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Dudley MZ, Squires GK, Petroske TM, Dawson S, Brewer J. The Use of Narrative in Science and Health Communication: A Scoping Review. PATIENT EDUCATION AND COUNSELING 2023; 112:107752. [PMID: 37068426 DOI: 10.1016/j.pec.2023.107752] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 04/08/2023] [Accepted: 04/11/2023] [Indexed: 05/09/2023]
Abstract
BACKGROUND Many people deny science and reject health recommendations despite widely distributed facts and statistics. Didactic science and health communication is often dry, and relies on the false assumption that people make purely evidence-based decisions. Stories can be a powerful teaching tool by capturing attention and evoking emotion. OBJECTIVE We explore the impact and appeal of, and describe best practices for, using narrative (storytelling) versus didactic methods in science and health communication. PATIENT INVOLVEMENT No patients were involved in the review process. METHODS We searched PubMed and Web of Science for articles either: assessing effectiveness of narrative science/health communication; assessing acceptability of (or preference for) narrative science/health communication; giving advice on how best to use narrative; and/or providing science-based explanations for how/why narrative succeeds. RESULTS Narrative science/health communication is effective and appealing for audiences across a variety of topics and mediums, with supporting evidence across fields such as epidemiology, neuroscience, and psychology. Whether narrative or didactic messaging is most effective depends on the topic, audience, and objective, as well as message quality. However, combining narrative with didactic methods is likely to be more effective than using either strategy alone. DISCUSSION Narrative science/health communication merits wider implementation and further research. Narrative communication creates openness to information by delaying the formulation of counterarguments. PRACTICAL VALUE Science and health communicators should collaborate with cultural and storytelling experts, work directly with their target audiences throughout the message development and testing processes, and rely on popular story elements (e.g., first-person point of view, relatable protagonists) to improve the comprehension, engagement, and thoughtful consideration of their intended audience. FUNDING This work was funded by Thirty Meter Telescope, with which two authors (GKS and SD) were affiliated. Otherwise, the funding organization had no role in the study and/or submission.
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Affiliation(s)
- Matthew Z Dudley
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, w5041, Baltimore, MD 21205, USA; Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, w5041, Baltimore, MD 21205, USA.
| | - Gordon K Squires
- California Institute of Technology / IPAC, 1200 E California Blvd, 315 Keith Spalding, Pasadena, CA 91125, USA
| | | | - Sandra Dawson
- Thirty Meter Telescope International Observatory, Pasadena, CA, USA
| | - Janesse Brewer
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, w5041, Baltimore, MD 21205, USA; Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, w5041, Baltimore, MD 21205, USA
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2
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Gosselin S, Thaivalappil A, Papadopoulos A, McWHIRTER JE. Public Health Messaging to Address Indoor Tanning: A Scoping Review. JOURNAL OF HEALTH COMMUNICATION 2023; 28:241-253. [PMID: 36992625 DOI: 10.1080/10810730.2023.2196519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Indoor tanning (IT) is an avoidable skin cancer risk. Although numerous communication interventions have been assessed for IT deterrence, less attention has been paid to the persuasive messages within these interventions. This scoping review summarizes the current peer-reviewed literature on persuasive messages for IT. Overall, 20 articles (21 studies) were included. Most were experimental or quasi-experimental and conducted in the US. Participants were mostly young women who had tanned indoors before. Few studies evaluated persuasive theme; in those that did, health and appearance themes were effective. Narrative and statistical evidence formats were also effective. The included studies also supported normative messages, loss-framed messages, and images. Improved reporting on message design and evaluation would be beneficial for future evidence synthesis. Our understanding of persuasive messages for IT has expanded in recent years, but more research is needed to optimize them.
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Affiliation(s)
- Sydney Gosselin
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Abhinand Thaivalappil
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Andrew Papadopoulos
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Jennifer E McWHIRTER
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
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Shanahan EA, DeLeo RA, Albright EA, Li M, Koebele EA, Taylor K, Crow DA, Dickinson KL, Minkowitz H, Birkland TA, Zhang M. Visual policy narrative messaging improves COVID-19 vaccine uptake. PNAS NEXUS 2023; 2:pgad080. [PMID: 37096197 PMCID: PMC10122412 DOI: 10.1093/pnasnexus/pgad080] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 02/18/2023] [Accepted: 02/28/2023] [Indexed: 04/26/2023]
Abstract
In the face of vaccine hesitancy, public health officials are seeking more effective risk communication approaches to increase vaccination rates. We test the influence of visual policy narratives on COVID-19 vaccination behavior through a panel survey experiment conducted in early 2021 (n = 3,900) and then 8 weeks later (n = 2,268). We examine the effects of three visual policy narrative messages that test the narrative mechanism of character selection (yourself, your circle, and your community) and a nonnarrative control on COVID-19 vaccine behavior. Visual risk messages that use narratives positively influence COVID-19 vaccination through serial mediation of affective response to the messages and motivation to get the COVID-19 vaccination. Additionally, character selection matters, as messages focusing on protecting others (i.e. your circle and your community) perform stronger than those of yourself. Political ideology moderated some of the effects, with conservative respondents in the nonnarrative control condition having a higher probability of vaccination in comparison to the protect yourself condition. Taken together, these results suggest that public health officials should use narrative-based visual communication messages that emphasize communal benefits of vaccinations.
