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Chapter 1
THE PROBLEM AND ITS SCOPE
INTRODUCTION
Chapter 1 presents the rationale of the study, the main theory that was
anchored, the problem, the beneficiaries, where the study conducted as well
as the respondents, the instrument and some definition of terms commonly
used in the study.
Rationale of the Study
It is sometimes wrongly assumed that just by providing people with
information they will automatically be able to make healthy choices. While
more knowledge, information and health education is important, the
evidence shows that decisions to adopt health: enhancing behavior are often
constrained by the broader physical, social, economic and cultural
environments which influence the choices that individuals, groups and local
communities make. (World Health Organization, 2005).
According to the National Institute of Health (2006) the United States
Dietary Supplement Health and Education Act of 1994 (United States
DSHEA) defined dietary supplements also known as food supplement,
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nutritional supplement, natural supplement and health supplement, as any
product (other than tobacco) that is intended to supplement the diet that
contains one or more of the following ingredients: a vitamin, a mineral, an
herb or other botanical, an amino acid, a supplement used by man to
supplement the diet by increasing the total dietary intake, or a concentrate,
metabolite, constituent, extract, or combination of any ingredient described
above. It can be in the form of capsule, powder, softgel, gelcap, tablet,
liquid, or other form that can be ingested by human. Dietary supplements
are neither considered as drugs nor conventional food (National Institutes of
Health, 2005). It is considered as a nutraceuticals or "food, or parts of food,
that provide medical or health benefits, including the prevention and
treatment of disease (Lockwood, 2007).
The consumption of dietary supplement has increase dramatically in
todays world. Common food supplements are B Vitamins, Calcium,
Coenzyme Q10, Fish oil, Folic acid, Iron, Melatonin, Multivitamins,
Vitamin C, Vitamin D, Zinc, and Glutathione supplements. According to the
Philippine market research conducted last 2013, the Philippines has 86
dietary supplements available in the market-coenzyme Q10, fish oils/omega
fatty acids, mineral supplements and glucosamine were vibrant in 2013. This
is mainly due to the increasing health awareness among consumers, aging
3

population, and marketing effort such as media advertisements of the dietary
supplements companies (Euromonitor International, 2009). According to
Miller and Russell (2005), as well as Ayranci, Son a, and Son b (2005) had
identified variety of reason for people to take dietary supplements. One of
the reasons is to decrease their susceptibility to health problems such as
stress, heart attacks, colds, osteoporosis, cancer, and so on. Other reasons for
consumption of dietary supplement include for energy enhancement,
promote weight loss, retarding of aging, and enhance athletic performance.
Dietary supplement use is a world-wide growing phenomenon. Few
studies, however, examine why increasing numbers of consumers are
choosing to use dietary supplements. Some of the more frequently reported
motivations for the increasing use of dietary supplements include a desire for
health maintenance, a response to changes in eating patterns or health status
due to changes in acute or chronic conditions, a belief in anti-aging
medicine, concerns about the adequacy or safety of the consumer food
supply, or a desire for greater autonomy and control over self-care. Triggers
for increasing the use of dietary supplements differ for different groups of
persons and stem from different behavioral, social, and cultural roots.
For some, the growing use of dietary supplements and herbs are part
of the growing use of health promotion and complementary and alternative
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medicine (CAM) practices, which also may include other psychological and
spiritual therapies. Other consumers express dissatisfaction with the
perceived lack of efficacy and excessive dependence on prescription
medication within the traditional medical community, as well as a lack of
holism and ignorance of social and spiritual dimensions of health by many
medical doctors. Others experiencing or perceiving the effects of aging use
dietary supplements to address and treat explicit symptoms (energy,
memory lapses, joint pain, etc). The growth in Internet and television
advertising has heightened consumer awareness and exposure to the
existence of potential products.
However, Ayranci et al. (2005) and Lockwood (2007) reported that
supplement had lead to several adverse effects such as nausea and vomiting,
headaches, gastrointestinal disturbance, liver insufficiency, and interfering
with insulin secretion. Timbo, Ross, McCarthy, and Lin (2006) had
discovered that most supplements used are multivitamins/multiminerals, and
it has accounted to 13% of the reported adverse events (Nesheim, 2005;
FDA, 2009).
Dietary supplements are commonly used to lose weight and build
muscle, but the Food and Drug Administration has issued
a warning regarding exposure to a potentially harmful ingredient. The
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agency says DMAA or dimethylamylamine, found in supplements including
OxyElite Pro and Jack3d, can cause increased blood pressure, shortness of
breath, chest tightening, cardiovascular problems and even heart attacks.
It may be difficult for consumers to tell whether DMAA is an
ingredient in their supplement. Different names such as methylhexanamine,
1,3 DMAA or geranium extract could be used. The FDA says it has received
reports of 86 illnesses and deaths associated with supplements containing
DMAA as of last week. Illnesses also included nervous system and
psychiatric disorders, the agency said, and DMAA could be especially
dangerous taken with caffeine.
Consumers obtain information on supplements from a variety of
sources, including health professionals, but most frequently the media.
Although scientific conclusions are methodically scrutinized, news stories
are judged by instant appeal. Dietary supplements add a complicating twist
because folkloric use predates scientific research by thousands of years. The
incongruity between science and the media perpetuates misinformation and
fails to provide the context that gives scientific research meaning.
The health effects of supplements are one of the many scientific issues
needing responsible communications. When any scientific study is
concluded, it is unlikely that its findings will be the final word on a subject.
6

