Using message framing to motivate HIV testing among low-income, ethnic minority women.

This study compared the effectiveness of 4 videotaped educational programs designed to motivate HIV testing among low-income, ethnic minority women. 480 women were assigned randomly to watch one of 2 gain-framed or 2 loss-framed videos. Consistent with prospect theory, participants' perceptions of the certainty of the outcome of an HIV test moderated the effects of framing on self-reported testing behavior 6 months after video exposure. Among participants who reported being certain of the test's outcome, those who saw a gain-framed video reported a higher rate of testing than those who saw a loss-framed message. Among women who perceived the outcome of HIV testing as relatively uncertain, gain- and loss-framed videos led to similar rates of self-reported testing, with some advantage for the loss-framed message. (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)     

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)     

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)     

Deconstructing the monolith: Differences in attitudes about mammography among low-income African American women.

The purpose of this study was to explore how health beliefs may vary within a minority group. In this mixed-method study, 63 low-income African American women engaged in six focus groups discussing beliefs that inhibited or facilitated mammography. Differences in cognitive complexity, self-efficacy, and attributions of causality occurred across neighborhoods despite the geographic proximity and demographic similarity. The attitude change that occurred during the discussion suggested ways to construct effective health interventions. The data suggest (a) that women were similarly knowledgeable about mammography and cancer, (b) knowledge did not correspond with attitudes, (c) attitudes must be addressed before knowledge can be utilized, (d) attitudes are developed and maintained within neighborhood social networks and that stories maintain these attitudes, (e) increasing the discussion among peers should lead to greater attitude change and discussion leads to increased thought, and (f) motivation and follow through are connected to women’s roles within their communities. (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)     

Spiritual health locus of control and breast cancer beliefs among urban African American women.

The present study examined the relationship between spiritual health locus of control, breast cancer beliefs, and mammography utilization among a sample of 1,227 African American women from urban public health centers. Spiritual health locus of control was conceptualized as having an active and passive dimension, empowering individuals in their health beliefs and behaviors or rendering them to rely on a higher power (e.g., God) to determine their health outcomes, respectively. The active dimension was negatively associated with perceived benefits of mammography and positively associated with perceived barriers to mammography. The active and passive spiritual dimensions are distinct from internal and external health locus of control. Further study of their associations with other health-related beliefs and behaviors is warranted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Persuasive communication and proenvironmental behaviours: How message tailoring and message framing can improve the integration of behaviours through self-determined motivation.

Public concern about environmental issues has grown substantially in the last two decades. As a consequence, the promotion of environmentally conscious behaviours that are integrated in people's lifestyle has become an ongoing and important challenge. Persuasive messages are often perceived as the first step in efforts to motivate people to change a specific behaviour. In this article, the authors propose that (a) tailoring messages according to proposed processes underlying behaviour change (i.e., being aware of a problem, deciding what to do, initiating, and implementing a behaviour); and (b) framing these messages in terms of whether they serve intrinsic goals (i.e., health, well-being) as opposed to extrinsic goals (i.e., make or save money, comfort) could make messages more effective by progressively increasing the level of self-determined motivation of the targeted population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of message recipients' power before and after persuasion: A self-validation analysis.

In the present research, the authors examined the effect of a message recipient's power on attitude change and introduced a new mechanism by which power can affect social judgment. In line with prior research that suggested a link between power and approach tendencies, the authors hypothesized that having power increases confidence relative to being powerless. After demonstrating this link in Experiment 1, in 4 additional studies, they examined the role of power in persuasion as a function of when power is infused into the persuasion process. On the basis of the idea that power validates whatever mental content is accessible, they hypothesized that power would have different effects on persuasion depending on when power was induced. Specifically, the authors predicted that making people feel powerful prior to a message would validate their existing views and thus reduce the perceived need to attend to subsequent information. However, it was hypothesized that inducing power after a message has been processed would validate one's recently generated thoughts and thus influence the extent to which people rely upon their thoughts in determining their attitudes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A prospective study of age differences in consequences of emotional control in women referred to clinical mammography.