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Affiliation(s)
- Elizabeth A Shanahan
- Department of Political Science, Montana State University, Bozeman, MT 59717, USA
| | - Rob A DeLeo
- Department of Global Studies, Bentley University, Waltham, MA 02452, USA
| | - Elizabeth A Albright
- Division of Environmental Science and Policy, Nicholas School of the Environment, Duke University, Durham, NC 27708, USA
| | - Meng Li
- School of Public Affairs, University of Colorado, Denver, CO 80217, USA
| | | | - Kristin Taylor
- Department of Political Science, Wayne State University, Detroit, MI 48202, USA
| | | | | | - Honey Minkowitz
- Department of Public Administration, School of Public and International Affairs, North Carolina State University, Raleigh, NC 27695, USA
| | - Thomas A Birkland
- Department of Public Administration, School of Public and International Affairs, North Carolina State University, Raleigh, NC 27695, USA
| | - Manli Zhang
- School of Public Affairs, University of Colorado, Denver, CO 80217, USA
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4
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Ma Z. The Role of Narrative Pictorial Warning Labels in Communicating Alcohol-Related Cancer Risks. HEALTH COMMUNICATION 2022; 37:1345-1353. [PMID: 33601986 DOI: 10.1080/10410236.2021.1888456] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This study examined the role of pictorial warning labels (PWLs) featuring narrative content in communicating alcohol-related cancer risks. In an online experiment, 169 adult alcohol consumers were randomly assigned to view two narrative PWLs, two non-narrative PWLs, or control. Results showed that exposure to narrative PWLs significantly increased participants' worry about, feelings of risk of, and perceived severity of harm of getting alcohol-related cancer, but did not affect their comparative likelihood of getting alcohol-related cancer or intentions to reduce alcohol use. Exposure to narrative PWLs also indirectly influenced intentions through increased worry. Moreover, participants' risk perceptions and intentions in non-narrative PWLs condition did not differ from those in narrative PWLs and control conditions. Therefore, these findings suggest that narrative PWLs are a promising strategy in informing consumers about the cancer risks of alcohol.
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Affiliation(s)
- Zexin Ma
- Department of Communication, Journalism, and Public Relations, Oakland University
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5
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Ren Y, Shen F. Effects of Narratives and Behavioral Involvement on Adolescents' Attitudes toward Gaming Disorder. HEALTH COMMUNICATION 2022; 37:657-667. [PMID: 33334198 DOI: 10.1080/10410236.2020.1862397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This paper examines the impact of using narratives to communicate a controversial health issue, gaming disorder, on adolescents' issue attitudes. In a between-subjects experiment, 115 adolescent participants read either a narrative or an informational message on gaming disorder. Results indicated that compared to the informational message, the narrative health message generated more positive attitudes toward the medical view of problematic gaming and greater attitude certainty. Transportation mediated the narrative's effect on attitudes. Behavioral involvement moderated the narrative's effect on attitudes and attitude certainty, such that the positive effects of the narrative on attitudes and attitude certainty were more pronounced for high-involvement adolescents than for low-involvement adolescents. In addition, behavioral involvement also enhanced the effect of message absorption on attitudes. By extending our research on narrative effects to the adolescent population, this study presents findings with both theoretical and practical implications.
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Affiliation(s)
- Yuchen Ren
- School of Media and Communication, Shenzhen University
| | - Fuyuan Shen
- Donald P. Bellisario College of Communications, Pennsylvania State University
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6
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Reaney M, Gladwin T, Chmiel N, Churchill S. Encouraging foot care in people with and without diabetes through narrative communication. J Health Psychol 2021; 27:1993-2012. [PMID: 34000870 DOI: 10.1177/13591053211017206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
In order to minimize risk of infection and potential foot complications, it is recommended that people with and without diabetes check their feet regularly for problems such as cuts, sores, blisters or calluses. Hence, an understanding of how to craft effective messages to encourage people to check their feet is important. Two studies investigated the use of narrative stories to encourage foot problem detection behaviour; Study 1 in a general population sample (N = 193), and Study 2 in a sample of people with type 1 or type 2 diabetes (N = 129). In both studies participants were randomised to either (a) receive an information sheet written in first-person narrative; (b) the same in non-narrative format; or (c) no information sheet. Changes in weekly detection behaviour was the outcome of interest. In both studies, greater detection behaviour was observed in the narrative message condition vs. non-narrative condition and the non-narrative condition vs. no information condition. Our findings have implications for the design of health messages in delivering effective foot care education to people with and without diabetes, suggesting that narrative information sheets may be more effective than non-narrative information sheets.
