Relative Persuasiveness of Gain‐ Versus Loss‐Framed Human Papillomavirus Vaccination Messages for the Present‐ and Future‐Minded

This research examines how young adults' attitudes toward human papillomavirus (HPV) vaccination and their intentions to get the vaccine are influenced by the framing of health messages (gain vs. loss) and time orientation (i.e., the extent to which people value immediate vs. distant consequences of their decisions). Results of an experiment showed an overall persuasive advantage for loss‐framed messages. Attitudes and behavioral intentions toward HPV vaccination were found to be more favorable among future‐minded individuals. Moreover, an interaction between framing and time orientation was found to predict persuasive outcomes. Present‐minded participants responded more favorably to the loss‐framed message, whereas future‐minded participants were equally persuaded by both frames. Implications of the findings for vaccine risk communication are discussed.     

Examining the Influence of Self-Efficacy on Message-Framing Effects: Reducing Salt Consumption in the General Population

Health-promoting messages can be framed in terms of the gains associated with healthy behavior or the losses associated with unhealthy behavior. Studies show inconsistent results as to which type of framing is more effective. In this study, we investigated whether participants' self-efficacy to decrease salt intake would moderate the effects of gain- and loss-framed messages promoting a low-salt diet on information acceptance, intention, and behavior. We hypothesized that loss-framed messages would more effectively decrease salt intake than gain-framed messages, but only when participants had high self-efficacy. A total of 575 adults, recruited from an Internet panel, took part in the study. Half of the participants received self-efficacy enhancing information, whereas the other half received no such information. After this self-efficacy manipulation, half of the participants received a gain-framed and half of the participants received a loss-framed message promoting a low-salt diet. Information acceptance and intention were assessed at immediate posttest and salt consumption was assessed at a 3-week follow-up. The results revealed the hypothesized effect on behavior. However, the interaction between self-efficacy and framing on salt consumption was not mediated by measures of information acceptance and intention to reduce salt intake. Our results suggest that messages stressing losses may be more effective than messages stressing gains in decreasing salt intake but only in persons with high self-efficacy to do so.     

Message framing and color priming: How subtle threat cues affect persuasion

Message framing involves the presentation of equivalent decision outcomes in terms of either gains or losses. Loss-framed messages tend to be more persuasive than gain-framed messages when the decision is perceived to involve uncertainty or threat. The current study examined whether the effectiveness of loss-framed information would be enhanced by the presence of a peripheral threat cue - the color red - which was expected to prime threat via its association with blood and danger. In addition to being primed with the color red or gray (control), male participants (n = 126) read either a gain- or loss-framed pamphlet promoting human papillomavirus vaccination. As predicted, vaccination intentions were higher among participants exposed to a loss-framed message than to a gain-framed message, but only when primed with red (not gray). Findings shed light on the interactive effects of message framing and color priming, and demonstrate that peripheral threat cues may affect processing of persuasive health messages.     

Dispositional motivations and message framing: a test of the congruency hypothesis in college students.

The authors examined the congruency hypothesis that health messages framed to be concordant with dispositional motivations will be most effective in promoting health behaviors. Undergraduate students (N=63) completed a measure of approach/avoidance orientation (behavioral activation/inhibition system) and read a gain- or loss-framed message promoting flossing. Results support the congruency hypothesis: When given a loss-framed message, avoidance-oriented people reported flossing more than approach-oriented people, and when given a gain-framed message, approach-oriented people reported flossing more than avoidance-oriented people. Discussion centers on implications for health interventions and the route by which dispositional motivations affect health behaviors through message framing.     

Approach/avoidance motivation, message framing, and health behavior: understanding the congruency effect

Health messages framed to be congruent with individuals’ approach/avoidance motivations have been found to be more effective in promoting health behaviors than health messages incongruent with approach/avoidance motivations. This study examines the processes underlying this congruency effect. Participants (undergraduate students, N=67) completed a measure of approach/avoidance orientation (the BIS/BAS scales) and read either a gain- or loss-framed message promoting dental flossing. Results demonstrated a congruency effect: Participants who read a congruently framed message had greater flossing efficacy, intended to floss more, and used more dental flosses than did the participants who read an incongruent message. Moreover, intention to perform the behavior predicted the congruency effect and self-efficacy mediated participants’ intentions to perform the health behavior. Discussion centers on the role of personality factors and situational factors in models of behavior change.

