The Relative Persuasiveness of Gain-Framed Loss-Framed Messages for Encouraging Disease Prevention Behaviors: A Meta-Analytic Review

Northwestern University, Evanston, Illinois 60208-3545, USA.
Journal of Health Communication (Impact Factor: 1.61). 10/2007; 12(7):623-44. DOI: 10.1080/10810730701615198
Source: PubMed


A meta-analytic review of 93 studies (N = 21,656) finds that in disease prevention messages, gain-framed appeals, which emphasize the advantages of compliance with the communicator's recommendation, are statistically significantly more persuasive than loss-framed appeals, which emphasize the disadvantages of noncompliance. This difference is quite small (corresponding to r = .03), however, and appears attributable to a relatively large (and statistically significant) effect for messages advocating dental hygiene behaviors. Despite very good statistical power, the analysis finds no statistically significant differences in persuasiveness between gain- and loss-framed messages concerning other preventive actions such as safer-sex behaviors, skin cancer prevention behaviors, or diet and nutrition behaviors.

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    • "O'Keefe and Jensen's (2009) analysis also found that for disease prevention, gain messages were more effective than loss messages (r D .046). However, according to O'Keefe and Jenson (2009), the difference between gain and loss messages was not significant. In light of these prior results, the overall effect size for narrative messages is fairly respectable. "
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    ABSTRACT: This meta-analysis assessed the persuasive effects of narratives in health communication. A search of the literature identified 25 studies (N D 9,330) that examined the effects of narratives on persuasion as measured by changes in attitudes, intentions, and behaviors. Analyses of the effect sizes indicated that, overall, narratives had a small impact on persuasion (r D .063, p < .01). Narratives delivered via audio and video produced significant effects; print-based narratives, however, did not exhibit a significant impact. Further, not all health issues were equally affected by narrative messages aiming at intervention. Those narratives that advocated detection and prevention behaviors led to significant effects, whereas those advocating cessation behaviors did not have significant effects. These findings offer both theoretical and practical implications.
    Journal of Advertising 04/2015; 44(2):105-113. DOI:10.1080/00913367.2015.1018467 · 0.99 Impact Factor
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    • "Anekdotische evidentie moet volgens Rieke en Sillars (1984, p. 92) worden opgevat als een specifiek geval of als een voorbeeld dat wordt aangevoerd ter ondersteuning van een standpunt, terwijl statistische evidentie bestaat uit een numerieke samenvatting van een groot aantal gevallen die worden opgevoerd om een standpunt te schragen. De uitkomsten van het vele empirisch onderzoek dat naar de relatieve overtuigingskracht van beide vormen van argumentatie verricht is, zijn verre van eenduidig (zie bijvoorbeeld Baesler & Burgoon, 1994; Allen & Preiss, 1997; O'Keefe, 2002). Datzelfde geldt evenzeer voor al het empirisch onderzoek naar gain-en loss framing: soms blijkt het in empirische zin (Salovey et al., 2002) effectiever om de wenselijke, positieve gevolgen van een aanbevolen gedragslijn uit te doeken te doen (gain framing), soms blijkt het juist doeltreffender (Levin et al., 1998) om de onwenselijke gevolgen van het niet-opvolgen van het gepropageerde gedrag te verwoorden (loss framing), en dan weer kunnen er al helemaal geen verschillen in overtuigingskracht tussen beide varianten worden aangetroffen (O'Keefe & Jensen, 2007). "
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    ABSTRACT: Abstract Culture dependent appraisal of age thresholds for mammographic screening; the effectiveness of health communication in cross-cultural perspective In previous empirical studies it was found that Dutch women could hardly be convinced by experimental health communication leaflets in which they were dissuaded to participate in systematic mammographic screening programs when they are younger than 50. In contrast, the far majority of the Dutch experimental participants accepted with enthusiasm the standpoint that women above 50 should go for a breast cancer screening every other year. The empirical research presented in this article is a replication of the Dutch studies, but now conducted in Ticino (Switzerland). Ticino is a culture that is quite different from Holland regarding the nature of preventive screening on breast cancer: systematic screening in Holland versus opportunistic screening in Ticino. Moreover, in Ticino the mass media pay far less attention to issues concerning breast cancer compared with those in Holland. As predicted, the Swiss participants were more susceptible for the persuasive attempts and experimental manipulations in the health communication leaflets.
    12/2014; 36(3). DOI:10.1557/TVT2014.3.MEUF
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    • "However, in spite of generally high numeracy, the performance of Japanese sample on the Schwartz-J and Lipkus-J tests still accounted for susceptibility to the framing effect, which can influence patients’ decisions regarding their medical options, such as acceptance of surgery (e.g. [12,19,38]; however, empirical results on framing effects in a clinical setting are mixed, reviewed in [39]). A number of previous studies using the original Schwartz and Lipkus scales have shown a numeracy effect on understanding and decision making based on medical information (reviewed in [5,8-11]). "
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    ABSTRACT: Background Health numeracy is an important factor in how well people make decisions based on medical risk information. However, in many countries, including Japan, numeracy studies have been limited. Methods To fill this gap, we evaluated health numeracy levels in a sample of Japanese adults by translating two well-known scales that objectively measure basic understanding of math and probability: the 3-item numeracy scale developed by Schwartz and colleagues (the Schwartz scale) and its expanded version, the 11-item numeracy scale developed by Lipkus and colleagues (the Lipkus scale). Results Participants’ performances (n = 300) on the scales were much higher than in original studies conducted in the United States (80% average item-wise correct response rate for Schwartz-J, and 87% for Lipkus-J). This high performance resulted in a ceiling effect on the distributions of both scores, which made it difficult to apply parametric statistical analysis, and limited the interpretation of statistical results. Nevertheless, the data provided some evidence for the reliability and validity of these scales: The reliability of the Japanese versions (Schwartz-J and Lipkus-J) was comparable to the original in terms of their internal consistency (Cronbach’s α = 0.53 for Schwartz-J and 0.72 for Lipkus-J). Convergent validity was suggested by positive correlations with an existing Japanese health literacy measure (the Test for Ability to Interpret Medical Information developed by Takahashi and colleagues) that contains some items relevant to numeracy. Furthermore, as shown in the previous studies, health numeracy was still associated with framing bias with individuals whose Lipkus-J performance was below the median being significantly influenced by how probability was framed when they rated surgical risks. A significant association was also found using Schwartz-J, which consisted of only three items. Conclusions Despite relatively high levels of health numeracy according to these scales, numeracy measures are still important determinants underlying susceptibility to framing bias. This suggests that it is important in Japan to identify individuals with low numeracy skills so that risk information can be presented in a way that enables them to correctly understand it. Further investigation is required on effective numeracy measures for such an intervention in Japan.
    BMC Medical Informatics and Decision Making 09/2012; 12(1):104. DOI:10.1186/1472-6947-12-104 · 1.83 Impact Factor
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