentiments. Other measures specific to the res earch method of qualitative interviews and focus groups will be discussed in more deta il within their respective sections. Qualitative Interview The qualitative interview is one method of qua litative research that seeks to obtain an insight into the minds of partic ipants via direct, free-flowing qu estioning. These interviews, also called personal or active interviews, ar e appropriate for situations in which extensive, detailed probing of attitudes, behaviors, motivations, or needs is required (Davis, 1997, pg. 198). In the case of this study, the qualitative interview wa s essential for probing those behind the account planning process of hormonal contraceptive adve rtising campaigns. A qualitative interview is typically performed one-on-one and takes betwee n 30 and 60 minutes, and contains samples of between five and 15 individuals (Davis, 1997, pg. 197). The goal of a qualitative interview is to obtain the actors experience to result in words that can only be uttered by someone who has been there (Lindlof and Taylor 2002, pg. 173). In other words, the goal of the interviews for 32


this study was to obtain an insight into the a ccount planning process. The only way to truly understand the m anner in which the account plan ning team came to reach certain decisions regarding how to portray women in their hormonal contraceptive print advertisements was to ask them directly. These personal interviews sought to gain an insiders pers pective on how decisions are made on the agency side. Maintaining reliability in qualitative interviews is not as strict as reliability assurance in quantitative research, but it is still possible by developing an interview guide. This interview guide allows for a standardized format to conduct the interviews. The re searcher should do their best to try and stick to the interview guide, although it can sometimes be subject to change. Qualitative interviews are often mutable, even if following an interview guide, because each informant is asked a particular set of questions only once, and in mo st types of interview research the questions will vary across participants (Lindlof and Taylor, 2002, pg. 239). Thus, a line of questioning that was relevant to someone at one agency, may not be relevant to someone at a different agency due to di fferent account planning practices or the nature of the hormonal contraceptive. While the interview guide was followed initially for each interview, some questions were changed, deleted, or new questio ns were added depending on the nature of the interview. Because each interviewee is different, and maintain ing consistency can be a challenge, qualitative interviews must center on different reliability criteria, such as how meaning is constructed, the circumstances of the construc tion, and the meaningful linkages that are assembled for the occasion, (Holstein and Gubrium, 1995, pg. 9). Validity and reliability can also be maintained by following scholarly guide lines for qualitative in terview research, making the data collection more systematic and more rigid. 33


The Interview Guide (Appendix C) An interview guide consists of groupings of topics and que stions that the interviewer can ask in different ways for different partic ipants (Lindlof and Ta ylor, 2002, pg. 195). The interview guide for this study begins with an in troduction that acts as a signpost to guide active respondents through the open terrai n of their experien ce (Holstein and Gubrium, 1995, pg. 41). This introduction helped to familiarize the resp ondents once again with the nature of the study, the studys significance, and the reasoning behind the respondent being chosen for involvement. In addition to this more formal introduction, the interviewer presented a self-disclosure in which her personal reasons for engaging in such a study and her interest in the topic were disclosed. This self-disclosure allows the respondent and the interviewer to be on somewhat of an equal footing and provides a more personal rapport betw een the two (Lindlof and Taylor, 2002, pg. 190). Additionally, the interviewer asked the res pondent for a brief self-disclosure where he/she told the respondent about his/her job and interest in the business. This tactic allows for the respondent to feel comfortable talking about them selves and also helps to further build rapport (Lindlof and Taylor, 2002, pg. 190). The questions following the introduction begi n with those that are simplest and less revealing to those that are more challenging a nd require a higher leve l of trust with the interviewer. In this way, the respondent was eased into the interview and not overwhelmed with the demands of sharing information. However, as previously mentioned, the guide does not necessarily dictate that the questi ons be asked in their assigned orde r. The nature of conversation and free-discourse allowed for the interviewer to follow the flow of the conversation rather than the strict guidelines of an interview guide. In addition to the questions li sted on the guide, the researcher enjoys the freedom to ask op tional questions or go down an unexpected conversational path (Lindlof and Taylor, 2002, pg 195). Therefore, many of the questions that 34


appear in th e interview transcript may not be one s that are found in the interview guide. Because the goal of this study is to obtain as much insigh t into the minds of advertising professionals as possible, it was not necessary to maintain a highly structured in terview format. In other words, the research goals do not require that the account planners receiv ed exactly the same questions, in exactly the same manner. In fact, by allo wing for case-by-case alterations to the interview guide, the researcher is likely to glean more information. Thus, th e interviews were structured to follow the interview guide, but not so structured that the interview followed the guide precisely. Additionally, in keeping with the grounded theory, some ques tions that appeared in the first qualitative interview did not appe ar in following interview. Als o, new questions were added as needed. Any key concepts that were uncovered during the first interview helped to generate further questions for the interview that followed (Corbin and Strauss, 1990). Respondent Selection The first step in organizing a qualitative interview is selecting the interview participants. This step is somewhat uncertain as new part icipants can be recruited during the interview process: designating a group of respondents is tentative, provisional, and sometimes even spontaneous (Holstein and Gubrium, 1995, pg. 74). In this study, the first round of selected participants was the direct result of the print ads obtained by the researcher. These advertisements are for the following hormona l contraceptive products: NuvaRing, Yaz, and Seasonique. Using the interviewers fathers pe rsonal contacts (he runs a DTC publication and conference), those agencies behi nd Seasonique and Yaz were found. However, contact with the NuvaRing advertising agency unfortunately was not established. Those involved with Yaz and Seasonique were contacted via an email that detailed the nature of the study and a request for a personal interview to be conducted at their c onvenience (Appendix A). Following receipt of replies from these emails, those who agreed were contacted via tele phone for the personal 35


inte rview. Due to the location of the two of the agencies in New York City and Northern New Jersey, the interviews were via telephone. Telephone interviewing can be just as intimate and engrossing for the callers, and ultimately as pr oductive, as those conducte d in person (Lindlof and Taylor, 2002, pg. 186). Only two qualitati ve interviews were conducted due to the inaccessibility of agency professionals. Interview Process/Data Collection The interviews occurred at a time conve nient to each respondent and lasted approximately an hour. The interviews were conducted in an informal yet professional manner and all attempts were made to make the respo ndents feel comfortable and not intimidated. The interviewer established a good ra pport with each respondent, maki ng sure that the two agreed that each others viewpoint was worthy of a ttention and that they agreed on a similar communication style, such as ta king turns between questions a nd answers and not allowing for anyone to be interrupted (Lindlof and Taylor 2002, pg. 188). These interview sessions were recorded via a digital recorder placed next to a speakerphone on a cellular telephone. This recording allowed the interviewer to concentrate completely on the responses of the respondent, rather than worrying about noting everything that was said. This recording was then transcribed in order to end up with a text that reproduces the discoursenot only what was said but also how words or phrases were uttered (Lindlof and Taylor, 2002, pg. 187). Interview transcripts allowed for a much closer examination of the in terview for better analysis. In addition to the recording and transcripts, notes were taken regarding th e circumstances surrounding the interview, and any signs of confusion, contradiction, ambiguity, and reluctance were also noted as qualitative interviewing is as much about how things we re said as much as what was said (Holstein and Gubrium, 1995, pg. 78). 36


Focus Groups A focus group, a for m of qualitative research, is a carefully planned discussion designed to obtain perceptions on a defined area of interest in a permissive, non-threatening environment (Krueger, 1994, pg. 6). Focus groups are very simila r to qualitative intervie ws, except they are a discussion between the interviewer or moderator and several other respon dents. The grouping of participants together facilitates discussion and allows for a variet y of viewpoints at once (Babbie, 2007, pg. 308). Additionally, this group format allows for the participants to interact more with one another, rather than the interviewer, leading to a greater emphasis on participants points of view (Morgan, 1988, pg. 18). Focus groups are particularly useful in so cial science research, when informational needs require deep insights into individua ls thoughts and attit udes and direction for understanding how these thoughts a nd attitudes influence behavior (Davis, pg. 219). Thus, in a study such as this, where the goal is to understa nd how females perceive themselves when it comes to hormonal contraceptive advertising, a focus group format allowed for an in-depth discussion of such views. In focus groups, when the questions are asked skillfully, the result can be candid portraits of customer perceptions (Krueger, pg. 11). Focus groups are also a very strong qualitative method, as unlike other forms of qualitative research, such as the personal interview, the researcher has less control over the data that is genera ted (Morgan, 1988, pg. 21). In focus groups, the researcher is less involv ed with the data because they serve merely as a moderator, asking questions and probing the part icipants, but mainly staying silent, allowing for the members of the group to feed off of one another and engage in a relatively candid discussion. Other advantages of the focus group method include their low cost, high level of flexibility, and speed of data collection (Babbie, 2007, pg. 309). 37


While focus groups provide several advantag es to the researcher the organized group situation has a few disadvantages. First, the focus groups occurred in conference rooms or designated focus group rooms, complete with tape r ecorders. These staged settings can make the conversation between the participants less na tural and somewhat forced, as opposed to conversation that springs up organically at a re staurant, bar, or in someones home (Morgan, 1988, pg. 21). Second, because the participants were forced together to have a discussion, they might have been wary of one another, feeli ng uncomfortable sharing their personal beliefs among strangers. In addition, a dominant member of the focus groups did emerge, sometimes stifling others ability to speak their opinions uninhibited (Stewart and Shamdasani, 1990, pg.17). Third, focus groups allow the researcher less control than personal interviews. While this can be a positive (as mentioned earlier), the lack of the control on the part of the researcher did sometimes inhibit the focus group from actually focu sing on the topics that the researcher wished to cover (Morgan, 1988). Fourth, focus group data an alysis was a bit of a challenge as the openended nature of the responsesof ten makes summarization and interpretation difficult (Stewart and Shamdasani, 1990, pg. 17). Finally, mainta ining consistency among groups was rather difficult, as each group had its own orga nic discussion (Babbie, 2007, pg. 313). Measuring the reliability and validity of focus groups is a highly disputed topic. This dispute arises due to the free-form nature of focus groups. However, Krueger (1994) suggests focus groups are valid if they are used carefully for a problem that is suitable for focus group inquiry (pg. 31). Because validity is the degree to which the procedure really measures what it proposes to measure, Krueger is correct in his statement (pg. 31). That is, if the goal of the study is to measure female perceptions of the por trayals of women in pr int advertisements for hormonal contraceptives, do the questions addr essed in the focus groups and the responses 38


record ed address the research questions? If a proper match up between the result and the research questions exist, then Krue ger (1994) asserts that the research is valid. In the case of this study, the questions and responses did appropr iately address the research questions. Additionally, because this study followed all of the recommended focus groups procedures, it has a much greater likelihood of being a valid study (1997, pg. 31). The issues involved with measuring reliability in focus groups are very si milar to the aforementioned issues pertaining to qualitative interviews. Because each focus group c ontained different particip ants and the flow of discussion varied among the three groups, maintain ing reliability was very difficult. The best way to maintain consistency was to use the same moderators guide with each group and attempt to address the same issues and topics across a ll of the groups. Further attempts to attain reliability occur during the analysis and c oding process (Stewart and Shamdasani, 1990, pg. 111). Research Design Several steps were involved in the construc tion of focus groups. Once the purpose of the focus group was established, the researcher organi zed the logistics of the focus group as well as created a moderators guide and pre-tested that guide. Once these steps were complete, the focus groups were finally ready to take place. Each on e of these steps will be discussed in detail and elaborated to make the study easily repeatable. Selection of Participants Quantitative research demands that participants be randomly selected, while qualitative research allows for a more free-form type of se lection. In qualitative re search, the goal is to understand how the participants view a topic, rather than findi ng patterns generalizable to a larger population (Morgan, 1988). In addition, the topic for disc ussion in focus groups often dictates a certain audience that would not be obtained via a random sample of a population. For 39