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Affiliation(s)
| | - Thomas Gladwin
- University of Chichester, UK.,Radboud University, the Netherlands.,University of Greenwich, UK
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Balog‐Way D, McComas K, Besley J. The Evolving Field of Risk Communication. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2020; 40:2240-2262. [PMID: 33084114 PMCID: PMC7756860 DOI: 10.1111/risa.13615] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 09/28/2020] [Indexed: 05/03/2023]
Abstract
The 40th Anniversary of the Society for Risk Analysis presents an apt time to step back and review the field of risk communication. In this review, we first evaluate recent debates over the field's current state and future directions. Our takeaway is that efforts to settle on a single, generic version of what constitutes risk communication will be less productive than an open-minded exploration of the multiple forms that comprise today's vibrant interdisciplinary field. We then review a selection of prominent cognitive, cultural, and social risk communication scholarship appearing in the published literature since 2010. Studies on trust in risk communication messengers continued to figure prominently, while new research directions emerged on the opportunities and critical challenges of enhancing transparency and using social media. Research on message attributes explored how conceptual insights particularly relating to framing, affective and emotional responses, and uncertainty might be operationalized to improve message effectiveness. Studies consistently demonstrated the importance of evaluation and how varying single attributes alone is unlikely to achieve desired results. Research on risk communication audiences advanced on risk perception and multiway engagement with notable interest in personal factors such as gender, race, age, and political orientation. We conclude by arguing that the field's interdisciplinary tradition should be further nurtured to drive the next evolutionary phase of risk communication research.
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Affiliation(s)
| | | | - John Besley
- Department of Advertising and Public RelationsMichigan State UniversityEast LansingMIUSA
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8
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Kim J. The Impact of Narrative Strategy on Promoting HPV Vaccination among College Students in Korea: The Role of Anticipated Regret. Vaccines (Basel) 2020; 8:E176. [PMID: 32290099 PMCID: PMC7349232 DOI: 10.3390/vaccines8020176] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 03/30/2020] [Accepted: 04/09/2020] [Indexed: 11/17/2022] Open
Abstract
Human papillomavirus (HPV) vaccine hesitancy contributes to unsatisfactory vaccination coverage in Korea despite its high efficacy in preventing various diseases including cervical cancer. To enhance HPV vaccine uptake, effective communication with the public is key. To develop effective health promotion messages, this study examined the effects of message format on attitudes and intentions toward HPV vaccination, specifically focusing on anticipated action and inaction regrets. It employed a randomized experimental message design format (narrative versus didactic messages). A total of 222 Korean undergraduate students who had not received the HPV shot participated in the experiment. The results showed that didactic messages produce greater anticipated inaction regret, which further influences HPV vaccination attitudes and behaviors. Anticipated regret could potentially explain mixed narrative effects across health behaviors as described in existing literature.
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Affiliation(s)
- Jarim Kim
- Department of Communication, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea
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9
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Shanahan EA, Reinhold AM, Raile ED, Poole GC, Ready RC, Izurieta C, McEvoy J, Bergmann NT, King H. Characters matter: How narratives shape affective responses to risk communication. PLoS One 2019; 14:e0225968. [PMID: 31815957 PMCID: PMC6901229 DOI: 10.1371/journal.pone.0225968] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 11/15/2019] [Indexed: 11/20/2022] Open
Abstract
Introduction Whereas scientists depend on the language of probability to relay information about hazards, risk communication may be more effective when embedding scientific information in narratives. The persuasive power of narratives is theorized to reside, in part, in narrative transportation. Purpose This study seeks to advance the science of stories in risk communication by measuring real-time affective responses as a proxy indicator for narrative transportation during science messages that present scientific information in the context of narrative. Methods This study employed a within-subjects design in which participants (n = 90) were exposed to eight science messages regarding flood risk. Conventional science messages using probability and certainty language represented two conditions. The remaining six conditions were narrative science messages that embedded the two conventional science messages within three story forms that manipulated the narrative mechanism of character selection. Informed by the Narrative Policy Framework, the characters portrayed in the narrative science messages were hero, victim, and victim-to-hero. Natural language processing techniques were applied to identify and rank hero and victim vocabularies from 45 resident interviews conducted in the study area; the resulting classified vocabulary was used to build each of the three story types. Affective response data were collected over 12 group sessions across three flood-prone communities in Montana. Dial response technology was used to capture continuous, second-by-second recording of participants’ affective responses while listening to each of the eight science messages. Message order was randomized across sessions. ANOVA and three linear mixed-effects models were estimated to test our predictions. Results First, both probabilistic and certainty science language evoked negative affective responses with no statistical differences between them. Second, narrative science messages were associated with greater variance in affective responses than conventional science messages. Third, when characters are in action, variation in the narrative mechanism of character selection leads to significantly different affective responses. Hero and victim-to-hero characters elicit positive affective responses, while victim characters produce a slightly negative response. Conclusions In risk communication, characters matter in audience experience of narrative transportation as measured by affective responses.
