-
BMJ Global Health Jul 2022Vaccine safety is a primary concern among vaccine-hesitant individuals. We examined how seven persuasive messages with different frames, all focusing on vaccine safety,... (Randomized Controlled Trial)
Randomized Controlled Trial
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.
Topics: Adult; Aged; COVID-19; COVID-19 Vaccines; Humans; Malaysia; Persuasive Communication; Viral Vaccines
PubMed: 35906015
DOI: 10.1136/bmjgh-2022-009250 -
Health Research Policy and Systems Mar 2019There is increased interest in using narratives or storytelling to influence health policies. We aimed to systematically review the evidence on the use of narratives to...
BACKGROUND
There is increased interest in using narratives or storytelling to influence health policies. We aimed to systematically review the evidence on the use of narratives to impact the health policy-making process.
METHODS
Eligible study designs included randomised studies, non-randomised studies, process evaluation studies, economic studies, qualitative studies, stakeholder analyses, policy analyses, and case studies. The MEDLINE, PsycINFO, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), WHO Global Health Library, Communication and Mass Media Complete, and Google Scholar databases were searched. We followed standard systematic review methodology for study selection, data abstraction and risk of bias assessment. We synthesised the findings narratively and presented the results stratified according to the following stages of the policy cycle: (1) agenda-setting, (2) policy formulation, (3) policy adoption, (4) policy implementation and (5) policy evaluation. Additionally, we presented the knowledge gaps relevant to using narrative to impact health policy-making.
RESULTS
Eighteen studies met the eligibility criteria, and included case studies (n = 15), participatory action research (n = 1), documentary analysis (n = 1) and biographical method (n = 1). The majority were of very low methodological quality. In addition, none of the studies formally evaluated the effectiveness of the narrative-based interventions. Findings suggest that narratives may have a positive influence when used as inspiration and empowerment tools to stimulate policy inquiries, as educational and awareness tools to initiate policy discussions and gain public support, and as advocacy and lobbying tools to formulate, adopt or implement policy. There is also evidence of undesirable effects of using narratives. In one case study, narrative use led to widespread insurance reimbursement of a therapy for breast cancer that was later proven to be ineffective. Another case study described how the use of narrative inappropriately exaggerated the perceived risk of a procedure, which led to limiting its use and preventing a large number of patients from its benefits. A third case study described how optimistic 'cure' or 'hope' stories of children with cancer were selectively used to raise money for cancer research that ignored the negative realities. The majority of included studies did not provide information on the definition or content of narratives, the theoretical framework underlying the narrative intervention or the possible predictors of the success of narrative interventions.
CONCLUSION
The existing evidence base precludes any robust inferences about the impact of narrative interventions on health policy-making. We discuss the implications of the findings for research and policy.
TRIAL REGISTRATION
The review protocol is registered in PROSPERO International prospective register of systematic reviews (ID = CRD42018085011 ).
Topics: Awareness; Health Policy; Humans; Narration; Persuasive Communication; Policy Making; Thinking
PubMed: 30836972
DOI: 10.1186/s12961-019-0423-4 -
Psychological Bulletin Nov 2015Fear 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)
Meta-Analysis Review
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.
Topics: Attitude; Behavior; Fear; Female; Humans; Intention; Male; Models, Psychological; Persuasive Communication; Risk Factors
PubMed: 26501228
DOI: 10.1037/a0039729 -
Journal of Medical Internet Research Sep 2019Persuasive design, in which the aim is to change attitudes and behaviors by means of technology, is an important aspect of electronic health (eHealth) design. However,...
BACKGROUND
Persuasive design, in which the aim is to change attitudes and behaviors by means of technology, is an important aspect of electronic health (eHealth) design. However, selecting the right persuasive feature for an individual is a delicate task and is likely to depend on individual characteristics. Personalization of the persuasive strategy in an eHealth intervention therefore seems to be a promising approach.
OBJECTIVE
This study aimed to develop a method that allows us to model motivation in older adults with respect to leading a healthy life and a strategy for personalizing the persuasive strategy of an eHealth intervention, based on this user model.
METHODS
We deployed a Web-based survey among older adults (aged >60 years) in the Netherlands. In the first part, we administered an adapted version of the revised Sports Motivation Scale (SMS-II) as input for the user models. Then, we provided each participant with a selection of 5 randomly chosen mock-ups (out of a total of 11), each depicting a different persuasive strategy. After showing each strategy, we asked participants how much they appreciated it. The survey was concluded by addressing demographics.
RESULTS
A total of 212 older adults completed the Web-based survey, with a mean age of 68.35 years (SD 5.27 years). Of 212 adults, 45.3% were males (96/212) and 54.7% were female (116/212). Factor analysis did not allow us to replicate the 5-factor structure for motivation, as targeted by the SMS-II. Instead, a 3-factor structure emerged with a total explained variance of 62.79%. These 3 factors are intrinsic motivation, acting to derive satisfaction from the behavior itself (5 items; Cronbach alpha=.90); external regulation, acting because of externally controlled rewards or punishments (4 items; Cronbach alpha=.83); and a-motivation, a situation where there is a lack of intention to act (2 items; r=0.50; P<.001). Persuasive strategies were appreciated differently, depending on the type of personal motivation. In some cases, demographics played a role.
