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Narrative communication of risk: Toward balancing accuracy and acceptance

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Abstract

This chapter reviews the capacities of and challenges to narrative communication of risk. Importantly, it distinguishes narrative communication for promoting accuracy in risk judgments from narrative communication for promoting acceptance of or adherence to prescribed risk prevention behavior. It explores the mechanisms underlying these effects, and the characteristics of narratives that may activate these processes and effects. It offers suggestions for addressing challenges to narrative risk communication and for appropriately utilizing narratives for risk communication.
180
CHAPTER 4
Introduction
Risk communicators have increasingly been inter-
ested in narratives for their potential for informing
people about risk, for motivating risk reduction,
and for overcoming barriers to these tasks that may
not be overcome by efforts using other forms of
messages. However, evidence for the advantages of
narratives over other forms of messages has not
been consistent (Allen & Preiss, 1997). As reviewed
below, while some studies found narrative advan-
tages, others found no difference or disadvantages.
Simultaneously, concern has been voiced over the
possibility that narratives may engender biased
judgments (Winterbottom, Bekker, Conner, &
Mooney, 2008). Together, the expectations for nar-
rative effects, the inconsistent evidence for effec-
tiveness amassed thus far, and the concern over
undesirable effects, point to the need for a close
examination of narrative communication as related
to risk perceptions and practices.
Thus, the goal of this chapter is to review nar-
rative research in divergent disciplines to identify
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CHAPTER 12
Narrative Communication
of Risk
Toward Balancing Accuracy and Acceptance
Hyunyi Cho and L. Brooke Friley
the capacities of and challenges to narrative com-
munication of risk. Instead of intending to be
exhaustive, this chapter focuses on the areas of
narrative research that are most relevant to risk
communication theory and practice. Overall, this
chapter recognizes that narrative effects occur at
micro-, meso-, and macrolevels. It then explores
the mechanisms underlying these effects, includ-
ing intrapersonal processes and interpersonal
and societal-level interactions. On this basis, the
characteristics of narratives that may activate
these processes and effects are discussed.
Importantly, this chapter distinguishes narra-
tive communication for facilitating accuracy in
risk judgments from narrative communication
for promoting acceptance of risk reduction behav-
ior implicitly or explicitly suggested in the mes-
sage. The accuracy goal concerns informed and
correct judgments; the acceptance goal concerns
motivations to adopt and adhere to risk reduction
behavior. On this basis, this chapter posits that
narrative messages may be less capable of achiev-
ing the accuracy goal than the acceptance goal.
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Chapter 12 Narrative Communication of Risk—— 181
Suggestions for research and practice center on
ways challenges for narrative risk communication
may be addressed and how the potentials of
narratives can be appropriately utilized for risk
communication.
Scope of Narratives
Scholars define narratives as stories that connect
actions and events involving characters with the-
matic and temporal sequences (for a review, see
Abbott, 2008). Furthermore, scholars consider
narratives a fundamental form of human com-
munication (e.g., Fisher, 1984). Humans are sto-
rytellers, and it is through stories humans
connect and communicate with each other, creat-
ing and sustaining shared beliefs, values, and
norms (Fisher, 1984).
Perhaps as a result, narratives are found in a
wide array of messages. Although recent research
focuses on narratives without overt persuasive
intent, narratives, including those about risk, are
not always communicated in the absence of
observable persuasive intent. In fact, historically,
research on the processes and effects of narra-
tives involved diverse forms of narratives such as
those in news (e.g., Strange & Leung, 1999),
advertisements (e.g., Adaval & Wyer, 1998), and
testimonials (e.g., Ubel, Jepson, & Baron, 2001),
as well as novels (e.g., Green & Brock, 2000) and
dramas (e.g., Slater, Rouner, & Long, 2006).
Mirroring the divergence, narratives have been
referred to as, and taken the form of, anecdotes
(e.g., Slater & Rouner, 1996), case histories (e.g.,
Rook, 1987), exemplars (e.g., Zillmann & Brosius,
2000), vivid messages (e.g., Rook, 1986), and
scenarios (e.g., Mevissen, Meertens, Ruiter,
Feenstra, & Schaalma, 2009).
1
Narratives have also been utilized in strategic
approaches to influencing changes in individual
behaviors and public policies for risk reduction.
