Eye Movement Patterns in Response to Anti-Binge Drinking Messages

Health message design combines selected visual and textual components that are thought to work in concert to produce a particular intended message effect. Most health message effects research assumes rather than determines that message recipients attend to those visual and textual components. In contrast, the present research mapped viewing patterns of 50 participants in response to a set of anti-binge drinking print messages using eye-tracking methodology. Results showed that participants primarily viewed faces of persons portrayed in the messages, as well as alcohol use cues and cryptic one-liners. Textual components (e.g., information about consequences of heavy drinking) were viewed infrequently and briefly. Viewing patterns were associated with perceptions of message effectiveness, but more so for women than for men. Additionally, men, for whom anti-binge drinking messages were more self-relevant than for women, viewed message components more often and longer than women. These findings suggest that when message recipients view a self-relevant health message, they may attend primarily to a subset of components that do not necessarily convey the full message.     

An Examination of Adolescent Recall of Anti-Smoking Messages: Attitudes,Message Type,and Message Perceptions

Delayed message recall may be influenced by currently held accessible attitudes, the nature of the message, and message perceptions (perception of bias and message elaboration). This study examined the potential of message perceptions to mediate the influence of valenced attitude accessibility and message type on unaided recall of anti-smoking Public Service Announcements (PSAs). In a field experiment, ninth grade students (N = 244) watched three PSAs and responded to items on laptop computers. Twelve weeks later, follow-up telephone surveys were conducted to assess unaided recall. Both valenced attitude accessibility and message type were associated with message perceptions. However, only perception of message bias partially mediated the relationship between message type and unaided recall.     

Message Framing and Defensive Processing: A Cultural Examination

Past research has shown that health messages on safer sexual practices that focus on relational consequences are more persuasive than messages that focus on personal consequences. However, we theorize that it is defensiveness against personal risk framing that threatens the self among people from more individualistic cultures. Two studies tested this idea. Study 1 showed that European Americans were less persuaded by personal framing than by relational framing but that this pattern was not found for Asian Americans, who are more collectivistic. Study 2 showed that these defensive patterns were eliminated among European American participants when a person's self-image was affirmed. These results suggest defensive processes as the mechanism behind the differences in message framing effectiveness and motivate a closer look at cultural patterns.     

Effects of Issue Involvement and Framing of a Responsible Drinking Message on Attitudes,Intentions, and Behavior

To decrease the prevalence and the amount of alcohol consumption among students, health messages advocating responsible alcohol behavior can be used. However, it is unclear whether responsible drinking messages are most effective when they use a gain frame, presenting the advantages of responsible drinking, or a loss frame, presenting the disadvantages of irresponsible drinking. This study tests the effects of framing and the moderating role of involvement with the issue of responsible drinking. A three-wave, between-subjects, experimental study was conducted, in which participants (N = 90) were exposed to either a gain- or loss-framed message about responsible drinking behavior at Wave 2. At all three waves, attitudes, intentions and behavior toward responsible drinking were measured. Results showed that for participants with low issue- involvement, a gain frame led to more positive attitudes and intentions toward responsible alcohol use, whereas a loss frame did not have any effects for them. For participants with high issue involvement, a loss frame led to more positive attitudes and intentions toward responsible alcohol use, whereas a gain frame did not have an effect on attitude and only a delayed effect on intention. However, there were no effects of frame and issue involvement on adhering to the guideline of responsible alcohol use and average drinking behavior.     

Moderating Effects of Social Norms and Alcohol Consumption on Message Framing in Responsible Drinking Campaigns: Value from Deviance Regulation Theory

ABSTRACT

This study examined how the interplay between message framing and social norms affected college students’ responses to advertisements and their intentions to drink responsibly, using the lens of deviance regulation theory. The results showed more favorable responses to gain-framed messaging than loss-framed messaging, especially among college students who believed that most of their peers use alcohol irresponsibly (i.e., they observed an unhealthy social norm). This study also investigated how the moderating effects of social norms on message framing differ depending on the level of individual alcohol consumption, and found that the deviance regulation effects on intention to drink responsibly were mitigated among heavy drinkers. The findings suggest strategic potential for using messaging, social context, and individual factors to develop effective campaigns that promote responsible drinking.     