Rather, scientific conclusions and the methods used to reach them are
deliberately and methodically scrutinized for their accuracy, validity,
reliability and applicability. Conversely, news stories are judged by their
instant appealthe effect of a headline or the allure of a sound bite.
Scientists may view the practicality of a specific studys conclusion much
differently from those who report the information to the public.
Dietary supplements add a complicating twist to the communications
mix because folkloric use and motherly advice on use predate scientific
research by thousands of years. This incongruity between science and the
media not only perpetuates misinformation but also fails to provide the
wider context that gives single scientific conclusions their meaning.
Recent statistics indicate that Americans are increasingly replacing
prescription medications with vitamin and mineral supplements as well as
medicinal herbs. Consumers spend more than $19 billion a year on these
substancesan amount that has grown steadily since the early 1990s. In
2005, a secondary analysis of the complementary and alternative medicine
(CAM) supplement to the 2002 National Health Interview Survey
(NHIS) estimated that more than 38 million Americans use herbs and dietary
supplements. More recent estimates have placed this number as high as 60
million. Despite the widespread use of these products, primary care
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physicians are generally unaware of the non prescribed therapies their
patients are taking. Most patients are reluctant to share this information with
their healthcare providers, even if they experience adverse events that might
be related to use of medicinal herbs or dietary supplements.
Herbal remedies and dietary supplements are not classified as drugs
by the US Food and Drug Administration (FDA). Therefore, although the
1994 Dietary Supplement Health and Education Act allows manufacturers to
make claims intended to influence public opinion regarding the benefits of
these products, herbs and supplements are exempt from the rigorous federal
regulations and testing required for products classified as prescription drugs.
Only recently has the FDA developed good manufacturing process
guidelines for herbal products and dietary supplements. On November 4,
2004, the FDA released a strategy for dietary supplements that would focus
on monitoring and evaluating product and ingredient safety, ensuring
product quality, and monitoring and evaluating product labeling. The focus
of these measures is to protect consumers against dietary supplements that
are unsafe, as well as those making unauthorized, false, or misleading
claims. However, no policy has been adapted to date. As a consequence,
research on herbs and supplements within the context of randomized
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controlled trials has seldom been performed, and many questions regarding
the efficacy, safety, and purity of these substances remain.
Anecdotally, it is thought that herbal products and dietary
supplements are popular as a result of a widespread belief that the
preparations are natural and, therefore, safe. However, in conjunction with
this increasing popularity, the number of adverse events, drug interactions,
and deaths involving these products has been on the rise. The World Health
Organization reported since 1994 up to the present that it had received
thousands of reports of suspected adverse reactions to herbal products.
From 1994 to 1998, the FDA received more than 800 reports of
adverse events associated with dietary products containing ephedrine
alkaloids, specifically Ephedra or ma huang. In 2004 to 2008, after a meta-
analysis commissioned by the National Institutes of Health reported more
than 16,000 adverse events associated with Ephedra, the FDA banned
dietary supplements containing this plant-based alkaloid. Adverse events
associated with Ephedra sinica include cardiac arrest, heart palpitation,
insomnia, stroke, and tremor. Drug interactions involving a number of other
herbal products are also becoming increasingly well documented.