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Affiliation(s)
- Elizabeth A. Shanahan
- Department of Political Science, College of Letters & Science, Montana State University, Bozeman, Montana, United States of America
- Montana Institute on Ecosystems, Montana State University, Bozeman, Montana, United States of America
- * E-mail:
| | - Ann Marie Reinhold
- Department of Land Resources & Environmental Sciences, College of Agriculture, Montana State University, Bozeman, Montana, United States of America
| | - Eric D. Raile
- Department of Political Science, College of Letters & Science, Montana State University, Bozeman, Montana, United States of America
| | - Geoffrey C. Poole
- Montana Institute on Ecosystems, Montana State University, Bozeman, Montana, United States of America
- Department of Land Resources & Environmental Sciences, College of Agriculture, Montana State University, Bozeman, Montana, United States of America
| | - Richard C. Ready
- Montana Institute on Ecosystems, Montana State University, Bozeman, Montana, United States of America
- Department of Agricultural Economics & Economics, College of Agriculture, Montana State University, Bozeman, Montana, United States of America
| | - Clemente Izurieta
- Montana Institute on Ecosystems, Montana State University, Bozeman, Montana, United States of America
- Department of Computer Science, Gianforte School of Computing, Montana State University, Bozeman, Montana, United States of America
| | - Jamie McEvoy
- Montana Institute on Ecosystems, Montana State University, Bozeman, Montana, United States of America
- Department of Earth Sciences, College of Letters & Science, Montana State University, Bozeman, Montana, United States of America
| | - Nicolas T. Bergmann
- Department of Earth Sciences, College of Letters & Science, Montana State University, Bozeman, Montana, United States of America
| | - Henry King
- Department of Computer Science, Gianforte School of Computing, Montana State University, Bozeman, Montana, United States of America
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Fung TKF. The Role of Counterfactual Thinking in Narrative Persuasion: Its Impact on Patients' Adherence to Treatment Regimen. HEALTH COMMUNICATION 2019; 34:1482-1493. [PMID: 30058843 DOI: 10.1080/10410236.2018.1500432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The purpose of this study is twofold: (1) to explicate the underlying process of how narratives, accompanied with counterfactual thinking, exert cognitive and affective influence on audiences and (2) to examine how counterfactual thinking and regulatory focus, as story characteristics, enhance the persuasiveness of the narrative. Participants in the experiment were exposed to animated narratives in which the protagonist described her nonadherence to the peritoneal dialysis treatment regimen that resulted in her hospitalization. One hundred thirty-six patients undergoing peritoneal dialysis participated in a 2 (Goal failure framing: promotion-framed failure versus prevention-framed failure) by 2 (Counterfactual thinking: additive counterfactuals versus subtractive counterfactuals) between-subject factorial experiment. The analyses showed that narratives with additive counterfactuals, as opposed to those with subtractive counterfactuals, elicited greater anticipated regret and mental simulation, and, in turn, influenced the audience's attitude toward and intention of adherence. More important, promotion-/prevention-framed failure and additive/subtractive counterfactuals jointly influenced the audience's anticipated regret and mental simulation. Specifically, in the prevention-framed goal failure condition, narratives with additive counterfactuals elicited greater anticipated regret and mental simulation; however, in the promotion-framed goal failure condition, there was no significant difference on anticipated regret and mental simulation between narratives with subtractive counterfactuals and those with additive counterfactuals. The theoretical and practical implications were discussed.
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Affiliation(s)
- Timothy K F Fung
- Department of Communication Studies, Hong Kong Baptist University , Kowloon Tong , Hong Kong
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Sypes EE, McWhirter JE. Content Analysis of Health Warning Labels for Indoor Tanning in the United States. AMERICAN JOURNAL OF HEALTH EDUCATION 2019. [DOI: 10.1080/19325037.2019.1571965] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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12
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Leandro-França C, Murta SG. Evidências de Eficácia de Programas de Educação para Aposentadoria: Um Estudo Experimental. PSICOLOGIA: TEORIA E PESQUISA 2019. [DOI: 10.1590/0102.3772e35422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo O estudo avalia a eficácia de três programas de educação para aposentadoria, longo, breve e testemunho, utilizando um design experimental, com grupo controle e follow-up de seis meses, em amostra de servidores públicos (N=30). Utilizaram-se escalas de mudança em comportamentos de planejamento para aposentadoria, bem-estar subjetivo, perspectiva de tempo futuro e questionário de satisfação. Dados foram analisados por estatística descritiva, não paramétrica e análise de conteúdo. Não houve diferença estatisticamente significativa entre os grupos. Análises de tamanho de efeito revelaram efeitos positivos da intervenção longa em perspectiva de tempo futuro e satisfação com a vida, bem como efeitos positivos do grupo controle em investimento ocupacional-social, autonomia e bem-estar. Constata-se que as evidências são inconclusivas acerca da eficácia das intervenções.
