Does it matter who’s at risk?: Testing message framing and narrative as moderators of the effects of self-referencing in obesity prevention messages targeting Hispanic adults living in the U.S.

Abstract

This study tested whether the effect of self-referencing in a health-marketing message was amplified or attenuated when combined with message framing and narrative. Hispanic adults (N?=?146) were randomly assigned to read and respond to an obesity prevention message. Self-referencing messages generated greater cognitive elaboration but only when placed in a narrative. Conversely, self-referencing messages highlighting health risks of obesity produced higher levels of involvement and intention to increase physical activity and healthy eating. Health marketing professionals can use these findings to enhance the effectiveness of obesity prevention messages that target Hispanic adults.     

Role of Narrative Perspective and Modality in the Persuasiveness of Public Service Advertisements Promoting HPV Vaccination

In the context of public service advertisements promoting human papillomavirus (HPV) vaccination, the current research examines 1) the relative persuasiveness of narrative vs. non-narrative messages and 2) the influence of narrative perspective (first- vs. third-person) and modality (text-based vs. audio-based) on message effectiveness. Results of a controlled experiment (N = 121) suggested that both a non-narrative message and a first-person narrative message led to greater perceived risk of getting HPV than a third-person narrative message. There was no difference in risk perception between the non-narrative and first-person narrative conditions. These findings were confined to the text-based condition, however. When the messages were audio-based, no differential message effects were detected. The analysis also provided partial evidence for an indirect effect of narrative perspective on intentions to vaccinate against HPV through HPV risk perception. Theoretical and practical implications of the findings are discussed.     

Designing Anti-Binge Drinking Prevention Messages: Message Framing vs. Evidence Type

We investigated whether presenting anti-binge drinking health campaign messages in different message framing and evidence types influences college students’ intention to avoid binge drinking, based on prospect theory (PT) and exemplification theory. A 2 (message framing: loss-framed message/gain-framed message) X 2 (evidence type: statistical/narrative) between-subjects factorial design with a control group was conducted with 156 college students. College students who were exposed to the loss-framed message condition exhibited a higher level of intention to avoid binge drinking in the near future than those who did not see any messages (the control group). This finding was mainly among non-binge drinkers. Regardless of evidence type, those who were exposed to the messages exhibited a higher level of intention to avoid binge drinking than those in the control group. This is also mainly among non-binge drinkers. We also found the main effects of message framing and evidence type on attitude toward the message and the main effect of message framing on attitude toward drinking.     

Assessing the Potential Use of Narrative and the Entertainment Education Strategy In an mHealth Text-Message Intervention

As the use of mobile phones for health promotion continues to grow, more work needs to be done to determine which health communication strategies are influential on mobile devices. In two studies conducted with college women in the United States, we assessed the potential for the use of narratives, a strategy found successful in a number of communication channels, in a text-message intervention. The first study consisted of seven focus groups with young women (n = 31) about their perceptions of narrative storylines in a text-message intervention about alcohol and casual sexual encounters. In a second study, we then used an experiment (n = 137) to test the potential of narrative messages to influence transportation, counter-arguing, identification, attitudes toward the intervention type, and attitudes toward the messages. Results showed that women were interested in the possibility of receiving health messages, including narrative health messages, via text message. However, the experiment found limited differences between narrative, non-narrative, and control conditions. Transportation was greater in the narrative condition than in the control, but did not significantly differ from the non-narrative condition. Counter-arguing was also greater in the narrative condition than in the non-narrative condition. Participants who viewed the narrative messages had more positive attitudes toward the messages. Based on both studies, we found that the use of narratives in text messages may be a promising strategy, but it may be a challenge to craft effective content.     

Differential Effects of Message Framing on Obesity Policy Support Between Democrats and Republicans

This study tests whether gain- and loss-framed messages about establishing obesity-reducing policies have different persuasive effects on Republicans and Democrats. In a randomized between-subject experiment, participants (N = 384) read a message emphasizing either benefits to a society by establishing policies aimed to reduce obesity (i.e., gain-framed message) or costs to a society that fails to establish those policies (i.e., loss-framed message). Results indicated that Democrats perceived the gain-framed message as more persuasive than the loss-framed message and the perceived argument strength fully mediated the framing effect on Democrats’ policy support; however, there was no framing effect on perceived argument strength among Republicans. On the other hand, the gain-framed message led Republicans to attribute the cause of obesity less to the individual level compared to the loss-framed message and the no-message condition. We observed no framing difference among Democrats on causal attributions. Theoretical and practical implications of these findings are discussed.     

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.     

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.     