exam ple, in this study, the goal is to unde rstand how the target audience for hormonal contraceptives perceives the portr ayal of women, so composing fo cus groups of the prime users of hormonal contraceptives, women aged 15 to 24 (Mosher, Martinez, Chandra, Abma & Wilson, 2004), was the only way to garner such insights. Composing groups of teenage males or middle-aged women would not help to address the topic, as the researcher should decide who the target audience is and invite people from those char acteristics (Krueger, 1994, pg. 18). Furthermore, the goal is to gain participants that have a shared perspec tive on the issue and thus, using focus groups to learn about the full range of experiences and perspectives in a broad population can be a fools errand. Indeed, there is often no reason to be lieve that a randomly sampled group holds a shared perspective on your topic (Morgan, 1988, pg. 45). Thus, the participants must be selected based on their ability to address the res earch questions and their commonalities. Therefore, participants selected fo r this study were Caucasian females ages 20 to 24. The targeted age begins at 20 rather than the aforementioned 15 beca use research indicates that there are a slightly highe r number of women using hormonal contraceptives at ages 20-24 than ages 15 (Mosher, Martinez, Chandra, Abma & Wilson, 2004, pg. 23). The participants were Caucasian so as to avoid a ny discrepancies due to racial bias es or prejudices. All of the women featured in the print advertisements were also Caucasian to match-up with the participants race. Those selected were United St ates citizens so as to assure that cultural differences did not affect the resu lts of the study. Additionally, in order to better create a level of comfort between the moderator and the particip ants, the researcher, a 23-year-old Caucasian female college student, moderated all of the groups. The goal of the participant selection is ach ieve a level of homogeneity among the group. The homogeneity is dual purpose: to have partic ipants capable of addressing the research 40


question and to have participan ts that are sim ilar enough to fo ster discussion. While total homogeneity was not necessary in this study, it wa s necessary for the group to be similar enough so that participants should really have someth ing to say about the topic and they should feel comfortable saying it to each other (Morga n, 1988, pg. 46; Krueger, 1994, pg.14). Although it is better to work with strange rs in focus group research, due to the limited number of females eligible to participate in th is study, some friendship pairs ha ve appeared within the groups (Morgan, 1998, pg. 48). While friendships are not recommended, they did provide a level of comfort among the group and it is seldom fatal if a group recruited as strangers in fact contains one friendship pair (Morgan, 1998, pg. 48). Recruitment of Participants Participants were selected from a pool of mass communication gr aduate students at a large Southeastern university. The participants were provided with fr ee dinner during the focus group session. The participants were told of the general topic of the disc ussion, but not the entire nature and purpose of the group. This is because if excessive background information is supplied prior to the study, the partic ipants may research the topic, disc uss it with others in advance, or rehearse their opinions (Krueger 1994, pg. 94). It was best if the participants did not have preconceived opinions about the study or time to formulate their opinions, so that the focus group discussions remained organic and honest. In order to narrow down participants, a screening questionnai re (Appendix D) was disseminated via email to those who responded to the initial informationa l email disseminated to all mass communication graduate students via a list server (Appendix C). The questionnaire asked basic demographic questions such as age, gender, race, and nationality and requested contact information. Those who filled out th e questionnaire and met the demographic requirements were notified via email of their elig ibility, the incentives they were to receive for 41


participating as well as the date, time and location of the fo cus group session. Additionally, a reminder email was sent one week prior to the session and again one day prior to the session. Number of Groups Research goals dictate th e number of groups to arrange Davis (1997) recommends at least two groups while Calder (1977) recommends using around three or four groups. Calder suggests that it usually takes ar ound three or four groups until th e moderator can anticipate the data that will be gleaned from any forthcom ing groups. Once the moderator finds that no new information is presented, the focus group rese arch is finished. This is based on the aforementioned principle of theoretical saturation. Thus, in orde r to accommodate for theoretical saturation, this study aimed for three focus gr oups, initially. After th e third group, it was determined that the study achieved theoretical saturation and the decision was made not to add more groups (Krueger, 1994, pg. 88). Size of Groups Traditionally, focus groups contain six to 12 participants (Krueger 1994, pg. 78). If the focus group contains less than six, the discus sion may be rather dull whereas if the group contains more than 12, not every member of th e group may not get a chance to participate, and the moderator may have difficulty managing such a large number of indi viduals (Stewart and Shamdasani, 1990, pg. 56). This study recruited six to eight participants fo r each group, in order to allow for each individual to have a turn to speak and to better gain a clear sense of each participants reaction to a t opic (Morgan, 1994, pg.43). In orde r to allow for no-shows, the researcher overrecruit[ed] [sic] by 20% (Morgan, 1994, pg. 43). However, during the three focus group sessions, the number of participan ts that showed up for each session was six. Therefore, 18 participants were interviewed in total. 42


Moderators Guide (Ap pendix F) Along with the recruiting of participants and the selection of the moderator, the moderator guide is one of the three most important parts of the focus group process (Greenbaum, 1993, pg. 38). The moderators guide is a list of questions and topics for discussion that the moderator will use to guide the focus group. On average, a moderators guide consists of approximately 12 questions, although the moderator is at liberty to ask probing questions or develop new questions necessitate d by the discussion (Stewart and Shamdasani, 1990, pg. 62; Corbin and Strauss, 1990). According to Greenbaum (1993), there are five sections in a moderators guide: the introduction, the wa rm-up, the details section, the key content section, and a summary section ( pg. 41-43). These sections gu ided the construction of this studys moderators guide. The first section, the introduction, serves as a platform for the moderator to introduce herself and to reiterate the purpose of the focu s group, and to explain that the session will be recorded for research purposes (Greenbaum, 1993, pg. 41). In this section, the moderator can elaborate a bit more about herself and her intere st in the topic as well as establish some ground rules for the focus group session. Within this se ction, the participants were asked their first question. This first question s hould break the ice and should gi ve every participant the chance to talk. This question must also be the sort that can be answered ve ry quickly and cannot demand excessive reflection or long-past memories (Krueger, 1994, pg. 114). For this study, the participants were asked to provide their fi rst name and their favorite television show. This question was non-threatening and helped to relax the participants. Follow ing the introduction, a warm-up question was asked to the participants. This warm-up question was loosely related to the topic and familiarized the participants with th e format and flow of questions that occurred throughout the focus group session (Greenbaum, 1993, pg. 43). Next, a details section asked 43


the par ticipants some more general questions that are related to the research topic, but that are less involved than the key conten t section that followed. In the key content section, input [was] gained from the participants about the resear ch topic itself (Greenbaum, 1993, pg. 43). This section is the heart of the focus group discussion and is where much of the data for analysis was gleaned. Finally, the discussion concluded with the summary section, where the participants were given an opportunity to share any informati on about the topic that they may have forgotten or otherwise omitted (Greenbaum, 1993, pg. 43). Pretesting the moderators guide: To allow for a successful discussion, free of confusion and full of responses, the moderators gui de was pretested. This pretest allowed for the researcher to determine whether the wording of the questions is appropriate, to determine whether the questions elicit discus sion, and to identify questions that are not understood easily (Stewart and Shamdasani, 1990, pg. 66). Ideally, sm all, mock focus groups can be conducted to pretest the moderators guide. However, due to time and money constraints, the moderators guide was pretested by members of the studys th esis committee. Additionally, the first focus group that was conducted served to pretest the moderators guide. Fort unately, there were no major issues with the questions, and therefore only minor adjustments were necessary. Conducting the Focus Groups Three all female focus groups were conducte d between February 3, 2009 and February 5, 2009. They were conducted over the course of a week and were conducted in one of the classrooms of the communications building. Becaus e the participants were recruited from the College of Journalism and Comm unications, it was helpful to conduct the groups within that building, to assure that the participants were familiar and comfortable with the location. The focus groups took place at 6:00 pm. each night. 44


Once the participants arrive d at the designated focus group location, they were greeted by the moderator who provided the participants with an IRB-approved release form. The participants were given ample time to fill out th is form, to select their dinner, and to get comfortable in their seats. Once everyone wa s settled, the moderator turned on the audiorecording equipment, a digital recorder, situated so that all of the participants were within a close distance to the device. The moderator then test ed the audio equipment by asking the participants to state their name. Once the device was shown to be effective in adequately recording the discussion, the moderator began to follow the mode rators guide. During the key content section of the moderators guide, five print advertisemen ts were distributed among the participants and they were asked to evaluate each ad carefu lly. Throughout the entire discussion, the moderator took copious notes, which not only recorded notabl e responses to the ques tions, but also noted the body language of the participants and a ny other noteworthy happenings (Morgan, 1988). These notations are necessary to qualitative research as, when co mbined with the participants verbal responses, their behavioral responses he lp to glean a complete understanding of those being studied. Data Analysis The data collected from both the qualitative interviews and the three focus groups were transcribed and any significan t body language or vocal gestures were noted within this transcription. These transcripts were then edited to excise any pieces of information that were totally irrelevant to the study such as off-topic discussions or non-sequiturs. In keeping with qualitative research, the analysis of the transcripts was performed inductively where general principles are developed from specific observations (Babbie, G5). Thus, the transcripts were coded so that the patter ns that evolved from the transcripts would lead to overarching themes and general statements. In order to accomplish this, the researcher 45


followed the three basic types of coding involved in grounded theory research as laid out by Corbin and Strauss (1990). The first step in grounded theory coding process is open coding whereby the data, or transcripts, are broken down analytically (pg. 12). During this stage, like elem ents were grouped together and were give n conceptual labels to form categories and subcategories (pg. 12). Thus, similar comments or statements made by focus group participants were grouped together and placed under a simila r category heading (This grouping of elements will become more apparent in the results section of the study). This step also included special attention to the core of the st udy, or the key questions section of the moderators guide, where any statement that pertained specifically to the portrayal of women in print advertisements for hormonal contraceptives were made to be the focus of the axial coding state. In this next step of axial coding, the subcat egories were related the core categories and groupings and sub groupings were further categorized. The data wa s analyzed in an attempt to understand how the participants, based on their other non-core categorical and subcategorical responses, arrived at the core category responses. This stage led to the final stage of selective coding whereby all categories [were] unified around a cor e category, and the categories that need[ed] further explication [wer e] fill[ed]-in with descriptive detail (Corbin and Strauss, 1900, pg. 14). These three coding stages led to the resulting overall analysis discussed in Chapter 4. 46