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Hann KEJ, Ali N, Gessler S, Fraser LSM, Side L, Waller J, Sanderson SC, Lanceley A. Attitudes towards a programme of risk assessment and stratified management for ovarian cancer: a focus group study of UK South Asians' perspectives. BMJ Open 2018; 8:e021782. [PMID: 30021754 PMCID: PMC6059306 DOI: 10.1136/bmjopen-2018-021782] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE Population-based risk assessment, using genetic testing and the provision of appropriate risk management, could lead to prevention, early detection and improved clinical management of ovarian cancer (OC). Previous research with mostly white British participants found positive attitudes towards such a programme. The current study aimed to explore the attitudes of South Asian (SA) women and men in the UK with the aim of identifying how best to implement such a programme to minimise distress and maximise uptake. DESIGN Semistructured qualitative focus group discussions. SETTING Community centres across North London and Luton. PARTICIPANTS 49 women and 13 men who identified as SA (Indian, Pakistani or Bangladeshi), which constitutes the largest non-European ethnic minority group in the UK. METHODS Seven community-based focus groups were held. Group discussions were transcribed verbatim, coded and analysed thematically. RESULTS Awareness and knowledge of OC symptoms and specific risk factors was low. The programme was acceptable to most participants and attitudes to it were generally positive. Participants' main concerns related to receiving a high-risk result following the genetic test. Younger women may be more cautious of genetic testing, screening or risk-reducing surgery due to the importance of marriage and childbearing in their SA cultures. CONCLUSIONS A crucial first step to enable implementation of population-based genetic risk assessment and management in OC is to raise awareness of OC within SA communities. It will be important to engage with the SA community early on in programme implementation to address their specific concerns and to ensure culturally tailored decision support.
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Affiliation(s)
- Katie E J Hann
- Department of Women’s Cancer, EGA UCL Institute for Women’s Health, University College London, London, UK
- Health Psychology Research Unit, Royal Holloway, University of London, Egham, UK
| | - Nasreen Ali
- Institute for Health Research, University of Bedfordshire, Luton, UK
| | - Sue Gessler
- Department of Women’s Cancer, EGA UCL Institute for Women’s Health, University College London, London, UK
| | | | - Lucy Side
- Department of Women’s Cancer, EGA UCL Institute for Women’s Health, University College London, London, UK
- Department of Clinical Genetics, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Jo Waller
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Saskia C Sanderson
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK
- Department of Clinical Genetics, Great Ormond Street Hospital, London, UK
| | - Anne Lanceley
- Department of Women’s Cancer, EGA UCL Institute for Women’s Health, University College London, London, UK
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Janssen E, Ruiter RAC, Waters EA. Combining risk communication strategies to simultaneously convey the risks of four diseases associated with physical inactivity to socio-demographically diverse populations. J Behav Med 2018; 41:318-332. [PMID: 29027602 PMCID: PMC5899069 DOI: 10.1007/s10865-017-9894-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 10/07/2017] [Indexed: 12/17/2022]
Abstract
A single risk factor can increase the risk of developing multiple diseases, but most risk communication research has been conducted in the context of a single disease. We explored which combination of three recommended risk communication strategies is most effective in simultaneously conveying risk estimates of four diseases associated with physical inactivity: colon cancer, stroke, diabetes, and heart disease. Participants (N = 1161, 50% no college experience, 50% racial/ethnic minority) were shown hypothetical risk estimates for each of the four diseases. All four diseases were placed at varying heights on 1 of 12 vertical bar charts (i.e., "risk ladders") to indicate their respective probabilities. The risk ladders varied in a 2 (risk reduction information: present/absent) × 2 (numerical format: words/words and numbers) × 3 (social comparison information: none/somewhat higher than average/much higher than average) full factorial design. Participants were randomly assigned to view one of the risk ladders and then completed a questionnaire assessing message comprehension, message acceptance, physical activity-related risk and efficacy beliefs, and physical activity intentions. Higher message acceptance was found among (1) people who received risk reduction information versus those who did not (p = .01), and (2) people who did not receive social comparison information versus those told that they were at higher than average risk (p = .03). Further, absolute cognitive perceived risk of developing "any of the diseases shown in the picture" was higher among people who did not receive social comparison information (p = .03). No other main effects and only very few interactions with demographic variables were found. Combining recommended risk communication strategies did not improve or impair key cognitive or affective precursors of health behavior change. It might not be necessary to provide people with extensive information when communicating risk estimates of multiple diseases.
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Affiliation(s)
- Eva Janssen
- Department of Work and Social Psychology, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - Robert A C Ruiter
- Department of Work and Social Psychology, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - Erika A Waters
- School of Medicine, Department of Surgery (Division of Public Health Sciences), Washington University in Saint Louis, Campus Box 8100, 600 S. Euclid Ave, Saint Louis, MO, 63110, USA.
