-
Vaccines Jun 2024This systematic review of 54 cross-disciplinary peer-reviewed causal empirical studies helps public health officials, researchers, and healthcare professionals better... (Review)
Review
This systematic review of 54 cross-disciplinary peer-reviewed causal empirical studies helps public health officials, researchers, and healthcare professionals better comprehend the effects of fear appeals in vaccine promotional campaigns on message processing, persuasion, vaccination attitudes, and vaccination intentions. This review documents inconsistent findings across studies, which it attempts to clarify by considering differences in research designs, sample populations, and outcomes measured. In general, we find that fear appeals increase risk perceptions, message involvement, and vaccination attitudes. However, fear appeals have less influence on vaccination intentions, especially among female and general adult populations or populations from the U.S. and other Western cultures. On the other hand, the effect of fear appeals on vaccination intentions is stronger among student populations and those from China (People's Republic of China and Hong Kong) and other non-Western cultures. Also, fear appeals are less persuasive when promoting COVID-19 vaccines and boosters than they are for other vaccines (e.g., HPV, influenza, MMR). Future research should compare fear appeal effectiveness in messages across vaccines or when combined with other executional elements, such as the endorser or type of evidence provided. Finally, future studies should explore other methodological approaches and measure underexplored message outcomes, such as vaccine uptake behavior, in more naturalistic settings.
PubMed: 38932382
DOI: 10.3390/vaccines12060653 -
Health Communication May 2024This systematic review evaluates health messaging strategies for the prevention and cessation of e-cigarette use among youth and young adults. Health messaging...
This systematic review evaluates health messaging strategies for the prevention and cessation of e-cigarette use among youth and young adults. Health messaging strategies were defined as the strategic process of developing messages with the intent to shape, reinforce, or change recipients' health attitudes and behaviors. McGuire's Communication/Persuasion Model guided the analysis of the messaging strategies, focusing on the model's five communication inputs (i.e. source, message, channel, audience, destination) and 14 persuasive outcomes. Nine databases were searched from January 2007 to September 2023. The inclusion criteria encompassed studies in English that presented quantitative data on messaging strategies aimed at discouraging vaping among youth and young adults. Each study was also coded for study characteristics and the utilization of theory. Out of 6,045 studies, 25 met the inclusion criteria. The reviewed studies exhibit a diverse array of research methods and a consistent integration of theories. The review emphasizes the nuanced main and interaction effects of various communication inputs, such as message features and audience characteristics, while also pointing out a research gap in message sources. In addition, the utilization of social media for effective messaging to engage the audience requires further research. Only one study specifically evaluated messaging strategies for vaping cessation. More research is imperative to develop targeted and tailored messages that effectively prevent and reduce vaping, especially among populations at higher risk of vaping-related harms, while also leveraging effective channels and innovative communication technologies to engage the audience.
PubMed: 38742648
DOI: 10.1080/10410236.2024.2352284 -
Patient Education and Counseling Feb 2024Although health promotion scholars and practitioners frequently employ video-based promotion, its effectiveness remains uncertain due to mixed findings. Nuanced details... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Although health promotion scholars and practitioners frequently employ video-based promotion, its effectiveness remains uncertain due to mixed findings. Nuanced details regarding content and design also remain under-explored.
METHODS
We conducted a comprehensive search across nine databases to identify relevant empirical research articles.
RESULTS
Our systematic review included a total of 54 studies, with 38 studies eligible for meta-analysis. Findings highlight the promising potential of video messaging strategies in promoting health behaviors.
CONCLUSIONS
Future research should focus on designing video content that targets detection behaviors within an appropriate length, guided by robust theoretical frameworks to maximize the efficacy of video promotion. More substantial evidence is needed to assess whether video promotion can achieve similar persuasive effectiveness across diverse cultural, political, and economic circumstances. Factors related to the audience (e.g., distinct psychological and personality influences) and message characteristics (e.g., length, credibility) should be further explored to better elucidate the relationship between video-based health promotion and health outcomes.