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To meet this communications challenge, the International Food
Information Council (IFIC) seeks to bridge the gaps between how science is
practiced and how science is communicated to opinion leaders (those who
have influence with consumers). IFICs mandate is to facilitate
communication among the media and other communicators so that
consumers are given an appropriate context for science-based information.
Although IFIC is supported primarily by the broad-based food, beverage and
agricultural industries, it does not lobby nor does it have a policy charge.
The IFIC Foundation is the educational arm of IFIC and further helps the
media, educators, health professionals and scientists effectively
communicate nutrition and food safety to the public.
Providing the bridge between scientific research and communication
with the public is particularly relevant because consumers are consulting a
widening variety of sources for health and nutrition advicesources that can
sometimes be confusing and contradictory. The American Dietetic
Associations trends survey shows that journalists are the primary deliverers
of health and nutrition information to consumers. Forty-eight percentage of
consumers polled in the 2008 survey said that they received their health
news from television (down from 57% in the 2004 survey); magazines and
newspapers follow at 47 and 18%, respectively. Family, friends, books,
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physicians, the Internet and the radio are also key information sources. The
American Dietetic Association survey also examined the value of nutrition
information sources. At least 90% of those surveyed said they placed the
most value on information from doctors, registered dietitians and
nutritionists followed by magazines (87%), nurses (85%), newspapers (82%)
and television news (79%).
Consumers are often confused by what they hear in the media about
health information. A 2008 report by the National Health Council noted that
68% of survey participants agreed with the statement, When reporting
medical and health news, the media often contradict themselves, so I dont
know what to believe. Also in the same time, the Food Marketing Institute
reported that 8 of 10 consumers think that it is very or somewhat likely the
experts will have a completely different idea about which foods are healthy
and which are not within the next 5 years. Research conducted by Princeton
Research Associates for Rodale Press highlighted which health stories
consumers find the most confusing. Stories about vitamins and supplements
top the list followed by nutrition stories. Consumers find it difficult to
distinguish between public-interest trivia and information that actually
warrants behavioral change.
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Every two years the IFIC Foundation commissions the Center for
Media and Public Affairs to conduct an in-depth qualitative and quantitative
analysis of food news to determine the popular media issues that reach
consumers. In 2006 coverage of diet, health, nutrition and food safety issues
was 15% less than two years before. However, there was still a 15% increase
in coverage in 2006 compared with 2001. The IFIC Foundation also found
that during the three months of coverage analyzed, science experts and
researchers were the primary source of information for the media. This
indicates that reporters and editors are consulting experts in order to put new
findings into the context of scientific literature on a subject. The medias
reliance on scientific experts also underscores the role that each scientist and
professional can play in helping to interpret science for the public.
The medias major obstacle in communicating science is a lack of
understanding of the scientific process itself, especially among writers
without science backgrounds. Journalists with science backgrounds may
better understand that every new study is not necessarily news but rather part
of a larger process of discovery and debate. To a general assignment reporter
who may not understand this process, each new study may seem to provide
newsworthy information and potential headlines. For example, the
information presented at this workshop showed how continued research has
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the potential to affect individuals. However, no single health message will
apply to all individuals. Therefore, it is imperative that the emerging and
ongoing science discussed at the workshop be translated in a way that
ultimately makes it meaningful to the public. Recognizing this need, the
IFIC Foundation has worked with science and health communicators to
determine how best to provide scientists and experts with an understanding
of their critical role in the communications process and a level of comfort in
providing context when speaking with journalists.
According to Philippine Daily Inquirer, 2010, Filipino consumers are
spending more than P75 billion a year on food and herbal supplements,
which the health department said do not have therapeutic effects and, worse,
may have harmful side-effects. Health Secretary Esperanza Cabral has
repeatedly asked the public not to be misled by food supplements
exaggerated claims of efficacy. Many are being misled into thinking that
these food supplements can cure diseases when in fact, they cant. Food
supplements, many of which are endorsed by celebrities, are not drugs and
have no special powers to cure or help cure health conditions like poor
eyesight, arthritis, liver problems, diabetes, cancer of what-have-you that
glossy advertisements say complete with testimonials of cured patients. The
way food supplements are being advertised is making people believe they
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can be substituted for drugs or medicines. According to the Department of
Health, the use of celebrity endorsers in testimonials about the supposed
curative effects of food supplements has made the food and herbal
supplements industry an even more lucrative venture.
The researchers have observed that nowadays many people are using
food supplements even if it is evidently stated that it has no therapeutic
claims. Many are being influenced by factors or sources that are not
completely reliable such as testimonies that can be scripted just to capture
the attention and the behavior of the consumers and also the media which
has a great influence not just on food supplement but also in different aspect
of life. Food supplements are now use as a medicine to cure or prevent
diseases by people who do not have knowledge about it and prefer to self-
medicate instead of consulting to a physician. The researchers have seen in
the area that there are a lot of food supplement consumers. In line with, the
researchers would want to determine the factors that influence them and as a
student nurse, health teaching will be provided on emphasis of proper
labeling and information of the food supplements.


