How Fear-Arousing News Messages Affect Risk Perceptions and Intention to Talk About Risk

Building on the theoretical arguments of the impersonal-impact and differential-impact hypotheses, this study has a twofold purpose: first, to demonstrate how fear-arousing media messages about risk are associated with personal-level risk perception, as well as, and perhaps more so than, societal-level risk perception; and second, to examine how the resulting risk perceptions can mediate intention to talk about the risk with family and friends. A news message evaluation study was conducted among the general public in South Korea concerning two major risks, carcinogens and bovine spongiform encephalopathy (BSE). Two sets of structural equation models reveal three main findings: (a) Fear-arousing news messages are positively related to personal-level risk perception, as well as to societal-level risk perception; (b) fear-arousing news messages result in intention to talk about the risk directly and indirectly through risk perception; and (c) personal-level risk perception appears more strongly related to intention to talk than does societal-level risk perception, although such relationships may vary across risk topics.     

A systematic review of communication interventions for countering vaccine misinformation

BackgroundMisinformation and disinformation around vaccines has grown in recent years, exacerbated during the Covid-19 pandemic. Effective strategies for countering vaccine misinformation and disinformation are crucial for tackling vaccine hesitancy. We conducted a systematic review to identify and describe communications-based strategies used to prevent and ameliorate the effect of mis- and dis-information on people’s attitudes and behaviours surrounding vaccination (objective 1) and examined their effectiveness (objective 2).MethodsWe searched CINAHL, Web of Science, Scopus, MEDLINE, Embase, PsycInfo and MedRxiv in March 2021. The search strategy was built around three themes(1) communications and media; (2) misinformation; and (3) vaccines. For trials addressing objective 2, risk of bias was assessed using the Cochrane risk of bias in randomized trials tool (RoB2).ResultsOf 2000 identified records, 34 eligible studies addressed objective 1, 29 of which also addressed objective 2 (25 RCTs and 4 before-and-after studies). Nine ‘intervention approaches’ were identified; most focused on content of the intervention or message (debunking/correctional, informational, use of disease images or other ‘scare tactics’, use of humour, message intensity, inclusion of misinformation warnings, and communicating weight of evidence), while two focused on delivery of the intervention or message (timing and source). Some strategies, such as scare tactics, appear to be ineffective and may increase misinformation endorsement. Communicating with certainty, rather than acknowledging uncertainty around vaccine efficacy or risks, was also found to backfire. Promising approaches include communicating the weight-of-evidence and scientific consensus around vaccines and related myths, using humour and incorporating warnings about encountering misinformation. Trying to debunk misinformation, informational approaches, and communicating uncertainty had mixed results.ConclusionThis review identifies some promising communication strategies for addressing vaccine misinformation. Interventions should be further evaluated by measuring effects on vaccine uptake, rather than distal outcomes such as knowledge and attitudes, in quasi-experimental and real-life contexts.     

Maternal schooling and comprehension of child health information in urban Zambia: is literacy a missing link in the maternal schooling-child health relationship?

This paper examines the relationship between literacy skills and comprehension of health information by studying mothers of young children in a high-density urban area in Zambia. Both decontextualized language and print literacy skills were assessed for each woman and the resulting scores were related to her comprehension of both broadcast and printed health information. The results indicate that fluency in a language is not sufficient for full comprehension of broadcast messages in the decontextualized type of language used in bureaucratic communication, and that a woman's ability to use decontextualized language is associated with greater comprehension of such messages. Skill in using this type of language increases with years of schooling, even in the poorly equipped schools in Zambia, as does print literacy, even though the levels of comprehension achieved are well below their grade level on average for these women. Some implications of these findings for both health care providers and educators are then considered.     

