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. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of message framing on mammography utilization.

This experiment compared the effectiveness of gain- versus loss-framed messages to persuade women to obtain mammography screening. One hundred and thirty-three women 40 years and older and not adhering to current guidelines for obtaining mammography screening were assigned randomly to view either gain-framed (emphasizing the benefits of obtaining mammography) or loss-framed (emphasizing the risks of not obtaining mammography) persuasive videos that were factually equivalent. Attitudes and beliefs were measured before and immediately following the intervention. Mammography utilization was assessed 6 and 12 months later. Consistent with predictions based on prospect theory, women who viewed the loss-framed message were more likely to have obtained a mammogram within 12 months of the intervention. These findings suggest that loss-framed messages may have an advantage in the promotion of detection behaviors such as mammography. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Why Are You Bringing Up Condoms Now? The Effect of Message Content on Framing Effects of Condom Use Messages.

According to prospect theory (A. Tversky & D. Kahneman, 1981), messages advocating a low-risk (i.e., easy, low-cost) behavior are most effective if they stress the benefits of adherence (gain framed), whereas messages advocating a risky behavior are most effective if they stress the costs of nonadherence (loss framed). Although condom use is viewed as a low-risk behavior, it may entail risky interpersonal negotiations. Study 1 (N = 167) compared ratings of condom use messages advocating relational behaviors (e.g., discussing condoms) or health behaviors (e.g., carrying condoms). As predicted, loss-framed relational messages and gain-framed health messages received higher evaluations. Study 2 (N = 225) offers a replication and evidence of issue involvement and gender as moderators. Results are discussed with reference to the design of condom use messages. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparing gain- and loss-framed messages for smoking cessation with sustained-release bupropion: A randomized controlled trial.

Prospect theory suggests that because smoking cessation is a prevention behavior with a fairly certain outcome, gain-framed messages will be more persuasive than loss-framed messages when attempting to encourage smoking cessation. To test this hypothesis, the authors randomly assigned participants (N=258) in a clinical trial to either a gain- or loss-framed condition, in which they received factually equivalent video and printed messages encouraging smoking cessation that emphasized either the benefits of quitting (gains) or the costs of continuing to smoke (losses), respectively. All participants received open label sustained-release bupropion (300 mg/day) for 7 weeks. In the intent-to-treat analysis, the difference between the experimental groups by either point prevalence or continuous abstinence was not statistically significant. Among 170 treatment completers, however, a significantly higher proportion of participants were continuously abstinent in the gain-framed condition as compared with the loss-framed condition. These data suggest that gain-framed messages may be more persuasive than loss-framed messages in promoting early success in smoking cessation for participants who are engaged in treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Using message framing to promote acceptance of the human papillomavirus vaccine.

Objective: Use of message framing for encouraging vaccination, an increasingly common preventive health behavior, has received little empirical investigation. The authors examined the relative effectiveness of gain-versus loss-framed messages in promoting acceptance of a vaccine against human papillomavirus (HPV)-a virus responsible for virtually all cases of cervical cancer. Design: Undergraduate women (N = 121) were randomly assigned to read a booklet describing the benefits of receiving (gain-framed message) or the costs of not receiving (loss-framed message) a prophylactic HPV vaccine. After reading the booklet, participants indicated their intent to obtain the HPV vaccine. Main Outcome Measure: A 5-item composite representing intentions to obtain the HPV vaccine. Results: The effect of message framing on HPV vaccine acceptance was moderated by risky sexual behavior and approach avoidance motivation. A loss-framed message led to greater HPV vaccination intentions than a gain framed message but only among participants who had multiple sexual partners and participants who infrequently used condoms. The loss-frame advantage was also observed among participants high in avoidance motivation. Conclusion: Findings highlight characteristics of the message recipient that may affect the success of framed messages promoting vaccine acceptance. This study has practical implications for the development of health communications promoting vaccination. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Heart disease education and prevention program targeting immigrant Latinos: using focus group responses to develop effective interventions

