A Meta-Analysis of the Effectiveness of Guilt on Health-Related Attitudes and Intentions

Guilt appeals are successful in encouraging healthy behaviors as proved by many studies. However, there has been no previous systematic review of guilt research in health domain. Thus, a meta-analysis of eight studies (2,061 subjects) was conducted to examine the effectiveness of guilt on health-related attitudes and intentions. The result revealed a strong positive overall effect of guilt (r = .49, 95% CI 0.31–0.64) despite the heterogeneity. Guilt had a stronger power in changing attitudes/intentions when paired with text-only messages than text-picture mixed messages. For studies using a college sample, the percentage of females marginally moderated the effect of guilt. Whether a message was self focused or other focused did not significantly moderate the effect of guilt. Future directions and practical implications are provided.     

Effects of Message Framing on Influenza Vaccination: Understanding the Role of Risk Disclosure,Perceived Vaccine Efficacy,and Felt Ambivalence

The current study examined the effects of framing in promotional health messages on intention to vaccinate against seasonal influenza virus. The findings of an experimental study (N = 86) indicated that exposure to both benefits and side effects of vaccination (gain-framed with risk disclosure message) led to lower intention to receive the flu vaccine. This relationship was mediated by both perceived vaccine efficacy and felt ambivalence in a serial order, revealing the underlying psychological mechanisms important for understanding health-related behaviors. Theoretical implications of constructing sub-framed messages are discussed and the concept of second-order framing is introduced.     

Message Framing Strategies to Increase Influenza Immunization Uptake Among Pregnant African American Women

We explored the attitudes, opinions, and concerns of African American women regarding influenza vaccination during pregnancy. As influenza immunization coverage rates remain suboptimal in the United States among this population, we elicited message framing strategies for multicomponent interventions aimed at decreasing future incident cases of maternal and neonatal influenza. Semi-structured in-depth interviews (N = 21) were conducted with pregnant African American women at urban OB/GYN clinics who had not received an influenza vaccine. Interviews were transcribed, subjected to intercoder reliability assessment, and content analyzed to identify common thematic factors related to acceptance of the influenza vaccine and health communication message preferences. Four major themes were identified. These were communication approaches, normal vaccine behavior, pregnancy vaccination, and positive versus negative framing. Two strong themes emerged: positively-framed messages were preferred over negatively-framed messages and those emphasizing the health of the infant. Additionally, previous immunization, message source, and vaccine misperceptions also played important roles in decision-making. The majority of women indicated that positively framed messages focusing on the infant’s health would encourage them to receive an influenza vaccine. Messages emphasizing immunization benefits such as protection against preterm birth and low birth weight outcomes have potential to overcome widespread negative community perceptions and cultural beliefs. Additionally, messages transmitted via interpersonal networks and social media strongly influence motivation to obtain vaccination during pregnancy. The findings of this study will assist in developing tailored messages that change pregnant African American women’s influenza vaccination decision-making to achieve improved coverage.     

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).     

Evaluation of a Social Norms Approach to a Suicide Prevention Campaign

Suicide is a leading cause of death for college-aged youth, and university counseling centers (UCC) strive to educate students about mental health issues and available campus services. The current research evaluates a college campus social norms campaign that used both peer and celebrity sources to promote help seeking among college students as a suicide prevention strategy. Postcampaign surveys of this quasi-experiment (n = 391) revealed that compared to students in the control neighborhood condition, students exposed to the campaign messages in the experimental neighborhood conditions were more likely to perceive students would refer a friend to the UCC and more likely to visit the UCC for a mental health concern. Students living in the intervention neighborhood with a peer message source reported a greater willingness to refer friends to the UCC compared to those who lived in the celebrity and control neighborhoods. Regardless of condition, students who reported seeing UCC messages reported greater effects than those who reported not viewing the messages (e.g., greater intentions to seek help and to talk to others about the UCC). Results of this study are discussed within a social norms framework and support the need for continued exposure to campaign messages to impact health outcomes.     

Communicating to increase public uptake of pandemic flu vaccination in the UK: Which messages work?

BackgroundVaccination is considered the most effective preventive measure against influenza transmission, yet vaccination rates during the 2009/10 influenza A/H1N1 pandemic were low across the world, with the majority of people declining to receive the vaccine. Despite extensive research on the predictors of uptake of influenza vaccination, little research has focused on testing the effectiveness of evidence and theory-based messages.AimsTo examine the persuasiveness of messages promoting vaccination and antiviral use either as health-enhancing or as risk-reducing, as well as messages which conveyed evidence-based information about the costs and benefits of vaccination, or which applied anticipated regret as a motivator for vaccine uptake.MethodWe conducted 11 focus groups with forty-one members of the general population in England including young and older adults, those with lower education, parents, and those with elevated health risk. The data were analysed using thematic analysis.ResultsThe factual, evidence-based messages were well received with participants finding them the most convincing and useful, particularly where they gave cost–benefit comparisons. Health-enhancing messages were received with scepticism and concern that the messages were not honest about the potential lack of safety of vaccination. In contrast, risk-reduction messages were perceived as being more balanced and credible. Messages aiming to elicit feelings of anticipated regret for not getting vaccinated were generally perceived as patronising and unprofessional.ConclusionsVaccination messages should be kept brief, but convey balanced, evidence-based information, and be transparent in their communication of potential side-effects. The general public seem to prefer messages that are factual and emphasise the costs and benefits of vaccination, particularly with regards to vaccine safety.     