CHAP TER 4 RESULTS This study sought to undercover the manner in which both advertising professionals and the target female consumers viewed the portrayal of women in print advertisements for hormonal contraceptives, using both qualitative interviews and focus groups. The results of the qualitative interviews will be discussed first, as they provide excellent insight in the account planning process behind hormonal contraceptive advertising. The results of the focus groups will then be discussed, categorically, in order to glean overarching themes from these discussions. Finally, in Chapter 5, the discussion section, the two result s sections will be compared to uncover the answers to the research questions as to whet her or not the responses of the advertising professionals and the target female cons umers were congruent in this study. Qualitative Interviews The qualitative interviews were conducted ove r a three-week period in February of 2009 via the telephone. There were two interview participants, both agency professionals, involved with two heavily advertised hormonal contracep tive brands: Seasonique and Yaz. The agency professionals were both the account managers of the project as well as part of the strategic/account planning team. The agency professional for Yaz, hereby listed as Account Planner 1, was male. The agency professional fo r Seasonique, hereby listed as Account Planner 2, was female. Both account planners worked on their brands current campaigns, which include the advertisements that were shown to the focu s group participants (Appendices H-K). For more information about each qualitative interview participant, please see Appendix M. These two interviews were tape recorded a nd then transcribed. Below, both interviews are discussed in detail and categorized by common topics. Because the interviews followed the same interview guide and largely kept to the in terview questions, their formats mirror each other 47


and m ost of the topics discussed are the same. However, any differences in opinion that arise will be noted and discussed in detail. The reasons for these differences will be addressed further in Chapter 5, the discussion section. The Differences between Advertising Non-Prescription Drugs and Prescription Drugs The first question posed to the account planne rs regarding their sp ecific knowledge of direct-to-consumer advertising involved e xplaining the difference between advertising prescription drugs (DTC) and adve rtising over-the-counter products (OTC). Both interviewers answered that the key difference is regulatory requirements. Account Planner 1 elaborated on these regulatory concerns: In terms of the claims about the brand, you real ly cant say anything th at isnt in the label of the product, and unlike even OTC, you cant even imply things. Its a lot more strict not only in terms of how you say it, but the kinds of areas that you can get into. None of the rest of consumer marketing is like that. Brands can be a bout all kinds of things lik e implied benefits that you cant do in pharma. We get a product and it s a brand and its got product attributes and claims that are approved by the FDA and thats got to be where we start as opposed to saying what do we want this brand to be about. Its a lot more about what doe s this product do and how do we make it motivating and relevant to consumers. Thus, DTC advertising is a lot stricter in cont rolling the advertisements description of the product attributes and the product benefits. Prescription drug products can only claim benefits that the FDA has deemed acceptable. It is also interesting that A ccount Planner 1 notes that they are not even allowed to imply things. Thes e regulations make branding a DTC product much less creative than branding an OTC product or other fast moving consumer goods. Another important element of DTC advertisi ng, Account Planner 1 point s out, is that a lot of decisions that planners woul d have to make for other produc ts are already decided for you in DTC advertising: The big theme is that because pharma is a lo t more defined by the products, the claims you can make about them, the disease states or c onditions, a lot of decisions are already made for you. For example: Sometimes its kind of open, but a lot of cases, its fairly defined. On a brand like Humira, which is for rheumatoid arthritis, you have to have rheumatoid arthritis or its not 48


relevant to you. The m ore general the conditi on, the broader the strategy could be. You are playing in a smaller, more defined universe in pharma. While the universe is smaller in pharmaceu tical advertising, Account Planner 2 notes that, In terms of planning and the strategy, marketing, messaging, distribution, understanding the insights in the marketplace, and being able to make an emotional connection with the end user, those are all the same. Because this study is focused on how these hormonal contraceptive account planners make their emotional connectio ns with the user, the regulatory environment will not play a huge role in addressing the re search questions, but is interesting nonetheless. Research, Research, Research The next question asked of the account pla nners involved the extent to which they perform primary research during their account planning phase and whether this primary research is qualitative or quantitative. Both participants noted that they do in fact perform primary research, though only Account Planner 2 answered that they perform both qualitative and quantitative. To both participants, the nature of the qualitative research is fairly similar: both perform focus groups and one-on-one interviews. Account Planner 1 us es qualitative research to get a sense of what positioning ar eas are interesting to [the qualitative participants]. We typically write out little statemen ts and see which ones are of inte rest to them. In addition to utilizing focus groups and one-on-ones to garner consumer opinion, Account Planner 2 also uses qualitative research to obtain the insights of physicians. In terms of quantitative research, Account Planner 1 notes that the process of turning qualitative research into quantitative data is not really necessary in developing a hormonal contraceptive campaign, though Account Planner 2 does make use of this strategy. Account Planner 1 explains, typically, what we do, across all oral contra ceptive brands, we usually do some kind of qualitative research. Some companies will refine those statements and will take them through a 49


quantitative process. We dont usually do that. We knew we wanted to be the pill that does more than other pills. The nua nces that capture that dont really work on paper anyway. Despite their difference of opinion regardi ng the use of quantitative research, both account planners follow a sim ilar process involving thei r qualitative research. To both of these account planners, obtaining direct in-depth consumer insights is highly significant to developing an appropriate strategy. Focus Groups and One-On-Ones Following a discussion of qualitative research, the participants were asked to explain some of the comments that develop from the focus groups or personal interviews. Account Planner 2 noted that the biggest issue qualitative research partic ipants had with Seasonique was its ability to give its user four periods a year as oppos ed to 12 with other hormonal contraceptives. This issue caused many consumers to have a great deal of questions regarding the safety of the product and other concerns rela ted to its ability to lim it periods. Because of these questions, the team behind Seasonique developed a Frequently Aske d Questions-style of text in their print advertisements. Account Planner 1 had a very different answer from Account Planner 2, in response to this question. Instead of taking consumer insight s and crafting them into a very consumer-based advertisement, Account Planner 1 does not let co nsumers dictate the nature of the advertisement: Consumers have a hard time telling you what th ey want. The big struggle that we have, when you go to consumers and ask them what they want, they cant tell you. Or theyll tell you but its not really what they want. They dont as a group have the ability to tell you how to craft something that will be creative and exciting. So we want to know if people understand what we are saying and how they feel about the advertisi ng but we want to avoid letting them be too directive about what works and what doesnt wo rk about the actual communication. They all say that they want information but then you put a lot of information in but they dont read it. They say that they dont want it to be cheesy, but they cant tell you what they think will or wont be cheesy. They can only react really. 50


Thus, Account Planner 1 takes a different level of insight from the qualitative research than Account Planner 2. Account Planner 1 really uses the qu alitative research to gauge emotional responses and make sure that cons umers understand the tone and language of the advertisement, rather than letting the consumer affect the construction of the advertisement. The Account Planning Process in Hormonal Contraceptives Following a discussion of the research pro cess, the account planners were asked to explain how the advertisement develops from re search to strategy to the final creative end product. Both account planners follow a similar process and keep fairly close to the account planning process discussed in Chapter 2 of this study. According to Account Planner 2, before the research phase, th e account planners start with examining the competitive set and look at what theyve done well. We try and determine which ones will be most directly rela ted and we look at the strengths and weaknesses of their campaign and how we will position ou r brand. And how do we position our brand as unique and different from theirs. According to both account planners, once this primary and secondary research phase is complete, the research is expressed in a cr eative brief, where a loose concept for the advertisement is developed. This concept is then tested: Well take it to focus groups to get an overall sense of what people think about the ideas. Well bring th em five ideas and theyll help us narrow it down to two or so. We take the best of the ideas and turn them into rough commercials (Account Planner 1). Following the concept testing, the ideas most liked by the focus groups will be transformed into a creative piece: once the conc ept is selected, we m ove forward with putting the actual messages together and the actual graphics and using the charts and data to convey the messages that we want to and those are tested as well (Account Pla nner 2). This testing, according to Account Planner 1, involves a quantitative study with a sample of at least 200 51


wom en. The study tells you how well people reme mber it, how motivated they are to take action and other communication points. Once the quantitative study is comp lete, the final step is garnering FDA approval for the campaign, before the advertisements can be released to the public. While the process behind the account planni ng stage is very similar for both account planners, it is important to note that the re lationship between the account planners and the creative team varies greatly in each agency. In Account Pl anner 1s agency, the account planners develop a creative brief expressing the advertisements tona lity and its brand essence. In this case, for Yaz, the advertisements tonality, according to Account Planner 1, was female empowerment. This creative brief is then given to the creative team and it is this creative team that is left to develop an advertisement on th eir own: Well say this advertising should be upbeat and empowering, but how its empowering is left to the crea tive process. According to this account planner, the creativ e team can do whatever they want to develop the advertisement, as long as it follows the cr eative briefs elements. In contrast to this interaction betwee n the account planners and the creative team, Account Planner 2 notes that there is a very close association with the creative and the account side. This closeness exists because, according to Account Planner 2, The more we can give them an understanding of our direction, the more creative their development is. We of course let them have a range of creative, from the conserva tive to the more edgy. From this range of creative, the account planners, with the help of the client, choose the best style of campaign for the brand. While Account Planner 1s rela tionship with his creative team is a little looser, it is important to note that the account planners at his agency do meet with the creative team at least 52


twice during the creative development of the adve rtisement to make sure the advertisement is following the guidelines of the creative brief: Typically, we will give [the creative team] the assignment, well give them a couple of weeks and then well see a round of ideas, typically, theyll do some more work, we ll see another round and then we ll bring it to the client. Account Planner 1 notes that this leeway given to the creative team is due to the fact that the account planners dont know exactly what [t hey] are looking for in their campaign. The Portrayal of Women in Hormonal Contraceptive Advertisements At the heart of the qualitative interviews wa s garnering insights concerning how agency professionals choose portray women in their horm onal contraceptive advertisements. As it turns out, there is very little research or planning that goes into how the models are portrayed in the advertisements. Of course, the account planners are involved in the actress/model selection process, but as will be seen from the interviews, the final decision regarding the portrayal of the women involves the creativ es and the clients. When asked what kind of women they pref er to place in their hormonal contraceptive advertisements, both account planners noted that the models must be relatable. Account Planner 2 notes that at her agency, she prefers the model to be more relatable than anything else. Account Planner 1 agrees, noting that the models have to be relatable and thats a judgment call. While both account planners agree that the m odel should be relatable, they differ on whether or not the model should be aspirational. Account Planner 1 beli eves that the models must be aspirational: People say they want to se e real but they want to see real but something they would aspire to. In orde r to achieve this aspi rational appearance, A ccount Planner 1 makes sure to choose models that are attractive. Ho wever, when Account Planner 2 was asked whether or not she preferred casting attractive models, she responded, We want people to say wow shes just like me, so maybe I should consider this As opposed to wow, thats Angelina Jolie. 53


And while Account Planner 2 notes that the m odel must look like the average woman, it is important to note that the model in the Seasonique print advertisement (Appendix K) is actually quite attractive. The final appearance of the model in a ny hormonal contraceptive print advertisement goes beyond mere account planning decisions. In the case of Account Pla nner 1, the models are selected based on their ability to appear relatable, attractive, and aspirati onal: For a brand like Yaz, well do big casting and how all those things come together depends on who we meet. We sort of know those three guideline s is sort of what we are look ing for. Based on the interview with Account Planner 1, it appear s that the account planners and th e creative team work together to cast a model that fulfills their three require ments. This model is then used in the advertisement, pending the clients final approval. In the case of Account Planner 2, casting deci sions work a little diffe rently in her agency than in Account Planner 1s agen cy. In developing Seasonique, Account Planner 2 and her team first select the segment that is most likely to take action first. We then craft our messages to that audience. In that audience, we want to try a nd reach the broadest set. They are more likely to take on an edgier nature. Once the target market is divided into subsets, the primary target is selected and the team Select[s] a group of women that reflect the demographics and the psychographics of that segmentOur selection of the subset of women is based on the emotive quality that we want to get across to the indi vidual. However, while Account Planner 2s selection process for the female models relies on relatability and insp iring emotive responses from the target market, its usually the client that will have the final say. It is the client that ultimately decides which model will appear in the final advertisement and also the way the model is dressed, the way her hair is stylize d, and other decisions related to appearance. 54