Rethinking Risk: Prospect Theory Application in Health Message Framing Research

Although prospect theory conceptualizes risk as uncertainty, health message framing research based on the theory typically conceptualizes risk as severity. This study reports the results of two experiments designed to explore these alternative conceptualizations of risk and their effect on health decision making. Participants (N₁ = 768, N₂ = 532) were randomly assigned to one of four conditions that presented a hypothetical scenario of a sexually transmitted disease (STD) outbreak. The conditions were defined by message prompt (deadly vs. easily curable STD) and response option frame (gain vs. loss). Participants selected which of two programs (certain outcome vs. uncertain outcome) they would prefer to combat the outbreak. Across both experiments, participants expressed strong preferences for certain (low risk) outcomes in the gain-framed conditions and no preferences in the loss-framed conditions. These differences held regardless of the consequence severity of the scenario. We discuss the theoretical and practical implications of these results and offer directions for future research.     

陕西省饮水型氟中毒防治效果调查

目的 调查陕西省饮水型地方性氟中毒的防治效果.方法 于2008年采用随机整群抽样方法分别抽取中(2.0mg/L＜水氟≤4.0 mg/L)、重(水氟＞4.0 mg/L)病区村39、46个.对饮水氟含量以及儿童氟斑牙病情和尿氟含量进行调查.结果 改水病区饮水氟含量为(1.4±0.8)mg/L,低于未改水病区[(2.6±1.5)mg/L],差异有统计学意义(t=-7.695,P＜0.01).但两病区饮水氟含量仍高于国家标准.改水病区儿童尿氟含量中位数为1.8 mg/L,低于未改水病区(中位数为2.9 mg/L),差异有统计学意义(P＜0.01).改水病区儿童氟斑牙患病率为43.69%,低于未改水病区(59.92%),差异有统计学意义(χ~2=78.349,P＜0.01).改水病区轻度及其以下的氟斑牙患者占73.58%,高于未改水病区(61.85%),差异有统计学意义(χ~2=21.564,P＜0.01).两病区氟斑牙指数均为中等水平.结论 陕西省改水预防饮水型氟中毒取得了良好效果.

Abstract：

Objective To know the effect of on the drinking water type endemic fluorosis control and prevention in Shaannxi province.Methods With random cluster sampling method,39 and 46 villages were respectively selected from the modcrate(water fuoride:2.0-4.0 mg/L)and serious (Water fluoride:＞4.0 mg/L)fluorosis areas in 2008.The fluoride content of the drinking water,the chlidren's dental fluorosis and urinary fluoride were investigated.Results The fluoride in drinking water in the water improved areas was(1.4±0.8)mg/L,which was significantly lower than that in the non-water improved areas(2.6±1.5)mg/L(P＜0.01).But the fluoride content of drinking water in two areas were still higher than the national standards limit.The children's urinary fluoride in the water-improved areas was 1.8 mg/L,which was lower than that in the non-water improved areas(2.9 mg/L)with significant difference(P＜0.01).In the water-improved areas,the dental fluorosis rate was 43.69%,which was significantly lower than that in the non-water improved areas (59.92%)(P＜0.01).In the water-improved areas,the patients with dental fluorosis of slight level accounted for 73.58%,which was significantly higher[P＜0.01 compared with that in the non water-unimproved areas(61.85%)].The dental fluorosis indices in two areas were middle level.Conclusion Water improvement for controlling the drinking water type fluorosis has acquired favorable effect in Shaanxi province.     