PRACTICE IMPLICATIONS
Health practitioners and organizations should incorporate video-based messages in interventions as supplement or alternative means to educate audiences of positive prevention methods, establish accurate attitude and intentions toward prevention behaviors, and increase their vigilance toward risky behaviors.
Topics: Humans; Health Promotion; Health Behavior; Communications Media
PubMed: 38070298
DOI: 10.1016/j.pec.2023.108095 -
Frontiers in Psychology 2023Guilt appeals are widely used as a persuasive approach in various areas of practice. However, the strength and direction of the persuasive effects of guilt appeals are...
INTRODUCTION
Guilt appeals are widely used as a persuasive approach in various areas of practice. However, the strength and direction of the persuasive effects of guilt appeals are mixed, which could be influenced by theoretical and methodological factors.
METHOD
The present study is a comprehensive meta-analysis of 26 studies using a random-effects model to assess the persuasive effects of guilt appeals. In total, 127 effect sizes from seven types of persuasive outcomes (i.e., guilt, attitude, behavior, behavioral intention, non-guilt emotions, motivation, and cognition) were calculated based on 7,512 participants.
RESULTS
The analysis showed a small effect size of guilt appeals [ = 0.19, 95% CI (0.10, 0.28)]. The effect of guilt appeals was moderated by the theoretical factors related to appraisal and coping of guilt arousal, including attributed responsibility, controllability and stability of the causal factors, the proximity of perceiver-victim relationship, recommendation of reparative behaviors, and different outcome types. The effect was also associated with methods used in different studies.
DISCUSSION
Overall, the findings demonstrated the persuasive effects of guilt appeals, but theoretical and methodological factors should be considered in the design and testing of guilt appeals. We also discussed the practical implications of the findings.
PubMed: 37842697
DOI: 10.3389/fpsyg.2023.1201631 -
Journal of Medical Internet Research Oct 2023The ubiquity of short videos has demonstrated vast potential for health communication. An expansion of research has examined the persuasive effect of health... (Review)
Review
BACKGROUND
The ubiquity of short videos has demonstrated vast potential for health communication. An expansion of research has examined the persuasive effect of health communication in short videos, yet a synthesis of the research is lacking.
OBJECTIVE
This paper aims to provide an overview of the literature by examining the persuasive effect of health communication in short videos, offering guidance for researchers and practitioners. In particular, it seeks to address 4 key research questions: What are the characteristics of short videos, samples, and research designs in short video-based health communication literature? What theories underpin the short video-based health communication literature? What are the persuasive effects of health communication in short videos? and What directions should future research in this area take?
METHODS
Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, an electronic search of 10 databases up to March 10, 2023, generated 4118 results. After the full-text screening, 18 articles met the eligibility criteria.
RESULTS
The current research lacks a uniform definition of short videos, demonstrates sample biases in location and education, and adopts limited methodologies. Most studies in this synthesis are theoretically grounded or use theoretical concepts, which are predominantly well examined in persuasion research. Moreover, relevant topics and suitable themes are effective in persuasive health communication outcomes, whereas the impact of diverse narrative techniques remains ambiguous.
CONCLUSIONS
We recommend that future research extends the definition of short videos beyond time constraints and explores non-Western and less-educated populations. In addition, researchers should consider diverse methods to provide a more comprehensive examination and investigate the impact of audience targeting and narrative techniques in short video health communication. Finally, investigating how the unique aspects of short videos interact with or challenge traditional persuasion theories is essential.