The fact that the client has the final say in deciding how the females will be portrayed in hormonal contraceptive advertisements, greatly affects the final product and how the target market relates to that product. While Account Pla nner 1 is largely in charge of deciding what the model will look like, in the case of Account Planner 2s experience, the client always makes the decisions. A really interesti ng concern that Account Planner 2 expressed during her interview was how clients of the male gender have a tendency to disagree with her regarding the portrayal of the women in the advertisement: Its always interesting to wo rk with clients of a different gender when you are working on womens health. Because there are different att itudes and its hard for your personal attitude not to influence things sometimes. My personal preference is to present women as thoughtful, intelligent, and assertive and being able to make their own healthcare decisions. Thats not necessarily the way that the cl ient wants to present them. Account Planner 2s statement is very interest ing and quite surprising. Her response here was unexpected, particularly as Account Planner 1 did not express similar concerns. It must be reemphasized that Account Planner 1 is male and A ccount Planner 2 is female. As is evident based on their responses, this difference in gender proves to be an important factor in determining the final appearance of the female models in hor monal contraceptive advertisements. This discrepancy must be kept in mind during the analys is of the focus group results, as it will play a large role in Chapter 5, the discussion of the results. Focus Groups The three focus groups, conducted over a one-w eek period in February of 2009 at a large Southeastern university, consisted of 18 Caucasia n females, between the ages of 20-24, all of whom were sexually active, not against birth co ntrol for any religious reasons, and were United States citizens. All of the respondents were grad uate students at the College of Journalism and Mass Communications. During the tran scription phase, all of the par ticipants names were erased 55


and they were each assig ned a participant numbe r, 1-18, based on the order of the focus groups and the order in which they first s poke in these respective focus groups. Overall, the focus groups revealed several themes (labeled as Categories 1-4): Hormonal Contraceptives are Still Prescr iption Drugs, Wheres the Birt h Control in Birth Control Advertisements, Motivation to Take Acti on, and The Portrayal of Women in Print Advertisements for Hormonal Contraceptives. Th ese categories/themes ar e discussed in detail below. Category 1: Hormonal Contracepti ves are Still Prescription Drugs I just think its important that advertisers th at put [hormonal contra ceptive advertisements] together realize that they are not necessarily re lating to the consumers and that were not stupid, especially if youve been on birth control before. I need to be informed. You dont take birth control to hang out with your buds. Its really trivializing something important that women have to deal with on the daily basis. -Participant 1 Prior to the core discussion of the port rayal of women in hormonal contraceptives advertisements, the focus groups were asked to express their opini ons toward hormonal contraceptive advertisements in general. Th e reaction was primarily negative and the most overarching theme behind this negativity was the treatment of horm onal contraceptives by advertisers as a trivial and in significant prescription drug, as succinctly summarized above by Participant 1. This characterization of hormonal contraceptives as trivial was affirmed by three subcategories Frivolity, Wheres the beef, an d Transparency. In thes e three categories, the focus group participants reveal that the decision to take hormonal contraceptives is not a light one, and thus advertisements must have a seri ous tone and should pr ovide adequate, honest information so that the target market can make informed decisions. Subcategory 1: Frivolity When talking about the most recent Nuva Ring campaign (Appendix L), before even having a chance to view the print advertisement, simply from the top of their minds, the 56


participants lam ented its frivol ity. Participant 3 had difficulty understanding the commercials relevance: I dont think it really re lates to birth control. Its ki nda just showing that you can be different from everyone else by wearing like a bikini. I dont know its just kind of stupid. It doesnt mean anything to me. Similarly, Participant 4 had a gene ral dislike of the advertisement and felt that the stupidity of the advertisement reflected negatively on women: Yeah, I mean. I think that. pharmaceutical companies can get information across to women in a more [ pause ] I mean its just kind of embarrassi ng, kind of demeaning. Like were so stupid that like [ raises voice] yay, birth control! So y eah um. Just kind of annoying. With these two comments regarding the N uvaRing advertisement, it is clear the participants reacted to the unnecessarily light content in the advertisement, which they found both stupid and irrelevant. And while the NuvaRing commercial did ev oke many feelings of negativity, hormonal contraceptive advertisements in general were derided for taking such a serious topic too lightly. When asked what participants like least about advertisements for hormonal contraceptives, the majority of re spondents felt that they lacked importance. Participant 2 noted that hormonal contraceptives are for a very specific purpose thats actually very serious. In the third focus group, Participants 12 and 13 both ag reed that hormonal contraceptive advertising is treated too loosely: Participant 13: [Birth control advertisements] makes it seem like its more of a fad thing than a serious thing. Participant 12: Its not good th at they make it seem like such a carefree thing and it is a big deal to be on hormones. Finally, Participant 3 explained her feelings with a very dire ct five-word statement: Birth control is not funny. As demonstrated above, the respondents do not take hormonal contraceptives lightly. 57


Thus, to m ake an advertisement that treats the product as frivolous or light-hearted evokes feelings of negativity among many respondents. When shown a recent print advertisement for Yaz (Appendix H), in which two young women are shown clearly laughing and smiling, the respondents continued their protes tations that taking hormonal contraceptives is a serious matter, not one to be taken lightly: Participant 2: When I first saw it I saw them laughing and I was like, why are they laughing about their birth control? Participant 4: Yeah, I agree. Its not a f unny topic; its not a li ght-hearted topic. Anybody thats had their birth control fail knows thatSo ha ha ha talk about it with your friends [ said sarcastically]. Usually when you are having a talk about birth control w ith your friends its not a pleasant conversation. In later focus groups, without prompting, the sen timents were largely the same. Participant 7 cautioned: Its a serious topic because youre having to take something every day to control your hormones. So its not something that should be taken lightly. Other participants also disliked the laughing images: Participant 13: I dont like that they are laughing. Participant 14: People dont make jokes about birth control. It s not a funny matter. Overwhelmingly, any advertisement that turn s birth control into a light matter was criticized. The response from the focus groups was clear: hormonal contraceptives are still a prescription drug and must be treated as such in order to affirm female beliefs that to be on hormonal contraceptives means making a seriou s commitment to alter bodily hormones. Subcategory 2: Wheres the beef? Another area of major concern among the partic ipants was the lack of information that the hormonal contraceptives print advertisements had provided. When participants were asked to describe their ideal advertisement for horm onal contraceptives, many participants emphasized 58


their desire to have the advertisem ents be more informative and dense in relevant details. For example, Participant 8 explains how confusing the lack of inform ation can be to decide which pill is right for whom: [HC ads] can be really confusing or overb earing though because a lo t of time you see ads where youre like, Im not sure what the diffe rence is between this one, and this one, and this one. How do I know which one is the best for me? Sometimes I feel like its overly confusing. Many other participants cite conf usion and frustration due to l ack of information in hormonal contraceptive advertisements: Participant 3: I like ads that compare becau se a lot of times Im trying, I know, every birth control essentially does the same thing but everyone is different and that always confused me. Sometimes I go online and look this stuff up but I think if a commercial pointed out more of the things that were different about it compared to the ot her ones would be helpful. Participant 8: They dont even show you the product. Id like to know how it actually works. How does it work? Why does it work? Several participants had problems with the N uvaRing advertisement specifically (Appendix L) due to its focus on style over substance: Participant 7: I think [the NuvaRing ad is] worse than the Yaz ads because at least the Yaz ad has some kind of medical implication because it has some information as to why this birth cont rol is better than another type. It gives some indication of the side eff ects, etc. The NuvaRing one is just ridiculous. Participant 8: I just feel like its not info rmative at all. Like, you get caught up in the visuals of it, the jingle; you kind of fo rget what they are promoting. These are things that younger girl s are watching, they don t understand what it is. While many participants argued that the horm onal contraceptive advertisements contained too little information, when shown an advert isement that was full of text (Appendix H), participants lamented it for being too text-heavy. Participant 15 comp lained, I hate it. Its too much text. Its overwhelming. Participant 13 agreed, noting that th e advertisement is too cluttered. They need to have a little more white space. 59


Despite this discrep ancy regarding the le vel of text in hor monal contraceptive advertisements, the majority of focus group part icipants felt that the amount of information presented in current campaigns left much to be desired. These women were much less interested in the visuals of the advertisements and catchy slogans and much more interested in the bottom line: what is the product, how does it work, why does it work, how does it work for me? Additionally, the lack of viable information left many participants feel ing like taking hormonal contraceptives should be an easy decision that requires little exp lication, again trivializing the seriousness of this category of prescription drugs. Subcategory 3: Transparency Along with presenting hormonal contraceptives with frivolity and a noticeable lack of information, participants also noted that most of the advertisements lacked transparency, something they feel is necessary for a prescr iption drug. Because hormonal contraceptives act directly on the bodys hormones, they can have so me pretty dramatic physiological effects. Participant 1 experienced these effects first-ha nd and laments not being told that they might occur: I was on Yasmin for a while and I do nt know about everyone else but [ emphatic ] I got like really emotional. All: [ Noises of agreement ] I mean no one told me that. No one was honest with me about that. I just remember like it was just a really light dosage pill. So I would prefer someth ing that said, Look, these are the good things about it, these are the bad stu ff, so you know, just weigh your options. In addition to neglecting to mention the psychological burden that some hormonal contraceptives can bring to their users, some part icipants also noted that advertisements also neglect to mention the more practical burdens th at come with being on hormonal contraceptives: 60


Participant 6: No advertisement ever tells you that you have to take the pill at the same time every day either. I mean you have to put yourself on a schedule. And its not easy to follow, especially when youre young. Participant 11: I mean NuvaRing never told you in the ad that you need to store NuvaRing in a cool, dark place and my roommate used to keep it in our fridge. While these concerns may seem a little less si gnificant than others and therefore may not seem necessary to include on the main page of the advertisement, they can still have a tremendous effect on whether or not women choose to request a specific bra nd to their doctor. This issue of transparency actually took a very interesting turn during the week in which the focus groups were performed. In the second focus group session, Participant 7 noted a new commercial for Yaz that she had seen just the da y before. They actually ran a retraction ad to that (Appendix H). They said that apparently some of things we said in this ad were misleading. No one else in the focus group sess ions had seen that new advertisement nor had the moderator; however, a few days later, an article appeared in The New York Times entitled A Birth Control Pill That Promised Too Much. In this article, the author notes the reason behind the retraction ad: As part of an unusual crackdown on deceptive consumer drug advertising, the Food and Drug Administration and the attorneys general of 27 states have required Bayer to run these new ads to correct previous Yaz mark eting. Regulators say the ads overstated the drugs ability to improve womens moods and clear up acne, while playing down its potential health risks. (Singer, 2009) Thus, the focus group participants were not the only ones to find hormonal contraceptives advertisements confusing and l acking in honesty. The question of how much a prescription drug campaign should reveal about the products benefits and side effects is a topic for future research; however, it is significant to note that the FDA is taking a stance against misleading DTC advertisements, albeit retroactively. 61


One advertisement that was shown to partic ipants during the focus group sessions seemed to pro-actively counter any claims of being misleading or uninformative. When shown a print advertisement for Seasonique (Appendix K), mo st participants responded positively to the abundance of information, which was not only br oken down into a Frequently Asked Questions (FAQ) format but also included negative details about the product: Participant 9: I like the FAQ, with the pros and cons. Participant 6: They actuall y say the negatives in the ad. Participant 8: I think this one is the best one. Participant 14: I like this I like that its an FAQ. Participant 12: Its a good fo rmat for a birth control ad. The participants resounding pos itivity toward the Seasonique print advertisement was best explained by Participant 9, I think transpar ency is the thing thats missing from all these ads. Seasonique comes closest to attaining that. Thus, on a general level, for hormonal contraceptives advertisements to be successful among their target audience, they should be somewhat transparent. This transparency allows for the hormonal contraceptive to be seen as a serious commitment, full of health risks and nega tive side effects, just like any other prescription drug. Category 2: Wheres the Birth Control in Birth Control Advertisements? Interestingly, in all three focus groups, w ithout ever being prompted on the topic, participants noted the strange lack of se x and pregnancy in hormonal contraceptive advertisements. Because hormonal contraceptives are contraceptives/birth control pills and thus a means to prevent pregnancy, participants found it interesting that none of the advertisements make any mention of sexual intercourse nor the main reason for the products existence, its ability to prevent pregnancy: 62


