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.     

Features of Empathy–Arousing Strategic Messages

ABSTRACT

There has been evidence that empathy-arousing messages might be an effective and ethical approach to persuasion in health communication. Knowledge of intrinsic message features is needed to better design and craft such messages. The goals of this research were (a) to identify message features with the potential to arouse state empathy, (b) to verify the association between the identified message features and state empathy, and (c) to determine if state empathy mediates the impact of the message features on persuasion and social stigma. In the present study, a coding scheme was developed for empathy-arousing message features; 532 individuals recruited from Qualtrics Panel each viewed five messages randomly selected from a total of 20 stimuli messages that varied in empathy message features. Multilevel modeling analyses confirmed the association between the identified message features and state empathy; and state empathy’s mediating role of message feature effects on persuasion and social stigma.     

Targeting Smokers With Empathy Appeal Antismoking Public Service Announcements: A Field Experiment

A field experiment study (N = 189) was conducted to investigate the effectiveness of empathy appeal antismoking messages and their potential advantage over fear appeal messages. Data from 12 antismoking public service announcements showed that (a) smokers resist antismoking messages and (b) overall empathy appeal was equally effective as fear appeal messages. There was also evidence for moderators. First, empathy messages were more effective to women than to men. Second, fear appeal messages were more effective to occasional smokers than were empathy messages. Third, empathy messages were more effective to regular smokers than were fear appeal messages. Implications for audience segmentation and message targeting in public health antismoking efforts are discussed.     

The Impact of Locus of Control and Controlling Language on Psychological Reactance and Ad Effectiveness in Health Communication

Based on two theoretical models—psychological reactance theory (PRT) and locus of control—this study examines the individual and joint effects of locus of control and controlling language on young adults’ information processing. Two experimental studies on anti-driving-after-drinking (anti-DAD) and antismoking public service announcements (PSAs) were conducted that were conceptual replications of each other. Both studies afforded evidence that those with external locus of control were more involved in risky behaviors. There was a consistent interaction between locus of control and controlling language, such that those with internal locus of control were more sensitive to this message feature compared to those with external locus of control. Controlling language was found to increase reactance. The theoretical and managerial implications for health communication are elaborated. Limitations and directions for future research are also outlined.     

The Effects of Frame,Appeal, and Outcome Extremity of Antismoking Messages on Cognitive Processing

Research on the impact of antismoking advertisements in countermarketing cigarette advertising is equivocal. Although many studies examined how different message appeal types influence people's attitudes and behavior, there have been few studies that have explored the mechanism of how individuals attend to and remember antismoking information. This study examined how message attributes of antismoking TV ads (frame, appeal type, and outcome extremity) interacted to influence people's attention (secondary task reaction time) and memory (recognition). Antismoking public service announcements were chosen that were either loss- or gain-framed, had either a health or social appeal, or had either a more or less extreme outcome described in the message. Among the key findings were that loss-framed messages with more extreme outcomes required the most processing resources (i.e., had the slowest secondary task reaction times) and were the best remembered (i.e., were best recognized). These findings indicate ways that different message attributes affect individuals' cognitive processing, and they are discussed in light of prior framing and persuasion research.     

The Unintended Target: Assessing Nonsmokers' Reactions to Gain- and Loss-Framed Antismoking Public Service Announcements

This study examined nonsmokers' emotional responses and intentions to promote smoking cessation after exposure to a gain- or loss-framed antismoking public service announcement (PSA). Participants were 183 nonsmokers, and results reveal that gain- and loss-framed antismoking PSAs elicited different types and levels of affect as a function of the message theme for the antismoking PSA. Although secondhand smoke PSAs elicited higher levels of anger toward smokers and fear of secondhand smoke, smoking addiction PSAs tended to elicit more guilt among nonsmokers. Elicited emotions were significant predictors of intentions, and overall, loss-framed appeals worked better than gain-framed appeals at increasing nonsmokers' intentions to talk to friends who smoke about quitting.     

Anti-Sugar-Sweetened Beverage Messages Elicit Reactance: Effects on Attitudes and Policy Preferences

Messages that convey the dangers associated with consumption of sugar-sweetened beverages (SSBs) may be the most effective means of changing attitudes toward consumption and policy preferences. However, there is a risk that this message type also stimulates reactance, a form of resistance to persuasion. A study (N = 618) using messages from the 2012 New York City anti-SSB campaign and a sample of New York City residents showed just such effects. Reactance was heightened by prior message exposure, conservative political orientation and prior consumption of SSBs. The net message effect was still persuasive overall for attitudes, but could be improved by 17% if reactance were eliminated. In contrast, the net message effect on policy preferences was counterpersuasive, due to processes other than reactance. Anti-SSB threat appeals can change attitudes toward one’s own behavior in a more healthful direction, while simultaneously eroding support for more restrictive SSB policies.     