Topics: Humans; Persuasive Communication; Health Communication; Narration; Surveys and Questionnaires
PubMed: 37831488
DOI: 10.2196/48508 -
Journal of Medical Internet Research Jun 2023Taxonomies and models are useful tools for defining eHealth content and intervention features, enabling comparison and analysis of research across studies and... (Review)
Review
BACKGROUND
Taxonomies and models are useful tools for defining eHealth content and intervention features, enabling comparison and analysis of research across studies and disciplines. The Behavior Change Technique Taxonomy version 1 (BCTTv1) was developed to decrease ambiguity in defining specific characteristics inherent in health interventions, but it was developed outside the context of digital technology. In contrast, the Persuasive System Design Model (PSDM) was developed to define and evaluate the persuasive content in software solutions but did not have a specific focus on health. Both the BCTTv1 and PSDM have been used to define eHealth interventions in the literature, with some researchers combining or reducing the taxonomies to simplify their application. It is unclear how well the taxonomies accurately define eHealth and whether they should be used alone or in combination.
OBJECTIVE
This scoping review explored how the BCTTv1 and PSDM capture the content and intervention features of parent-focused eHealth as part of a program of studies investigating the use of technology to support parents with therapy home programs for children with special health care needs. It explored the active ingredients and persuasive technology features commonly found in parent-focused eHealth interventions for children with special health care needs and how the descriptions overlap and interact with respect to the BCTTv1 and PSDM taxonomies.
METHODS
A scoping review was used to clarify concepts in the literature related to these taxonomies. Keywords related to parent-focused eHealth were defined and used to systematically search several electronic databases for parent-focused eHealth publications. Publications referencing the same intervention were combined to provide comprehensive intervention details. The data set was coded using codebooks developed from the taxonomies in NVivo (version 12; QSR International) and qualitatively analyzed using matrix queries.
RESULTS
The systematic search found 23 parent-focused eHealth interventions described in 42 articles from various countries; delivered to parents with children aged 1 to 18 years; and covering medical, behavioral, and developmental issues. The predominant active ingredients and intervention features in parent-focused eHealth were concerned with teaching parents behavioral skills, encouraging them to practice and monitor the new skills, and tracking the outcomes of performing the new skills. No category had a complete set of active ingredients or intervention features coded. The two taxonomies conceptually captured different constructs even when their labels appeared to overlap in meaning. In addition, coding by category missed important active ingredients and intervention features.
CONCLUSIONS
The taxonomies were found to code different constructs related to behavior change and persuasive technology, discouraging the merging or reduction of the taxonomies. This scoping review highlighted the benefit of using both taxonomies in their entirety to capture active ingredients and intervention features important for comparing and analyzing eHealth across different studies and disciplines.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)
RR2-doi.org/10.15619/nzjp/47.1.05.
Topics: Child; Humans; Behavior Therapy; Delivery of Health Care; Persuasive Communication; Technology; Telemedicine
PubMed: 37342082
DOI: 10.2196/42083 -
Health Communication Jul 2024Vaccination is a vital defense against COVID-19 infections and outbreaks, yet vaccine hesitancy poses a significant threat to pandemic response and recovery. We...
Vaccination is a vital defense against COVID-19 infections and outbreaks, yet vaccine hesitancy poses a significant threat to pandemic response and recovery. We conducted a systematic review of published randomized controlled trials ( = 47) assessing the persuasive effects of COVID-19 communication on COVID-19 vaccine acceptance. Individual vs. collective appeals and gain vs. loss frames are among the most frequently assessed message features, but they generally do not make a difference in persuasion. Normative messages that highlight higher (vs. lower) prevalence of vaccine acceptance are more persuasive. Message sources overall have limited impact on COVID-19 vaccine acceptance, but sources that have a shared identity with the message receivers tend to be persuasive. More engaging message channels such as interactive chatbots and videos are promising communication tools but are generally under-utilized and under-studied. Compared to no communication or irrelevant communication, COVID-19 vaccine messages generally have a small advantage in increasing COVID-19 vaccine acceptance. Messages that include 1) vaccine safety and/or efficacy information; 2) collective appeals combined with embarrassment appeals; and 3) political leaders' vaccine endorsement are among the most effective messaging strategies. There is no evidence of any backfire effects of COVID-19 vaccine messages. We discuss the implications of our findings for persuasive message design in pandemic vaccine communication.