Two practical frameworks that make use of narra-
tives for risk reduction are entertainment educa-
tion and media advocacy. Entertainment
education uses dramas, rather than didactics, to
influence individuals’ beliefs and behaviors for
risk reduction (for a review, see Singhal, Cody,
Rogers, & Sabido, 2003). Media advocacy uses
news stories to gain mass media attention to risk
issues and thereby to influence policymakers to
change the larger structural and environmental
conditions surrounding risk (Wallack & Dorfman,
1996). Whereas persuasive intent has to be covert
with entertainment education and does not have
to be with media advocacy, central to both
approaches are narratives. While entertainment
education aims to influence individual behaviors,
media advocacy seeks to influence public policy.
Although these are different approaches, the goal
of both is risk reduction. In sum, the scope of nar-
ratives reviewed above suggests that their effects
may be relevant to multiple levels of society.
Effects of Narratives
Understanding the effects of the wide array of
forms and strategic uses of narratives reviewed
above requires an organizing framework. A
review of extant research suggests that narrative
effects may occur at micro-, meso-, and macro-
levels. Microlevel effects include the assessment
of probabilities and attitudes, as well as actions
related to risk reduction. Mesolevel effects include
those on interpersonal and within-community
interactions and communication. Macrolevel
effects include media attention to risk issues and
accompanying public judgments about the causes
of and solutions to risk issues in society.
Furthermore, the effects at each level may be
both intended and unintended from the risk
communicators standpoint (see Cho & Salmon,
2007, for a conceptual treatment of unintended
effects).
Microlevel Effects
One of the key components of risk percep-
tion is personal probability estimation, or indi-
viduals’ assessment of their own likelihood of
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182—— SECTION 5 Risk Communication Messages
experiencing harm (Slovic, 1967). Therefore,
personal probability estimation has been a crite-
rion with which the efficacy of narrative risk
communication was assessed. On the one hand,
there are studies that found narrative advantage.
For example, exposure to narrative rather than
statistical evidence produced higher personal
probability estimation of hepatitis B virus infec-
tion among men who have sex with men (De
Wit, Das, & Vet, 2008). On the other hand,
other studies found that narratives were less
effective. When messages featuring narratives
and frequency statistics about chlamydia were
compared, narratives showed less impact on
sexually active adults’ personal probability esti-
mation of contracting the disease (Mevissen
et al., 2009). Other studies have found little dif-
ference between narratives and nonnarratives in
affecting personal probability of risk (e.g.,
Golding, Krimsky, & Plough, 1992; Greene &
Brinn, 2003).
While a large number of studies have investi-
gated whether narratives amplify personal prob-
ability, a limited number of studies examined
narrative effects on the accuracy of probability
estimation. Extant evidence, although from dif-
fering domains, is not consistent. Sanfey and
Hastie (1998) compared various evidence pre-
sentation formats, including numeric tables, bar
graphs, brief text, and a biographical story, and
found that the more accurate judgment of the
future performance of marathon runners was
reached with text and story rather than with
tables and graphs. On the other hand, Dickson
(1982) compared narrative and statistical mes-
sages about refrigerator failure rates and found
that narrative presentation produced an overes-
timation of the failure rate, while statistical pre-
sentation yielded a more accurate estimation of
the rate.
In influencing attitudes toward risk preven-
tion behavior, available evidence suggests that
narratives may be more effective than nonnarra-
tives when motivation to process information is
low rather than high. For example, a vivid rather
than an abstract message about osteoporosis was
more persuasive for premenopausal women,
while both vivid and abstract messages were per-
suasive for postmenopausal women (Rook,
1986). Similarly, people who were at high risk but
wanted to minimize the risk (i.e., in denial) were
more persuaded by a case history than an abstract
message (Rook, 1987). Greater message engage-
ment was reported by women who read narrative
rather than statistical messages about breast can-
cer screening (Cox & Cox, 2001).
Narrative effects on risk reduction behavior
have been reported. In a study comparing enter-
tainment and informational television programs
dealing with safe sex, college students who were
exposed to an entertainment program indicated
more consistent safe sex behavior as compared to
those who were exposed to an informational
program at a 2-week follow-up (Moyer-Guse &
Nabi, 2010). A safety message using a story about
a serious injury caused by a mistake produced
greater enactment of precautionary behavior
than safety messages using nonnarratives that
were either concrete or abstract (Ricketts,
Shanteau, McSpadden, & Fernandez-Medina,
2010).