Participant 2: The point of birth control is not solely to take away PMS or maybe to take away acne. My main reason is to make sure I dont get pregnant. To me, everything else is secondary. Participant 5: None of them seem to be advertising the dont get pregnant thing. Participant 7: Now that I think about it, th ey never mention sex. They always mention like, oh, youre acne will clear up or whatever but never like you wont get pregnant. But they never outwardly mention, explicitly birth control. Participant 9: Theres like no relationship to sex Participant 8: Completely unrelated to sex. While these participants are not expressing a desire to see sexual acts or innuendos displayed in the advertisements, they are looki ng to see hormonal contrace ptives advertise their ability as contraceptives rather than as just ache-fighters, PMS-blockers, or PMDD cures. Participants also commented on the noticeable absence of males in the contraceptive advertisements. Every one of the advertisements discussed by the participants and every one of those shown by the moderator to the particip ants included only wo men. Participant 17 commented that hormonal contraceptive advertisemen ts are never about sex and there is never a guy in the advertisement. This lack of males was a problem to some pa rticipants for different reasons. Participant 13 found the lack of men interesti ng because a male was active in her selection of birth control, For one of my birth control choices, it was af ter a discussion with my boyfriend, so he was a deciding factor in that. Another participant responded negatively to the fact that hormonal contraceptive advertisements included only women: Participant 2: Its weird that there are no men. I mean the reason women take this is because they want to have certain relations with me. For me, a so cial value, its saying that women are responsible for making sure bad sh it doesnt happen and that bothers me. Thus, this participant felt that by having only women in hormonal contraceptive advertisements, society was saying that it is a womens burde n to prevent pregnancy and that men have no 63


responsibility should som ething go aw ry. Therefore, the issue of whether or not to portray men and sex in hormonal contraceptives is not just a question of taste, but of responsibility. Whose responsibility is it to not get pregnant and to choose the right hormonal contraceptive? Category 3: Motivation to Take Action An important aspect of understanding how the target market percei ves current hormonal contraceptive advertising is dete rmining the extent to which viewing the advertisements actually motivates the target to ask their doctor about the drug. After all, encouraging women to request their drug is the reason advert isers even bother to advert ise hormonal contraceptives. Understanding whether or not consumers were mo tivated to ask their doctor about a specific drug might also be indicative about how turned o ff/turned on the participants were by the models in the advertisements. This will be discussed in more detail later. In this study, seven of the 18 focus group part icipants said that se eing an advertisement for hormonal contraceptives motivated them enou gh to request that particular drug to their doctor. One participant did not even ask for anything but Yaz because she had seen the advertisements, both print and television and felt like Yaz appealed to her because of the youthful strategy of the campaign: Participant 3: I wanted to take [Yaz]. I remember but I didnt ask for anything else because of the ad and it was targeting more toward my age group. For some reason I was thinking that I dont want to take a birth contro l pill thats for someone older. I dont know why. In this instance, the tone created by the adver tisement directly appealed to Participant 3 enough for her to ask her doctor to put her on that specific drug. Participant 6 felt similarly when she saw an advertisement for Loestrin24Fe, a form of hormonal contraceptive infused with Iron, and was motivated to talk to her doctor: I thought [Loestrin24Fe] sounded good. And I saw another thing for it while I was in the waiting room and I brought it in. I saw the comm ercial for Loestrin24FE and they advertised shorter, lighter periods, and I immediately went to my doctor and was like, I want to go on this. 64


And I was put on it and I stopped getting m y period completely. So I went to a different doctor and told me that I should never ha ve been put on it, its for women with serious period problems. While Participant 6s experience with her hor monal contraceptive was not very positive, it did show how much seeing a hormonal contraceptive advertisement can influence the target market to request a specific drug to her doctor. Two other participants in the third focus group had a similar experience: Participant 15: The commercials for Yaz worked for me. I remember the one about the colorful balloons just because it talk ed expressly about the symptoms. It caught my attention because it talked about something I wanted to hear. Participant 13: I went on the patch because of the commercials I saw. They created awareness for the product and made me want to ask my doctor about the product. As these experiences suggest, hormonal contraceptive advertisements, though widely criticized by the three focus gr oups, were also effective in motiv ating many of them to request a specific drug. While many cited the advertisemen ts for creating awareness for a specific drug, it is interesting to discover whet her the participants took initia l notice to the advertisements because of their imagery, such as their female models. Core Category: Portrayal of Women in Print Advertisements for Hormonal Contraceptives While the focus group participants had ma ny interesting insights into hormonal contraceptives in general, the heart of the study was how the target market of hormonal contraceptives viewed the manner in which fema les were portrayed in the advertisements. Several themes were gleaned from the participan ts comments. These themes will be discussed in detail in this section. Add itionally, in keeping with the three phases of grounded theory coding, the relationship of the prev ious three aforementioned categorie s to this core category will also be included. 65


Subcategory 1: Unrealistic/fake The m ain reaction among focus group participan ts regarding the portr ayal of women in print advertisements for hormonal contraceptives involved criticism because the models were too unrealistic. This sort of unrealis tic portrayal bothered many participants because it made them feel negatively toward their own body image: Participant 5: I get bothered when all of the women are like picture perfect like tall, thin, big-chested. So wow yeah, Im just plain and ug ly, I dont think thats me. Theyre off in their little land doing their little thing. Most of these unrealistic portrayals were met with eye rolls and sarcastic tones, especially in two advertisements, a current Yaz advertisement (Appendix H) and the latest NuvaRing campaign (Appendix L). In response to the Yaz advertisement, two participan ts noted that the two models were so non-relatable and irrelevant to the topic of the advertisement that they could be modeling for anything: Participant 6: Here are just two women in their late 20s, and I dont know what they are doing. They are just smiling. It has nothing to do with anything. Participant 9: Yeah, it could be an ad fo r Coach bags or sunglasses, I have no idea. Participant 14 was also turned off by the sa me Yaz advertisement, feeling that the women were unbelievable spokes women for that drug: They are all decked out and they look like models. They dont look like normal women. The woman totally did not look like she was in med school. And she looked too young. They are very fake. Participant 12 agreed, calling the models in the advertisement not very relatable. In reaction to such idealized, model-types, Participant 7 noted that she would actually like to see someone suffering from the symptoms that a Yaz print adve rtisement (Appendix I) is supposed to treat: I want to see someone fatigued or bloated. Th eres a cognitive dissonance between what the words say and what the image says. 66


The Yaz advertisements were not the only ones that were shown to the participants that caused them to react negatively toward th e models unrealistic qua lities. The NuvaRing advertisement was found to be almost uniformly unr ealistic by all of the pa rticipants because of the models body types: Participant 2: I mean they all look very similar because they are all dressed up like synchronized swimmers so they are all meant to look the same. And of course they all have the same body proportions: skinny and tall and perfect Moderator: So this woman is not believable to you? Participant 2: Well [ laughing] I definitely dont have those abs or those thighs. Other participants also found the models too skinny and too perfect to be in an advertisement for a prescription drug. Participant 6 called the women in the Nu vaRing advertisement, really skinny and model-esk. Particip ant 8 agreed, finding this characterization of the females unfitting: I saw the NuvaRing ad where she was walki ng out of the pool and I was like shes ridiculously in shape.Everybody is like that computerized perfect looking Barbie type. I just found it to be kind of inappropriate that it would be a pool with girls like hanging out in their two-piece bathing suits. The portrayal of the models as unrealistic and non-relatable helps to explain why many focus group participants found the advertisements to be presenting hormonal contraceptives as frivolous products. The models are smiling, wear ing bathing suits, or laughing. To the focus group participants, the models ch aracterization makes them appear more like models for purses or make up than for hormonal contraceptives. Th e fact that, on first glance, the advertisement could be confused for any other womens pr oduct also lessens the transparency of the advertisement. If the advertisements are pres ented as too closely modeled after cosmetics or clothing advertisements, the hormonal contraceptive s they advertise appear less like prescription drugs and more like toiletries or fashion accessories. 67


Subcategory 2: Sexualized bimbos Many participants comm ented on the overl y sexualized models in the hormonal contraceptive advertisements. The majority of complaints of sexy models came from the Yaz party advertisement (Appendix H) and the latest NuvaRing (Appendix L) advertisement. In regards to the Yaz party advertisement, participants cast the over-sexualized model in this advertisement into the role of partier, a role that was viewed as larg ely negative. Participant 2 noted that the model kinda looks like a bimb o to me and Participant 7 jokingly called the model a sophisticated partier. Participant 3 noted that the advertisement is trying to appeal to a woman that wants to have fun and not have children. [ Laughing] That overall look: partying. Thus, the model in the role of pa rtier was not viewed as relatable. Her label as partier seemed to be a poor fit with the category of the drug advertised. The NuvaRing print advertisement also inspired negative reaction to the portrayal of the model as sexy. In the case of this advertisement, the model was not criticized for her surroundings in a party, but rather her body positi on and physical features. Participant 7 noted that the model is really posed. Shes staring seductively at the camera. Shes so posy, poesy. Shes super skinny. Participant 6, also in th e second focus group agreed, citing that the model is in a slutty pose. Thus, the general consensus re garding these sexualized females was fairly negative and also caused some confusion rega rding their placement in advertisements for products marketed only toward other women: Participant 5: The way shes positioned looks to me like shes trying to attract men and thats not an ad for me. Like, I see a woman thats like, Hey, Im sexy. Wellwhy would I care about that? I dont care a bout sexy women. That should be in a mens magazine. Participant 5 presented a valid concern in her statement here as the sexualized models seemed not only to cause confusion but also to up set the participants in such a manner that the 68


sexy m odel turned off some participants from the advertisement as a whole. Participant 9, in response to the models sexy pose, angrily inquired, What does she have to do with NuvaRing? The idea that the models portrayal w ould inspire anger or resentment toward the product is a valid concern. The third focus gr oup, when asked if the models in hormonal contraceptive advertisements would ever motivate them to ask their doc tor about the specific drug, one participant replied, It would only influence me negatively. Especially if the model is a really bad fit. Thus, in situations such as the aforementioned NuvaRing and Yaz advertisements, the sexualized appearance of th e model may not only turn-off consumers to the advertisement, it might also cause the consumer to have a negative associa tion with the brand. Subcategory 3: Relatable In comparison to the aforementioned Yaz and NuvaRing advertisements, many participants found the models in the Seasonique (Appendix K) and Yaz balloon (Appendix J) advertisements relatable. The Yaz balloon advertisement was ranked as the best hormonal contraceptive advertisement across all of the focu s groups in terms of how it portrayed females. It is interesting that this advertisement appeal ed most to the participants, as it is the one advertisement shown in which th e model is not the focus of the advertisement. In this advertisement, the model is more in the bac kground, secondary to the balloons that encompass the foreground. Participants in the second focus group session had some gr eat insights into why they preferred the model in the Yaz balloon advertisement: Participant 7: She is most relatable because shes normal. Participant 6: She looks the most relaxed, free. Participant 9: Shes not wear ing ridiculous clothes either. Participant 7: The focus is not on her face, and this makes her more anonymous and therefore more relatable. 69


Participant 2, from the first focus group, also find s the model to be more relatable, noting Its a much more natural shot compared to the really posed bikini model, so I am able to identify with her. It is important to note th at to these participants, the concepts of normal and natural are equated with relatability a nd empathy with the model. As demonstrated by these participants, this model became the most relatable because her physical features were somewhat vague. Because she was positioned in the background of the advertisement, her looks were less defined. Her face could be of any ethnicity and her clothes are fairly simplistic. The focus of the model in this advertisement is really on her body position and her emotions rather than on her appearance. When participants were asked to express how they would ideally like to see females portrayed in advertisements, the participants we re fairly unanimous in requesting relatable and normal women. As evident in the previous subc ategory, the focus group pa rticipants were highly unimpressed by fake and unrealistic models. Those sorts of portrayals may work for cosmetic and fashion advertisements, but in hormonal contraceptive advertisements they seem frivolous and out of place. Participant 2 summed up this opinion succinctly, noting: The more [the models] look like someone you see on the street or someone that looks like they might have a daily life, you can relate to them better than if they are in a swimsuit and jumping all around, then thats not me. The idea of being able to relate to the models is an important one, mirrored by Participant 5 in her statement: I personally like an ad where I see a woman who looks like a real woman with curves and maybe blemishes and funny hair, still attractive, but normal. To me that means that normal people can take this too, its not just for supermodels. Thus, utilizing a normal model not only makes the model more relatable, but it also brings about a positive reaction to an advertisement. 70


In the case of the Yaz balloon advertisem ent, it is no coincidence that the advertisement that garnered the most praise for its portrayal of women, also garnered the most positive review overall. While participants commented that ideally, the Yaz balloon ad vertisement could use more information, it was still high ly rated for evoking pleasant feelings in these viewers. Women felt that the appeal in the advertisement was how f ree the model appeared. The fact that many participants could see themselves as the model in the advertisement, allowed the participants to take an interest in the advertisements other elements, such as the brand name, brand logo, and product attributes. 71