Topics: Humans; Persuasive Communication; COVID-19; Randomized Controlled Trials as Topic; COVID-19 Vaccines; Motivation; SARS-CoV-2; Health Communication; Vaccination Hesitancy; Vaccination
PubMed: 37254940
DOI: 10.1080/10410236.2023.2218145 -
Campbell Systematic Reviews Jun 2022Limited knowledge regarding the relative effectiveness of workplace accident prevention approaches creates barriers to informed decision-making by policy makers, public... (Review)
Review
BACKGROUND
Limited knowledge regarding the relative effectiveness of workplace accident prevention approaches creates barriers to informed decision-making by policy makers, public health practitioners, workplace, and worker advocates.
OBJECTIVES
The objective of this review was to assess the effectiveness of broad categories of safety interventions in preventing accidents at work. The review aims to compare effects of safety interventions to no intervention, usual activities, or alternative intervention, and if possible, to examine which constituent components of safety intervention programs contribute more strongly to preventing accidents at work in a given setting or context.
DATE SOURCES
Studies were identified through electronic bibliographic searches, government policy databanks, and Internet search engines. The last search was carried out on July 9, 2015. Gray literature were identified by searching OSH ROM and Google. No language or date restrictions were applied. Searches done between February and July of 2015 included PubMed (1966), Embase (1980), CINAHL (1981), OSH ROM (NIOSHTIC 1977, HSELINE 1977, CIS-DOC 1974), PsycINFO (1806), EconLit (1969), Web of Science (1969), and ProQuest (1861); dates represent initial availability of each database. Websites of pertinent institutions (NIOSH, Perosh) were also searched.
STUDY ELIGIBILITY CRITERIA PARTICIPANTS AND INTERVENTIONS
Included studies had to focus on accidents at work, include an evaluation of a safety intervention, and have used injuries at work, or a relevant proxy, as an outcome measure. Experimental, quasi-experimental, and observational study designs were utilized, including randomized controlled trials (RCTs), controlled before and after (CBA) studies, and observational designs using serial measures (interrupted time series, retrospective cohort designs, and before and after studies using multiple measures). Interventions were classified by approach at the individual or group level, and broad categories based on the prevention approach including modification of: Attitudes (through information and persuasive campaign messaging).Behaviors (through training, incentives, goal setting, feedback/coaching).Physiological condition (by physical training).Climate/norms/culture (by coaching, feedback, modification of safety management/leadership).Structural conditions (including physical environment, engineering, legislation and enforcement, sectorial-level norms). When combined approaches were used, interventions were termed "multifaceted," and when an approach(es) is applied to more than one organizational level (e.g., individual, group, and/or organization), it is termed "across levels."
STUDY APPRAISAL AND SYNTHESIS METHODS
Narrative report review captured industry (NACE), work setting, participant characteristics, theoretical basis for approach, intervention fidelity, research design, risk of bias, contextual detail, outcomes measures and results. Additional items were extracted for studies with serial measures including approaches to improve internal validity, assessments of reasonable statistical approaches (Effective Practice of Organization of Care [EPOC] criteria) and overall inference. Random-effects inverse variance weighted meta-analytic methods were used to synthesize odds ratios, rate ratios, or standardized mean differences for the outcomes for RCT and CBA studies with low or moderate levels of heterogeneity. For studies with greater heterogeneity and those using serial measures, we relied on narrative analyses to synthesize findings.