Different Frames to Reduce Red Meat Intake: The Moderating Role of Self-Efficacy

ABSTRACT

Previous research has shown that messages aimed at reducing red meat intake often do not have the expected effect. In the present study, we tested whether prefactual (“If… then”) or factual messages focused on health or wellbeing concerns have different persuasive effects depending on the recipient’s level of eating self-efficacy. Young adult participants (N = 247) completed a questionnaire measuring their eating self-efficacy and current red meat consumption. They were then presented with a prefactual or factual version of a message describing the possible negative impact of excessive red meat consumption on either health or wellbeing. After reading the message participants reported their involvement with the message and intention to eat red meat in the future. Results showed that prefactual wellbeing messages and factual health messages trigger participants’ involvement and, in turn, reduce their intention to eat red meat more than the other message combinations. Eating self-efficacy moderates these effects, with factual health messages persuading people with high self-efficacy and prefactual wellbeing messages persuading also receivers with an average level of self-efficacy. Discussion focuses on which message frames can be more effective in promoting a reduction in red meat consumption in a wider population.     

Sensation Seeking as a Moderator of Gain- and Loss-Framed HIV-Test Promotion Message Effects

This study used an experiment (N = 504) to test whether the fit between sensation-seeking disposition and frame enhances the persuasiveness of gain- and loss-framed HIV test promotion messages. Gain- and loss-framed messages may be consistent with low and high sensation seekers’ disposition with respect to risk behavior. We hypothesized that a loss-framed message would be more persuasive for high sensation seekers and that a gain-framed message should be more effective for low sensation seekers. We also expected elaboration to mediate the interaction. Results demonstrated the hypothesized interaction. When the message frame fit with the viewer's way of thinking, the persuasive power of the message was enhanced. The mediation hypothesis was not supported. Practical implications for targeting and message design are discussed.     

Reading or Listening to a Gain- or Loss-Framed Health Message: Effects of Message Framing and Communication Mode in the Context of Fruit and Vegetable Intake

Gain-framed health messages are found to be more effective when targeting prevention behaviors. However, framing research has only minimally investigated the role of communication mode, another important factor in health communication. This study explored the role of communication mode in interaction with message framing, and the influence of two individual differences related to involvement as conditions under which gain framing can lead to health behavior change. Participants (N = 258) were exposed to either an auditory or written health message concerning fruit and vegetable intake, with either gain- or loss-framed arguments. In addition, the online experiment consisted of baseline and posttest measures, among which intention to consume sufficient fruit and vegetables. Moderating effects of perceived baseline fruit and vegetable consumption and baseline intention were assessed. A significant interaction between message framing and communication mode was observed: In case of a gain-framed message, an auditory message resulted in a higher intention than a written message. This pattern was most explicitly found among those with a lower perceived fruit and vegetable intake at baseline. Although further research is warranted in health persuasion research, the findings can possibly be used to target health interventions better at specific groups of people who behave less healthy.     

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.     

Acceptability of the H1N1 vaccine among older adults: the interplay of message framing and perceived vaccine safety and efficacy

This study examines the relative effectiveness of using gain- versus loss-framed messages to promote H1N1 vaccination among older adults, focusing on the moderating roles of perceived vaccine safety and efficacy. An experiment was conducted with older adults recruited from senior centers in the state of Maryland. Results show that older adults who perceived low vaccine efficacy developed greater intentions to receive the vaccine when presented with a loss-framed message (versus a gain-framed message). For those who perceived high vaccine efficacy, message framing did not make a difference in postexposure intentions. Evidence regarding the interaction between message framing and perceived vaccine safety is limited. Theoretical and practical implications of the findings are discussed.     

Acceptability of the H1N1 Vaccine Among Older Adults: The Interplay of Message Framing and Perceived Vaccine Safety and Efficacy

This study examines the relative effectiveness of using gain- versus loss-framed messages to promote H1N1 vaccination among older adults, focusing on the moderating roles of perceived vaccine safety and efficacy. An experiment was conducted with older adults recruited from senior centers in the state of Maryland. Results show that older adults who perceived low vaccine efficacy developed greater intentions to receive the vaccine when presented with a loss-framed message (versus a gain-framed message). For those who perceived high vaccine efficacy, message framing did not make a difference in postexposure intentions. Evidence regarding the interaction between message framing and perceived vaccine safety is limited. Theoretical and practical implications of the findings are discussed.     

General Audience Engagement With Antismoking Public Health Messages Across Multiple Social Media Sites: Comparative Analysis