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Theoretical Background
Theory of Reasoned Action (TRA) and Theory of Planned
Behavior (TPB) proposed by Martin Fishbein and Icek Ajzen and were
formulated in 1988 in an attempt to provide consistency in studies of the
relationship between behavior and attitudes. TPB is considered as an
extension of TRA (Werner , 2006). The main assumption of TRA and TPB
is that individuals are rational in considering their actions and
the implications of their actions (decision-making). Rational decision-
making assumes that the decision is made under uncertainty. Rational
decision-making implies that either optimum results were expected or the
decision-making unit was aware of all the impacts and consequences (Basu,
2005)


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TRA posits that individual behaviour is driven by behavioural
intentions where behavioural intentions are a function of an individual's
attitude toward the behaviour and subjective norms surrounding the
performance of the behaviour. Attitude toward the behaviour is defined as
the individual's positive or negative feelings about performing a behaviour.
It is determined through an assessment of one's beliefs regarding the
consequences arising from a behaviour and an evaluation of the desirability
of these consequences. Formally, overall attitude can be assessed as the sum
of the individual consequence x desirability assessments for all expected
consequences of the behavior (Fishbein, 2006).
Subjective norm is defined as an individual's perception of whether
people important to the individual think the behaviour should be performed.
The contribution of the opinion of any given referent is weighted by the
motivation that an individual has to comply with the wishes of that referent.
Hence, overall subjective norm can be expressed as the sum of the individual
perception x motivation assessments for all relevant referents (Eppen, 2006)



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Core Assumptions and Statements
Theory of Reasoned Action suggests that a person's behaviour is
determined by his/her intention to perform the behaviour and that this
intention is, in turn, a function of his/her attitude toward the behaviour and
his/her subjective norm. The best predictor of behaviour is intention.
Intention is the cognitive representation of a person's readiness to perform a
given behaviour, and it is considered to be the immediate antecedent of
behavior (Wenner, 2005).
This intention is determined by three things: their attitude toward the
specific behaviour, their subjective norms and their perceived behavioural
control. The theory of planned behaviour holds that only specific attitudes
toward the behaviour in question can be expected to predict that behaviour.
In addition to measuring attitudes toward the behaviour, we also need to
measure peoples subjective norms their beliefs about how people they
care about will view the behaviour in question. (Grandon, 2005)
To predict someones intentions, knowing these beliefs can be as
important as knowing the persons attitudes. Finally, perceived behavioural
control influences intentions. Perceived behavioural control refers to
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people's perceptions of their ability to perform a given behaviour. These
predictors lead to intention (Basu, 2005).
A general rule, the more favourable the attitude and the subjective
norm, and the greater the perceived control the stronger should the persons
intention to perform the behaviour in question.
B = Behaviour
B1 = Behavioural intention
AB = Attitude toward behaviour
SN = Subjective Norm
The model has some limitations including a significant risk of
confounding between attitudes and norms since attitudes can often be
reframed as norms and vice versa. A second limitation is the assumption that
when someone forms an intention to act, they will be free to act without
limitation. In practice, constraints such as limited ability, time,
environmental or organizational limits, and unconscious habits will limit the
freedom to act. The theory of planned behaviour (TPB) attempts to resolve
this limitation. (Benham, 2006)
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Technology Acceptance Model (TAM)
TAM is an adaptation of the Theory of Reasoned Action (TRA) to the field
of IS. TAM posits that perceived usefulness and perceived ease of use
determine an individual's intention to use a system with intention to use
serving as a mediator of actual system use. Perceived usefulness is also seen
as being directly impacted by perceived ease of use.
Researchers have simplified TAM by removing the attitude construct
found in TRA from the current specification (Venkatesh, 2005). Attempts to
extend TAM have generally taken one of three approaches: by introducing
factors from related models, by introducing additional or alternative belief
factors, and by examining antecedents and moderators of perceived
usefulness and perceived ease of use (Wixom and Todd, 2005). TRA and
TAM, both of which have strong behavioural elements, assume that when
someone forms an intention to act, that they will be free to act without
limitation. In practice constraints such as limited ability, time, environmental
or organizational limits, and unconscious habits will limit the freedom to act.
The theory of planned behaviour (TPB) was developed by Ajzen in
1988. The theory proposes a model which can measure how human actions
are guided. It predicts the occurrence of a particular behaviour, provided that
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behaviour is intentional. The model is out lined in the next figure and
represents the three variables which the theory suggests will predict the
intention to perform a behaviour. The intentions are the precursors of
behaviour. Ajzen and Fishbein formulated in 1980 the theory of reasoned
action (TRA). This resulted from attitude research from the Expectancy
Value Models. Ajzen and Fishbein formulated the TRA after trying to
estimate the discrepancy between attitude and behaviour. This TRA was
related to voluntary behaviour. Later on behaviour appeared not to be 100%
voluntary and under control, this resulted in the addition of perceived
behavioural control. With this addition the theory was called the theory of
planned behaviour (TPB).
The theory of planned behaviour is a theory which predicts deliberate
behaviour, because behaviour can be deliberative and planned. The variable
names in the model reflect psychological constructs and so they have
meaning within the theory. In implementation research, interventions are
designed to change the behaviour of individuals. The target behaviour
should be defined carefully in terms of its Target, Action and Time. In a
transport context this is the target is the commuter, action is the trip, context
is the type of trip and time is the time taken to travel.
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Although there is not a perfect relationship between behavioural
intention and actual behaviour, intention can be used a proxy measure of
behaviour. This observation is one of the most important contributions of the
TPB model compared to previous models of the attitude-behaviour
relationship. Therefore, the variables in this model can be used to determine
the effectiveness of the implementation interventions even if there is not a
readily measure of actual behaviour.
Attitude toward the behaviour is a persons overall evaluation of the
behaviour. It is assumed to have two components which work together:
beliefs about consequences of the behaviour (behavioural beliefs: by
providing a new LRT system it will increase public transport trips) and the
corresponding positive or negative judgements about each of these features
of the behaviour (outcome evaluations: decreasing car trips is desirable).
Subjective norms are a persons own estimate of the social pressure to
perform the target behaviour. Subjective norms are assumed to have two
components which work in interaction: beliefs about how other people, who
may be in some way important to the person, would like them to behave
(normative beliefs).