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15
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Dillard AJ, Ferrer RA, Welch JD. Associations between narrative transportation, risk perception and behaviour intentions following narrative messages about skin cancer. Psychol Health 2017; 33:573-593. [PMID: 28975805 DOI: 10.1080/08870446.2017.1380811] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Narrative messages may be an effective strategy to increase risk perceptions and motivate preventive behaviours related to cancer. The aim of this research was to examine associations between narrative transportation (i.e. psychological absorption into a narrative), risk perceptions, and intentions following narrative messages about skin cancer. DESIGN In two studies, women who reported indoor tanning read first-person narrative messages about skin cancer. We examined associations between narrative transportation and the women's responses to the narratives, including risk perceptions for skin cancer and behaviour intentions to reduce risk. Associations between transportation, knowledge and worry were also examined. RESULTS Greater transportation was associated with higher intentions to perform skin self-examination, talk to one's doctor about skin cancer, and look for more information. Greater transportation was also associated with higher gut feelings of risk and higher worry about skin cancer, but not deliberative risk perceptions or knowledge from the message. Additional analyses showed that after controlling for risk perception and worry, transportation had unique associations with some behaviour intentions. CONCLUSION Findings suggest that narrative transportation may be an important component to the persuasion of cancer narratives. Future research should explore ideas such as the role of the experiential system in narratives' influence.
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Affiliation(s)
- Amanda J Dillard
- a Department of Psychology , Grand Valley State University , Allendale , MI , USA
| | - Rebecca A Ferrer
- b Basic Biobehavioral and Psychological Sciences Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences , National Cancer Institute , Bethesda , MD , USA
| | - Jessica D Welch
- a Department of Psychology , Grand Valley State University , Allendale , MI , USA
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Nan X, Futerfas M, Ma Z. Role of Narrative Perspective and Modality in the Persuasiveness of Public Service Advertisements Promoting HPV Vaccination. HEALTH COMMUNICATION 2017; 32:320-328. [PMID: 27224002 DOI: 10.1080/10410236.2016.1138379] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
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.
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Affiliation(s)
- Xiaoli Nan
- a Department of Communication , University of Maryland
| | | | - Zexin Ma
- a Department of Communication , University of Maryland
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Perrier MJ, Martin Ginis KA. Changing health-promoting behaviours through narrative interventions: A systematic review. J Health Psychol 2016; 23:1499-1517. [PMID: 27387514 DOI: 10.1177/1359105316656243] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The objective of this review was to summarize the literature supporting narrative interventions that target health-promoting behaviours. Eligible articles were English-language peer-reviewed studies that quantitatively reported the results of a narrative intervention targeting health-promoting behaviours or theoretical determinants of behaviour. Five public health and psychology databases were searched. A total of 52 studies met inclusion criteria. In all, 14 studies found positive changes in health-promoting behaviours after exposure to a narrative intervention. The results for the changes in theoretical determinants were mixed. While narrative appears to be a promising intervention strategy, more research is needed to determine how and when to use these interventions.
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Dwyer LA, Shepperd JA, Stock ML. Predicting Avoidance of Skin Damage Feedback Among College Students. Ann Behav Med 2016; 49:685-95. [PMID: 25894276 DOI: 10.1007/s12160-015-9703-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Showing people a personal ultraviolet (UV) photograph depicting skin damage can be an effective method for changing sun protection cognitions and behaviors. PURPOSE We examined whether people opt not to see their UV photograph if given a choice. We also examined predictors of avoidance of skin damage feedback. METHODS College students (N = 257) completed questionnaires, viewed example UV photographs, and received the opportunity to see a UV photograph of their face. RESULTS Over one-third of participants opted not to see their UV photograph. Greater perceived risk of sun damage and having fewer coping resources corresponded with greater avoidance, particularly among participants who reported infrequent sun protection behavior. CONCLUSION The health benefits of UV photography are realized only if people are willing to view the photograph. Our findings suggest the need for interventions that increase receptivity to viewing one's UV photograph.
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Affiliation(s)
- Laura A Dwyer
- The George Washington University, Washington, DC, USA,
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Waters EA, Janssen E, Kaufman AR, Peterson LM, Muscanell NL, Guadagno RE, Stock ML. The Relationship Between Young Adult Smokers' Beliefs About Nicotine Addiction and Smoking-Related Affect and Cognitions. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2016; 31:338-47. [PMID: 25903051 PMCID: PMC4619178 DOI: 10.1007/s13187-015-0819-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Risk beliefs and self-efficacy play important roles in explaining smoking-related outcomes and are important to target in tobacco control interventions. However, information is lacking about the underlying beliefs that drive these constructs. The present study investigated the interrelationships among young adult smokers' beliefs about the nature of nicotine addiction and smoking-related affect and cognitions (i.e., feelings of risk, worry about experiencing the harms of smoking, self-efficacy of quitting, and intentions to quit). Smokers (n = 333) were recruited from two large universities. Results showed that quit intentions were associated with feelings of risk, but not with worry or self-efficacy. Furthermore, higher feelings of risk were associated with lower beliefs that addiction is an inevitable consequence of smoking and with lower beliefs that the harms of smoking are delayed. This suggests that it is important for health messages to counter the possible negative effects of messages that strongly emphasize the addictiveness of nicotine, possibly by emphasizing the importance of quitting earlier rather than later. The findings also add to the evidence base that feelings of risk are powerful predictors of behavioral intentions. Furthermore, our results suggest that in some circumstances, feelings of risk predict quit intentions beyond that predicted by worry and self-efficacy. Gaining additional understanding of the tobacco-related beliefs that can increase feelings of risk and incorporating those beliefs into educational campaigns may improve the quality of such campaigns and reduce tobacco use.