The influence of self‐efficacy on the effects of framed health messages

Health promoting messages can be framed in terms of the gains that are associated with healthy behaviour, or the losses that are associated with unhealthy behaviour. In this study, we examined the influence of self‐efficacy to quit smoking on the effects of gain framed and loss framed anti‐smoking messages in a randomized controlled trial among 539 adult smokers. Participants with a high self‐efficacy to quit smoking reported higher levels of motivation to quit smoking after receiving a loss framed message than after receiving a gain framed message or no message. For these participants receiving a gain framed message did not result in a higher motivation to quit smoking than receiving no message. For participants with a low self‐efficacy to quit smoking there were no differences in motivation to quit smoking between the gain framed message condition, loss framed message condition and control condition. Our results suggest that self‐efficacy can moderate the effects of message framing on persuasion. Copyright © 2008 John Wiley & Sons, Ltd.     

The role of message framing in promoting MMR vaccination: evidence of a loss-frame advantage

This study examined the effects of message framing on intentions to obtain the measles, mumps and rubella (MMR) vaccine for one's child and investigated whether Theory of Planned Behaviour (TPB) and perceived outcome efficacy variables mediate and/or moderate message framing effects. One hundred and forty women read either a loss-framed or gain-framed message and then completed measures assessing their intentions to obtain the MMR vaccine for their child, and TPB and outcome efficacy variables. Exposure to the loss frame increased intentions to obtain the MMR vaccine and influenced perceptions of outcome efficacy. This suggests that outcome efficacy, but not other TPB variables may mediate framing effects within the context of MMR vaccination. Message frame, in addition to TPB variables, significantly predicted unique variance in behavioural intentions. These findings are discussed within the context of Prospect Theory, perceived risk and prevention/detection behaviours.     

Visual and Auditory Message Framing Effects on Tobacco Smoking1

Persuasive health messages can be framed to emphasize the benefits of adopting a health behavior (gains) or the risks of not adopting it (losses). This study examined the effects of message framing on beliefs, attitudes, and behaviors relevant to cigarette smoking. In video presentations about tobacco smoking, visual images and auditory voiceover content were framed either as gains or losses, yielding 4 message conditions. Undergraduates (N= 437) attending a public university in New England were assigned randomly to view one of these messages. Gain‐framed messages about smoking in visual and auditory modalities shifted smoking‐related beliefs, attitudes, and behaviors in the direction of avoidance and cessation. Health‐communication experts, when promoting prevention behaviors like smoking avoidance or cessation, may wish to diverge from the tradition of using loss‐framed messages and fear appeals in this domain, and instead consider using gain‐framed appeals that present the advantages of not smoking.     

Message framing and color combination in the perception of medical information

A 2 x 2 between-subjects design was used to examine the effects of message framing (gain vs loss) and color combination (red background with white characters vs white background with black characters) on 120 university students' perception of materials promoting the H1N1 flu vaccine and their willingness to receive the vaccine after they had read the materials. Each participant completed a 6-item questionnaire, and the results of an analysis of variance showed that participants rated vaccine information presented through loss-framed messages as having greater interest and leading to greater understanding. Loss-framed messages presented on a white background with black characters significantly increased the willingness of the participants to receive the vaccine.     

Promoting Safe Driving Behaviors: The Influence of Message Framing and Issue Involvement

This study examined the influence of framing and issue involvement on the intentions of participants to perform safe driving behaviors. It was hypothesized that when participants were involved with the issue, gain messages would increase intentions to perform safe driving behaviors more than would loss messages. To examine this hypothesis, participants were classified as either being high or low in involvement, and then were required to read either a gain or a loss message promoting a particular safe-driving behavior. After reading the message, the participants' agreement with the message, cognitive and affective responses to the message, and intentions to perform the behavior were recorded. The results supported the hypothesis.     

The Effects of Source Credibility and Message Framing on Exercise Intentions,Behaviors, and Attitudes: An Integration of the Elaboration Likelihood Model and Prospect Theory1

This study examined the influence of source credibility and message framing on promoting physical exercise in university students. Participants were randomly assigned to reading a positively or negatively framed communication that was attributed to either a credible or a noncredible source. Exercise intentions and attitudes were measured immediately following the delivery of the communication and following a 2‐week delay. Exercise behavior was also measured following the delay. There were Source Frame interactions for the exercise intentions, exercise behaviors, and cognitive response/elaboration measures such that participants receiving a positively framed communication from a credible source elaborated more and reported more positive exercise intentions and behaviors than participants in the other conditions. The results of the present investigation indicate that it might be beneficial for health professionals to provide exercise‐related information stressing the benefits of participating in exercise, rather than the traditional fear appeals, to motivate clients to engage in regular physical exercise. Implications for future research are discussed.     