Understanding the Effects of Stigma Messages: Danger Appraisal and Message Judgments

Media coverage of health issues has been criticized for creating health stigmas. The model of stigma communication (MSC, Smith, 2007) provides insights into why this is so, but it has two problems: Some of its mediators have not been supported, and it does not do a good job of predicting the transmission of stigma messages (i.e., social transmission). We present a revised model of stigma message effects in which exposure to stigma messages leads to stigma beliefs and stigmatization as a result of a person-oriented danger appraisal. In addition, message judgments—shock value and common ground—are introduced as mediators of the relationship between danger appraisal and social transmission. Participants (N = 200) were randomly assigned to read a health story written either with or without the intrinsic features of stigma messages. The revised model of stigma-message effects was supported: Reading a health news story written with (vs. without) the intrinsic features of stigma messages resulted in greater danger appraisal, which directly predicted stigma-related outcomes and indirectly predicted social transmission through message judgments. Social transmission varied by message judgment: Shocking messages were shared in ways that facilitate diffusion, but common ground messages were shared with influential others, suggesting different means by which stigma as a collective norm may emerge from interactions among community members.     

Message Framing in Vaccine Communication: A Systematic Review of Published Literature

Suboptimal vaccination rates are a significant problem in many countries today, in spite of improved access to vaccine services. As a result, there has been a recent expansion of research on how best to communicate about vaccines. The purpose of the present article is to provide an updated review of published, peer-reviewed empirical studies that examined the effectiveness of gain versus loss framing (i.e., goal framing) in the context of vaccine communication. To locate studies, we examined the reference list from the previous meta-analytic review (O’Keefe & Nan, 2012), and we conducted systematic searches across multiple databases. We included 34 studies in the qualitative synthesis. The relative effectiveness of goal-framed vaccine messages was often shown to depend on characteristics of the message recipient, perceived risk, or situational factors, yet most effects were inconsistent across studies, or simply limited by an insufficient number of studies. Methodological characteristics and variations are noted and discussed. The review points to several directions concerning moderators and mediators of framing effects where additional rigorous studies would be needed.     

Integrating Self-Affirmation with Health Risk Messages: Effects on Message Evaluation and Response

This study tested a new method of using self-affirmation theory to increase adaptive responses to health risk messages. Participants’ self-concepts were affirmed via text integrated with risk messages (public service announcements/PSAs) rather than by methods used in most previous studies that have limited applicability for campaigns employing mediated messages. Participants were exposed to health risk PSAs either including or not including affirming text to examine relative effects on message evaluation and adaptive responses. The moderating effect of personal relevance of the behavior on responses was also examined. Participants exposed to PSAs with integrated, affirming text (affirmed participants) reported more positive attitudes toward the PSA, greater self-efficacy, and greater intention to reduce risky behavior than participants exposed to messages without affirming text (non-affirmed participants). Compared to non-affirmed participants, affirmed participants also reported weaker perceptions of risk severity and equivalent perceptions of susceptibility. The personal relevance of the behavior did not moderate any effects of self-affirmation. Implications for health campaigns that employ mass-mediated messages are discussed.     

The Roles of Prevention Messages,Risk Perception,and Benefit Perception in Predicting Binge Drinking among College Students

To account for the effect of prevention-message exposure on binge drinking among college students, I hypothesized a conceptual model outlining potential mechanisms including perceived probability of negative consequences (PPNC), perceived severity of negative consequences (PSNC), perceived probability of positive consequences (PPPC), and perceived beneficiality of positive consequences (PBPC) from binge drinking, based on the two-step process model. I conducted an online survey at a public university in the US (N = 278). Findings suggested only PBPC was significantly related to binge drinking and the relationship was positive; prevention-message exposure was not directly associated with binge drinking, but was positively associated with PPNC, PSNC, PPPC, and PBPC; none of the mediational paths was significant; higher risk perception (interaction between PPNC and PSNC) was significantly related to less binge drinking, while benefit perception (interaction between PPPC and PBPC) was not predictive of binge drinking. Implications of findings were discussed.     