Age differences in emotional control and their consequences were examined in women referred to mammography on the suspicion of breast cancer but with benign results of the examination. Under natural experimental conditions, the levels of emotional control and distress were measured 1 week prior to the examination as well as 4 and 12 weeks after the examination in 717 younger women (ages 19–39), middle-aged women (ages 40–59), and older women (ages 60–85). A higher level of emotional control was found in the older women; this indicates that, in these birth cohorts, emotion-focused coping is more prevalent in old age than in young adulthood, even when similar stressors are experienced. The analyses revealed an interaction between age and emotional control; higher levels of control were related to a reduction in distress during the course of the study in older women, whereas emotional control was unrelated to changes in distress in younger and middle-aged women. The findings support the life span theory of control, which suggests that secondary control strategies are more adaptive in old age. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Body dissatisfaction, ethnic identity, and disordered eating among African American women.

Initial research suggested that only European American women developed eating disorders (Garner, 1993), yet recent studies have shown that African American women do experience them (e.g., Lester & Petrie, 1998b; Mulholland & Mintz, 2001) and also may be negatively affected by similar sociocultural variables. In this study, we examined a sociocultural model of eating disorders for African American women but included the influences of ethnic identity (e.g., Hall, 1995; Helms, 1990). Participants (N = 322) were drawn from 5 different universities. They completed measures representing ethnic identity, societal pressures regarding thinness, internalization of societal beauty ideals, body image concerns, and disordered eating. Structural equation modeling revealed that ethnic identity was inversely, and societal pressures regarding thinness directly, related to internalization of societal beauty ideals. Societal pressures regarding thinness was also related to greater body image concerns. Both internalization of societal beauty ideals and body image concerns were positively associated with disordered eating (R2 = .79). Overall, the final model fit the data well, supporting its generalizability and the importance of ethnic identity in determining risk. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Temporal framing and persuasion to adopt preventive health behavior: Moderating effects of individual differences in consideration of future consequences on sunscreen use.

Objective: Previous work on temporal framing of health communications has focused upon detection behaviors that possess an inherent immediate risk of negative consequences. The present studies evaluate the role of temporal frame for a preventive behavior, using sunscreen. Design: Two experimental field studies manipulated the temporal frame in which positive and negative consequences of using sunscreen were presented. Main Outcome Measures: Cognitive responses, intention, and behavior (experiment 2). Results: Consistent with hypotheses, Experiment 1 showed that individual differences in consideration of future consequences (CFC; A. Strathman, F. Gleicher, D. S. Boninger, & C. S. Edwards, 1994) moderated (a) the processing of long- versus short-term consequences and (b) the persuasive impact of the different temporal frames on behavioral intentions. In Experiment 2, the balance of positive versus negative thoughts generated by reading the persuasive communications was shown to mediate the effects of the Temporal Frame × CFC interaction on a behavioral measure. Conclusion: Findings extend previous work by demonstrating the importance of individual differences in CFC to the processing of health communication about a preventive health behavior and to a behavioral outcome. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Getting the message across: Age differences in the positive and negative framing of health care messages.

Although valenced health care messages influence impressions, memory, and behavior (Levin, Schneider, & Gaeth, 1998) and the processing of valenced information changes with age (Carstensen & Mikels, 2005), these 2 lines of research have thus far been disconnected. This study examined impressions of, and memory for, positively and negatively framed health care messages that were presented in pamphlets to 25 older adults and 24 younger adults. Older adults relative to younger adults rated positive pamphlets more informative than negative pamphlets and remembered a higher proportion of positive to negative messages. However, older adults misremembered negative messages to be positive. These findings demonstrate the age-related positivity effect in health care messages with promise as to the persuasive nature and lingering effects of positive messages. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of culturally specific cessation messages on theoretical antecedents of behavior among low-income african american smokers.

Previous research has highlighted the importance of cultural relevance in health risk communications, including tobacco interventions. However, few studies have examined the active components of smoking cessation messages targeting low-income African American smokers. This study tested the influence of message content and culturally specific framing in a sample of adult smokers. In a 2 × 2 factorial experiment, 243 African American smokers (M = 19 cigarettes/day) recruited from the community (55% women; mean age = 43 years) were randomly assigned to 1 of 4 conditions: culturally specific smoking messages, standard smoking messages, culturally specific exercise/weight messages, or standard exercise/weight messages. The primary outcome measures were theoretical antecedents to behavior change, including risk perceptions (general, personal, and culturally specific), readiness to quit smoking, and smoking-related knowledge. The results showed that the smoking messages produced greater culturally specific risk perceptions, readiness to quit smoking, and smoking-related knowledge. The culturally specific messages produced greater personal risk perceptions and intentions to quit. Culturally specific risk perceptions were most affected by culturally specific smoking messages. Findings support the roles of message content and culturally specific framing in the efficacy of brief written interventions for smoking cessation in this population. Future research is needed to examine the influence of these constructs on behavior change. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of framing and action instructions on whether older adults obtain flu shots.