21

Perceived behavioural control is the extent to which a person feels
able to enact the behaviour. It has two aspects: how much a person has
control over the behaviour and how confident a person feels about being
able to perform or not perform the behaviour. It is determined by control
beliefs about the power of both situational and internal factors to inhibit or
facilitate the performing of the behaviour.
With the exception of behaviour, the variables in the TPB model are
psychological (internal) constructs. Each predictor variable may be
measured directly e.g. by asking respondents about specific behavioural
beliefs and outcome evaluations. Direct and indirect measurement
approaches make different assumptions about the underlying cognitive
structures and neither approach is perfect. When different methods are
tapping the same construct, scores are expected to be positively correlated,
so it is recommended that both be included in TPB questionnaires.

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It is important to establish the reliability of each measure. For direct
measures, one form of reliability may be established using an index of
internal consistency (to determine whether the items in the scale are
measuring the same construct). However, because people can quite logically
hold both positive and negative beliefs about the same behaviour, it is not
appropriate to assess the reliability of indirect measures using an internal
consistency criterion.
Another Theory is Consumer behavior has a major influence in our
daily life. Every human being is confronting with multitude decisions from
day to day. For instance, deciding on what food to eat, what car to buy, what
profession to pursue, or what movie to watch, are all influence by consumer
behavior. According to Blackwell, Miniard, and Engel (2005), they defined
consumer behavior as a field of study that focuses on consumer activities. It
is the activities that consumer carry out when obtaining, consuming and
disposing of products and services. In other words, consumer behavior
reveals why people buy, how, where and when they use, and how they
dispose. Hence, it is easier for marketers to develop effective strategies to
influence consumers when they know why consumers purchase the product.

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2.1.1 Purchase Intention
Intention is defined by Ramayah, Lee, and Mohamad (2010) as a will
to act in a certain way. Ramayah et al. (2010) claimed that intentions are the
best predictor of planned behaviour and an unbiased predictor of action.
According to Moore (1982); Luso (1975); and Page and Rosenbaum (1992),
purchase intention used in concept testing with a five-point scale is the most
predictive question to determine product trial. Moreover, Taylor, Houlahan,
& Gabriel (2005) discovered a positive relationship between buying interest
and purchase behavior. Ronteltap et al. (2007) also showed that intention to
use will determine the actual adoption of innovation of the food. However,
intention from respondents who have short exposure to the new product and
have little knowledge about it is not a good predictor of their purchasing
behavior (Duke, 2005). For instant, lack of knowledge of the new product
use and benefits would cause lower score on the concept test, thus
discouraging innovation for new product.
Taylor et al. (1975) discovered that all respondents who gave less than
favorable answer did not actually bought the product in store. Thus, product
abandonment decisions can be predicted by question about intention. Hence,
they suggested that purchase intention is a useful tool in identifying losers.
Other than that, managers are able to distinguish between those who are
24