The Indirect Effect of Source Information on Psychological Reactance Against Antismoking Messages Through Perceived Bias

This study investigates the indirect effect of source information on attitudes toward antismoking campaigns through perceived bias and psychological reactance by employing a survey experiment (N = 416). Findings demonstrate that an editorial advocating antismoking campaigns from ideologically congruent media is perceived as less biased than the same editorial from hostile media. The perceived bias is linked to perceived threat to freedom, which, in turn, is linked to psychological reactance against the editorial, resulting in less favorable attitudes toward antismoking campaigns. Smokers are more likely to show the linkages than nonsmokers. Implications of the findings are discussed.     

Utilizing Audiovisual and Gain-Framed Messages to Attenuate Psychological Reactance Toward Weight Management Health Messages

Guided by the psychological reactance theory, this study predicted that gain-framed messages and audiovisual content could counteract state reactance and increase the persuasiveness of weight management health messages. Data from a 2 (message frame: gain/loss) × 2 (modality: audiovisual/text) × 2 (message repetition) within-subjects experiment (N = 82) indicated that in the context of weight management messages for college students, gain-framed messages indeed mitigate psychological reactance. Furthermore, the modality and the frame of the health message interacted in such a way that gain-framed messages in an audiovisual modality generated the highest motivations to comply with the recommendations in the persuasive health messages.     

Theories and Messages in South Korean Antismoking Advertising

This study evaluated antismoking advertisements in South Korean television by drawing upon a Health Communication article by Cohen, Shumate, and Gold (2007) and on Gold, Cohen, and Shumate’s (2008) typology. This study examined the theories and messages in South Korean antismoking advertisements. First, South Korean antismoking advertisements primarily targeted adults. In addition, the advertisements for adults normally used statistical evidence, whereas those for adolescents often used testimonial evidence. In terms of the type of performance, narration was often used in advertisements for both adults and adolescents. Second, the most prevalent persuasive health message used social norms, whereas the most prevalent affective appeal used fear appeals. Third, antismoking advertisements in South Korea mentioned more benefits of not smoking than barriers to not smoking. This study also identified the message difference in the U.S. and South Korean antismoking advertisements.     

How Message Fatigue toward Health Messages Leads to Ineffective Persuasive Outcomes: Examining the Mediating Roles of Reactance and Inattention

Message fatigue refers to a state of being exhausted and tired of prolonged exposure to similarly-themed messages (e.g., anti-obesity messages; So, Kim, & Cohen, 2017). This study tests a mediational model that accounts for how one’s preexisting fatigue toward anti-obesity messages may contribute to two different types of resistance—reactance and disengagement—toward an incoming anti-obesity message, which, in turn, reduce intention to adopt weight-management behaviors advocated in the message. The proposed model was tested in an experimental study (N = 312) involving a sample of overweight or obese adults in the United States. In the meditational model, reactance significantly mediated the negative effects of message fatigue on intention to adopt only one of four weight-management behaviors promoted in the message. However, inattention, which was an operationalization of disengagement, significantly mediated the negative effects of message fatigue on behavioral intention to adopt all four weight-management behaviors. This study urges future research on message fatigue and resistance to persuasion to consider disengagement with a message as a significant barrier to effective health communication and to devise ways to increase engagement with messages communicating “overtaught” health issues.     

Beyond Personal Responsibility: Examining the Effects of Narrative Engagement on Communicative and Civic Actions

Moving beyond personal responsibility-taking behaviors, this paper examines communicative (interpersonal talk and online message sharing) and civic (public policy support and intention to donate) behavioral outcomes in the context of narrative persuasion. A web-based experiment was conducted to test the mediating effects of two narrative engagement constructs, transportation and empathy, on these behavioral outcomes. Participants recruited via Amazon Mechanical Turk (n = 467) participated in an experiment conducted on Qualtrics, where they were randomized to read either a narrative or a nonnarrative message about factors contributing to obesity. The narrative message, compared to the nonnarrative message, generated greater transportation and affective empathy but had no overall advantage regarding behavioral outcomes. Path analyses showed consistent, significant indirect effects via transportation and affective empathy on all the outcome variables: online message sharing, interpersonal talk, public policy support, and intention to donate to a non-profit obesity organization. Our study contributes to the extant narrative research by shedding light on how narrative messages, via engaging the audience, could shape social responses beyond personal responsibility-taking. Implications and limitations of findings were discussed.     

Family Communication Patterns Moderate the Relationship Between Psychological Reactance and Willingness to Talk About Organ Donation

Considerable research has investigated how psychological reactance affects individuals' responses to health promotion messages, but little is known about how family processes might moderate the reactance process. In this study, 301 participants were exposed to a persuasive message about organ donation. The moderating role of family communication patterns in the reactance process was tested using hierarchical regression. We found that family conversation orientation had a direct effect on willingness to talk with family members about being an organ donor and that family conformity orientation and family conversation orientation each interacted with reactance to predict willingness to communicate with family about donation. Theoretically, these results extend psychological reactance theory by considering how interpersonal factors affect the reactance process. Practically, the findings suggest that for optimal impact, family processes should be considered in the design of messages promoting organ donation.     

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.     