CONCLUSIONS
The personal type of motivation of older adults (intrinsic, externally regulated, and/or a-motivation), combined with their educational level or living situation, affects an individual's like or dislike for a persuasive eHealth feature. We provide a practical approach for profiling older adults as well as an overview of which persuasive features should or should not be provided to each profile. Future research should take into account the coexistence of multiple types of motivation within an individual and the presence of a-motivation.
Topics: Aged; Aged, 80 and over; Electronics; Female; Health Communication; Humans; Internet; Male; Middle Aged; Motivation; Persuasive Communication; Surveys and Questionnaires
PubMed: 31493323
DOI: 10.2196/11759 -
Prevention Science : the Official... Jun 2008The limited efficacy of prior eating disorder (ED) prevention programs led to the development of dissonance-based interventions (DBIs) that utilize dissonance-based... (Meta-Analysis)
Meta-Analysis Review
The limited efficacy of prior eating disorder (ED) prevention programs led to the development of dissonance-based interventions (DBIs) that utilize dissonance-based persuasion principles from social psychology. Although DBIs have been used to change other attitudes and behaviors, only recently have they been applied to ED prevention. This article reviews the theoretical rationale and empirical support for this type of prevention program. Relative to assessment-only controls, DBIs have produced greater reductions in ED risk factors, ED symptoms, future risk for onset of threshold or subthreshold EDs, future risk for obesity onset, and mental health utilization, with some effects persisting through 3-year follow-up. DBIs have also produced significantly stronger effects than alternative interventions for many of these outcomes, though these effects typically fade more quickly. A meta-analysis indicated that the average effects for DBIs were significantly stronger than those for non-DBI ED prevention programs that have been evaluated. DBIs have produced effects when delivered to high-risk samples and unselected samples, as well as in efficacy and effectiveness trials conducted by six independent labs, suggesting that the effects are robust and that DBIs should be considered for the prevention of other problems, such as smoking, substance abuse, HIV, and diabetes care.
Topics: Adolescent; Cognitive Dissonance; Feeding and Eating Disorders; Female; Health Promotion; Humans; Outcome Assessment, Health Care; Persuasive Communication; Preventive Health Services; Randomized Controlled Trials as Topic
PubMed: 18506621
DOI: 10.1007/s11121-008-0093-x -
Proceedings of the National Academy of... Jul 2022From vaccination refusal to climate change denial, antiscience views are threatening humanity. When different individuals are provided with the same piece of scientific...
From vaccination refusal to climate change denial, antiscience views are threatening humanity. When different individuals are provided with the same piece of scientific evidence, why do some accept whereas others dismiss it? Building on various emerging data and models that have explored the psychology of being antiscience, we specify four core bases of key principles driving antiscience attitudes. These principles are grounded in decades of research on attitudes, persuasion, social influence, social identity, and information processing. They apply across diverse domains of antiscience phenomena. Specifically, antiscience attitudes are more likely to emerge when a scientific message comes from sources perceived as lacking credibility; when the recipients embrace the social membership or identity of groups with antiscience attitudes; when the scientific message itself contradicts what recipients consider true, favorable, valuable, or moral; or when there is a mismatch between the delivery of the scientific message and the epistemic style of the recipient. Politics triggers or amplifies many principles across all four bases, making it a particularly potent force in antiscience attitudes. Guided by the key principles, we describe evidence-based counteractive strategies for increasing public acceptance of science.
Topics: Attitude; Climate Change; Cognition; Denial, Psychological; Humans; Information Avoidance; Persuasive Communication; Politics; Science
PubMed: 35858405
DOI: 10.1073/pnas.2120755119 -
Journal of Medical Internet Research Aug 2017Major depressive disorders are common among adolescents and can impact all aspects of their daily life. Traditional therapies, cognitive behavioral therapy (CBT), and... (Review)
Review
BACKGROUND
Major depressive disorders are common among adolescents and can impact all aspects of their daily life. Traditional therapies, cognitive behavioral therapy (CBT), and interpersonal psychotherapy (IPT) have been delivered face-to-face. However, Internet-based (online) delivery of these therapies is emerging as an option for adolescents. Internet-based CBT and IPT involve therapeutic content, interaction between the user and the system, and different technological features embedded into the online program (eg, multimedia). Studies of Internet-based CBT and IPT for adolescent depression differ on all three aspects, and variable, positive therapy effects have been reported. A better understanding of the treatment conditions that influence therapy outcomes is important to designing and evaluating these novel therapies.
OBJECTIVE
Our aim was to examine the technological and program delivery features of Internet-based CBT and IPT for adolescent depression and to document their potential relation to treatment outcomes and program use.