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Affiliation(s)
- Erika A Waters
- Division of Public Health Sciences, Washington University School of Medicine, 660 S. Euclid Ave, Campus, Box 8100, St. Louis, MO, 63110, USA.
| | - Eva Janssen
- Maastricht University School for Public Health and Primary Care (Caphri), Department of Health Promotion, Faculty of Health, Medicine and Life Sciences, Maastricht, The Netherlands
| | - Annette R Kaufman
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | | | | | - Rosanna E Guadagno
- Emerging Media and Communication; Department of Psychology, University of Texas at Dallas, Richardson, TX, USA
| | - Michelle L Stock
- Department of Psychology, George Washington University, Washington, DC, USA
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Tannenbaum MB, Hepler J, Zimmerman RS, Saul L, Jacobs S, Wilson K, Albarracín D. Appealing to fear: A meta-analysis of fear appeal effectiveness and theories. Psychol Bull 2015; 141:1178-204. [PMID: 26501228 PMCID: PMC5789790 DOI: 10.1037/a0039729] [Citation(s) in RCA: 402] [Impact Index Per Article: 44.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Fear appeals are a polarizing issue, with proponents confident in their efficacy and opponents confident that they backfire. We present the results of a comprehensive meta-analysis investigating fear appeals' effectiveness for influencing attitudes, intentions, and behaviors. We tested predictions from a large number of theories, the majority of which have never been tested meta-analytically until now. Studies were included if they contained a treatment group exposed to a fear appeal, a valid comparison group, a manipulation of depicted fear, a measure of attitudes, intentions, or behaviors concerning the targeted risk or recommended solution, and adequate statistics to calculate effect sizes. The meta-analysis included 127 articles (9% unpublished) yielding 248 independent samples (NTotal = 27,372) collected from diverse populations. Results showed a positive effect of fear appeals on attitudes, intentions, and behaviors, with the average effect on a composite index being random-effects d = 0.29. Moderation analyses based on prominent fear appeal theories showed that the effectiveness of fear appeals increased when the message included efficacy statements, depicted high susceptibility and severity, recommended one-time only (vs. repeated) behaviors, and targeted audiences that included a larger percentage of female message recipients. Overall, we conclude that (a) fear appeals are effective at positively influencing attitude, intentions, and behaviors; (b) there are very few circumstances under which they are not effective; and (c) there are no identified circumstances under which they backfire and lead to undesirable outcomes.
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Affiliation(s)
| | | | | | - Lindsey Saul
- Department of Social and Behavioral Health, Virginia Commonwealth University
| | - Samantha Jacobs
- Department of Social and Behavioral Health, Virginia Commonwealth University
| | - Kristina Wilson
- Department of Psychology, University of Illinois at Urbana- Champaign
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Zebregs S, van den Putte B, de Graaf A, Lammers J, Neijens P. The effects of narrative versus non-narrative information in school health education about alcohol drinking for low educated adolescents. BMC Public Health 2015; 15:1085. [PMID: 26499061 PMCID: PMC4619486 DOI: 10.1186/s12889-015-2425-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 10/16/2015] [Indexed: 12/29/2022] Open
Abstract
Background Traditionally most health education materials are written in an expository non-narrative format. Scholars have argued that the effectiveness of materials may increase when these texts are replaced by narrative texts, and that the non-narrative texts should be replaced by narrative texts. However, no previous studies have tested these claims in the context of school health education for low educated adolescents. This study aims to do so for an existing preventive health education intervention about alcohol for low educated adolescents. Based on the empirical findings of previous studies, it is expected that the claims about narratives being more effective than non-narrative texts are not true for effects on knowledge. Instead non-narrative texts are expected to have a stronger impact on this outcome variable. For attitude towards alcohol and intention to drink alcohol the claims are expected to be true, because participants are expected to be less aware of the persuasive intent of the narrative texts, which would make them less resistant. As a result, narrative texts are expected to have a stronger effect on attitude and intention. Methods This study compares the effects on knowledge, attitude towards alcohol, and intention to drink alcohol of both information formats in a two-condition (non-narrative vs. narrative information) experiment with repeated measures (pre-measurement, immediate post-measurement, and delayed post-measurement). The experiment was conducted amongst 296 students of the two lowest levels of the Dutch secondary education system. Results The results showed immediate effects on knowledge and attitude towards alcohol, which did not differ between conditions and school levels. These effects did not persist over time. There were no effects on intention to drink alcohol. Conclusion It is concluded non-narrative and narrative information are equally effective in the context of school health education, suggesting the claims that scholars have made about the superior effects of narrative texts are not true. Given the fact that narrative texts are more expensive to develop, policy makers may not be advised to prefer these types of texts over the traditionally used non-narrative texts.
