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.     

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.     

The effects of health narratives: Examining the moderating role of persuasive intent

Prior research has indicated that narratives are more persuasive than nonnarrative messages. One of the reasons for this effectiveness is that the narratives’ intention to persuade is often not explicit, thus making them less likely to be disputed. The goal of this research is to examine the moderating role of persuasive intent in narrative persuasion. To do so, we conducted a 2 (Message format: narrative vs. nonnarrative messages) × 2 (Persuasive intent: intent vs. no intent) experiment with a factorial design among 205 participants on the effects of health narrative messages. Results indicated that persuasive intent undermined the effects of health narratives on persuasion by reducing believability and increasing reactance. Both believability and reactance partially mediated the effects of the narrative messages on attitudes and behavioral intention.     

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.     

More on Inoculating Against Reactance to Persuasive Health Messages: The Paradox of Threat

This research examined the efficacy of inoculation as a strategy to mitigate psychological reactance based on the level of threat communicated in the forewarning and subsequent persuasive health appeal. Two 2 (inoculation) × 2 (freedom-threatening language) experiments were conducted. The first (N = 181) used elaborated inoculation designed to enhance the threat of impending reactance to a message advocating for responsible alcohol consumption. The second (N = 159) used limited inoculation designed to minimize the threat of impending reactance to a message advocating for responsible soft drink consumption. Results showed that elaborated inoculation increased reactance, whereas limited inoculation decreased reactance but only when the subsequent appeal used less freedom-threatening language. These findings suggest that inoculation has the potential to facilitate or buffer reactance depending on the level of threat communicated in inoculation forewarnings and in subsequent persuasive health appeals.     

Reactance and Coping Responses to Tobacco Counter-Advertisements

Tobacco prevention messages generally take one of three tactics: They can be educational, attack the tobacco industry, or attack particular brands. Being a smoker and smoking a particular brand may form an essential part of a person’s self-identity. As such, reactance theory suggests that attack messages can unintentionally attack smokers’ self-image. A 2 × 2 × 2 × 2 experiment using six different messages and 260 respondents tested whether smokers have different reactions to tobacco counter-advertisements than nonsmokers. It also examined whether attacking a smoker’s brand leads to greater reactance and other maladaptive responses compared to attacking other brands. Consistent with predictions, smokers reported more maladaptive coping responses and fewer adaptive coping responses to tobacco counter-ads than nonsmokers. The study also reveals differences attributable to brand identification. These findings suggest that interventions should consider different counter-advertising tactics for smokers and nonsmokers. Similar admonitions may apply to counter-advertising strategies on other health issues.     

Promoting Oral Health in Appalachia: Effects of Threat Label and Source Accent on Message Acceptance

ABSTRACT

This study examined the effects of threat label (i.e., the name assigned to a health threat) and source accent (i.e., the source’s manner of pronunciation) on Appalachian residents’ acceptance of oral health promotion messages. Participants (N = 348) listened to an audiotaped oral health promotion message about tooth decay or Mountain Dew Mouth; the message was delivered either in a standard American English or a Southern accent. Compared to the label Mountain Dew Mouth, the label tooth decay elevated perceptions of threat susceptibility, threat severity, and response-efficacy and resulted in higher message acceptance. The effect of threat label on message acceptance was mediated by severity perceptions. Participants attributed more status to the source and agreed more with her message when she spoke in a standard than a Southern accent. The effect of source accent on message acceptance was mediated by status perceptions. These findings suggest that the success of persuasive health messages depends not only on message content (i.e., what is said), but also on how that content is linguistically framed and delivered (i.e., how it is said).     

Persuasive Effects of Linguistic Agency Assignments and Point of View in Narrative Health Messages About Colon Cancer

The authors explored the effects of linguistic agency and point of view on narrative force. Participants (N = 499) were randomly assigned to read one version of an article about colon cancer, defined by a 2 (disease agency: cancer, human) × 2 (temporal agency: death, human) × 2 (point of view: first person, third person) between-subjects design. Disease agency language assigned agency to cancer (e.g., “Cancer developed in me”) or to humans (e.g., “I developed cancer”). Temporal agency language described death as approaching humans (e.g., “as death closes in on patients) or as being approached by humans (e.g., “as patients close in on death”). The narrative was presented from the first-person singular or third-person plural viewpoint. Participants then completed a questionnaire measuring threat perceptions, efficacy, transportation, and other study variables. Language assigning agency to humans rather than to cancer elevated susceptibility beliefs. Death-approach language led to greater fear than human-approach language without impacting efficacy perceptions. Human-approach language was rated more persuasive than death-approach language, but only in first-person point-of-view narratives. Transportation and identification were positively associated with ratings of threat severity and susceptibility, fear, efficacy, behavioral intentions, and message persuasiveness. Implications for message design are discussed.     

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.     