The Effects of Gain-, Loss-, and Balanced-Framed Messages for Preventing Indoor Tanning among Young Adult Women

Indoor tanning (IT) increases the risks of skin cancer, but evidence on how to design health education messaging targeting IT among young adult women remains limited. This study investigated the effects of theory-guided gain-, loss-, and balanced-framed IT prevention messages. Young adult women ages 18–30 who indoor tan (n = 552, mean age = 24.9 years [standard deviation = 3.1]) were recruited online, completed pre-exposure measures, and were randomized to view a gain-, loss-, or balanced-framed message. Participants completed post-exposure measures of message response (emotional response, message receptivity), IT risk (perceived severity, susceptibility), and efficacy (self-efficacy, perceived benefits of avoiding IT) beliefs, and IT behavioral intentions. Loss- and balanced-framed messages promoted significantly greater emotional response and message receptivity and lower IT behavioral intentions than gain-framed messages. The effects of loss- and balanced-framed messages on IT behavioral intentions were mediated by greater emotional response and message receptivity compared with the gain-framed message. These results can inform the development of public health education campaigns to prevent and reduce IT among young adult women. Future research can build from these findings by investigating additional message themes and tailoring strategies to maximize their effects, examining the effects of framed messages prospectively, and investigating ways to enhance message receptivity, such as through novel message delivery channels (e.g., mobile devices).     

Audience Responses to a Risk Communication Message in Four Media Formats

This study compared consumer reactions to four media formats — video news release, video public service announcement, print news release, and newsprint column — that contained a parallel message about the use of agricultural chemicals in the food supply. Eight message evaluation sessions were held in four regions of the United States with 86 women. Based on their responses to a background questionnaire, the women were distinguished by level of concern for pesticide use and food safety, urban versus rural residence, and farm versus nonfarm employment. While all formats were favorably received, Likert-type scale reactions, cognitive responses, and some focus group comments showed audience preference for the video news release and newsprint column approaches. Consumers who indicated high concern for the pesticide/food safety issue responded more favorably to the two print formats than did less concerned consumers. No such distinctions based on level of concern were found for the two broadcast formats. This work illustrates the dilemma communicators have in educating about controversial risk issues, that is, in creating messages that are considered objective and nonsensational, yet also maintain the interest of readers and viewers. Also, the study provides an example of combining quantitative research designs with qualitative message evaluation focus groups.     

Effect of Warning Labels on Consumer Motivation and Intention to Avoid Consuming Processed Foods

Nutritional warnings (NWs) as a front-of-package label were implemented as a public policy aiding consumers with recognizing processed foods with high levels of critical nutrients (sodium, saturated fats, carbohydrates, and calories). However, in spite of this tool being well positioned in consumer decision making, there is little extant knowledge about the relationship between the message sent by NW, nutritional knowledge, consumer motivation, and the intention to avoid consuming processed foods. To understand these dimensions’ relations, a theoretical model was created and subsequently tested through structural equations. We applied a survey to 807 home food purchasing decision makers. The results show that the direct effect of NW messages raises the intention to avoid processed foods, while eating motivation is negative in its direct effect on the same avoidance intention. However, the message sent by NWs had a mediating effect between the intentions to avoid processed food and eating motivation but showed no such effect on nutritional knowledge. This suggests that the message sent by NWs was able to turn negative eating motivation into positive eating motivation to avoid processed foods. In conclusion, NWs help mitigate eating motivations, as well as boost the intention to avoid processed foods.     

Interpretations of Cigarette Advertisement Warning Labels by Philadelphia Puerto Ricans

This study examined Philadelphia Puerto Ricans' interpretations of the Surgeon General's warnings that appear on cigarette packaging and in advertisements. In-home family focus groups in which participants were asked to comment on magazine cigarette advertisements showed a great variety of interpretations of the legally mandated warning labels. These findings (a) corroborate and add to research in public health and communications regarding the possibility of wide variations in message interpretations and (b) support the call for public health messages to be carefully tested for effectiveness among different social groups. The article's focus on Puerto Ricans addresses the problem of misleading conclusions that can arise from aggregating all Latino subpopulations into one group. The use of a naturalistic setting to examine interpretations of messages about smoking departs from the experimental methods typically used for such research and provides new evidence that even a seemingly straightforward message can be interpreted in multiple ways. Understanding and addressing differences in message interpretation can guide public health campaigns aimed at reducing health disparities.     

Health Messaging to Individuals Who Perceive Ambiguity in Health Communications: The Promise of Self-Affirmation

The perception that extant health messages about risk factors for a disease are ambiguous can be associated with greater anxiety and reduced interest in taking precautionary action. In this experiment, 247 female alcohol consumers who perceived varying degrees of ambiguity in current cancer prevention messages read an unambiguous article about the documented link between alcohol consumption and breast cancer. Before reading the article, half were given the opportunity to self-affirm by reflecting on an important value—a technique previously shown to enhance receptivity to threatening messages. The authors found that self-affirmation increased message acceptance among those who perceived relatively higher levels of ambiguity in cancer communications. Also, the relation between perceived ambiguity and risk perception became positive among self-affirmed participants, suggesting they had become less defensive. Self-affirmation may be an effective technique to use when delivering health communications to audiences who perceive a lack of consistency in prevention messages.     