Speaking up about Lighting up in Public: Examining Psychosocial Correlates of Smoking and Vaping Assertive Communication Intentions among U.S. Adults

Against a backdrop of increasing smoke-free policies, electronic cigarette use, and discussion about public health risks posed by smoking and vaping, this study examines psychosocial predictors of intentions to ask others not to use e-cigarettes (vape) and smoke - i.e., assertive communication intentions. A national sample of U.S. adults (n = 474) reported assertive communication intentions for public venues. Psychosocial correlates included perceived risks of exposure to secondhand smoke (SHSe) and secondhand vapor (SHVe), SHSe and SHVe attitudes, subjective norms, and perceived self-efficacy. Separate linear regression models were conducted for smoking and vaping assertive communication intention outcomes. Perceived risks and self-efficacy were associated with greater vaping and smoking assertive communication intentions; subjective norms were only significant for vaping assertive communication intentions. Although a majority of respondents indicated they were unlikely to intervene to voice objections about SHSe and SHVe in public venues, this study suggests that incidental or intentional messages and policies that influence perceptions of risk, norms, and efficacy could affect willingness to voice objections about others’ vaping and smoking in public.     

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.     

Reducing Concurrent Sexual Partnerships Among Blacks in the Rural Southeastern United States: Development of Narrative Messages for a Radio Campaign

In the United States, heterosexual transmission of HIV infection is dramatically higher among Blacks than among Whites. Overlapping (concurrent) sexual partnerships promote HIV transmission. The authors describe their process for developing a radio campaign (Escape the Web) to raise awareness among 18–34-year-old Black adults of the effect of concurrency on HIV transmission in the rural South. Radio is a powerful channel for the delivery of narrative-style health messages. Through six focus groups (n = 51) and 42 intercept interviews, the authors explored attitudes toward concurrency and solicited feedback on sample messages. Men were advised to (a) end concurrent partnerships and not to begin new ones; (b) use condoms consistently with all partners; and (c) tell others about the risks of concurrency and benefits of ending concurrent partnerships. The narrative portrayed risky behaviors that trigger initiation of casual partnerships. Women were advised to (a) end partnerships in which they are not their partner's only partner; (b) use condoms consistently with all partners; and (c) tell others about the risks of concurrency and benefits of ending concurrent partnerships. Messages for all advised better modeling for children.     

Short and Sweet: The Persuasive Effects of Message Framing and Temporal Context in Antismoking Warning Labels

Current warning labels on cigarette packages are generally focused on long-term losses that can be incurred if one continues smoking. This study compares the effects of these labels against warning labels that stress short-term losses of smoking as well as labels that stress short- and long-term benefits that can be obtained when one quits smoking. A 2 (message frame: gain vs. loss) × 2 (temporal context: short vs. long term) between-subjects experiment was conducted among 132 smokers, with attitude toward quitting smoking and intention to quit smoking, as well as information-seeking behavior and message recall, as the dependent variables. Findings were in line with theory regarding message framing and temporal discounting, showing enhanced effects of gain over loss frames and short-term over long-term consequences on warning labels for attitudes and intentions. In addition, an interaction between message frame and temporal context was found. Especially, gain-framed messages showed stronger effects on intentions to quit smoking than loss-framed messages when warning labels concerned short-term outcomes. Findings suggest that current warning labels, with an emphasis on long-term negative health outcomes, should be reconsidered.     

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.     

Factors influencing pandemic influenza vaccination of healthcare workers--a systematic review

Introduction

Maintaining the health and availability of Health care workers (HCW) is an essential component of pandemic preparedness. A key to protecting HCW during the H1N1 pandemic was influenza vaccination. Numerous researchers have reported on factors influencing H1N1 vaccination behaviour in various HCW groups. This systematic review aims to inform future influenza vaccine interventions and pandemic planning processes via the examination of literature in HCW H1N1 vaccination, in order to identify factors that are (1) unique to pandemic influenza vaccination and (2) similar to seasonal influenza vaccination research.

Methods

We conducted a comprehensive review of literature (MEDLINE, PubMed, EMBASE, PsycINFO, CINHAL, AMED, Cochrane Library, ProQuest, and grey literature sources) published between January 2005 and December 2011 to identify studies relevant to HCW pH1N1 vaccine uptake/refusal.