Clicking Health Risk Messages on Social Media: Moderated Mediation Paths Through Perceived Threat,Perceived Efficacy,and Fear Arousal

ABSTRACT

This study drew on appraisal theory to examine how fear appeal messages and individual coping styles combined to drive users’ intention to click (ITC) health risk messages on social media. A 2 × 2 × 2 mixed-design experiment was conducted, with threat and efficacy as between subject factors and message as the within subject factor. The results suggested that: (1) threat and efficacy message influenced ITC via the mediating effect of perceived threat, and perceived efficacy; (2) fear arousal was positively related to intention to click; (3) blunting style used by the participant suppressed fear arousal’s ability to mobilize ITC; and (4) monitoring style had a positive main effect on ITC. Theoretical and practical implications are discussed.     

Inoculating Against Reactance to Persuasive Health Messages

This investigation examined the possibility of decreasing psychological reactance to health campaigns through the use of inoculation messages. It was hypothesized that an inoculation message, which forewarned of the potential of subsequent reactance, would decrease participants’ likelihood of reacting negatively to a freedom-threatening message aimed to reduce excessive alcohol consumption. Participants (N = 275) who were inoculated against potential reactance felt less threatened and experienced less reactance compared to those who did not read an inoculation message. Structural equation modeling showed that inoculation indirectly predicted lower intention to drink alcohol via the theorized mediated reactance process. This research suggests that it is possible to inoculate against self-generated cognitions that might otherwise lead toward negative health behaviors.     

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.     

The Effects of Narrative and Message Framing on Engagement and Eating Intention Among a Sample of Adult Hispanics

ObjectiveTo test the effect of narrative messages and gain- and loss-framed messages on persuasive outcomes with a sample of Hispanic adults.MethodsA 2 (message type: narrative, non-narrative) × 2 (message frame: gain-framed, loss-framed) between subjects posttest only. Data were collected at 2 outdoor festivals in West Texas. Participants were a convenience sample of 72 Hispanic adults (mean age, 40.6 years). Main outcome measures were message engagement, message relevance, attitude toward message, healthy eating intention, and physical activity intention. Data analysis included analysis of variance and multivariate analysis of variance.ResultsThere was no significant difference between narrative and non-narrative messages. Gain-framed messages were rated more positively, whereas loss-framed messages were considered more engaging and also produced higher intentions to eat healthy and to become physically active. The interaction between message type and message framing was not significant.Conclusions and ImplicationsLoss-framed messages produced the unanticipated effect of higher message engagement and higher intention. This finding suggests that messages emphasizing losses associated with unhealthy eating and lack of physical activity may be more effective when targeting Hispanic adults than messages emphasizing potential gains. The lack of difference between narrative and non-narrative messages suggests there is no disadvantage to using narratives, but also no advantage.     

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.     

Developing a Point-of-Sale Health Communication Campaign for Cigarillos and Waterpipe Tobacco

ABSTRACT

Adolescents and young adults smoke waterpipe tobacco (WT) and cigarillos, at least in part, based on erroneous beliefs that these products are safer than cigarettes. To address this challenge, we used a systematic, three-phase process to develop a health communication campaign to discourage WT and cigarillo smoking among at-risk (tobacco users and susceptible non-users) 16- to 25-year-olds. In Phase 1, we used a national phone survey (N = 896) to determine salient message beliefs. Participants reported constituents (i.e., harmful chemicals) emitted by the products were worrisome. In Phase 2, we developed and evaluated four message executions, with varying imagery, tone, and unappealing products with the same constituents, using focus groups (N = 38). Participants rated one execution highly, resulting in our development of a campaign where each message: (1) identified a tobacco product and constituent in the smoke; (2) included an image of an unappealing product containing the constituent (e.g., pesticides, gasoline) to grab attention; and (3) used a humorous sarcastic tone. In Phase 3, we tested the campaign messages (17 intervention and six control) with a nationally representative online survey (N = 1,636). Participants rated intervention and control messages highly with few differences between them. Exposure to messages resulted in significant increases in all risk beliefs from pre to post (p < 0.05). For WT, intervention messages increased beliefs about addiction more than control messages (p < 0.05). This systematic, iterative approach resulted in messages that show promise for discouraging WT and cigarillo use.     

Effects of Consideration of Future Consequences and Temporal Framing on Acceptance of the HPV Vaccine Among Young Adults

This study examines how individual difference in consideration of future consequences (CFC) and temporal framing (i.e., present- vs. future-oriented message) interact to influence the persuasive outcomes of a health message promoting human papillomavirus (HPV) vaccination among young adults. Results of an experiment (N = 416) showed a significant interaction effect of CFC and temporal framing on persuasion. The nature of the interaction suggested that individuals with high CFC generally were more persuaded by the present-oriented messages, compared to the future-oriented messages. On the other hand, those with low CFC responded similarly to the present- and future-oriented messages. Implications of the findings for HPV vaccination messaging are discussed.     

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).     

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

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