Effects of Temporal Framing on Response to Antismoking Messages: The Mediating Role of Perceived Relevance

This study tested the effect of temporal framing on young adult smokers’ response to antismoking communication messages. In two studies using largely identical designs, young adult smokers recruited from a large university (n = 52) and Amazon Mechanical Turk (n = 210) were exposed to either no messages or messages featuring different temporal frames. Analysis of the combined data (N = 262) showed that framing the health consequences of smoking in a proximal (vs. distal) time frame led to greater perceived message relevance, less use of heuristic processing, greater use of systematic processing, greater positive affect, and more intense fear. Mediation analysis showed that perceived relevance was a significant mediator of the effect of temporal framing on message processing and emotional responses. In separate analysis of the Amazon Mechanical Turk data, the proximal frame also showed a consistent pattern of stronger impact on behavioral intentions compared to the distal frame, but the difference was only significant on the measure of intending to try to quit. Overall, findings of this study suggest that using proximal (vs. distal) frames may enhance receptivity to antismoking messages among young adult smokers, although the behavioral impact of this framing strategy still awaits further research.     

Collective Efficacy and the Regulatory Framing of Health Messages: Influences on Concern for Body Image

A collective efficacy scale is presented and used in 2 experiments that tested the effects of collective efficacy and regulatory framing on concern for body image. In Study 1 (N = 73), participants viewed online video messages from a health campaign that varied in their regulatory frame (promotion vs. prevention), after which they expressed the likelihood that they would discuss it with someone else. In Study 2, participants (N = 307) viewed either a regulatory-framed message or no message, after which they expressed their concern for the issue and their behavioral intentions. Study 2 also introduced moderating variables and addressed potential alternate explanations. Overall, participants who were higher in collective efficacy indicated greater concern for the issue of body image and expressed a greater likelihood to discuss the issue. The messages' regulatory frame also moderated the effect of collective efficacy. Collective efficacy was a stronger predictor in the prevention condition than in the promotion condition, presumably because the promotion frame was more effective in increasing participants' concern and intentions regardless of their sense of collective efficacy.     

Adolescents' Perceptions of Canadian Cigarette Package Warning Labels: Investigating the Effects of Message Framing

This study investigates gain-framed and loss-framed messages on graphic cigarette warning labels and their effects on adolescents' smoking-related attitudes and behaviors. Canadian cigarette warning labels emphasizing health consequences of smoking (loss-framed) were digitally manipulated into gain-framed versions. High school students (N?=?210) completed a questionnaire measuring attitudes, perceptions of the warnings, and behavioral intentions. The study used a posttest-only comparison group design with random assignment. The independent variable was message framing (loss-framed, gain-framed avoidance, gain-framed benefits), and the dependent variables were (a) attitudes toward the warning, (b) attitudes toward smoking, (c) effectiveness in reducing smoking levels, (d) intentions to smoke, (e) effectiveness in improving one's ability to quit, and (f) effectiveness in increasing the likelihood of a smoker quitting. Results indicate that adolescents had more favorable attitudes toward the loss-framed warnings and perceived them as more effective than the gain-framed warnings. Further, smokers exposed to the loss-framed version featuring decaying teeth had significantly lower intentions to smoke in the future. Loss-framed warning labels appear to have a positive influence on adolescents' smoking-related attitudes and behavioral intentions.     

Narrative and Framing: A Test of an Integrated Message Strategy in the Exercise Context

Health communication interventions encouraging exercise may aid in mitigating the obesity crisis in the United States. Although much research has investigated behavioral predictors of exercise, little work has explored message characteristics most persuasive in the exercise context. The purpose of this study, therefore, was to test a message strategy drawing on previous work in health behavior theory combined with persuasion theories (exemplification theory and prospect theory) to encourage positive exercise attitudes, control beliefs, and intentions. The authors report the results of a controlled experiment testing messages using gain or loss frames and narrative or statistical evidence. Results indicate that gain-framed messages are significantly more successful in promoting positive exercise variables and are perceived as more effective than are loss-framed or control messages. The authors discuss the implications of the results for future research.     

