Interactions between self-medicating consumers and the labeling of Over-the-Counter medications (OTC) influence the quality of information processing and hence the appropriateness of medication decisions. Our previous work on human-package interaction yielded evidence that early stages of processing important regulatory information were necessary to improve OTC packaging labeling and human-package interactions, and thus to inform appropriate decisions.Under the framework of Human-Package Interaction model (H-PIM) and the types of directiveness of label designs, we proposed two novel labeling strategies: Front-of-Pack (FOP) labeling and personalized FOP labeling. The FOP strategy utilized the concepts of front-of-pack, boxing, grouping, and highlighting (HL), whereas the personalized FOP strategy further combined the concepts of the FOP labeling with augmented user interface and decision-support signals to assist the decision-making process for enhancing human-package interactions.To quantitatively investigate the effectiveness of those FOP labeling strategies, we firstly conducted a change detection test to evaluate the impact of the FOP labeling strategy on consumers' attention to critical drug information. Additionally, we then developed an absolute judgement test to evaluate the effectiveness of the personalized FOP labeling strategy for assisting decision-making to benchmark the potential benefits of this strategy.The change detection test results indicated that the use of HL was effective and efficient to garner attentions. Specifically, the presence of HL increased change detection accuracy (HL:ME=0.932, SE=0.008; not HL:ME=0.770, SE=0.019; p<0.001)) and shortened the time to correctly detect changes. (HL: ME=3.790, SE=0.200; not HL:ME=5.073, SE=0.268; p<0.001). However, no evidence was found to suggest that the use of FOP labels enhanced the change detection accuracy. Moreover, the presence of FOP labels could prolong the time consumers used to correctly detect changes on the OTC packages than the standard labels. (FOP: ME=4.542, SE=0.238; standard: ME=4.233, SE=0.225; p=<0.001) These results may be caused by factors such as the FOP label location and unbalanced experimental design. Further studies are needed to gain more knowledge of this strategy. The absolute judgement test results supported the effectiveness and efficiency of the personalized FOP strategy on assisting consumer's decision making. When introduced and educated with the concept of personalized FOP labeling, participants made decisions significantly more accurate (personalized FOP: ME=0.977, SE=0.007; standard: ME=0.933, SE=0.017; p=0.002) and faster (personalized FOP: ME=9.584, SE=0.854; standard: ME=19.052, SE=2.322; p<0.001) with the presence of personalized FOP labels compared to the presence of standard ones. In conclusion, this dissertation extends FOP labeling strategies from non-directive labels to personalized labels. The personalized FOP labeling could act as a very important role in improving the consumer-package interactions in the OTC market. Future studies can explore different designs and presentation modes of personalized labeling to identify the most effective design combination that can assist consumers' information processing of OTC packaging and medical decision-making. More research is also needed to generalize the effectiveness of personalized labels on medication decision-making to various natural settings, different package types, and other populations.
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