RESULTS
In total 100 original studies were included for synthesis analysis, including 16 RCT study designs, 30 CBA study designs, and 54 studies using serial measures (ITS study designs). These studies represented 120 cases of safety interventions. The number of participants included 31,971,908 individuals in 59 safety interventions, 417,693 groups/firms in 35 safety interventions, and 15,505 injuries in 17 safety interventions. Out of the 59 safety interventions, two were evaluating national prevention measures, which alone accounted for 31,667,110 individuals. The remaining nine safety interventions used other types of measures, such as safety exposure, safety observations, gloves or claim rates. Strong evidence supports greater effects being achieved with safety interventions directed toward the group or organization level rather than individual behavior change. Engineering controls are more effective at reducing injuries than other approaches, particularly when engineered changes can be introduced without requiring "decision-to-use" by workplaces. Multifaceted approaches combining intervention elements on the organizational level, or across levels, provided moderate to strong effects, in particular when engineering controls were included. Interventions based on firm epidemiologic evidence of causality and a strong conceptual approach were more effective. Effects that are more modest were observed (in short follow-up) for safety climate interventions, using techniques such as feedback or leadership training to improve safety communication. There was limited evidence for a strong effect at medium-term with more intense counseling approaches. Evidence supports regulation/legislation as contributing to the prevention of accidents at work, but with lower effect sizes. Enforcement appears to work more consistently, but with smaller effects. In general, the results were consistent with previous systematic reviews of specific types of safety interventions, although the effectiveness of economic incentives to prevent accidents at work was not consistent with our results, and effectiveness of physiological safety intervention was only consistent to some extent.
LIMITATIONS
Acute musculoskeletal injuries and injuries from more long-time workplace exposures were not always clearly distinguished in research reports. In some studies acute and chronic exposures were mixed, resulting in inevitable misclassification. Of note, the classification of these events also remains problematic in clinical medicine. It was not possible to conduct meta-analyses on all types of interventions (due to variability in approach, context, and participants). The findings presented for most intervention types are from limited sources, and assessment of publication bias was not possible. These issues are not surprising, given the breadth of the field of occupational safety. To incorporate studies using serial measures, which provide the only source of information for some safety interventions such as legislation, we took a systematic, grounded approach to their review. Rather than requiring more stringent, specific criteria for inclusion of ITS studies, we chose to assess how investigators justified their approach to design and analyses, based on the context in which they were working. We sought to identify measures taken to improve external validity of studies, reasonable statistical inference, as well as an overall appropriate inferential process. We found the process useful and enlightening. Given the new approach, we may have failed to extract points others may find relevant. Similarly, to facilitate the broad nature of this review, we used a novel categorization of safety interventions, which is likely to evolve with additional use. The broad scope of this review and the time and resources available did not allow for contacting authors of original papers or seeking translation of non-English manuscripts, resulting in a few cases where we did not have sufficient information that may have been possible to obtain from the authors.
CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS
Our synthesis of the relative effectiveness of workplace safety interventions is in accordance with the Public Health Hierarchy of Hazard Control. Specifically, more effective interventions eliminate risk at the source of the hazard through engineering solutions or the separation of workers from hazards; effects were greater when these control measures worked independently of worker "decision-to-use" at the worksite. Interventions based on firm epidemiological evidence of causality and clear theoretical bases for the intervention approach were more effective in preventing injuries. Less effective behavioral approaches were often directed at the prevention of all workplace injuries through a common pathway, such as introducing safety training, without explicitly addressing specific hazards. We caution that this does not mean that training does not play an essential function in worker safety, but rather that it is not effective in the absence of other efforts. Due to the potential to reach large groups of workers through regulation and enforcement, these interventions with relatively modest effects, could have large population-based effects.
PubMed: 36911341
DOI: 10.1002/cl2.1234 -
Journal of Behavioral Addictions Sep 2022This systematic review examines whether sports betting behaviors differ among and between sports bettors in different countries, evaluates psychosocial problems related... (Review)
Review
BACKGROUND AND AIMS
This systematic review examines whether sports betting behaviors differ among and between sports bettors in different countries, evaluates psychosocial problems related to sports betting behaviors and how problems may vary by country, and lastly, summarizes the current regulatory guidelines for sports betting.