most likely to purchase and those who are less likely to purchase. Therefore,
management can plan marketing strategies to target the segment which
consist of people who most likely to purchase (Newberry, Klemz, & Boshoff
, 2003).
The predictor of action in several studies is often refer to behavioural
intention instated of effective behaviour, as the product is not available in
the market and they are not require to purchase the product when they are
participating in the survey (De Steur, 2010). Since Tropical Seaweed Dietary
Supplement is still in the development stage in this study, respondents are
asked on their behavioural intention. Purchasing intention is usually measure
in a 5-point scale: definitely would buy, probably would buy, might or might
not buy, probably would not buy, and definitely would not buy (Taylor et al.,
1975).
Theory of Planned Behavior (TPB) proposed by Ajzen (2006) and
Fishbein (2006) which been widely use in predicting consumer behavior
such as purchase intention towards organic foods (Chen, 2007), novel foods
enriched with omega-3 fatty acids (Patch, Tapsell, & William, 2005),
sustainably produced foods (Robinson & Smith, 2002), and use of
multivitamin supplement (Pawlak, Brown, Meyer, Connell, Yadrick,
Johnson, & Blackwell, 2008; Conner, Kirk, Cade, & Barrett, 2003; Conner
25

et al., 2003) also supported that intention is a dominant determinant of
behavior in the TPB research. Underlying intentions are attitudes, subjective
norms, and perceived behavioral control (Robinson & Smith, 2002).
However, the focus on this study is on purchasing intention only.
In concept testing, Taylor et al. (1975) stated that purchase intention
often determines whether the new product should proceed to the next stage
of the development. In other words, does the product receive enough
purchase intention to support further development. According to certain
rough rules of thumb requirements for further development, a concept
statement should receive 80% to 90% favorable answer and a trial product
which respondents can actually use should receive 70% to 80% favorable
answers in order to continue developmental work. The favorable answers
would be definitely would buy and probably would buy. While a
finished product with finished packaging should receive at least 60% to 70%
of favorable answers in order to be successful in the market. In this study,
we consider Tropical Seaweed Dietary Supplement as a product concept as it
is not being tried by the respondents and the product was not in the market
yet. Therefore the product concept should receive 80-90% favorable answer.
However, Schwartz (1987) stated that there may be variation in the
rules of thumb requirements for different product categories as well as
26

industries, yet there is no research on similar product category found
currently to support the findings (as cited in Fraser, 1994). According to
Carson et al, (2001) argued that respondents have an incentive to
strategically overstate their preference during the survey conducted. This is
because there is no cost to overstate their purchase intent in a hypothetical
survey and the actual purchase decision will be made at a future date.
Therefore, it is advisable for a new product concept to receive high favorable
answer (as cited in Lusk, McLaughlin and Jaeger, 2006).
2.1.2 Awareness
OGarra, Mourato, and Pearson (2005) claimed that most of the
researchers agreed on knowledge/awareness as an influencing factor to the
acceptability of a product. Prior awareness regarding hydrogen as a source
of fuel for transport was found to increase the possibility of supporting the
introduction of hydrogen vehicles by 12.5% in London (OGarra et al.,
2005). Other than that, Mourato, Saynor, and Hart (2004) also found that
increase in the awareness of Fuel Cell vehicles and air pollution impacts will
increase willingness to pay (WTP) for Fuel Cell vehicles. Pessemier and
Wilton (2006) cited that increased levels of information regarding the
electric car will increase consumers knowledge about it, thus can better
predict the market share (percentage of people who are willing or intent to
27

purchase) of the product (as cited in Moore, 2006). Nevertheless, it is not a
good prediction of adoption level.
As for food-based products, Bower, Saadat, and Whitten (2003) had
also discovered that consumers who are concern about their health and
knowledgable in nutrition tends to have higher purchase intention for fat
spread with a proven health benefit label. Besides, De Steur et al. (2010)
mentioned that knowledge is the most important factor in determining the
Willingness To Accept (WTA) and Willingness To Pay (WTP) for Genetic
Modified food. In addition, Byun et al. (2009) found that the purchase
intention of food irradiation increased after the exposure of education
regarding the benefit of food irradiation to the respondents (women) in
Korea. In this study, all information channels (video, book, and lecture)
worked effectively in increasing purchase intention. In other words,
consumers negative attitude towards food irradiation decreased and the
positive attitude increased after the education. Therefore, a hypothesis can
be derived from these studies, where a positive relationship between
awareness/knowledge towards the product with purchase intention can be
obtained.Awareness towards seaweed will influence consumer purchase
intention towards Tropical Seaweed Dietary Supplement.