METHODS
We performed a realist synthesis. We started with an extensive search of published and gray literature. We included intervention studies that evaluated Internet-based CBT or IPT for adolescent depression. We included mixed-methods and qualitative studies, theoretical papers, and policy/implementation documents if they included a focus on how Internet-based psychological therapy is proposed to work for adolescents with depression/depressive symptoms. We used the Mixed-Methods Appraisal Tool to assess the methodological quality of studies. We used the Persuasive System Design (PSD) model as a framework for data extraction and analysis to examine how Internet-based CBT and IPT, as technology-based systems, influence the attitudes and behaviors of system users. PSD components described for the therapies were linked to reported outcomes using a cross-case comparison method and thematic synthesis.
RESULTS
We identified 19 Internet-based CBT programs in 59 documents. Of those, 71% (42/59) were of moderate to high quality. The PSD features surface credibility (competent "look and feel"), dialogue support (online program + in-person support), liking and similarity (esthetics and content appeal to adolescent users), the reduction and tunneling of therapeutic content (reducing online content into simple tasks, guiding users), and use of self-monitoring were present in therapies that resulted in improved therapy engagement, satisfaction, and adherence, as well as symptom and functional impairments.
CONCLUSIONS
When incorporated into Internet-based CBT for adolescent depression, PSD features may improve adolescent adherence, satisfaction, and depression-related outcomes. Testing of these features using hypothesis-driven dismantling approaches is recommended to advance our understanding of how these features contribute to therapy effectiveness.
Topics: Adolescent; Cognitive Behavioral Therapy; Depression; Humans; Internet; Persuasive Communication; Psychotherapy; Telemedicine; Treatment Outcome
PubMed: 28793983
DOI: 10.2196/jmir.7573 -
BMC Public Health Apr 2021Cultural differences in affective and cognitive intrinsic motivation could pose challenges for global public health campaigns, which use cognitive or affective goals to...
BACKGROUND
Cultural differences in affective and cognitive intrinsic motivation could pose challenges for global public health campaigns, which use cognitive or affective goals to evoke desired attitudes and proactive health-promoting actions. This study aimed to identify cross-cultural differences in affective and cognitive intrinsic motivation and discuss the potential value of this information for public health promotion.
METHODS
A cross-sectional survey using cross-culturally validated need for affect (NFA) and need for cognition (NFC) scales was carried out among 1166 Chinese participants, and the results were compared with published data from 980 American participants. Additionally, we assessed a highly prevalent symbolic geriatric health condition, hearing loss, in 500 Chinese community-dwelling seniors. The Chinese NFA scale was developed following the translation-back translation procedure, and the psychometric evaluation was performed by applying confirmatory factor analysis (CFA), exploratory structural equation modeling (ESEM), correlation analysis and multigroup invariance test. MANOVA and Hedge's g statistic were employed to compare the NFA and NFC levels between individuals from different countries and between Chinese seniors with and without hearing loss. The relation of early hearing intervention intention to NFA and NFC was also explored in the Chinese sample.
RESULTS
A basic two-factor model of NFA adequately fit the sample data from Chinese and American cultures. The questionnaire demonstrated reasonable invariance of the factor structure and factor loadings across the groups. Those in the primary Chinese sample had lower NFA and NFC than their American peers. This difference held in the senior sample. Moreover, Chinese seniors with hearing loss had even lower NFA and NFC than those without hearing loss. Their early hearing intervention intention was low but was associated with intrinsic motivation.
CONCLUSIONS
The Need for Affect (NFA) construct may be generalized beyond its Western origins. There was a general lack of affective and cognitive intrinsic motivation in Chinese individuals, particularly in seniors with hearing loss, compared with their American peers. These differences point to a potential challenge in framing effective messages for some cultures in the geriatric public health domain. Ideally, recognizing and understanding this challenge will inspire the consideration of novel persuasive strategies for these audiences.
Topics: Aged; Cognition; Cross-Sectional Studies; Health Promotion; Humans; Motivation; Persuasive Communication
PubMed: 33836715
DOI: 10.1186/s12889-021-10689-w -
Developmental Medicine and Child... Oct 2014
Topics: Humans; Medicine; Persuasive Communication
PubMed: 25208967
DOI: 10.1111/dmcn.12577 -
Scientific Reports Mar 2016The threshold model has been widely adopted as a classic model for studying contagion processes on social networks. We consider asymmetric individual interactions in...
The threshold model has been widely adopted as a classic model for studying contagion processes on social networks. We consider asymmetric individual interactions in social networks and introduce a persuasion mechanism into the threshold model. Specifically, we study a combination of adoption and persuasion in cascading processes on complex networks. It is found that with the introduction of the persuasion mechanism, the system may become more vulnerable to global cascades, and the effects of persuasion tend to be more significant in heterogeneous networks than those in homogeneous networks: a comparison between heterogeneous and homogeneous networks shows that under weak persuasion, heterogeneous networks tend to be more robust against random shocks than homogeneous networks; whereas under strong persuasion, homogeneous networks are more stable. Finally, we study the effects of adoption and persuasion threshold heterogeneity on systemic stability. Though both heterogeneities give rise to global cascades, the adoption heterogeneity has an overwhelmingly stronger impact than the persuasion heterogeneity when the network connectivity is sufficiently dense.
Topics: Community Networks; Humans; Models, Psychological; Persuasive Communication; Social Conformity; Social Networking
PubMed: 27029498
DOI: 10.1038/srep23766