Results

20 publications sampling HCW from different geographic regions are included in this review. H1N1 vaccine coverage was found to be variable (9–92%) across HCW populations, and self-reported vaccine status was the most frequently utilized predictor of pandemic vaccination. HCW were likely to accept the H1N1 vaccine if they perceived, (1) the H1N1 vaccine to be safe, (2) H1N1 vaccination to be effective in preventing infection to self and others (i.e. loved ones, co-workers and patients), and (3) H1N1 was a serious and severe infection. Positive cues to action, such as the access of scientific literature, trust in public health communications and messaging, and encouragement from loved ones, physicians and co-workers were also found to influence HCW H1N1 uptake. Previous seasonal influenza vaccination was found to be an important socio-demographic predictor of vaccine uptake. Factors unique to HCW pandemic vaccine behaviour are (1) lack of time and vaccine access related barriers to vaccination, (2) perceptions of novel and rapid pandemic vaccine formulation, and (3) the strong role of mass media on vaccine uptake.

Conclusions

Many of the factors that influenced HCW pandemic vaccination decisions have previously been reported in seasonal influenza vaccination literature, but some factors were unique to pandemic vaccination. Future influenza vaccine campaigns should emphasize the benefits of vaccination and highlight positive cues to vaccination, while addressing barriers to vaccine uptake in order to improve vaccine coverage among HCW populations. Since pandemic vaccination factors tend be similar among different HCW groups, successful pandemic vaccination strategies may be effective across numerous HCW populations in pandemic scenarios.     

Uncertainty Management Following a Positive Newborn Screening for Cystic Fibrosis

Text messaging is a potential HIV-prevention tool for men who have sex with men (MSM), specifically young MSM and MSM of color. To determine the willingness of MSM to receive text messages as part of an HIV-prevention intervention, we administered an online survey to MSM recruited from MySpace.com, which included questions about mobile phone ownership and willingness to participate in a future text message–based HIV research study. Of participants, 85% (n = 5,378) reported owning a mobile phone and 49% (n = 2,483) of mobile phone owners reported being willing to receive text messages in a future HIV research study. Black and Hispanic men were more willing than White non-Hispanic men to receive text messages. Men with a college degree were less willing to receive texts than men with a high school level of education, and men >22 years old were less likely to be willing to receive texts than those younger than 22 years of age. The authors' findings demonstrate that willingness to receive text messages as part of an HIV research study is moderate, and mirrors patterns of text message use in age and race. Variations in willingness should be taken into account when designing and implementing future interventions.     

A qualitative exploration of responses to self‐compassion in a non‐clinical sample

Research suggests that being self‐compassionate can have myriad benefits, including life satisfaction, health‐promoting behaviours and improved mental health. Given the possible advantages of being self‐compassionate, it seems critical to explore how to promote this in the general population. This qualitative study aimed to understand responses to the idea of being compassionate to oneself within the general population. Semi‐structured interviews were conducted in the North East of England between October 2014 and February 2015, they were analysed using thematic analysis. As part of an intervention study, non‐clinical volunteers watched a psychoeducation video about the concept of self‐compassion and then participated in one of four meditation exercises. Following this, participants were interviewed about their responses to the idea of being self‐compassionate. Three themes were identified: Benefits of Self‐Compassion; Being Self‐Compassionate and Barriers to Self‐Compassion. Participants believed that being self‐compassionate would be beneficial, for both themselves and the world, but they believed that self‐compassion would make them vulnerable and that others would judge them. Thus, participants were afraid to be the first ones to be self‐compassionate and stated that, in order for self‐compassion to be acceptable, we need to change the perspective of western culture. These findings underscore the importance of understanding society's role in a person's ability to be self‐compassionate. In order to reap the benefits of self‐compassion, we need to create a culture that accepts and encourages this. As practitioners, we are in a position to lead in self‐compassion and to encourage other leaders to promote this as a preventative mental health strategy.     

HPV Vaccine Information in the Blogosphere: How Positive and Negative Blogs Influence Vaccine-Related Risk Perceptions,Attitudes, and Behavioral Intentions

This research examines the impact of exposure to online blogs about the human papillomavirus (HPV) vaccine on vaccine-related risk perceptions, attitudes, and behavioral intentions. In a controlled experiment (N = 341), college students were exposed to either a negative blog post about the HPV vaccine or a positive one. Compared to the control group, participants who had viewed the negative blog perceived the vaccine as less safe, held more negative attitudes toward the vaccine, and had reduced intentions to receive the vaccine. In contrast, exposure to the positive blog did not alter any vaccine-related risk perceptions, attitudes, or intentions. Implications of the findings for online vaccine risk communication are discussed.     

Subjective Reality: The Influence of Perceived and Objective Conversational Valence on Binge Drinking Determinants

Previous studies have shown that interpersonal communication, and particularly perceived conversational valence (i.e., the perceived negativity or positivity of conversations) about health topics, influences health determinants. On the basis of 43 dyads (N = 86) discussing the topic of alcohol consumption, this study is the first to show that whereas perceived and objective conversational valence are positively related, only perceived conversational valence is a significant predictor of binge drinking attitudes and intentions. Thus, subjective reality matters more than objective reality. Furthermore, only the perceived valence of the participants’ own contributions—and not of their conversation partners—influences binge drinking intentions, indicating that self-persuasion is more influential than persuasion by others. Thus, conversations in which discussants themselves express negative opinions about unhealthy behaviors can enhance public health.     

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.