Although research has provided considerable knowledge concerning the positive effects of behavioral change on morbidity and mortality from heart disease and related risk factors, some segments of the population have not benefited equitably from this information. In April 1995, the National Heart, Lung, and Blood Institute (NHLBI) conducted seven focus groups to determine knowledge and attitudes about heart disease and associated risk factors, identify media usage and preferences, and assess publications usage and preferences among Spanish-speaking Latino immigrants residing in the Washington, D.C., metropolitan area. This information was gathered to assist in the development of key messages and strategies for the NHLBI Latino Community Cardiovascular Disease Prevention and Outreach Initiative, Salud para su Corazón--a heart disease prevention and education campaign. Findings from these focus groups indicate that Latinos may not benefit from heart disease prevention messages developed for the general population because of language and cultural differences. The researchers concluded that health education and disease prevention programs targeting the Latino community should develop educational materials and interventions that address language preferences and cultural values. Furthermore, to be effective, these programs should show people how to make positive behavioral changes based on their current circumstances, while remaining sensitive to the fact that Latino immigrants face major life adjustments and many are still greatly influenced by their country of origin.     

Using the theory of planned behavior to predict gambling behavior.

Gambling is an important public health concern. To better understand gambling behavior, we conducted a classroom-based survey that assessed the role of the theory of planned behavior (TPB; i.e., intentions, subjective norms, perceived behavioral control, and attitudes) in past-year gambling and gambling frequency among college students. Results from this research support the utility of the TPB to explain gambling behavior in this population. Specifically, in TPB models to predict gambling behavior, friend and family subjective norms and perceived behavioral control predicted past-year gambling, and friend and family subjective norms, attitudes, and perceived behavioral control predicted gambling frequency. Intention to gamble mediated these relationships. These findings suggest that college-based responsible gambling efforts should consider targeting misperceptions of approval regarding gambling behavior (i.e., subjective norms), personal approval of gambling behavior (i.e., attitudes), and perceived behavioral control to better manage gambling behavior in various situations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Message framing and sunscreen use: Gain-framed messages motivate beach-goers.

Prospect theory suggests that people respond differentially to factually equivalent messages depending on how these messages are framed (A. Tversky & D. Kahneman, 1981). A. J. Rothman and P. Salovey (1997) relied on prospect theory to predict that messages highlighting potential "gains" should promote prevention behaviors such as sunscreen use best. This experiment compared the effectiveness of 4 differently framed messages (2 highlighting gains, 2 highlighting losses) to persuade 217 beach-goers to obtain and use sunscreen. Attitudes and intentions were measured before and immediately following the delivery of the framed information, and after completing the questionnaire participants were given a coupon redeemable for a small bottle of sunscreen later that same day. People who read either of the 2 gain-framed brochures, compared with those who read either of the 2 loss-framed brochures, were significantly more likely to (a) request sunscreen, (b) intend to repeatedly apply sunscreen while at the beach, and (c) intend to use sunscreen with a sun protection factor of 15 or higher. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Receptivity and planned change: Community attitudes and deinstitutionalization.

An expectancy-value model was used to measure and explain receptivity attitudes (i.e., change climate) toward the implementation of deinstitutionalization programs. Questionnaires measuring values, expectancies, and behavioral intentions were mailed to community leaders and to members of community groups believed to be important in setting opinions and making decisions. Responses from 599 persons revealed that (a) the size of a proposed group home affected neither attitudes nor intentions of support, (b) group homes for mental health clients were viewed with less favorable attitudes and intentions than those for the retarded or the elderly, (c) members of various community groups held significantly different attitudes and intentions toward the programs, and (d) attitudes and intentions toward deinstitutionalization were more favorable than toward institutionalization. The application of this approach for assessing the implementation climate for planned change was discussed. (55 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Intention to commit driving violations: An application of the theory of planned behavior.

Assessed the ability of the theory of planned behavior (TPB) to account for drivers' intentions to commit 4 specific driving violations: drinking and driving, speeding, close following, and overtaking in risky circumstances. A stratified sample of drivers (N?=?881) was surveyed with a questionnaire constructed to measure attitudes toward behaviors, subjective norms, perceived behavioral control, and behavioral intentions, the key constructs in TPB. Results showed that the addition of perceived behavioral control led to significant increments in the amount of explained variance in intentions, thereby supporting the theory. The relation between subjective norms and behavioral intentions was consistently stronger than that between attitudes toward behaviors and behavioral intentions. Analyses of variance (ANOVAs) differentiated demographic subgroups of drivers in terms of behavioral beliefs, outcome evaluations, normative beliefs, motivation to comply, and control beliefs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The differential effects of rape prevention programming on attitudes, behavior, and knowledge.