72 CHAPTER 5 DISCUSSION This study sought to answer and expand on three research questi ons that guided the nature and direction of the research. The re sults obtained and analyzed in Chapter 4 are discussed in this chapter, particularly as they address the research questions. Answering the Research Questions and Generating Theory (RQ1): What do account planners think is the most advantageous manner to portray women in print advertisements for hormonal contraceptives? Both account planners revealed that the most advantageous manner to portray women in print advertisements for hormonal contraceptive is in a relatable fashion. The ability of the target market to relate to the model is pivotal to the success of any campaign. The manner in which each planner chose to convey relatability differed somewhat. In the case of Account Planner 1, the most advantageous way to portray females in hormonal contraceptive advertisements is as aspirational. To this end, models should be at tractive enough to provide an example to which the female consumer aspires, but not too attractiv e where the model alienates the average woman from the advertisement. Conversely, Account Planner 2 felt that females in hormonal contraceptive advertisements should not be aspira tional or particularly attractive, but rather should represent the average woman so that the c onsumer can look at the model and see herself. Account Planner 2 also felt that women in th ese advertisements s hould be portrayed as intelligent, assertive, and inqui sitive women, in control of their health care needs. While Account Planners 1 and 2 differed in their opinion regarding how best to portray women in a relatable fashion, they both ag reed that women in hormonal contraceptive advertisements must inspire the right emotions in the target market. Account Planner 1 achieved this emotional response by noting the tone of the advertisement and the personality of the brand


in the creative brief so that the creative team could develop an appropriately emotive advertisement. Account Planner 2 relied on cas ting a model that appeals to the emotional sensibilities of the target market. The client th en adjusted the model cas t by the account planners to their liking. It is this involvement of the c lient in the casting process that Account Planner 2 found unfortunate. Oftentimes, th e client will alter the portraya l of the model set out by the account planners to appeal to their own sensibilities. Unfortun ately, these sensibilities are not based on research or planning, but merely the clients own stylistic preferences. ( RQ2): How do the target females for hormonal contraceptives feel about the manner in which a female is portrayed in the print advertisement? Overall, females responded with dislike to the portrayal of women in the majority of the print advertisements shown during the focus groups. The main cause of distaste for these participants was two-fold. Fi rst, the participants found many of these models to be too unrealistic to be relatable or received positively. These unrealistic characteristics included the models unnatural body proportions such as extremely slender bodies and large breasts. The second reason for distaste was the sexualized nature of the models that most participants found out of place in an advertisement for a pr escription drug intended only for women. While the response was largely negative to most advertisements, there were two, namely Seasonique and the Yaz balloon advertisement th at many participants responded to positively. These two advertisements garnered positive reacti ons due to the portrayal of the models as relatable and aspirational. Th ey were perceived as attractiv e but not overly so and their body language expressed positiv e feelings such as fr eedom and empowerment. In their focus group discussi ons, the participants provided a few words of wisdom to advertising professionals that emphasize their ov erall opinions on the portrayal of females in 73


horm onal contraceptive print advertisements. Firs t, Participant 6 rightly expressed that Every type of woman uses birth control. Thus, the fe males in these advertisements should act as an everywoman, to appeal to all races and backgr ounds. Second, the most important aspect of the portrayal of the female is not the models appearance, but rather her emotions. Participant 9 addressed this point: Whats more important is th e expression on her face, rather than what she looks like. Participant 7 best expressed the ove rall feelings of the focu s participants: Unless the pill is going to make me look like the ski nny model, I dont care. I want to know how she FEELS. Focus group participants in th is study want to see attractive, yet relatable and aspirational models in their hormonal contraceptive print advert isements. The participants do not want to see females in print advertisements that are sexualized or frivolous. (RQ3): Is the manner with whic h the account planning team chose to portray females in print advertisements for hormonal contracepti ves congruent with the manner in which the target audience for hormonal contraceptives view themselves? The answer to this research question is somewhat complex. Based on the qualitative interviews, it would seem that Account Planner 2 was very well versed on how the female target market would like to see females portrayed in ho rmonal contraceptive advertisements. She noted that females in these advertisements should be presented as relatable, not overly attractive, intelligent, or assertive. All of these qualities represent what most focus group participants desired in female models for hormonal contraceptiv es. Focus group participants complained that the models in hormonal contraceptive advertisemen ts were too attractive, frivolous, or sexual, and Account Planner 2 agreed. For example, Acc ount Planner 2 felt that the models in hormonal contraceptive advertisements should inspire positiv e emotions from the target audience by being 74


relatable and in contro l of their healthcare needs. Base d on the responses by the focus group participants to Account Planner 2s Seasonique advertisem ent, she was largely successful in her advertisement. Account Planner 1 was not as successful in understanding how to properly portray females in hormonal contraceptive advertisements To him, models in hormonal contraceptive advertisements should be attractive, but relatabl e. In his experience, consumers are unable to express what they would like to see from models in hormonal contraceptive advertisements, so it is up to him and his experience to decide how to best reach these consumers. This strategy led to the creation of the most current Yaz advertis ement, an advertisement that largely failed to reach the focus group participants. Many focus group participants found the models in this ad to be too attractive and non-relatable. Participants called the main model in this advertisement a bimbo and were put off by her placement in a party scene. Focus group participants felt that by placing the models in a party or club setting, the advertisers made the product seem frivolous and the decision to take hormonal contraceptives a simple one. Despite the fact that Account Planner 1 did not seem to understand his target market as well as Account Planner 2, some of his concerns regarding the portrayal of women were valid. For instance Account Planner 1 noted that consumers have a hard time telling you what they want. One of the examples he gave is of cons umers that say that th ey want information, but then you put a lot of information in but they dont read it. The researcher experienced this consumer confusion first hand. In all three of the focus groups, participants noted that they wanted hormonal contraceptive advertisement to be highly informative. However, when shown actual advertisements (Appendix K and Appendix H) that contained a great deal of information, focus group participants responde d with the following comments: 75


Participant 2: Its very text heavyI wouldnt even look at it. Participant 7: And its a LOT of text. Participant 6: I dont know if there needs to be so much text. Im going to go online and research it no matter what. Participant 12: Too text heavy. Participant 15: I hate it. Its too much text. Its overwhelming. Participant 13: Its too cluttered. They need to have a little more white space. As evident by the fact that participants from all three fo cus groups said they disliked advertisements that were too text heavy, it appears th at consumers really are unable to properly define what elements they woul d or would not like in hormonal contraceptive advertisements. It must be noted that the reason most horm onal contraceptive advertisements are so text heavy is due to FDA regulations. Accordi ng to the Code of Federal Regulations for Prescription Drug Advertising, every prescr iption drug advertisement must include a statement of information in brief summary relating to side effects, contraindications (when used in this section ``side effects, contrai ndications'' include side effects, warnings, precautions, and contraindications and include any such information under such headings as cautions, special considerations, important notes, etc.) and effectiveness. (pg. 78) In addition to the required incl usion of side effects, contra indications, and effectiveness, prescription drug advertisements must also abid e by other regulations all of which are outlined within the FDAs lengthy document. It is interes ting that while advertisers must in include all of these required elements, focus group participants still found the hormonal contraceptive advertisements to be lacking in relevant information. Account Planner 1 was correct in his assertion that models in the advertisements must be aspirational. In terms of a models appearance, he noted, people say they want to see real but they want to see real but something they would aspire to. And while A ccount Planner 2 felt that aspirational models are not e ssential in hormonal contraceptive advertisements, focus group 76


participan ts indicated that models need to represent a woman worth aspiring to, someone who evokes positive feeling. Smiling models was th e one constant through all of the hormonal contraceptive advertisements shown to the focus groups. These smiles were attempting to evoke a feeling of happiness and well-being. One partic ipant called these models appropriate, smiling because they beat the symptoms. And in the e nd, the only thing that female consumers in this study really took away from these advertisements, besides the e fficacy level of the drug, was how the product would make them feel. All of the secondary product attributes of these hormonal contraceptives be it fighting acne, bl ocking PMS symptoms, or limiting the number of days of a period, are meant to make their users FEEL better about themselves. Placing aspirational models in these advertisements allo ws the viewer of the advertisement to imagine how it might feel to be on a specifi c brand of hormonal contraceptive. Overall, the account planners generally do understand how consumers feel regarding the portrayal of women in print advertisements fo r hormonal contraceptives. However, despite the fact that they seem to have pretty good understanding of consumer wants and needs, many hormonal contraceptive advertisements end up fall ing short of consumer expectation and actually upset many consumers in this study. Focus group interviews demonstrated that even current hormonal contraceptive advertisements make bi rth control seem too frivolous and present models that are so attractive that they end up bein g largely unrealistic. If account planners seem to understand their target consum er, how then do current print a dvertisements still manage to miss the mark? The answer, surprisingly, may lie in the ge nder of the account pla nner and the gender of the client. Account Planner 1, in explaining th e account planning process behind Yaz, noted that it was he and his team that cast models for the a dvertisement. This casting was based on the tone 77


that they desired to express in their advertisem ents. From ther e, the casting largely depended on acting ability and physical appearance. Because Account Planner 1 is a male, his perception of what accomplishes the tone of empowered wome n is different from ho w women in this study perceive powerful women. According to the Ya z advertisement, an empowered women is one who is clearly a working woman, in the case of this advertising campaign, a doctor, who has no time for PMS symptoms in between her bus y career and her exciting nightlife. The decision to make the main (and beautif ul) model/actress in th e Yaz advertisement a doctor and a partier backfired w ith the target market in the focus groups. Women found the attractive blondes occupation as a doctor unbelievab le and her setting in a nightclub unrealistic. In sum, the focus group participants felt that th e model and the advertisement belittled a serious health decision, and overall they had a very negative response to the advertisement. In contrast to the reception of the Yaz adve rtisement, Seasonique, developed by female Account Planner 2 and her team, received a la rgely positive reception. Account Planner 2 felt that women should be portrayed in hormonal contraceptive advertisements as relatable, intelligent, and in control of their health decisions. The Seasonique advertisement represents these qualities as the woman is attractive, but not overly so, and appears to be working on her laptop, researching the pros and c ons of Seasonique (It must be noted that seeing the Seasonique television spot helps to better e xplain the nature of the Seasonique advertisement). Focus group participants appreciated the fact that the m odel was fully clothed, appeared intelligent and somewhat concerned by her hormonal contraceptiv e decision, and that the advertisement was filled with text, but organized into an easily readable FAQ format. This advertisement, developed with a female at the helm, became one of the best-received print advertisements among the focus groups. 78