Family communication patterns moderate the relationship between psychological reactance and willingness to talk about organ donation

Considerable research has investigated how psychological reactance affects individuals' responses to health promotion messages, but little is known about how family processes might moderate the reactance process. In this study, 301 participants were exposed to a persuasive message about organ donation. The moderating role of family communication patterns in the reactance process was tested using hierarchical regression. We found that family conversation orientation had a direct effect on willingness to talk with family members about being an organ donor and that family conformity orientation and family conversation orientation each interacted with reactance to predict willingness to communicate with family about donation. Theoretically, these results extend psychological reactance theory by considering how interpersonal factors affect the reactance process. Practically, the findings suggest that for optimal impact, family processes should be considered in the design of messages promoting organ donation.     

The Role of Narrative and Other-Referencing in Attenuating Psychological Reactance to Diabetes Self-Care Messages

This study charts pathways through message resistance to enhance the persuasiveness of diabetes self-care messages. A 2 (narrative) × 2 (other-referencing) × 2 (message) × 4 (order) experiment with adult diabetics (N = 58) tested whether packaging overt recommendations as a story rather than an informational argument (i.e., narrative structure) and highlighting the impact of health decisions on family and friends rather than the individual (i.e., other-referencing) can effectively attenuate psychological reactance to messages encouraging healthy diet and physical activity. Narrative and other-referencing each led to lower perceived threat to choice, less state anger and counterarguing, less negative cognitive responses, more positive attitudes toward the ad and the behaviors promoted, and greater intended compliance with message recommendations. Findings illustrate two strategies that communicators may employ in order to benefit from clear, direct health messages while avoiding the reactance they may provoke. Moreover, findings inform message design for diabetes self-care education.     

Toward More Persuasive Diabetes Messages: Effects of Personal Value Orientation and Freedom Threat on Psychological Reactance and Behavioral Intention

This study seeks to explore more effective ways of creating tailored health messages in order to help self-management of diabetes symptoms. Personal value orientation and freedom threat as antecedents of psychological reactance are investigated as potential elements reflecting to tailored health messages and leading to more or less persuasive effects on self-management. Using these elements, the current study examines whether invoking an individual’s personal value orientation (i.e., two extreme value orientations: self-enhancement and self-transcendence) and threatening an individual’s freedom in health news messages about diabetes influence psychological reactance and affect suggested health behaviors. Based on the literature regarding tailored message strategies, value theory, and psychological reactance theory, a 2 (personal value orientation: self-enhancement value vs. self-transcendence value) x 2 (value-invoking message: invoked vs. non-invoked) x 2 (freedom threat: high vs. low) between-subjects factorial design experiment with within-subjects topics on diabetes (2: nutrition and physical activity) was conducted for prediabetes/diabetes adults. The findings are (1) direct effects of personal value orientation on psychological reactance, (2) direct effects of freedom threat on psychological reactance, and (3) the interaction effects of value orientation and freedom threat on psychological reactance and behavioral intention. Implications are discussed.     

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.     

Do Emotional Appeals in Public Service Advertisements Influence Adolescents’ Intention to Reduce Consumption of Sugar-Sweetened Beverages?

Mass media campaigns are a commonly used approach to reduce sugary drink consumption, which is linked to obesity in children and adolescents. The present study investigated the direct and mediated effects of emotional appeals in public service advertisements (PSAs) that aired between 2010 and 2012 on adolescents’ intention to reduce their sugar-sweetened beverage (SSB) consumption. An online randomized experiment was conducted with a national sample of adolescent respondents ages 13 to 17 years old (N = 805). Participants were randomly assigned to 1 of 4 conditions. Three experimental conditions represented PSAs with different emotional appeals: humor, fear, and nurturance, plus a fourth control condition. The outcome was adolescents’ intention to cut back on SSBs. The direct effect of fear appeals on intention was mediated through adolescents’ perception of the PSAs’ argument strength; perceived argument strength was also the key mediator for the indirect effects of humor and nurturance on intention. Several hypothesized mediators influenced by the appeals were not associated with intention. This is the first study to test the effect of persuasive emotional appeals used in SSB-related PSAs. The perceived strength of the PSAs’ arguments is important to consider in the communication of messages designed to reduce SSB consumption.     

How neuroticism affects responses to anti-smoking messages

The effect of trait neuroticism on college students' (n=200) responses to anti-smoking public service announcements (PSAs) was examined using a 2 (neuroticism: high vs. low)?× 3 (message type: personal testimony, secondhand smoke, and informative)?× 3 (message: nested within message type) design. We hypothesized that those high in neuroticism would be avoidant toward anti-smoking messages, have quicker and stronger negative reactions and perceive the messages as more biased and less involving. As hypothesized, those high in neuroticism were more likely to want to avoid thinking about smoking as a function of viewing the messages and more likely to see messages as biased; however, neuroticism did not affect judgments of message involvement. Tobacco use and gender also affected message bias and avoidance. Those scoring high in neuroticism also responded quicker to negative emotion assessments to messages. Implications for the importance of neuroticism in message design and message processing research are discussed.