BackgroundPublic health organizations have begun to use social media to increase awareness of health harm and positively improve health behavior. Little is known about effective strategies to disseminate health education messages digitally and ultimately achieve optimal audience engagement.ObjectiveThis study aims to assess the difference in audience engagement with identical antismoking health messages on three social media sites (Twitter, Facebook, and Instagram) and with a referring link to a tobacco prevention website cited in these messages. We hypothesized that health messages might not receive the same user engagement on these media, although these messages were identical and distributed at the same time.MethodsWe measured the effect of health promotion messages on the risk of smoking among users of three social media sites (Twitter, Facebook, and Instagram) and disseminated 1275 health messages between April 19 and July 12, 2017 (85 days). The identical messages were distributed at the same time and as organic (unpaid) and advertised (paid) messages, each including a link to an educational website with more information about the topic. Outcome measures included message engagement (ie, the click-through rate [CTR] of the social media messages) and educational website engagement (ie, the CTR on the educational website [wCTR]). To analyze the data and model relationships, we used mixed effects negative binomial regression, z-statistic, and the Hosmer-Lemeshow goodness-of-fit test.ResultsComparisons between social media sites showed that CTRs for identical antitobacco health messages differed significantly across social media (P<.001 for all). Instagram showed the statistically significant highest overall mean message engagement (CTR=0.0037; 95% CI 0.0032-0.0042), followed by Facebook (CTR=0.0026; 95% CI 0.0022-0.0030) and Twitter (CTR=0.0015; 95% CI 0.0013-0.0017). Facebook showed the highest as well as the lowest CTR for any individual message. However, the message CTR is not indicative of user engagement with the educational website content. Pairwise comparisons of the social media sites differed with respect to the wCTR (P<.001 for all). Messages on Twitter showed the lowest CTR, but they resulted in the highest level of website engagement (wCTR=0.6308; 95% CI 0.5640-0.6975), followed by Facebook (wCTR=0.2213; 95% CI 0.1932-0.2495) and Instagram (wCTR=0.0334; 95% CI 0.0230-0.0438). We found a statistically significant higher CTR for organic (unpaid) messages (CTR=0.0074; 95% CI 0.0047-0.0100) compared with paid advertisements (CTR=0.0022; 95% CI 0.0017-0.0027; P<.001 and P<.001, respectively).ConclusionsOur study provides evidence-based insights to guide the design of health promotion efforts on social media. Future studies should examine the platform-specific impact of psycholinguistic message variations on user engagement, include newer sites such as Snapchat and TikTok, and study the correlation between web-based behavior and real-world health behavior change. The need is urgent in light of increased health-related marketing and misinformation on social media.     

Temporal Consequences,Message Framing,and Consideration of Future Consequences: Persuasion Effects on Adult Fruit Intake Intention and Resolve

Message framing is a persuasive strategy that has seen mixed evidence for promoting fruit intake intentions, potentially because framed messages for fruit intake have not (a) explicitly compared short-term consequences versus long-term consequences, (b) considered individual-level differences in time perspective, and (c) used alternative measures of fruit intake intentions. In the present online study, the effects of persuasive messages created from temporal context (short term vs. long term) and message frame (gain framed vs. loss framed) were investigated on fruit intake intentions and resolve among a sample of Dutch adults who were categorized as either present oriented or future oriented. For intention and resolve, results showed a significant Type of Frame × Type of Temporal Context interaction, such that gain-framed messages were more persuasive when combined with long-term consequences and loss-framed messages were more persuasive when combined with short-term consequences. The effect sizes for these differences were similar for resolve and intention, but only differences for intentions were significant. No other effects were found. These results demonstrate that message framing theory may usefully consider the inclusion of temporal context of outcomes and alternative motivation measures to maximize their persuasive effects.     

Making Vaccine Messaging Stick: Perceived Causal Instability as a Barrier to Effective Vaccine Messaging

Health officials often face challenges in communicating the risks associated with not vaccinating, where persuasive messages can fail to elicit desired responses. However, the mechanisms behind these failures have not been fully ascertained. To address this gap, an experiment (N = 163) tested the differences between loss-framed messages—one emphasizing the consequence of not receiving a flu vaccine; the other emphasizing the consequence of receiving the flu vaccine. Despite an identical consequence (i.e., Guillain–Barre syndrome), the message highlighting the consequence of not receiving the flu vaccine produced lower negative affect scores as compared to the message highlighting the consequence of receiving the flu vaccine. Mediation analyses suggest that one reason for this difference is due to non-vaccination being perceived as temporary and reversible, whereas vaccination is perceived as being permanent. Implications on health communication and future research are discussed.     

Impacts of Message Framing and Social Distance in Health Campaign for Promoting Regular Physical Exercise

We investigated effects of message framing and social distance on individuals’ attitude toward health campaign and behavioral intention. Individuals who read a gain-framed message had better attitude toward the campaign and higher level of behavioral intention than those who read a loss-framed message. Perceived benefits mediated the relationship between message framing and behavioral intention. Perceived severity mediated the relationship between social distance and behavioral intention only in the loss framing condition. Theoretical and practical implications were discussed.     

The Moderating Role of Mood and Personal Relevance on Persuasive Effects of Gain- and Loss-Framed Health Messages

We predicted that mood would moderate the relation between message framing and two outcome variables, message evaluation and behavioral intention, when the message was personally relevant to the target audience. Participants (N = 242) were randomly assigned to an experimental condition in which a positive or negative mood was induced. Participants then read and evaluated a health message that emphasized potential benefits or risks associated with a vaccine. As predicted, participants who received a loss-framed message reported higher message evaluation and intention scores but only when the message was personally relevant and they were in a positive mood.