While the gender of the account planner seem ed to affect the final portrayal of females in hormonal contraceptive advertisements, it was th e gender of the client representative that determined the final product in this study. The gender of the hormonal contraceptive advertiser was not considered as affecting the portrayal of women in hormonal contraceptive advertisement until Account Planner 2 was interviewed. Account Planner 2 revealed that for most hormonal contraceptive accounts, clients have final selection of the models and tailor the models to their own stylistic preferences. When the client is male, his sty listic preference usually differs from that of a female account planner. While Seasoni que was able to escape with Account Planner 2s portrayal recommendations intact, she noted th at unfortunately, many hormonal contraceptive advertisements are not so lucky. Gender differences in the creation of hormona l contraceptive advertisements could help to explain why many current hormonal contracep tive advertisements receive largely negative receptions among their target market. While it seem s that these account planners do in fact have a pretty good understanding of their target market, gender can, perhaps s ubconsciously, alter this understanding. In many cases, even if the account pl anner clearly relates to the target market, when the client has final say regarding the portray al of the females in the advertisements, this relationship may not matter. In the end, the goal of many advertising agenci es is to please the client. Thus, any recommendations that this study proffers regarding the manner in which females are portrayed in hormonal contraceptive a dvertisements becomes moot if the clients are not also made aware of them. Practical Implications In order to keep adve rtising professionals a nd their clients on track to connect with their target and capitalize on a multi-billion dollar i ndustry, several recommendations are presented below based on the results of this study. Because little research had been conducted on hormonal 79


contraceptive advertising prio r to this study, and only one other study had touched on the portrayal of wom en in these adve rtisements, the results of this study offer a first look into how best to portray women in hormonal contraceptive print advertisements. The results of the study suggest that in or der to appeal to sexually active Caucasian females ages 20-24, a hormonal contraceptive a dvertisement should provide a great deal of information, presented in a format that is easily digestible, such as in bullet or FAQ form. Providing adequate information helps female c onsumers to better understand the product being advertised as well as assure consumers that the decision to take hormonal contraceptives is just as serious as deciding to take any other prescription drug. As demonstrated by this study, these consumers strongly dislike the current treatment of hormonal contraceptives as frivolous and light-hearted. To them, choosing to alter their bodys natural chemistry is a major concern and they must be properly informed in order to understand why they should be motivated to go to their doctor and request a hormonal contraceptive. In addition to being informative, hormonal contraceptive advertisements should contain a level of transparency. While a ll current hormonal c ontraceptives being advertised in print include a copy of their product inse rt on the backside of the page, it would be helpful to include some key side effects and any unusual dosing in formation within the cr eative portion of the advertisement. Providing this information up front allows consumers to be better informed as well as to feel as though they can better trust the advertisement and thus the brand itself. In keeping with this idea of transparency, consumers in this study prefer to see an image of the product, so that they can better understand how the product works and decide whether or not they are comfortable with that particular vari ety of hormonal contraceptive. In the case of NuvaRing, many focus group participan ts were not aware of what the product looked like. They 80


did not realize that it was a fairly large, clear, fl exible ring that m ust be inserted vaginally. To these participants, seeing the image made them realize that the product was not something they would be comfortable in utilizing. When choosing their spokesperson or mode l for print advertisements for hormonal contraceptives, advertisers should be careful to select a model th at is neither too unrealistic nor too sexual. Based on the discussions with th e focus group and account planners, models should be relatable, yet attractive enough that they are aspirational. While many focus group participants lamented attractiv e models, Account Planner 1 was correct in his assessment that women want to see real, but attractive real. However, while the model should be attractive enough to be aspirational, advertisers should be careful to make sure the model is not too modely. She should not be too thin or too busty. Her build s hould be thin in a healthy way, due to athleticism or a healthy di et. Her facial features should be attractive but not too beautiful or unattainable. In many ways, this model s hould represent an everywoman. The model should be someone who consumers strive to be but not someone who arouses feelings of jealousy or anger. While the model should be aspirational and attractive, she should never be sexy. Based on the comments of focus group participants, a sexualized model has no place in a hormonal contraceptive advertisement. Sexualized models in the hormonal contraceptive advertisements discussed with the focus groups not only inspired dislike, but in many cases, inspired anger. Advertisers should be careful not to provoke consumers into associating their brand with feelings of anger or resentment. Presenting advertisements that are informative, yet digestible and somewhat transparent will help advertisers better appeal to their target market. Advertisers should also be careful to 81


present a m odel that is attractive and aspiratio nal, never unrealistic or sexualized. If the advertisers or account planners are male, they must be careful not to let their gender influence the manner in which females are portrayed in th ese advertisements. There is much research involved in developing a campaign, especially in regards to understandin g the target market. Personal tastes or judgments on how female s are portrayed in hormonal contraceptive advertisements must always come second to research. If the research does not support portraying the model as sexualized or highly attractive, then the model should not represent either of those qualities. If followed, these r ecommendations should allow for advertisers and their agencies to have a closer relationship with their target c onsumers and perhaps have better success in building their brands. Limitations While this study generated many insights re garding hormonal cont raceptive advertising, it is not without some weaknesses. First, th e focus group participants were all Caucasian graduate students. Because all of the participants were Caucas ian, their responses regarding the portrayal of females in the advertisements were all based on similar racial backgrounds. Thus, it is possible that participants from other racial backgrounds would have responded differently to the models in the advertisements. Also, because th e participants were all graduate students, their education levels were high. It is possible that this education level affected the outcome of the results. For instance, the focus group participan ts in this study were very skeptical of the advertisements that they were shown. A bias ag ainst advertising may not be as prevalent with participants with lower educational backgrounds. The second area of limitation involves th e small number of account planners. Unfortunately, obtaining willing interview participan ts was extremely difficult. The response rate to interview requests was extremely low. Ve ry few account planners who were contacted 82


actually replied and am ong those who did reply, only two were actually av ailable and willing to aid in the research. Because the advertising business is extremely busy and involves erratic schedules, finding participants wil ling to take time out of their wo rk or to find an agreeable time to conduct the interview was challenging. Add itionally, those who did respond to the initial interview request found that due to privacy concerns and the desire to guard trade secrets, they were unable to be interviewed. It is possibl e that having a larger account planner pool would have affected the final results. Because the resp onses of the two account planners in this study were very different, this study was unable to reach theoretical satura tion for the qualitative interviews. Perhaps the gender is sues confronted in this study might not be an issue at other agencies. The final area of limitation involves the actual print advertisements that were shown to the participants during the focus group sessions (Appendices H-L). There was no sampling process for obtaining these advertisements. Thos e selected for this study were current print advertisements that the researcher was able to obtain from various magazines over the course of a two-year period. It is possible that there were other creative works from the same brands as those shown. Additionally, it is likely that ther e were other hormonal contraceptive brands that had advertised during this time period but were not selected for the study due to the nature of the selection process. Suggestions for Future Research Future research should allow for a more varied participant pool. It would be interesting to see how focus group respondents of other races and educational backgrounds would view the portrayal of women in print advertisements for hormonal contraceptives. Conducting focus groups with different ages of hormonal contracep tive consumers, such as those 15-19 or over the age of 24, would also make for an exciting area of research. Perhaps those who are older or 83


younger than those interviewed would have drasti cally different opinions regarding how fe males should be portrayed. Additionally, future resear ch should strive to interview more agency professionals, if possible. While the responses of those two participants interviewed in this study were extremely insightful, one w onders what other agency professi onals would have to say about their experiences with hormonal contraceptive adve rtising. Additionally, is would be interesting to discover whether or not the differences in opinion found between the male and female account planners would still remain if others were invol ved in the interview pool. Future studies could explore other factors that may have c ontributed to the drastically different responses between the a ccount planners. For example, it is possible that the size of the agency could influence the manner in which fema les are portrayed. Additi onally, age differences may account for a difference in opinion regardin g the proper manner to portray a female in hormonal contraceptive advertisements. While the account planners were not asked their ages, it seems that Account Planner 1 has been in th e business for a longer time frame than Account Planner 2 and may possibly be of a different genera tion than her. It is possible that generational differences may contribute to female portrayals. Finally, the qualitative nature of this study could be convert ed into a quantitative method such as survey research. The questions asked of the focus group pa rticipants could be rearranged into survey form and disseminated to a larger population of women. Additionally, a survey using the questions asked of the two account planners al so could be sent to many agency professionals at once. Conclusion This study, intended to determine how bot h target consumers and advertising professionals perceive the portrayal of wo men in print advertisements for hormonal contraceptives, has reached a somewhat unexpe cted conclusion. While the study aimed to 84


understand the portrayal of the fe male gender in hormonal contraceptive advertising and how that portrayal was perceived by bot h sides of the coin, the resear cher never imaged that gender would actually play such an important role in de termining the final outcome of that portrayal. Contrary to suspicion, account planners actually do understa nd their hormonal contraceptive consumers quite well. However, any understanding of the consumers needs and wants can be erased if gender biases are present. Even if the account plan ners do everything in their job description to connect perfectly with their target market, their clients could potentially reverse decisions. This qualitative studys findings have suggested that consumers of hormonal contraceptives want print adver tisements for these drugs to pr esent women as aspirational, attractive, relatable, and intellig ent. According to these participants, women should never be sexualized in these advertisements nor should th e product be made to seem frivolous. Altering ones body chemistry is not a deci sion to be taken lightly. While this study cannot generalize for th e entire target market of hormonal contraceptives, it has shed light on how some of these consumers perceive current hormonal contraceptive advertisements. Because this study has indicated that th ere is much negativity connected to current hormonal contraceptive adve rtisements, account planners and their clients must work harder to make sure that their final message resonates positively with their consumers. The hope of this study is to inspir e agency professionals, clients, and even other researchers to consider the importance of hormona l contraceptive advertisements and utilize the recommendations of this study, as well as explor e further avenues to develop effective hormonal contraceptive advertising campaigns in the future. 85


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91 APPENDIX A PRELIMINARY RESPONDENT E-MAIL Dr. Mr/Mrs/Ms. _______, My name is Amanda Ehrlich and I am curre ntly a second year Ma sters of Advertising student at the University of Flor ida. I am in the midst of composing my masters thesis on the topic of pharmaceutical marketing. To be more specific, I am studying the portrayal of women in print advertisements for hormona l contraceptives. In order to complete an aspect of my study, I am hoping to gain insight into the account planning process behind some of these print campaigns. In other words, I am looking to uncover what aspects of the account planning process led to a certain portrayal of a female model in the advertisement. I acquired your name and contact information via a search of the various hormonal contraceptives brands and their a dvertising agencies. I have dete rmined that it was your agency that was responsible for the _______ campaign. It is also my understanding that you were a part of the team that worked on creating this campai gn. As an aspiring account planner, I must admit that I admire the creative work of this campai gn and the effort and planning that went into obtaining the final product. If you would be so inclined, I would love to speak with you further regarding your involvement on this campaign, particularly, as it pertains to account planning. Any information that you can provide me would be greatly appr eciated. Of course, any information that you disclose is strictly for research purposes and will not be disclosed to any other agency or advertising personnel. I look forward to speaking with you further. If you would not wish to participate, please indicate your decision via an email reply. If you know of any colleague that may be interested in participating in my research, please let me know. I thank you for your attention.


APPENDIX B QUALIT ATIVE INTERVIEW GUIDE Intro : Hello, as we discussed via email, Im worki ng on my masters thesis at the University of Florida. In my thesis, I am focusing on prin t advertisements for hormonal contraceptives, specifically, as it pertains to the portrayal of women. I a ppreciate your work on the _____ campaign and I wanted to get your perspective on women in these ads and also to understand how you came to realize the final ad. That is, how did the account planning process lead you to make your final decisions? Anything you say in this interview is strictly for research purposes only. Feel free to verbally withdraw yourself fr om this interview at any time. Your name will not be used within the thesis. Instead, you w ill simply be referred to as a member of the _______ team. You are receiving no direct benefits or direct risks for participating. If this is agreeable, I would like to proceed with the interview. Any questions before we begin? Q1: First, how did you come to be involved with account planning? Q2: On a general level, are there any differe nces that youve noticed between planning a campaign for pharmaceutical drugs versus non-prescription products? Q2: What was your role in this campaign? Q3: Do you perform any primar y research for the campaign? Q3a: If so, what type of research di d you perform? Qualitative? Quantitative? Q4: How do you decide what is the main product benefit? Your USP? Q5: Do you interview/conduct focus groups w ith women? Hormonal contraceptive users? Q6: Can you give me a brief overview of the account planning process from earning ___ as your client to creating the final ad? Q7: How did you decide how to best portray women in the ads? Q8: What is your personal opinion regarding how best to portray women in hormonal contraceptive advertising? Q9: What do you think is the future of hormonal contraceptive advertising? 92


APPENDIX C FOCUS GR OUP SCREENING EMAIL From Amanda Ehrlich PLEASE HELP OUT A FELLOW GRADUATE STUDENT FOR MAS TER'S RESEARCH! Sexually active females are invited to participat e in a study about hormonal birth control ads. Those that qualify for the study will receive fr ee dinner and snacks during the session (as well as my utmost gratitude and respect). If you are interested, please contact Amanda Ehrlich at with the subject "Bir th Control Ad Study." In th e body of the email, simply put "participate." You will then receiv e further details via email. Thank you. 93