This investigation evaluated whether type of programming differentially affects elaboration likelihood model central route processing of rape prevention messages, attitudes, knowledge, behaviors, and stability of change. The 258 participants were assigned to a didactic-video program, an interactive drama, or control. Measured over S time periods, results indicated that (a) the interactive drama was most effective in promoting central route processing; (b) the didactic-video intervention was more effective than the control at altering men's rape myth acceptance at 1 month, but change was not stable; (c) a pattern of rebounding scores on rape attitudes occurred for both interventions; (d) interactive drama participants were more able to identify consent versus coercion; and (e) interactive drama participants demonstrated differences on behavioral indicators. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prevention and Health Promotion: Decades of Progress, New Challenges, and an Emerging Agenda.

Daily habits (e.g., smoking, diet, and exercise) and their immediate consequences (e.g., obesity) confer risk for most of the major health problems in industrialized nations. Hence, determinants of these behaviors and their modifications have been central topics in health psychology. Considerable scientific and applied progress has been made, but the field faces important challenges and opportunities in the future. These challenges and opportunities include changes in demographics and patterns of health, the need for a more comprehensive model of the domain of health behavior and prevention, the need to integrate behavioral and psychosocial risk and resilience, the incorporation of new technologies, and addressing a variety of professional and economic barriers to the implementation of prevention in health care. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Understanding and promoting AIDS-preventive behavior: Insights from the theory of reasoned action.

Psychological determinants of AIDS-preventive behaviors were examined from the perspective of the theory of reasoned action in prospective studies of gay men, heterosexual university students, and heterosexual high school students. Across samples, preventive behaviors, and prospective intervals of 1 and 2 months' duration, AIDS-preventive behaviors were predicted by behavioral intentions; behavioral intentions were a function of attitudes and norms; and attitudes and norms were a function of their theorized basic underpinnings. Discussion focuses on the development of AIDS-prevention interventions that modify intentions, attitudes, and norms concerning performance of AIDS-preventive behaviors by targeting the empirically identified underpinnings of attitudes and norms related to specific preventive behaviors in specific populations of interest. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Molecular alterations of canalicular transport systems in experimental models of cholestasis: possible functional correlations

Ajzen's (1988) theory of planned behavior (TOPB) was used to examine psychological determinants of high-risk UV radiation exposure-related behaviors (sunbathing, tanning salon use, and sunscreen use). Undergraduates at a midsized southeastern university were assessed on their psychological and behavioral tendencies toward high-risk UV radiation exposure-related behaviors. The results generally supported the utility of the TOPB as an explanatory model for high-risk behavior. Attitudes were strongly associated with high-risk intentions (e.g., not utilize sunscreen, use salons), whereas subjective norms were less so. Perceived behavioral control was found to moderate the relationship among attitudes, norms, and intentions to sunbathe and tan at a salon. Implications for intervention strategies and future model building in this area are discussed.     

Fear, anger, fruits, and veggies: Interactive effects of emotion and message framing on health behavior.

Objective: Message framing is a theoretically grounded health communication strategy designed to motivate action by emphasizing either the benefits of engaging in a particular behavior (gains) or the costs of failing to engage in the behavior (losses). This study investigated whether the effectiveness of a framed message depends on the emotional state of the message recipient. We examined effects of fear versus anger, emotions that frequently occur within the context of health decision-making. Methods: Undergraduate students (N = 133) were randomly assigned to complete a fear or anger induction task after which they read a gain- or loss-framed pamphlet promoting fruit and vegetable consumption. Fruit and vegetable intake (servings per day) subsequently was assessed over the following 2 weeks. Results: As predicted, a significant frame by emotion interaction was observed, such that participants in the fear condition reported eating more servings of fruits and vegetables after exposure to a loss-framed message than to a gain-framed message. In contrast, participants in the anger condition reported eating (marginally) more servings of fruits and vegetables after exposure to a gain-framed message than to a loss-framed message. Greater increases in fruit and vegetable intake from baseline to follow-up were observed when the message frame was matched to the participant's emotional state. Conclusion: The effectiveness of framed health communications depends on the message recipient's current emotional state. Affective factors that are incidental to the behavior recommended in a health communication can affect the relative success of gain- and loss-framed appeals. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Persuasive communications to change actions: An analysis of behavioral and cognitive impact in HIV prevention.