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2.1.3 Perception
According to Lindsay and Norman (2005), perception can be defined
as the process by which organisms interpret and organize sensation to
produce a meaningful experience of the world and it serves as a filter
between the external (objective) and internal (subjective) stimuli of the
consumer. Perception also determines consumers preferences, choices and
attitudes (Verbeke, 2002, p. 31). Messina, Saba, Turrini, Raats, and Lumber
(2008) stated that differences in consumers perceptions and consequently in
preferences were influenced by various factors, including culture differences
across countries. Consumers general attitudes and perception are also
shaped by previous experiences, and eventually affect consumer acceptance
towards new food (Ronteltap, van Trijp, Renes, & Frewer, 2007).
According to Rozin, Pelchat, and Fallon (1986), they found that
psychological properties of the product influenced food choice more than
physical properties of products (as cited in Yeung & Morris, 2001). One
good example of psychological interpretation of products properties that
influences the attitudes and behavior of consumers to purchase a food
product is perception of food safety risk. Perceived needs can also strongly
predict behavioral intention to purchase rather than affective and/or
cognitive attitude (Messina et al., 2008). For example, Warnick, Dearden,
29

Slater, Butron, Lanata, and Huffman (2004) found that the perceived need
for supplements and ability to obtain vitamins and minerals will determine
womens use of micronutrients.
According to Darby and Karni (1973), safety, sustainability, health,
and naturalness act as the credence qualities of food innovation where
individual consumer is unable to verify the costs and benefits clearly (as
cited in Ronteltap et al., 2007). Therefore, these will lead to a generation of
perceived risk and uncertainty among consumers. Therefore, when
consumers perceived risk is high, they are less likely to purchase a product.
According to the authors, they also identify several cost-benefit-related
determinants from previous study. These determinants can be measure in
terms of health benefits (Deliza, Rosenthal, & Silva, 2003; Magnusson &
Koivisto-Hursti, 2002), environmental benefits (Magnusson & Koivisto-
Hursti, 2002), sensory benefits or personal relevance. In our studies, the
environmental benefits and sensory benefits is not included, as dietary
supplement do not emphasize on these aspect. Besides, innovation features,
such as price, convenience-related features, physical appearance, taste
properties, and naturalness also influence the purchase interest.
Warnick et al. (2004) discovered that women with positive perception
towards the benefits of multivitamins were 1.7 times more likely to use
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multivitamins supplement than those with negative perception. Bian and
Moutinho (2009) discovered that perceived benefit also positively influences
on the consideration of a counterfeit branded product. In addition, Ronteltap
et al. (2007) revealed that benefit perceptions determined whether consumer
accepts or rejects an innovation. In summary, consumer who perceives a
product favorably is more likely to purchase it. This is also compatible to
Ronteltap et al.s (2007) study. They found that 9 studies have an effect on
actual behavior, 10 reported on behavioral intention, and eight showed
influence on attitude or related evaluative constructs. Hence, another
hypothesis can be derived from this study. In this paper, the consumers
perceptions we focus are uniqueness, convenience, benefits, safety,
acceptability, natural and relevancy.
2.1.4 Socio-demographic Characteristics
Many studies revealed that consumer purchase decisions are
influenced by demographic and socio-economic factors in various product
(Elaine, 1999; Foote, Murphy, Wilkens, Hankin, Henderson, and Kolonel
2002; Robinson & Smith, 2002; Bower, Saadat, & Whitten, 2003; Xu,
Summers, & Belleau, 2004; Goktolga, Bal, & Karkacier, 2006; Timbo, Ross,
McCarthy, & Lin, 2006; Rontelap et al, 2007; Ahmad, 2010). These factors
include gender, age, educational level, income, nationality, race, economic
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status, health status, family historys illness and familiarity. They have
significant effects on innovation acceptance and purchase intention. This is
because socio-demographic characteristics will influence ones thoughts,
perceptions, and preferences. However, De Steur et al. (2010) mentioned
that many studies conclude that socio-demographic variable itself do not
strongly explain or predict the acceptance of Genetic Modified products.
Ayranci, Son a, and Son b (2005) discovered that supplement users
strongly agree on the health benefits of supplement use as compare to non-
users. Therefore, they are more likely to consume dietary supplement
relatively to non-users. In addition, Ahmad (2010) found that chronic illness
history in family members also influences purchase intention of organic
food. Duke (2005) reported that familiarity with the products and the
product category makes the prediction of the purchase intention of a new
product more appropriate. However, in this paper, the purchase intention of
the respondents who are not familiar towards the product category (dietary
supplement) is also considered as they might be the potential consumers.
Therefore, respondents familiarity towards dietary supplement was
identified with question asking them to confess whether they are a
supplement user in the questionnaire. In conclusion, socio-demographic
characteristics do have some influence on purchase intention. Hence,
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hypothesis regarding Socio-demographic characteristics can be drawn from
here.
2.1.5 Other Factors That Influence Purchasing of Dietary Supplement
Choice tactics is often used to reduce the amount of time and
cognitive effort in decision making process. Price, performance and brand
loyalty, affect, and normative factors were the factors that often influenced
choice tactics in Merlin et als (2008) research regarding womens decisions
in purchasing childrens supplements. Therefore, these factors will
determine whether a consumer will purchase and consume the product.
Elaine (1999) also revealed that food trends and barriers to selecting foods
for healthful diets will influence food consumption.
However, for the purchasing of organic foods in Klang Valley,
Malaysia, Ahmad (2010) concluded that consumer believe of safety, healthy,
environmental friendly and perceive of the worth of buying organic product
will influence purchasing intention towards these product. The author also
mentioned in her literature that Price and product availability are also
important factors that influence purchasing intention towards organic food.
However, availability of organic product information does not significantly
lead to purchase intention. Krystallis and Chryssohoidis (2005) discover that
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quality and security, trust, senses, price sensitivity, convenience, and brand-
name value are the important factors that influence food purchasing
decisions of Greeks according to decreasing order. However, only quality
and security and trust significantly influence the willingness to pay more
for organic products.
Ares, Gimenez, and Deliza (2009) proved that brand, price, and health
claim are the three non-sensory factors that influence Uruguayan consumer
choice of functional yogurts according to descending order. The presence of
health claims was important to make consumer aware of the health effect of
a certain functional ingredient. Miller and Russell (2004) and Ayranci et al.
(2005) discovered that television, printed material, internet websites, family
members, and friends are usually seek by consumers to obtain information
about supplement, yet advice from physicians or other health care providers
were not frequently seek by women in their study. Supplement that is
natural is believed to be more wholesome and safe by some consumers,
but it is misleading to use the term natural in supplement labels, thus is
prohibited (Miller and Russell, 2004).