Smokers' recall of Australian graphic cigarette packet warnings &; awareness of associated health effects, 2005-2008

Background  

In 2006, Australia introduced graphic cigarette packet warnings. The new warnings include one of 14 pictures, many depicting tobacco-related pathology. The warnings were introduced in two sets; Set A in March and Set B from November. This study explores their impact on smokers' beliefs about smoking related illnesses. This study also examines the varying impact of different warnings, to see whether warnings with visceral images have greater impact on smokers' beliefs than other images.     

Interpretations of cigarette advertisement warning labels by Philadelphia Puerto Ricans

This study examined Philadelphia Puerto Ricans' interpretations of the Surgeon General's warnings that appear on cigarette packaging and in advertisements. In-home family focus groups in which participants were asked to comment on magazine cigarette advertisements showed a great variety of interpretations of the legally mandated warning labels. These findings (a) corroborate and add to research in public health and communications regarding the possibility of wide variations in message interpretations and (b) support the call for public health messages to be carefully tested for effectiveness among different social groups. The article's focus on Puerto Ricans addresses the problem of misleading conclusions that can arise from aggregating all Latino subpopulations into one group. The use of a naturalistic setting to examine interpretations of messages about smoking departs from the experimental methods typically used for such research and provides new evidence that even a seemingly straightforward message can be interpreted in multiple ways. Understanding and addressing differences in message interpretation can guide public health campaigns aimed at reducing health disparities.     

Perspective on the content of worker notifications

The concept of worker notification has evolved over the years to a prevailing view that workers should be notified of all epidemiologic studies that make use of their medical information. To adequately communicate health information to workers, epidemiologists must consider the intended audience along with its need for risk information that is scientifically valid and clearly outlines areas of uncertainty. This goal is facilitated by full disclosure to workers of information pertinent to the planning, conduct, and interpretation of research efforts. Subjectivity in choosing unanticipated research findings for inclusion in worker notifications may permit bias toward a personal viewpoint, but this can be minimized by prestudy agreement on appropriate criteria for selecting which research findings to communicate. Epidemiologic theory and principles of causal inference should guide the development of appropriate criteria. The timeliness of worker communications has received limited attention, and workers have often been the “last to know” about important studies. This may influence workers' receptivity to the risk message. Sponsoring organizations should ensure that an acceptable communications plan is included in research protocols and that the plan accords priority to notifying workers about study results. © 1993 Wiley-Liss, Inc.     

Matching health messages to information-processing styles: need for cognition and mammography utilization

The use of tailored health communications has become a favored technique for persuading individuals to engage in health behaviors, such as screening mammography. This experiment examined the impact of tailoring persuasive health communications to one aspect of individuals' information-processing styles, that of the need for cognition (NFC), the enjoyment of thinking deeply about issues. To determine whether messages matched to an individual's NFC are more influential than mismatched messages, 602 women who called the Cancer Information Service (CIS) of the National Cancer Institute were asked to participate in an experiment at the end of their service call. They were assigned randomly to receive 1 of 2 phone messages promoting mammography use and a similarly tailored pamphlet 1 month later. Messages matched to an individual's NFC were better at motivating mammography 6 months later among high-NFC women. After controlling for prior mammography utilization, age, worry, intentions, perceived norms, suggestions to get a mammogram, and marital status, the interaction between participant NFC and message type also approached statistical significance. The differential influence of these brief, tailored communications diminished after 12 months, however.     