This meta-analysis examined the validity of various theoretical assumptions about cognitive and behavioral change following a communication recommending condom use. The synthesis comprised 82 treatment and 29 control groups included in 46 longitudinal reports with measures of perceived severity and susceptibility, attitudes and expectancies, norms, perceptions of control, intentions, knowledge, behavioral skills, or condom use. Results indicated that across the sample of studies, communications taught recipients about facts related to HIV and also induced favorable attitudes and expectancies, greater control perceptions, and stronger intentions to use condoms in the future. Moreover, messages that presented attitudinal information and modeled behavioral skills led to increased condom use. Results are discussed in the context of theories of human behavior and change and in reference to HIV-prevention interventions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Risk behaviors, self-efficacy, and AIDS prevention among adolescents

This study was conducted to investigate risk behaviors and AIDS-preventive variables in high school adolescents. One hundred fifty-two students in Grades 10 through 12 were administered an AIDS-related behavior questionnaire and the Attitudes Toward AIDS Scale-High School Version (ATAS-HS; Goh, 1992). The results indicated that use of alcohol was far more common than other risk behaviors among the respondents. Rates of sexual intercourse and intravenous drug use were significantly lower than those reported in other research. Self-efficacy was significantly related to AIDS-preventive behavioral intentions, perceived knowledge, and measured knowledge about AIDS. Because the AIDS-preventive variables functioned differently in their relationships to sexual practices, the correlations suggest a pattern of co-occurrence between specific behavior intentions and actual AIDS-preventive behaviors (i.e., sexual experience, use of condoms). In addition, significant gender and grade differences were found on selected risk behaviors and AIDS-preventive variables.     

Today I'll use a condom, but who knows about tomorrow: A daily process study of variability in predictors of condom use.

Objective: Most models of health behavior change applied to condom use behavior have focused on individual differences in theoretical constructs to explain condom use or nonuse, while ignoring the possibility that day-to-day within-person changes in these constructs may contribute to understanding behavior. The goal of the present study was to investigate day-to-day variability in condom use attitudes, self-efficacy, and behavioral intentions and assess the utility of this variability in predicting the likelihood of condom use each day. Design: A 30-day Web-based structured daily diary was used to collect daily reports of sexual behaviors and data on theoretical predictors of condom use behavior from sexually active college students (N = 116). Main Outcome Measures: The authors investigated whether condom use attitudes, self-efficacy, and behavioral intentions vary day to day; whether this within-person variability predicts condom use behavior; and whether negative affective states explain this variability. Results and Conclusions: Within-person variability was found for each of the constructs. Within-person day-to-day changes in behavioral intentions and attitudes predicted the instances in which an individual used a condom and daily negative affect partially explained within-person day-to-day changes in behavioral intentions and self-efficacy. Implications for models of health behavior change and for behavior change interventions are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceived susceptibility to breast cancer moderates the effect of gain- and loss-framed messages on use of screening mammography.

Objective: This study examined the role of three distinct beliefs about risk (risks associated with screening, construal of the function of screening as health-affirming or illness-detecting, and perceived susceptibility to breast cancer) in moderating women's responses to framed messages that promote mammography. Design: Three hundred fifty-five women recruited from an inner city hospital, nonadherent to guidelines for receiving annual screening mammograms,were randomly assigned to view a gain- or loss-framed video message about the importance of mammography. Main Outcome Measure: Mammography screening was self-reported at a 3-month follow-up. Results: Only perceived susceptibility to breast cancer significantly moderated the effect of message framing on screening. Women with average and higher levels of perceived susceptibility for breast cancer were significantly more likely to report screening after viewing a loss-framed message compared to a gain-framed message. No effects of framing on reported screening were observed for women with lower levels of perceived susceptibility. Conclusion: The study identifies a key role for perceived susceptibility in shaping responses to framed messages that promote cancer screenings. (PsycINFO Database Record (c) 2011 APA, all rights reserved)