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Affiliation(s)
- Simon Zebregs
- The Amsterdam School of Communication Research ASCoR, Department of Communication Science, University of Amsterdam, Nieuwe Achtergracht 166, 1018 WV, Amsterdam, The Netherlands.
| | - Bas van den Putte
- The Amsterdam School of Communication Research ASCoR, Department of Communication Science, University of Amsterdam, Nieuwe Achtergracht 166, 1018 WV, Amsterdam, The Netherlands. .,Trimbos Institute, Netherlands Institute for Mental Health and Addiction, Postbus 725, 3500 AS, Utrecht, The Netherlands.
| | - Anneke de Graaf
- Centre for Language Studies, Faculty of Arts, Radboud University Nijmegen, Postbus 9103, 6500 HD, Nijmegen, The Netherlands.
| | - Jeroen Lammers
- Trimbos Institute, Netherlands Institute for Mental Health and Addiction, Postbus 725, 3500 AS, Utrecht, The Netherlands.
| | - Peter Neijens
- The Amsterdam School of Communication Research ASCoR, Department of Communication Science, University of Amsterdam, Nieuwe Achtergracht 166, 1018 WV, Amsterdam, The Netherlands.
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Steinhardt J, Shapiro MA. Framing Effects in Narrative and Non-Narrative Risk Messages. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2015; 35:1423-1436. [PMID: 25809457 DOI: 10.1111/risa.12368] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Narrative messages are increasingly popular in health and risk campaigns, yet gain/loss framing effects have never been tested with such messages. Three experiments examined framing in narrative messages. Experiment 1 found that only the character's decision, not framing, influenced judgments about characters in a narrative derived from a prospect theory context. Experiment 2 found that a framing effect that occurred when presented in a decision format did not occur when the same situation was presented as a narrative. Using a different story/decision context, Experiment 3 found no significant difference in preference for surgery over radiation therapy in a narrative presentation compared to a non-narrative presentation. The results suggest that health and risk campaigns cannot assume that framing effects will be the same in narrative messages and non-narrative messages. Potential reasons for these differences and suggestions for future research are discussed.
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Dillard AJ, Hisler G. Enhancing the effects of a narrative message through experiential information processing: An experimental study. Psychol Health 2015; 30:803-20. [DOI: 10.1080/08870446.2014.996565] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Janssen E, van Osch L, Lechner L, de Vries H. Influencing feelings of cancer risk: direct and moderator effects of affectively laden phrases in risk communication. JOURNAL OF HEALTH COMMUNICATION 2015; 20:321-327. [PMID: 25569710 DOI: 10.1080/10810730.2014.965362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Evidence is accumulating for the importance of feelings of risk in explaining cancer preventive behaviors, but best practices for influencing these feelings are limited. This study investigated the direct and moderational influence of affectively laden phrases in cancer risk messages. Two experimental studies were conducted in relation to different cancer-related behaviors--sunbed use (n = 112) and red meat consumption (n = 447)--among student and nonstudent samples. Participants were randomly assigned to one of two conditions: (a) a cognitive message using cognitively laden phrases or (b) an affective message using affectively laden phrases. The results revealed that affective phrases did not directly influence feelings of risk in both studies. Evidence for a moderational influence was found in Study 2, suggesting that affective information strengthened the relation between feelings of risk and intention (i.e., participants relied more on their feelings in the decision-making process after exposure to affective information). These findings suggest that solely using affective phrases in risk communication may not be sufficient to directly influence feelings of risk and other methods need to be explored in future research. Moreover, research is needed to replicate our preliminary indications for a moderational influence of affective phrases to advance theory and practice.
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Affiliation(s)
- Eva Janssen
- a Faculty of Health, Medicine, and Life Sciences, Department of Health Promotion, School for Public Health and Primary Care , Maastricht University , Maastricht , The Netherlands
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Scully M, Makin J, Maloney S, Wakefield M. Changes in coverage of sun protection in the news: threats and opportunities from emerging issues. HEALTH EDUCATION RESEARCH 2014; 29:378-387. [PMID: 24650946 DOI: 10.1093/her/cyu013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This study aimed to determine whether there have been shifts in news coverage of sun protection issues over a 12-year period in the context of an evolving skin cancer prevention agenda. A content analysis was performed on all relevant articles (N = 552) published in the two metropolitan daily newspapers in Melbourne, Australia, from 2001 to 2012. Coding variables included theme, article type, prominence, spokesperson and topic slant. Articles were collapsed into three 4-year blocks and a series of chi-square analyses conducted to examine changes over time in coverage of topical issues (i.e. vitamin D and sunbeds) and established sun protection themes [i.e. health effects of ultraviolet (UV) exposure, education/prevention, attitudes/behaviour]. Coverage of vitamin D and sunbed issues increased over time and became more positive for sun protection objectives. The proportion of articles reporting on established sun protection themes remained steady over time (range: 36-38%) and there were no changes observed in the way these topics were presented in the news media. These results highlight that potentially competing sun protection issues that emerge over time need not pose a threat to existing skin cancer prevention programmes but instead can provide opportunities to further spread programme messages while increasing credibility.
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Affiliation(s)
- Maree Scully
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Jennifer Makin
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Sarah Maloney
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Melanie Wakefield
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
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