Effects of Framing Health Messages in Terms of Benefits to Loved Ones or Others: An Experimental Study

Many health officials believe the future of public health is in prevention of infectious diseases like pandemic influenza. Vaccine promotion is becoming an increasingly important area for health communication researchers. One strategy health promoters can consider is to emphasize that getting vaccinated protects not only the self, but also loved ones, and unknown others to whom the disease could be spread. The set of experiments described here tested whether such a strategy (called “benefit-target framing”) could prove useful in promoting vaccine intentions. In two experiments, subjects from an online panel were randomized to receive a vaccination message focused on the benefits either to the self, to loved ones, or to society as a whole. Outcome measures included intentions to receive the vaccine and intentions to seek more information (n = 495). Results from two virtually identical studies were pooled to maximize power. Results suggest that messages framed in terms of benefits to society were more successful than those focused on the self, but messages focused on loved ones were not different from either of the others. Possible explanations for the findings, and implications for future research, are discussed.     

Framing Indoor Tanning Warning Messages to Reduce Skin Cancer Risks Among Young Women: Implications for Research and Policy

Objectives. We investigated the impact of indoor tanning device warnings that communicate the risks associated with indoor tanning (i.e., loss framed) or the benefits of avoiding indoor tanning (i.e., gain framed).Methods. A convenience sample of non-Hispanic White women aged 18 to 30 years who tanned indoors at least once in the past year (n = 682) participated in a within-subjects experiment. Participants completed baseline measures and reported indoor tanning intentions and intentions to quit indoor tanning in response to 5 warning messages in random order. A text-only control warning was based on Food and Drug Administration–required warnings for indoor tanning devices. Experimental warnings included graphic content and were either gain or loss framed.Results. In multivariable analyses, gain-framed warnings did not differ from the control warning on women’s intentions to tan indoors, but they prompted stronger intentions to quit than the control message. Loss-framed warnings significantly reduced intentions to tan indoors and increased intentions to quit indoor tanning compared with control and gain-framed warnings.Conclusions. The public health impact of indoor tanning device warnings can be enhanced by incorporating graphic content and leveraging gain- and loss-framed messaging.Skin cancer is the most common malignancy in the United States, where approximately 3.5 million cases of nonmelanoma skin cancer and 75 000 cases of melanoma are diagnosed each year.1,2 Although most skin cancers are preventable by reducing ultraviolet radiation exposure, their incidence is increasing.3–6 An estimated 9000 deaths occur each year as a result of melanoma,2 and the costs of skin cancer treatment exceed $8 billion annually.7Indoor tanning is major concern for skin cancer prevention.4,8 Approximately 380 000 skin cancer cases are attributable to indoor tanning annually in the United States.9 Recent meta-analyses have indicated that indoor tanning increases lifetime risks of nonmelanoma skin cancer by 29% to 67% and melanoma by approximately 20%.10,11 Among US adults, the prevalence of indoor tanning is highest among young adult, non-Hispanic White women, with nearly 30% tanning each year and 15% tanning 10 or more times each year.12,13 Indoor tanning before age 30 years and tanning more frequently further increase lifetime skin cancer risks,10,11,14,15 and tanning at a young age is associated with early-onset skin cancer.16As in other areas of public health, policies are advocated as part of a comprehensive approach to skin cancer prevention.4,17 Until recently, the US Food and Drug Administration (FDA) regulated indoor tanning devices as class I medical devices presenting minimal risks and largely exempt from premarket controls.18 In part because of advocacy for tighter regulations,17 the FDA recently published a new rule changing indoor tanning devices to class II devices with additional premarket controls and revised labeling requirements. Now, indoor tanning devices are required to display a text-only warning reading “Attention: This sunlamp product should not be used on persons under the age of 18 years.”19 Consumer-facing information for indoor tanning devices is also required to include several contraindication and warning statements.19Unfortunately, the required warnings do not reflect evidence for skin cancer prevention messaging20,21 and are inconsistent with warnings for other FDA-regulated products with associated health risks, such as tobacco.22 The FDA’s strategic plan for regulatory science emphasizes designing evidence-based public health messages to empower consumers to make healthy decisions about regulated products.23 The public health impact of indoor tanning device warnings could be enhanced through additional research to determine how to best promote preventive behavior. Under federal rulemaking procedures, the FDA could issue new labeling requirements based on the available evidence, and this evidence could also inform state and local policies on indoor tanning. Unlike warnings for tobacco,24 little published research is available on how to design indoor tanning warnings to enhance their public health impact.According to prospect theory, framing health messages in terms of the costs of engaging in risky behavior (i.e., loss framed) or the benefits of avoiding risky behavior (i.e., gain framed) differentially affects behavioral outcomes.25,26 The message-framing concept draws from fundamental tenets of behavioral economics and communication science that postulate that health messages can be crafted around gains or losses to shape perceptions and motivate behavior.25 Although recent reviews have indicated that loss-framed skin cancer prevention messages can promote behavior change,20,21 2 meta-analyses drew different conclusions regarding gain- and loss-framed skin cancer prevention messages,27,28 and no study has tested message-framing effects for indoor tanning warnings. Research has also consistently demonstrated that graphic warnings incorporating imagery to depict the health risks of tobacco use are more effective for promoting behavior change than text-only warnings because they more effectively attract attention, evoke an emotional response, and affect perceived risks and attitudes toward tobacco use.24,29–32 Although the available evidence on skin cancer prevention messages has suggested that graphic messages can promote preventive behaviors,20,21 no study has investigated the effects of graphic content for indoor tanning warnings.Given the theoretical support and empirical evidence indicating that gain- and loss-framed messages incorporating graphic imagery may be important to prevent and reduce indoor tanning, we examined the impact of these message features on indoor tanning intentions and intentions to quit indoor tanning in a convenience sample of young adult women. We compared gain- and loss-framed warnings with graphic imagery with a text-only warning, such as those required by the FDA. We focused on young adult women because of the high prevalence of indoor tanning in this population and evidence that indoor tanning early in life further increases skin cancer risks.10,11 This makes young adult women a priority population for public health skin cancer prevention efforts. We hypothesized that graphic, loss-framed messages conveying the health risks associated with indoor tanning would produce the greatest impact.     