The cultural congruency effect: Culture, regulatory focus, and the effectiveness of gain- vs. loss-framed health messages

The present study contributes a cultural analysis to the literature on the persuasive effects of matching message frame to individuals’ motivational orientations. One experiment examines how members of cultural groups that are likely to differ in their regulatory focus respond to health messages focusing on either the benefits of flossing or the costs of not flossing. White British participants, who had a stronger promotion focus, were more persuaded by the gain-framed message, whereas East-Asian participants, who had a stronger prevention focus, were more persuaded by the loss-framed message. This cultural difference in persuasion was mediated by an interaction between individuals’ self-regulatory focus and type of health message. Thus health messages framed to be culturally congruent led participants to have more positive attitudes and stronger intentions to perform the health behaviors, and the interaction between self-regulatory focus and message frame emerged as the pathway through which the observed cultural difference occurs. Discussion focuses on the integration of individual difference, socio-cultural, and situational factors into models of health persuasion.     

Effective communication of risks to young adults: using message framing and visual aids to increase condom use and STD screening

Sexually Transmitted Diseases (STDs)-including HIV/AIDS-are among the most common infectious diseases in young adults. How can we effectively promote prevention and detection of STDs in this high risk population? In a two-phase longitudinal experiment we examined the effects of a brief risk awareness intervention (i.e., a sexual health information brochure) in a large sample of sexually active young adults (n = 744). We assessed the influence of gain- and loss-framed messages, and visual aids, on affective reactions, risk perceptions, attitudes, behavioral intentions, and reported behaviors relating to the prevention and detection of STDs. Results indicate that gain-framed messages induced greater adherence for prevention behaviors (e.g., condom use), whereas loss-framed messages were more effective in promoting illness-detecting behaviors (e.g., making an appointment with a doctor to discuss about STD screening). The influence of the framed messages on prevention and detection of STDs was mediated by changes in participants' attitudes toward the health behaviors along with changes in their behavioral intentions. Moreover, when visual aids were added to the health information, both the gain- and loss-framed messages became equally and highly effective in promoting health behaviors. These results converge with other data indicating that well-constructed visual aids are often among the most highly effective, transparent, fast, memorable, and ethically desirable means of risk communication. Theoretical, economic, and public policy implications of these results are discussed.     

The persuasive effects of framing messages on fruit and vegetable consumption according to regulatory focus theory

According to Regulatory Focus theory (RFT), outcomes in persuasive messages can be framed in four different ways, as gains, non-gains, losses or non-losses. In study 1, the persuasiveness of all four frames was compared and the presence/absence effect that was expected on the basis of the feature-positive effect was verified: Statements about present outcomes (gain, loss) were more persuasive than those about absent outcomes (non-gain, non-loss). However, this study failed to support the prediction that a gain-framed message would be more persuasive than a loss-framed message when promoting a prevention behaviour. Study 2 was designed to examine the latter finding. It was hypothesised that the threat posed by the loss-framed message in study 1 was too low to elicit a defensive reaction. Therefore, in study 2, the personal relevance of the gain and the loss framed message was manipulated. Consistent with predictions, the gain-framed message was more persuasive than the loss-framed message, but only when the message was personalised to increase self-relevance. Moreover, the effect was due to a significant drop in persuasion in the loss condition, probably caused by a defensive reaction. These data shed a new light on the findings of past framing studies.     

The persuasive effects of framing messages on fruit and vegetable consumption according to regulatory focus theory

According to Regulatory Focus theory (RFT), outcomes in persuasive messages can be framed in four different ways, as gains, non-gains, losses or non-losses. In study 1, the persuasiveness of all four frames was compared and the presence/absence effect that was expected on the basis of the feature-positive effect was verified: Statements about present outcomes (gain, loss) were more persuasive than those about absent outcomes (non-gain, non-loss). However, this study failed to support the prediction that a gain-framed message would be more persuasive than a loss-framed message when promoting a prevention behaviour. Study 2 was designed to examine the latter finding. It was hypothesised that the threat posed by the loss-framed message in study 1 was too low to elicit a defensive reaction. Therefore, in study 2, the personal relevance of the gain and the loss framed message was manipulated. Consistent with predictions, the gain-framed message was more persuasive than the loss-framed message, but only when the message was personalised to increase self-relevance. Moreover, the effect was due to a significant drop in persuasion in the loss condition, probably caused by a defensive reaction. These data shed a new light on the findings of past framing studies.     

Health Message Framing: Moderators,Mediators, and Mysteries

Health message framing is an important aspect of health communication. Over the past 20 years, researchers have sought to identify the contexts in which gain‐framed and loss‐framed health messages are most likely to motivate healthy behavior. Two major approaches have emerged: One approach focusing on matching the frame of the message to how people perceive the risks and uncertainties of the advocated health behavior and the other approach focusing on matching the frame of the message to the motivational orientation of the recipient. In this review, we describe these two major approaches to health message framing, identify the most likely psychological mediators that explain why these approaches motivate behavior, suggest a way to integrate these two approaches, and outline several key future directions for both basic and applied research in health message framing.     

The effect of message framing on self-management of chronic pain: a new perspective on intervention?