Although explaining the inconsistencies in
narrative effects highlighted above may be out-
side the scope of this review, speculations about
reasons for these inconsistencies and suggestions
for future research may be offered. First, not all
narratives may be equal. Narratives, for example,
may vary in their ability to elicit emotional
engagement, depending on their characteristics
(see Characteristics of Narratives section below).
Thus, research is needed to investigate what
kinds of narratives are most effective, moving
beyond the currently predominant question of
whether narratives are more effective. Second, in
extant research investigating narrative effects, the
comparison points have varied. Whereas the
aforementioned De Wit et al. (2008) study com-
pared narratives with prevalence statistics,
Mevissen et al. (2009) compared narratives with
frequency rate statistics. Thus, a question to ask
may be what specific other messages are more, or
less, effective than narratives. Finally, the goal of
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Chapter 12 Narrative Communication of Risk—— 183
risk communication should be considered. For
example, the goal of facilitating accuracy in risk
judgment may entail encouraging a message-
processing strategy different from the goal of
facilitating acceptance of risk reduction behavior
(see Intrapersonal Processes section below).
Mesolevel Exchanges
Stimulation of exchanges between individuals
and within groups and communities may be one
of the unique capacities of narratives. As a basic
form of human communication, narratives may
be more conducive to spurring interactions
than other forms of messages. By being grounded
in concrete and specific cases and examples, nar-
ratives may be a closer representation of reality
than other forms of messages that utilize abstrac-
tions, and generalizations therefore are a more
distal description of reality. Perhaps as a result,
narratives may be easier to absorb for self
(Cox & Cox, 2001), to retrieve from memory
(Rook, 1987), and to relay to others. Furthermore,
these mesolevel exchanges may be in the direc-
tion intended or unintended by the risk
communicator.
Narratives may foster interpersonal commu-
nication and interaction consistent with the risk
communicators intention. In this process, nar-
ratives, ways to reduce the risk depicted in nar-
ratives, and support for enacting risk prevention
behavior demonstrated in the narrative may be
shared and discussed (Papa et al., 2000).
Evidence that narratives promote interpersonal
interactions has been reported by experimental
and case analysis studies. In an experimental
study, exposure to narratives, as compared with
nonnarratives, stimulated Belgian college wom-
ens conversations with friends and family about
skin cancer as reported at a 2-week follow-up
(Lemal & Van den Bulck, 2010). A case analysis
of an entertainment education radio soap opera,
Tinka Tinka Sukh , found that exposure to the
program facilitated interaction among the audi-
ence in an Indian village (Papa et al., 2000). The
authors’ examination of letters submitted by the
listeners of the program suggested that through
the interpersonal exchanges, the members of the
community constructed a social environment in
which ideas for community change could be
debated.
Narratives may not only spur intended
exchanges but also stimulate unintended interac-
tions and communication about risk, about
approaches to reducing the risk, and about effica-
cies of the risk reduction approaches. An example
of such a role of narratives may be antivaccina-
tion movements. While the movements date
back to the mid-1800s when vaccination became
compulsory in the United Kingdom (Wolfe &
Sharp, 2002), nowadays, the Internet provides a
worldwide avenue in which antivaccination com-
munication and movements take place. Kata’s
(2010) and Beans (2011) content analyses of
antivaccination websites have found that some of
the frequently employed message strategies
include personal testimonies, professional testi-
monies, and reports of adverse vaccination out-
comes. Kata (2010), for example, found that the
majority of antivaccination websites featured
emotional testimonies from parents who felt that
their children have been adversely affected by
vaccination.
These mesolevel exchanges of narratives, by
constructing realities, may have both down-
stream and upstream influences. On the one
hand, the mesoprocesses may impact microlevel
individuals’ judgments. Emotional narratives
about vaccine side effects may have a greater
impact on individuals’ judgments and decisions
about vaccination than statistical presentation of
the side effects (Betsch, Ulshofer, Renkewitz, &
Betsch, 2011). On the other hand, the mesopro-
cesses may unite groups with shared realities and
mobilize them toward altering and shaping mac-
rolevel public discourse and policies.
Philosophical positions against vaccination bol-
stered by narratives about side effects have
resulted in demonstrations, riots, and organized
efforts such as antivaccination leagues in Europe
and the United States (Wolfe & Sharp, 2002).
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184—— SECTION 5 Risk Communication Messages
Macrolevel Judgments
Narratives may function as a window to the
world. Although narratives are episodic anec-
dotes about specific situations, research suggests
that people may form judgments about society in
general on the basis of these particulars (Strange,
2002; Strange & Leung, 1999).