APPENDIX D FOCUS GR OUP SCREENING QUESTIONNAIRE Please fill out this form to be eligible to par ticipate in a focus group for graduate research. If your demographic information matches up with th e needs of the study, you will be contacted via email with further information. If you are chosen to participate in the study, you will receive free dinner. Everything you write in this form is confidential and stri ctly for research purposes only. This survey will be only used to select participants for the study, and the information will be discarded after that selection. Please note: the content of this focus group involves contraceptive (birth control) advertis ing and thus, the topic may be sensitive to some. If you feel that you would not be comfortable with the di scussion topic, please do not apply. 1. Name: ______________________________________________ 2. Gender: Male Female 3. Age: _______ 4. What best describes your racial background? Check only one. Caucasian/White Asian African American/Black Native American Hispanic/Latino Other: ______________________ Pacific Islander 5. Are you currently sexually active? Yes No 6. Do you have any religious concerns that pr event you from taking/u sing birth control? Yes No 5. How long have you lived in the United States? _____________________ 6. Please supply your email address: ________________________ 7. Please supply your cell phone or home phone number: ___________________ 8. Please check the date or dates in wh ich you are available to participate: Monday, February xx, between 6:00-8:00 pm Tuesday, February xx, between 6:00-8:00 pm Wednesday, February xx, between 6:00-8:00 pm 94


APPENDIX E MODER ATORS GUIDE Introduction: Hello everyone. I hope you have a ll found something to eat and are comfortable. My name is Amanda Ehrlich and I will be group moderator fo r the evening. I am also the one developing this study. Thank you so much for volunteering to be a part of my fo cus group. All of you will be receiving extra credit for your participation here as well as my sincerest gratitude. Tonight, we will be discussing the portrayal of women, specifically as it pertains to hormonal contraceptive advertising. Hormonal contracepti ves are any drug designed to act on hormones designed to prevent pregnancy. Thus, they are an y form of birth control that involves your hormones as its main method of preventing pregnancy. For the purposes of this study, it does not matter if you are on birth cont rol or not, or what kind of bi rth control you are taking/have taken. No one will be asked about their sex lif e. Any question that addresses usage of contraceptives will be merely hypothetical and should not feel obligated to answer every question. If at any time, you feel uncomfortable with the discussion, you may leave the room or simply pass on a question. Because the nature of this topic may be sensitive to some, please refrain from citing specific names or events during the discussion. As a reminder, your names will not be used in the in the data analyses or the final thesis work and your participation will be confidential to the extent provided by law. Additionally, I request that you keep the topics discussed tonight confid ential and refrain from discussing this focus group with others. However, I cannot guarantee that all gr oup members will respect this wish. Well be meeting here for about an hour, dependi ng on how the discussion goes. Please note that the restrooms are located ________ and you may help yourself to more food throughout; just try to be respectful of the discussion by doing so quietly. Ill be taping tonights session with these two di gital recorders. As noted in your release form, tonights recording is for research purposes only. I am recording the conversation simply for my own benefit, so that I may analyze your re sponses at a later time, at my own pace. You are here for one purpose: to talk. So I ask you kindly to please sh are whatever opinion you have regarding a subject, wit hout feeling embarrassed or intrus ive. There are no right or wrong answers, only opinions. I ask you to talk A LOT, but to do so in turn. Please do not interrupt one another. Speak to one another as if were speaking to a friend, but do so with respect. Remember that I am only here to facilitate di scussion, not to judge you or even comment on your responses. But also remember that I am a stude nt, just like you; so dont worry about being formal or polite with what you say. Say what you want to say, how you want to say it. Any questions before we begin? 95


Icebrea ker Question: 1. To get things going, were going to go around th e room and state our names, our major, and our favorite television show. Warm-up Question: 1. Can anyone here recall an ad fo r a prescription drug? By this I mean one that is not available over the counter. Details Section: 1. Can anyone here recall the last print ad they saw for a hormonal contraceptive? a. What was the ad for? b. Where did you see it? c. Why do you remember it? d. How did it make you feel? Indifferent? Intrigued? Frustrated? 2. If you could design an ad for a hormonal contraceptive what would it look like? a. What would the color scheme be? b. Would the product be in it? c. Would there be any models? d. What would they look like? e. What would be the text? 3. How would you describe a typical print ad fo r a hormonal contraceptive to someone who had never seen one before? a. What would the color scheme be? b. Would the product be in it? c. Would there be any models? d. What would he/she look like? e. What would be the text? 4. Please tell me what words/thoughts come to mind when I mention the following products: a. Yaz b. Seasonique c. NuvaRing d. OrthoEvra Key Questions: 1. How do you feel about the portrayal of women in hormonal contraceptive ads? a. Tell me about the model i. What does she look like? ii. How old is she? iii. Is she relatable? iv. Would she inspire you to chos e this product over another? Now, I am going to show you some actual print ads for hormonal contraceptives. 96


2. (Asked for each of the ______ ads) How do you feel about the portrayal of this woman in this ad? a. Tell me about the model i. What does she look like? ii. How old is she? iii. Is she relatable? iv. Would she inspire you to chos e this product over another? 3. Now that weve seen these ads, Id like to bring back a prev ious question. What words/thoughts come to mind when I mention the following products: a. Yaz? b. Seasonique? c. NuvaRing? d. Other? 4. What kind of woman takes/desc ribe the woman who takes: a. Yaz? b. Seasonique? c. NuvaRing? d. Other? 5. For those of you who wish to share, if you are on a hormonal contraceptive, did the advertising for that product have an effect on your brand choice? a. Did you have any say in your brand, or did the doctor simply recommend one for you? b. If yes, why? c. If no, why did you choose what you did? 6. For those of you who are not currently on a hormonal contraceptive or those that chose not to address the previous question, do you think the advertising a for hormonal contraceptive would affect your purchasing decision? a. If yes, why? b. If no, why not? Summary Question: 1. Do you feel that the average woman is repres ented in ads for hormonal contraceptives? 2. Is there anything that you did not say duri ng the discussion that you would like to add? 3. Any concluding comm ents? After the Discussion: Once again, thank you all for coming. I appreciate your honesty and opinions. For the sake of your confidentiality, please keep this discussion to yourself. Please do not discuss this focus group session with others especially your peers in your ADV____ class. 97


APPENDIX F FOCUS GR OUP INFORMED CONSENT In signing this informed consent document, you hereby agree to par ticipate in a studentrun focus group. Amanda Ehrlich, a graduate stud ent from the University of Florida, is conducting this focus group in order to garner in sight on hormonal contraceptive advertising for her masters thesis. You will be participating in this focus group for approximately an hour and will receive dinner. Other than your free meal, you will not be receiving any direct benefits, nor will you receive any direct risks from the study. Because the nature of this topic may be sensitive to some, please refrain from citing specific names or events during the discussion. Additionally, please refrain from discussing the focus group content with others. There is no gua rantee that all group memb ers will respect this wish. By signing this document you grant permission for the focus group to be tape recorded and transcribed, and to be used only by Amanda Eh rlich for analysis of interview data. In the transcripts, your name will not be identified and the tapes will be erased following transcription. Your name will not be used in the in the data analyses or the final thesis work. Besides being revealed to Amanda Ehrlich, your identity will be kept confidential to the extent provided by law. Your email address will be maintained until the focus group session, but following the session, your email address will be discarded. You are also consenting to the evaluation data generated from the focus group to be utilized in a masters thesis and possibly future publications. Your participation in this study is completely voluntary and you are free to withdraw from this study at any time without consequence. ________________________________ Signature of Participant _______________________________ Date Questions or concerns about your rights as rese arch participant may be directed to the IRB02 office, University of Florida, Box 112250, Gainesville, FL 32611, (352) 392-0433 or to Debbie Treise, this studys supervisor at 2012 Weimer, (352) 392-6557. 98


APPENDIX G FOCUS GROUP T RANSCRIPT EXAMPLE Moderator: So now I know you mentioned NuvaRing, so you can recall an ad for a hormonal contraceptive. So you said the ad was for NuvaRing, do you remember where you saw it? Participant 1: Well, it was the television ad. Mod: The television one. Ok. Thats fine. Why, why is it that it popped out in your mind, why do you remember it? Participant 1: Because its obnoxious. I mean completely annoying. A bunch of women in bathing suits jumping around. Mod: Does anyone else know what shes talking about? All: Yeah. Mod: So. You felt kind of frustrat edsaying it was just annoying? Participant 4: Yeah, I mean. I think that. pharmaceutical companies can get information across to women in a more [pause] I mean its just kind of embarrassing, kind of demeaning. Like were so stupid that like [r aises voice] yay, birth control! So yeah um. Just kind of annoying. Mod: Yeah. Any other f eelings about that ad? Participant 3: It doesnt, I mean I dont think it really relates to birth contro l. Its kinda just showing that you can be different from ever yone else by wearing lik e a bikini. I dont knowits just kind of stupid. It doesnt mean anything to me Mod: So, why do you remember it? Participant 3: Its on all the time. Mod: So you recall the ad, I mean you reme mber its for NuvaRing specifically? Participant 3: Yeah because they say. Its starts out where everyones kind of the same. Monday, Tuesday, Wed, you need to take a pill everyday but then you dont now because youre different. Participant 2: You can sit in the hot tub. All: [Laughs] Mod: Ok. So I dont know if you remember the women in the ad? Like do you remember anything about them at all? Or do you just remember the song in the commercial. 99

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Participant 2: I m ean they all look very simila r because they are all dr essed up like synchronized swimmers so they are all meant to look the sa me. And of course they all have the same body proportions. Mod: Which is? Participant 2: Skinny and tall and perfect. Mod: Do you recall any African Amer ican or Asian women at all? Participant 3: Yeah, one African American. Mod: Do you remember any other hormonal contraceptive ads that youve seen? Participant 2: I remember one with Were not going to take it anymore Participant 3: I hate that one also. Theres one out for Plan B out now also. Yeah I remember they started. Cuz they had never done that really before. They make sure to say its not the abortion pill. Yeah thats recent. Mod: Do you remember was there a story? Participant 3: No its like a bunch of different women saying that, talking about the 72 hours. You know, it doesnt have to be a huge big deal if you have plan B there. Like if plan a doesnt work basically have plan b. Mod: Ok and how did that make you feel? Participant 3: Not really anything. Mod: Would you say it was more appealin g/less appealing than the NuvaRing ad? Participant 3: More. Mod: Why? Was it less silly? Participant 3: Yeah it was less hokey I guess more um to the point. Informative. 100

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APPENDIX M ACC OUNT PLANNER PROFILES Account Planner 1 works at a major advertising agency in New York City. He is a liaison to the client as well as a strategic planner. He has been in the advertising business for many years; even before account planning was developed. He has worked on a myriad of products and services, such as life insurance, package foods, Phillip Morris tobacco brands, and over-the-counter drugs before joining pharmaceutical advertising. He has remained in the pharmaceutical sector since 2003, working on ma ny pharmaceutical brands including Humira and Yaz. Account Planner 2 is a strategic and tactical liaison to the client at a small pharmaceutical advertising agency in New Jersey She began her career working on medical technology in a hospital setting before going into pharmaceutical sales. Following her work in pharmaceutical sales, she worked on the client si de on product management in pharmaceuticals. Eventually, she switched to the agency side where she works currently. She has worked exclusively with healthcare-related products, including many womens health products such as Depo-Provera, Lunelle, Pl an B, and Seasonique. 106

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107 BIOGRAPHICAL SKETCH Amanda Ehrlich graduated from the University of Florida with a Master of Advertising in 2009. She graduated cum Laude from the University of Miami in 2007 with a Bachelor of Arts in English and a double minor in art history and religious studie s. During her tenure at the University of Miami, Amanda was inducted into the prestigious academic honor society Phi Beta Kappa