The authors tested the effects of cues to action-messages intended to increase flu immunizations. North Dakota counties were randomly assigned to reminder letters, action letters, or no letters. Within the reminder-letter counties, Medicare recipients received either (a) a reminder from the state peer review organization (PRO) to obtain a flu shot or (b) a reminder from the PRO, framed either in terms of the loss associated with failing to get a shot or (c) the benefits associated with getting a shot. Within the action-letter counties, Medicare recipients learned where and when to receive a flu shot. Reminder type failed to differentially affect the immunization rate (overall M =24.5%). However, the action messages worked better (28.2%) than no message (19.6%). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Validation of scales measuring attitudes and norms related to mammography screening in women veterans.

Validation of psychosocial measures for use in mammography screening research has been given inadequate attention in the literature. The authors report on the validation of 5 measures examining 4 attitudinal constructs (i.e., pros, cons, outcome expectations, and cancer worries) and 1 social influence construct (i.e., subjective norms) in a 22-item inventory. The study participants consisted of a national, randomly sampled population of women veterans (n = 2,910). After minor revision of scales, the authors found independent measures for 4 constructs: pros, cons, cancer worries, and subjective norms. The authors concluded that these scales have acceptable psychometric properties; support construct validity; and provide brief, reliable, and valid measures of attitudes toward and norms regarding mammography screening. These scales may be useful for intervention research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Temporal framing and the decision to take part in type 2 diabetes screening: Effects of individual differences in consideration of future consequences on persuasion.

Reliable individual differences in the extent to which people consider the long- and short-term consequences of their own behaviors are hypothesized to influence the impact of a persuasive communication. In a field experiment, the time frame of occurrence of positive and negative consequences of taking part in a proposed Type 2 diabetes screening program was manipulated in a sample of 210 adults with a mean age of 53 years. Individual differences in consideration of future consequences (CFC; A. Strathman, F. Gleicher, D. S. Boninger, & C. S. Edwards, 1994) moderated (a) the generation of positive and negative thoughts and (b) the persuasive impact of the different communications. Low-CFC individuals were more persuaded when positive consequences were short term and negative consequences were long term. The opposite was true of high-CFC individuals. Path analyses show that net positive thoughts generated mediated the effect of the CFC × Time Frame manipulations on behavioral intentions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Bringing the Frame Into Focus: The Influence of Regulatory Fit on Processing Fluency and Persuasion.

This research demonstrates that people's goals associated with regulatory focus moderate the effect of message framing on persuasion. The results of 6 experiments show that appeals presented in gain frames are more persuasive when the message is promotion focused, whereas loss-framed appeals are more persuasive when the message is prevention focused. These regulatory focus effects suggesting heightened vigilance against negative outcomes and heightened eagerness toward positive outcomes are replicated when perceived risk is manipulated. Enhanced processing fluency leading to more favorable evaluations in conditions of compatibility appears to underlie these effects. The findings underscore the regulatory fit principle that accounts for the persuasiveness of message framing effects and highlight how processing fluency may contribute to the "feeling right" experience when the strategy of goal pursuit matches one's goal. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Injury risk among children of low-income U.S.-born and immigrant mothers.

The number of immigrants in the United States is at an all time high, yet psychologists have largely ignored the domain of immigrant health. This article considers 1 aspect of immigrant health, risk for pediatric injury. A sample of over 5,000 5-year-old children from impoverished families was studied; approximately 13% had immigrant mothers. Children of immigrants had a significantly lower rate of injury in the prior year. This was particularly true of non-White children of immigrants. Three possible mediators for this finding--assistance with parenting, parenting style, and health care accessibility--were considered, but none explained the difference. The need for further research on the topic and implications of results for injury prevention are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)