Research further suggests that narratives may
impact judgments about causes of social prob-
lems and their prevalence and importance. For
example, after reading one of two narratives
about Michael, who was planning to drop out of
high school due either to deficiencies in the envi-
ronment (e.g., lack of school resources and ade-
quately trained teachers) or to deficiencies in
individual dispositions (e.g., emotional or moti-
vational issues during adolescence), those who
were engaged in the narrative were more likely to
assign the cause of school dropouts to the cause
focused in the narrative that they read (Strange &
Leung, 1999). Readers who were engrossed in a
novel about an innocent girl brutally stabbed to
death by a psychiatric patient at the mall ( Murder
at the Mall ) indicated a higher estimation of the
prevalence of stabbing deaths in society than
those who were not (Green & Brock, 2000).
Furthermore, Strange and Leung (1999) found
that compared with those who did not read,
those who read narratives about a school dropout
rated school dropouts as a more important soci-
etal issue than health care, which indicates an
agenda-setting effect of narrative exposure.
In addition to judgments about problems in
society, narratives may also influence judgments
about solutions and willingness to support poli-
cies consistent with the solutions. Among people
with a liberal ideology, those who read a narra-
tive message about the environmental causes of
obesity indicated a stronger belief that societal
actors (e.g., government and corporations) were
responsible for addressing obesity than those
who read an evidence message or a hybrid of nar-
ratives and evidence (Niederdeppe, Shapiro, &
Porticella, 2011). Green and Brock (2000) found
that participants who were engaged in the afore-
mentioned narrative about the death in the mall
( Murder at the Mall ) were also more likely to
support limiting the freedom of psychiatric
patients as compared with those who were not
engaged in the narrative.
Narrative effects on policy support have been
reported. Slater et al. (2006) found that exposure
to television dramas increased support for the
death penalty by removing the influence of prior
ideology and values on participants’ position on
the issue. Similarly, Shanahan, McBeth, and
Hathaway (2011) found that news narratives on
the policy concerning snowmobile access to
Yellowstone National Park influenced opinions
about the policy by either strengthening support
for the policy or modifying prior positions about
the policy.
Processes of Narrative Effects
Intrapersonal Processes
A range of intraindividual processes have
been identified for narrative effects (for a review,
see Bilandzic & Busselle, 2013), but the hallmark
of narrative message processing may be transpor-
tation, the process in which the audience mem-
bers are carried away from their actual world to
the story world (Green & Brock, 2000).
Specifically, transportation is “a convergent pro-
cess where all mental systems and capacities
become focused on events occurring in the nar-
rative” (Green & Brock, 2000, p. 701).
Research found that transportation entails
emotional responses. In Green and Brock’s (2000)
study, for example, rather than evaluating the
focal beliefs under consideration, readers of the
above-described novel Murder at the Mall indi-
cated global emotional reactions (p. 707).
Similarly, a comparison of narrative and statisti-
cal evidence messages for organ donation found
that emotional rather than cognitive reactions
were more pronounced during narrative process-
ing (Kopfman, Smith, Yun, & Hodges, 1998). To
the extent that emotional responses are predomi-
nant during narrative processing, narrative com-
munication may foster risk judgments based on
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Chapter 12 Narrative Communication of Risk—— 185
feelings rather than those based on analysis, as
distinguished by Slovic, Finucane, Peters, and
MacGregor (2004). Whereas risk judgments
based on analysis rely on logic, reason, abstrac-
tions, and quantifications; risk judgments based
on feelings rely on affect, emotions, intuitions,
images, and narratives (Slovic et al., 2004).
Slovic et al. (2004) argue that affect-based risk
judgments may not necessarily be irrational.
Evidence consistent with Slovic et al.’s (2004)
position is the aforementioned Sanfey and Hasties
(1998) study, in which exposure to narrative
rather than numeric information produced the
more accurate assessment. Conversely, Dickson
(1982) found that exposure to narrative rather
than statistical information produced inaccurate
assessment of frequency. Evidently, more research
is needed to address these inconsistent findings
for narratives’ role in assisting accurate judgments
(see also the Exemplar section below).
Along with eliciting emotional responses,
transportation encourages suspension of disbe-
lief. For example, while reading the above-
described novel Murder at the Mall , participants
were asked to circle “false notes,” which were
parts of a story that contradicted facts or did not
make sense (Green & Brock, 2000). The more
transported into the narrative, the fewer false
notes that the participants indicated. Thus, trans-
portation was inversely related to doubts or ques-
tions about the message and to counterarguments.
