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Pro-social advocacy with at-risk and counter-attitudinal audiences
It is often claimed that interventions aimed at promoting healthy behaviors tend to be most effective among people whose behavior least needs to change and least effective among those most in need of change. If true, the inevitable result would be widening disparities in health engagement between these groups. Using a between-subjects experimental design, this study examined the effects of a directive advocacy message based on the theory of planned behavior (TPB) on groups with different preexisting levels of engagement in healthy behaviors. The results confirmed that, compared to effects of a non-persuasive control message, the TPB-based message produced greater disparities in engagement between the group lowest in preexisting health engagement and groups with greater preexisting levels of engagement. The study suggests well-intended public health initiatives may seem to provide a net benefit to society but, in fact, actually contribute to the persistence of the disparities they attempt to address.
Persistent public resistance to an apparently safe, effective and life-saving public health practice such as HPV vaccination illustrates a significant issue in the communication of behavioral recommendations based on evidence-based scientific data and consensus views of scientific and medical experts. This study examines the influence of source expertise on pro-HPV-vaccine advocacy messaging effectiveness among audiences of differing political ideologies. The findings support prior research indicating greater resistance to HPV vaccination among political conservatives. Subjects who self-identified politically as Centrists and Conservatives were significantly less likely to think deeply about a pro-HPV advocacy message delivered by an expert spokesperson than were politically self-identified Progressives. Conservatives who viewed a pro-HPV vaccination message delivered by a non-expert spokesperson had significantly more positive attitudes toward HPV vaccination than Conservatives who received no advocacy message (the control condition). By contrast, attitudes of Conservatives who viewed a pro-HPV vaccination message delivered by an expert spokesperson were not significantly different from those who received no advocacy message. The findings suggest an over-reliance on expert spokespeople for delivering science-based behavioral recommendations.