Impact of communication on consumers' food choices

Consumers' food choices and dietary behaviour can be markedly affected by communication and information. Whether the provided information is processed by the receiver, and thus becomes likely to be effective, depends on numerous factors. The role of selected determinants such as uncertainty, knowledge, involvement, health-related motives and trust, as well as message content variables, are discussed in the present paper based on previous empirical studies. The different studies indicate that: uncertainty about meat quality and safety does not automatically result in more active information search; subjective knowledge about fish is a better predictor of fish consumption than objective knowledge; high subjective knowledge about functional foods as a result of a low trusted information source such as mass media advertising leads to a lower probability of adopting these foods in the diet. Also, evidence of the stronger impact of negative news as compared with messages promoting positive outcomes of food choices is discussed. Finally, three audience-segmentation studies based on consumers' involvement with fresh meat, individuals' health-related-motive orientations and their use of and trust in fish information sources are presented. A clear message from these studies is that communication and information provision strategies targeted to a specific audience's needs, interests or motives stand a higher likelihood of being attended to and processed by the receiving audience, and therefore also stand a higher chance of yielding their envisaged impact in terms of food choice and dietary behaviour.     

The Effectiveness of Empathy- Versus Fear-Arousing Antismoking PSAs

Building on a previous study (Shen, 2010), this paper investigates the effectiveness of fear- versus empathy-arousing antismoking PSAs and examines the roles of message-induced fear and state empathy in persuasion. Twelve professionally produced antismoking PSAs were used as stimuli messages in a 3 (message type: empathy, fear vs. control)?×?4 (messages) mixed design study. The 260 participants were randomly assigned to each message type and watched four PSAs presented in a random sequence. Results from multilevel modeling analyses showed that empathy-arousing messages are potentially more effective than fear-arousing ones. Both fear and state empathy were found to have a positive direct effect on persuasion. However, fear also had a negative indirect impact on persuasion by activating psychological reactance, while state empathy also had a positive indirect effect by inhibiting psychological reactance. Implications for persuasion, health communication campaigns, and future research were discussed.     

The effectiveness of empathy- versus fear-arousing antismoking PSAs

Building on a previous study (Shen, 2010), this paper investigates the effectiveness of fear- versus empathy-arousing antismoking PSAs and examines the roles of message-induced fear and state empathy in persuasion. Twelve professionally produced antismoking PSAs were used as stimuli messages in a 3 (message type: empathy, fear vs. control) × 4 (messages) mixed design study. The 260 participants were randomly assigned to each message type and watched four PSAs presented in a random sequence. Results from multilevel modeling analyses showed that empathy-arousing messages are potentially more effective than fear-arousing ones. Both fear and state empathy were found to have a positive direct effect on persuasion. However, fear also had a negative indirect impact on persuasion by activating psychological reactance, while state empathy also had a positive indirect effect by inhibiting psychological reactance. Implications for persuasion, health communication campaigns, and future research were discussed.     

The Context of Collecting Family Health History: Examining Definitions of Family and Family Communication about Health among African American Women

In an exploratory analysis of several highly circulated consumer cancer magazines, the authors evaluated congruency between visual images of cancer patients and target audience risk profile. The authors assessed 413 images of cancer patients/potential patients for demographic variables such as age, gender, and ethnicity/race. They compared this profile with actual risk statistics. The images in the magazines are considerably younger, more female, and more White than what is indicated by U.S. cancer risk statistics. The authors also assessed images for visual signs of cancer testing/diagnosis and treatment. Few individuals show obvious signs of cancer treatment (e.g., head scarves, skin/nail abnormalities, thin body types). Most images feature healthier looking people, some actively engaged in construction work, bicycling, and yoga. In contrast, a scan of the editorial content showed that nearly two thirds of the articles focus on treatment issues. To explicate the implications of this imagery–text discontinuity on readers' attention and cognitive processing, the authors used constructs from information processing and social identity theories. On the basis of these models/theories, the authors provide recommendations for consumer cancer magazines, suggesting that the imagery be adjusted to reflect cancer diagnosis realities for enhanced message attention and comprehension.     

Food as Risk: How Eating Habits and Food Knowledge Affect Reactivity to Pictures of Junk and Healthy Foods

This study explores how people respond to images of junk versus healthy food as a function of their eating habits and food knowledge. The experiment reported here proposed and tested the idea that those with unhealthy eating habits but highly knowledgeable about healthy eating would feel more positive and also more negative toward junk food images compared to images of healthy food because they may perceive them as risky—desirable but potentially harmful. The psychophysiological data collected from participants during their exposure to pictures of junk versus healthy food supported this idea. In addition, unhealthy eaters compared to healthy eaters with the same degree of food knowledge responded more positively to all food items. The findings are critical from a health communication perspective. Because unhealthy eaters produce stronger emotional responses to images of junk food, they are more likely to process information associated with junk food with more cognitive effort and scrutiny. Thus, when targeting this group and using images of junk food, it is important to combine these images with strong message claims and relevant arguments; otherwise, if the arguments are perceived as irrelevant or weak, the motivational activation associated with junk food itself may transfer into an increased desire to consume the unhealthy product.     