This study examines framed messages as a novel approach to promote self-management of chronic pain. Primary care patients reporting chronic pain (pain rated ≥?4 on 0-10 NRS-I for ≥3 months) were randomly assigned to receive a gain- or loss-framed message promoting self-management of pain. Impact of the framed message on behavioural self-management (including communicating with providers, relaxation, activity pacing, pleasant activities and healthy lifestyle) was assessed. Post-message, individuals in the loss-frame condition reported significantly greater interest in and more knowledge gained from the information presented in the message (p≤0.03). Loss-frame participants were significantly more likely to express confidence that they would practice relaxation (p≤0.03). Pain readiness to change, pain self-efficacy and message frame independently influenced motivation to engage in relaxation as a self-management strategy. Across all behaviours assessed, there were no observed interactions between message frame and either pain self-efficacy or pain readiness to change (p>0.05). Framing may be useful to promote pain self-management; larger trials are needed to fully evaluate its potential and to further assess the applicability of framed communication to impact a broader range of chronic conditions.     

Human papillomavirus vaccination intentions and uptake in college women

Objective: Using the health belief model (HBM) and theory of planned behavior (TPB) as theoretical frameworks, the objectives of this study were: (a) to identify correlates of human papillomavirus (HPV) vaccination intentions and (b) to explore differences between correlates of HPV vaccination intentions and uptake. Methods: Undergraduate women (N = 447) who did not intend to receive (n = 223), intended to receive (n = 102), or had received (n = 122) the HPV vaccine were surveyed. Logistic regressions were conducted to examine the correlates of vaccination intentions and uptake. Results: Negative health consequences of the vaccine, physician's recommendation, positive attitudes toward the vaccine, and subjective norms were significant correlates of vaccination intentions. When comparing correlates of vaccination intentions to correlates of vaccination uptake, physician's recommendation, subjective norms, and perceived susceptibility to HPV were unique correlates of uptake. Conclusion: Differences between correlates of vaccination intentions and uptake suggest that social influences of liked and trusted individuals may make an important and unique contribution in motivating young women to receive the HPV vaccine beyond other variables from the HBM and TPB. Future utilization of longitudinal designs is needed to understand which factors may cause individuals to decide to receive the HPV vaccine. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

Does message framing affect changes in behavioural intentions in people with psoriasis? A randomized exploratory study examining health risk communication

Message framing is important in health communication research to encourage behaviour change. Psoriasis, a long-term inflammatory skin condition, has additional comorbidities including high levels of anxiety and cardiovascular disease (CVD), making message framing particularly important. This experimental study aimed to: (1) identify whether health messages about psoriasis presented as either gain- or loss-framed were more effective for prompting changes in behavioural intentions (BI), (2) examine whether BI were driven by a desire to improve psoriasis or reduce CVD risk; (3) examine emotional reactions to message frame; and (4) examine predictors of BI. A two by two experiment examined the effects on BI of message frame (loss vs. gain) and message focus (psoriasis symptom reduction vs. CVD risk reduction). Participants with psoriasis (n = 217) were randomly allocated to one of four evidence-based health messages related to either smoking, alcohol, diet or physical activity, using an online questionnaire. BI was the primary outcome. Analysis of variance tests and hierarchical multiple regression analyses were conducted. A significant frame by focus interaction was found for BI to reduce alcohol intake (p = .023); loss-framed messages were more effective for CVD risk reduction information, whilst gain-framed messages were more effective for psoriasis symptom reduction information. Message framing effects were not found for BI for increased physical activity and improving diet. High CVD risk was a significant predictor of increased BI for both alcohol reduction (β = .290, p < .01) and increased physical activity (β = ?.231, p < .001). Message framing may be an important factor to consider depending on the health benefit emphasised (disease symptom reduction or CVD risk reduction) and patient-stated priorities. Condition-specific health messages in psoriasis populations may increase the likelihood of message effectiveness for alcohol reduction.     

Social-cognitive predictors of intention to vaccinate against the human papillomavirus in college-age women

This study examined social-cognitive predictors of college-age women's intentions to obtain the human papillomavirus (HPV) vaccine using the Health Belief Model (HBM) and Theory of Planned Behavior (TBP) as theoretical guides. Questionnaire data were collected from 143 women at a Midwestern university. Among the HBM variables, perceived susceptibility to HPV, perceived benefits of the vaccine, and self-efficacy to obtain the vaccine were significant predictors. Among the TPB variables, positive attitudes toward the vaccine and beliefs that important others would support vaccination predicted intentions. A model with all HBM and TPB variables explained nearly 60% of the variance in intentions. Comparison of the theories suggests that the TPB is a better predictor of intentions than the HBM. Results suggest that targeting personal beliefs about the vaccine, and increasing acceptance for the vaccine among social network members, may increase vaccination intentions among college-age women.