METHODS
We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and included peer-reviewed articles from PubMed, Web of Science, and PsycINFO. Studies on sports betting behavior were included if they were published in English or Chinese between January 1, 2010 and March 28th, 2022. We gathered regulatory information from peer-reviewed articles, legal acts, and relevant websites. Of 2,450 articles screened, 65 were included in the final review.
RESULTS
Marketing and promotion of sports betting were more prominent for sports betting in Australia and the United Kingdom. Interviews with sports bettors demonstrated that sports betting is persuasive and normalized. Psychosocial problems do not appear to differ greatly by country, and sports betting appears to be associated with elevated levels of problem gambling. Responsible gambling approaches have helped address risky sports betting behaviors. China and South Korea have imposed more strict regulations and restrictions on sports betting access in comparison to countries such as Australia or the United States.
DISCUSSION AND CONCLUSIONS
Currently, sports betting is easy to access, normalized, and contains many attractive features for sports bettors. Psychoeducation about potential risks of sports betting and encouragement of responsible gambling strategies could help lessen risky sports-betting behaviors, though cross-cultural adaptations should be explored.
Topics: Humans; Gambling; Sports; Risk-Taking; Marketing; Persuasive Communication
PubMed: 36067022
DOI: 10.1556/2006.2022.00064 -
JMIR MHealth and UHealth Mar 2022Pelvic floor muscle training (PFMT) is one of the first-line treatments for stress urinary incontinence among pregnant women. Mobile health (mHealth) technology is... (Review)
Review
BACKGROUND
Pelvic floor muscle training (PFMT) is one of the first-line treatments for stress urinary incontinence among pregnant women. Mobile health (mHealth) technology is potentially effective for delivering PFMT to pregnant women. Persuasive technology in the development of such mobile apps may facilitate behavior change by improving adherence to the exercises. The Capability, Opportunity, and Motivation-Behavior (COM-B) model is potentially useful in selecting the appropriate interventions to be incorporated into the apps.
OBJECTIVE
This review of mHealth apps for PFMT aims to describe the principles of persuasion used for each app and to propose mHealth app design features based on the COM-B model.
METHODS
A systematic literature search was conducted to answer three main research questions: what are the available mHealth apps for PFMT in the published literature, what persuasive strategies were used in their studies how were they mapped to the COM-B model, and how effective were the selected persuasive strategies for PFMT adherence? We searched PubMed, CINAHL, Web of Science, Scopus, and local Malaysian databases such as MyCite and MyMedR for articles reporting mHealth apps used for the delivery of PFMT. We included original articles reporting experimental and cross-sectional studies, including pilot or feasibility trials. Systematic and narrative reviews were excluded. Narrative and thematic syntheses were conducted on the eligible articles based on the research questions. The Cochrane risk of bias tool and the Risk of Bias Assessment Tool for Non-randomized Studies were used to assess study bias.
RESULTS
Of the 169 records from the initial search, 10 (5.9%) articles meeting the selection criteria were included in this review. There were 8 mHealth apps designed for the delivery of PFMT. The Tät, which used 3 categories of persuasive system design, improved PFMT adherence and was cost-effective. Only 1 app, the iBall app, used all categories of persuasive system design, by including social support such as "competition" in its design. The Diário Saúde app was the only app developed using operant conditioning. All apps incorporated Tailoring and Expertise as part of their PSD strategies. Only 3 apps, the Diário Saúde, Tät, and Pen Yi Kang demonstrated improved PFMT adherence.
CONCLUSIONS
Persuasive technology used in mobile apps may target desired behavior change more effectively. The persuasive system design can be mapped to the COM-B model to explain its effectiveness on behaviour change outcomes.
Topics: Cross-Sectional Studies; Female; Humans; Mobile Applications; Pelvic Floor; Persuasive Communication; Pregnancy; Technology; Telemedicine
PubMed: 35315777
DOI: 10.2196/28751