Extreme Heat Awareness and Protective Behaviors in New York City

Heat waves can be lethal and routinely prompt public warnings about the dangers of heat. With climate change, extreme heat events will become more frequent and intense. However, little is known about public awareness of heat warnings or behaviors during hot weather. Awareness of heat warnings, prevention behaviors, and air conditioning (AC) prevalence and use in New York City were assessed using quantitative and qualitative methods. A random sample telephone survey was conducted in September 2011 among 719 adults and follow-up focus groups were held in winter 2012 among seniors and potential senior caregivers. During summer 2011, 79 % of adults heard or saw a heat warning. Of the 24 % who were seniors or in fair or poor health, 34 % did not own AC or never/rarely used it on hot days. Of this subgroup, 30 % were unaware of warnings, and 49 % stay home during hot weather. Reasons for not using AC during hot weather include disliking AC (29 %), not feeling hot (19 %), and a preference for fans (18 %). Seniors in the focus groups did not perceive themselves to be at risk, and often did not identify AC as an important health protection strategy. While heat warnings are received by most New Yorkers, AC cost, risk perception problems, and a preference for staying home leave many at risk during heat waves. Improving AC access and risk communications will help better protect the most vulnerable during heat waves.     

Interpretation of Pharmaceutical Warnings Among Adolescents

PURPOSE: Warnings are an important component of pharmaceutical risk mitigation efforts, yet very little research attention has been directed toward adolescent interpretation of such warnings. This study examined adolescents' interpretations of and preferences for warning symbols and statements related to pharmaceuticals with teratogenic properties. METHODS: A total of 200 adolescents interpreted one of four warning symbols and four warning statements. Responses were coded using an established three-tier coding system. Symbol preferences were elicited. Interpretation accuracy and symbol preferences were analyzed by symbol and statement. RESULTS: The symbol in use on medication labels at the time of the study elicited nearly goal levels of interpretation accuracy; however it exceeded allowable levels of critical confusion. An alternative symbol elicited more fully correct responses than the existing symbol and was preferred to the existing symbol by a margin of 2 to 1. Yet another symbol was most preferred despite eliciting fewer correct interpretations. The impact of warning statements on overall warning interpretation varied by statement and statement-symbol combinations. At least one statement appeared to lessen the overall message of caution, and few adolescents expressed an awareness of risk if one "may become pregnant" until explicitly informed of this risk. CONCLUSIONS: Comprehension of medical warning symbols and statements among adolescents is an important public health issue. Those involved in adolescent health education and research have considerable theoretical and practical tools for approaching the development and evaluation of such warning messages. Understanding how warnings are interpreted can lead to more effective communication efforts and reduce risk.     

Relative Impact of Nutritional Warnings and Other Label Features on Cereal Bar Healthfulness Evaluations

ObjectiveTo investigate the relative influence of nutritional warnings and 2 marketing strategies commonly used in food labels, nutrient claims, and fruit images on consumers’ healthfulness judgments.DesignLabels of cereal bars were designed according to a full factorial design with 3 2-level variables: images of fruit (with vs without), nutrient claims about the fiber content (with vs without), and nutritional warnings about excessive content of sugar and saturated fat (with vs without).SettingExperiment conducted in Montevideo, Uruguay.ParticipantsOne hundred Uruguayan people, 75% female, aged 18–56 years.Main Outcome MeasuresHealthfulness perception and eye-tracking variables.AnalysisThe researchers used ANOVA to evaluate the influence of the experimental design's variables on perceived healthfulness and eye-tracking measures.ResultsNutritional warnings caught participants’ attention and reduced the amount of visual attention needed to evaluate healthfulness. Participants mainly relied on nutritional warnings to make healthfulness judgments.Conclusions and ImplicationsFindings of the current work confirm the potential of nutritional warnings to influence consumers’ healthfulness perception, overriding the effect of other label cues used by the food industry to convey the concept of healthfulness.