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Statement of the Problem
The factors that influence consumers food supplement intake is a
serious issue. Due to the continual variety of media, is people are exposed
to on a daily basis the response of poor behavior and unhealthy lifestyle
habits have shown to increase the health risks of this population. More than
one issue is at the root of this problem.
This study aimed to determine the effects of media and food
preferences among the students 13-19 years of age in UCLM. The results of
the study served as bases for a proposed intervention plan.
Specifically, this study answered the following questions:
1. What is the profile of the respondents in terms of:
1.1 age;
1.2 civil status;
1.3 educational attainment; and
1.4 combined family income
1.5 lifestyle
1.6 health problems
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2. To examine the influence of attitude towards intention to purchase dietary
supplement products.
3. To examine the influence of subjective norms towards consumers attitude
top 10 purchase dietary supplement products.
4. To examine the influence of perceived behavioural control (perceived
availability) towards consumers attitude to purchase dietary supplement
products.
5. To examine the influence of perceived behavioural control (importance of
price) towards consumers attitude to purchase dietary supplement products.
6. To examine the influence of consumers health consciousness towards
consumers attitude to purchase dietary supplement products.
7. To examine whether the relationship between subjective norms, perceived
behavioural control (perceived availability and importance of price), health
consciousness, advertisements and consumers intention to purchase dietary
supplement products are mediated by attitude.
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8. To examine the differences between dietary supplement products users
and non-users in relations to intention, attitude, subjective norms, perceived
behavioural control (perceived availability and importance of price) and
health consciousness/awareness that influence their purchase.
Null Hypothesis
There is no significant relationship between factors identified and food
supplement consumption.
Significance of the Study
This study is important to the students of UCLM that are 13-19 years old in
particular, to all UCLM students in general, the researcher of this study,
nursing practitioner, and future researchers where interests may approximate
the awareness of this study.
Students of UCLM in general will benefit from this study, as they will be
aware of the effects of media and food preferences. They will have the idea
about the long been suspected negative effects on their age groups health
and behavior relating to these preferences. They will modify activities, be
health conscious and have the capability in helping disseminate health
promotion programs especially in their age group.
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This study is important to the students of UCLM that are 13-19 years old in
particular, to all UCLM students in general, the researcher of this study,
nursing practitioner, and future researchers where interests may approximate
the awareness of this study.
Researchers: will be able to easily determine what the specific age group of
students media and food preferences and, thus, can recommend or propose
an intervention plan that can help those students who needs assistance and
modifications on the said preferences. The researchers will be able to
evaluate the awareness of the students about the importance of having a wise
usage of media and healthy food preferences. This study will also broaden
the knowledge of the researchers helping discover new ideas in proposing
future plans.
Health Practitioners: can gather information and readily accessible data
from previous and present studies which will further help them in their
course or field.
Future Researchers: whose areas of interest are related to this study can
use this as a baseline data for future related studies of wider and bigger
scope.

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