Do you favor positive information or dislike negative information? Cultural variations in the derivation of the framing effect

How to adjust the expected waiting time to improve patient's satisfaction?

BACKGROUND

Long waiting time in hospital leads to patient's low satisfaction. In addition to reducing the actual waiting time (AWT), we can also improve satisfaction by adjusting the expected waiting time (EWT). Then how much can the EWT be adjusted to attribute a higher satisfaction?

METHODS

This study was conducted though experimental with hypothetical scenarios. A total of 303 patients who were treated by the same doctor from August 2021 to April 2022 voluntarily participated in this study. The patients were randomly divided into six groups: a control group (n = 52) and five experimental groups (n = 245). In the control group, the patients were asked their satisfaction degree regarding a communicated EWT (T₀) and AWT (T_a) under a hypothetical situation. In the experimental groups, in addition to the same T₀ and T_a as the control group, the patients were also asked about their satisfaction degree with the extended communicated EWT (T₁). Patients in five experimental groups were given T₁ values with 70, 80, 90, 100, and 110 min respectively. Patients in both control and experiment groups were asked to indicate their initial EWT, after given unfavorable information (UI) in a hypothetical situation, the experiment groups were asked to indicate their extended EWT. Each participant only participated in filling out one hypothetical scenario. 297 valid hypothetical scenarios were obtained from the 303 hypothetical scenarios given.

RESULTS

The experimental groups had significant differences between the initial indicated EWT and extended indicated EWT under the effect of UI (20 [10, 30] vs. 30 [10, 50], Z = -4.086, P < 0.001). There was no significant difference in gender, age, education level and hospital visit history (χ² = 3.198, P = 0.270; χ² = 2.177, P = 0.903; χ² = 3.988, P = 0.678; χ² = 3.979, P = 0.264) in extended indicated EWT. As for patient's satisfaction, compared with the control group, significant differences were found when T₁ = 80 min (χ² = 13.511, P = 0.004), T₁ = 90 min (χ² = 12.207, P = 0.007) and T₁ = 100 min (χ² = 12.941, P = 0.005). When T₁ = 90 min, which is equal to the T_a, 69.4% (34/49) of the patients felt "very satisfied", this proportion is not only significantly higher than that of the control group (34/ 49 vs. 19/52, χ² = 10.916, P = 0.001), but also the highest among all groups. When T₁ = 100 min (10 min longer than T_a), 62.5% (30/48) of the patients felt "very satisfied", it is significantly higher than that of the control group (30/ 48 vs. 19/52, χ² = 6.732, P = 0.009). When T₁ = 80 min (10 min shorter than T_a), 64.8% (35/54) of the patients felt "satisfied", it is significantly higher than that of the control group (35/ 54 vs. 17/52, χ² = 10.938, P = 0.001). However, no significant difference was found when T₁ = 70 min (χ² = 7.747, P = 0.052) and T₁ = 110 min (χ² = 4.382, P = 0.223).

CONCLUSIONS

Providing UI prompts can extend the EWT. When the extended EWT is closer to the AWT, the patient's satisfaction level can be improved higher. Therefore, medical institutions can adjust the EWT of patient's through UI release according to the AWT of hospitals to improve patient's satisfaction.

Who and what messages are more suitable for health ads: the combined influence of endorsers and message framing on visual attention and ad effectiveness

Purpose

The author examined effects of endorser type and message framing on visual attention and ad effectiveness in health ads, including the moderator of involvement. This paper aims to discuss this issue.

Design/methodology/approach

An experiment was conducted with a 2 (celebrity vs. expert) × 2 (positive vs. negative framing) between-subject factorial design. Eye-tracking measured visual attention and a questionnaire measured ad effectiveness and product involvement.

Findings

Experimental data from 78 responses showed no vampire effect in the health advertisements. Celebrity endorsement with negative message framing received more attention and had less ad recall than that with positive message framing. Negative and positive message framing attracted the same amount of attention and ad recall in the expert endorsement condition. High involvement participants paid more attention to the ad message with the expert than that with the celebrity, but ad recall was not significantly increased. Low involvement participants exhibited the same attention to the ad message with the expert and with the celebrity, but had greater recall of the ad message with the expert. Visual attention to the endorser was associated with ad attitude but not with ad recall. Ad attitude impacted behavioral intention.

Originality/value

Studies examining influences of celebrity and message framing on ad effectiveness have focused on the response to advertising stimuli, not the information process. The author provides empirical evidence of the viewers' information processing of endorsers and health messages, and its relationship with ad effectiveness. The study contributes to the literature by combining endorser and message framing in health ads to promote public health communication from the information processing perspective.

When do persuasive messages on vaccine safety steer COVID-19 vaccine acceptance and recommendations? Behavioural insights from a randomised controlled experiment in Malaysia

INTRODUCTION

Vaccine safety is a primary concern among vaccine-hesitant individuals. We examined how seven persuasive messages with different frames, all focusing on vaccine safety, influenced Malaysians to accept the COVID-19 vaccine, and recommend it to individuals with different health and age profiles; that is, healthy adults, the elderly, and people with pre-existing health conditions.

METHODS

A randomised controlled experiment was conducted from 29 April to 7 June 2021, which coincided with the early phases of the national vaccination programme when vaccine uptake data were largely unavailable. 5784 Malaysians were randomly allocated into 14 experimental arms and exposed to one or two messages that promoted COVID-19 vaccination. Interventional messages were applied alone or in combination and compared against a control message. Outcome measures were assessed as intent to both take the vaccine and recommend it to healthy adults, the elderly, and people with pre-existing health conditions, before and after message exposure. Changes in intent were modelled and we estimated the average marginal effects based on changes in the predicted probability of responding with a positive intent for each of the four outcomes.

RESULTS

We found that persuasive communication via several of the experimented messages improved recommendation intentions to people with pre-existing health conditions, with improvements ranging from 4 to 8 percentage points. In contrast, none of the messages neither significantly improved vaccination intentions, nor recommendations to healthy adults and the elderly. Instead, we found evidence suggestive of backfiring among certain outcomes with messages using negative attribute frames, risky choice frames, and priming descriptive norms.

CONCLUSION

Message frames that briefly communicate verbatim facts and stimulate rational thinking regarding vaccine safety may be ineffective at positively influencing vaccine-hesitant individuals. Messages intended to promote recommendations of novel health interventions to people with pre-existing health conditions should incorporate safety dimensions.

TRIAL REGISTRATION NUMBER

NCT05244356.

Cultural Variability in the Attribute Framing Effect

An intriguing phenomenon that arises from decision making is that the decision maker’s choice is often influenced by whether the option is presented in a positive or negative frame, even though the options are, de facto, identical to one another. Yet, the impact of such differential framing of equivalent information, referred to as the attribute framing effect, may not be the same for every culture; rather, some cultures may be more readily influenced by the differentially valenced frames than others (i.e., showing a greater difference in evaluation in a positive vs. negative frame). The present study investigates to what extent and why cultures may differ in their sensitivity to the attribute framing effect. Participants were recruited from South Korea and the United States, cultures characterized by their focus on prevention and promotion, respectively, to test for the cultural variability in the attribute framing effect. The results revealed that Korean participants were markedly more influenced by the valence of the frame than North American participants. Regulatory focus explained why Koreas showed a greater sensitivity toward the attribute framing effect than North Americans. Specifically, a greater prevention (vs. promotion) orientation of Korean participants led them to show a greater evaluation gap in the positive and negative frames. Implications for cultural significance on the attribute framing effect are discussed.