Programmed vs. Thirst-Driven Drinking during Prolonged Cycling in a Warm Environment

We compared the effect of programmed (PFI) and thirst-driven (TDFI) fluid intake on prolonged cycling performance and exercise associated muscle cramps (EAMC). Eight male endurance athletes (26 ± 6 years) completed two trials consisting of 5 h of cycling at 61% V˙O2peak followed by a 20 km time-trial (TT) in a randomized crossover sequence at 30 °C, 35% relative humidity. EAMC was assessed after the TT with maximal voluntary isometric contractions of the shortened right plantar flexors. Water intake was either programmed to limit body mass loss to 1% (PFI) or consumed based on perceived thirst (TDFI). Body mass loss reached 1.5 ± 1.0% for PFI and 2.5 ± 0.9% for TDFI (p = 0.10). Power output during the 20 km TT was higher (p < 0.05) for PFI (278 ± 41 W) than TDFI (263 ± 39 W), but the total performance time, including the breaks to urinate, was similar (p = 0.48) between conditions. The prevalence of EAMC of the plantar flexors was similar between the drinking conditions. Cyclists competing in the heat for over 5 h may benefit from PFI aiming to limit body mass loss to <2% when a high intensity effort is required in the later phase of the race and when time lost for urination is not a consideration.     

Positive Facts,Negative Stories: Message Framing as a Moderator of Narrative Persuasion in Antismoking Communication

ABSTRACT

This study examines the moderating role of message framing in narrative persuasion in the context of promoting smoking cessation. A controlled experiment involving 101 college smokers revealed a significant interaction effect between message framing (gain-framing vs. loss-framing) and evidence type (narrative vs. nonnarrative) on smoking-related risk perceptions. For the gain-framed message, the nonnarrative version produced significantly greater perceived susceptibility to smoking-related diseases than did the narrative version. For the loss-framed message, evidence type did not make a difference in perceived susceptibility. On perceived severity of smoking-related diseases, the interaction was such that for the loss-framed message, the narrative version resulted in significantly greater perceived severity than did the nonnarrative version. In contrast, for the gain-framed message, evidence type did not make a difference in perceived severity. In addition, our results revealed that the interaction between message framing and evidence type had an indirect effect on attitudes toward quitting smoking through perceived severity of smoking-related diseases. Theoretical and practical implications are discussed.