This capacity of narratives that suppresses the
audiences critical processing of the message is
considered to be one of their persuasive advan-
tages. By decreasing counterarguments and by
increasing emotional engagement, transporta-
tion can promote attitudes and actions consistent
with the narrative (Green & Brock, 2000). This
may be useful when the audience members are
resistant to behavior change to prevent well-
established risk that harms their health.
Transportation can mitigate reactance (Moyer-
Guse & Nabi, 2010).
Communication to promote acceptance of
recommended risk prevention behavior, how-
ever, may differ from communication to help the
audience reach an accurate assessment of risk.
For the former, transportation, emotional reac-
tions, and suspension of disbelief may be useful.
For the latter, however, risk communicators may
need to enable and encourage critical processing
and counterarguments, rather than suppressing
them. This may be especially true when the risk
and its methods of prevention and control under
consideration are associated with uncertainties.
Considering the range of risk communication
situations involving uncertainties, narrative com-
munication of risk may require differentiating
between the goals of accuracy and acceptance.
Of note, some findings suggest that when
accuracy is the goal, people may not value narra-
tive information as much as they value other,
more representative or comprehensive informa-
tion. In Dickson’s (1982) study, narrative informa-
tion was evaluated to be less representative and
less sufficient than statistical information about
refrigerator failure rates. Satterfield, Slovic, and
Gregory (2000) found that didactic text was rated
to be more helpful than narrative text for people
to think through different aspects of the issue at
hand—the effect of a hydroelectric power plant
on the salmon population in a river. A review of
verbal and numeric information effects found
that people prefer numeric rather than verbal
information in making probability estimations
(Visschers, Meertens, Passchier, & de Vries, 2009).
Slovic et al. (2004) suggest that analysis-based
and feeling-based risk judgments need not be
competitive; rather, they can be used in comple-
mentary ways so that each can inform the other.
Therefore, research should investigate how nar-
ratives can be used in combination or conjunc-
tion with other forms of messages to facilitate
informed decisions and actions related to risk.
Processes Pertinent to
Societal Effects
Although direct investigations of narrative
effects on societal processes are rare, available the-
ory and research indirectly suggests that narratives
may play an important role in these processes. One
of the societal processes that narratives activate may
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186—— SECTION 5 Risk Communication Messages
be agenda setting (Strange & Leung, 1999) . Agenda
setting is a process by which a certain subset of
issues from the population is selected and commu-
nicated to the public by the media (Dearing &
Rogers, 1996) .
A major factor facilitating an issue’s inclusion
on the media agenda is the availability of drama,
or emotional and vivid stories that exemplify the
issue, according to the public arenas model
(Hilgartner & Bosk, 1988). Because public arenas
have limited capacities (e.g., media space and
time, the public’s attention and sympathy), the
issues with drama are more likely to enter and
survive in public arenas (Hilgartner & Bosk,
1988). Dearing and Rogers (1992) argue that the
stories about the death of movie actor Rock
Hudson and about the discrimination against a
Kokomo, Indiana boy, Ryan White, propelled
HIV/AIDS to the front line of the national issue
agenda. Prior to the stories about Hudson and
White, AIDS was not an issue of common concern
and relevance to the general public (Dearing &
Rogers, 1992, p. 182). Similarly, Nisbet and Huge
(2006) argue that the issue of plant biotechnology
has retained a low salience status on the national
issue agenda because it did not fit the typical
political narrative format featuring conflict,
drama, climax, and resolutions that are necessary
to gain media attention.
It is these capacities of narratives that the
practical framework of media advocacy seeks to
utilize. Specifically, media advocacy utilizes nar-
ratives to gain issue attention from the media and
then from policymakers to change the conditions
and contexts surrounding the risk and health of
individuals (Wallack & Dorfman, 1996).
Proponents of media advocacy have recom-
mended a balance between two primary narra-
tives to advance policy change. One is personal
narratives of risk experience to gain media atten-
tion initially; the other is narratives about the
root of the personal risk experience, which are
located at societal and structural levels (Wallack,
Woodruff, Dorfman, & Diaz, 1999). In sum, nar-
ratives may produce macrolevel effects by facili-
tating an issues inclusion on the media agenda
and thereby influencing public agenda.
Furthermore, being on the public agenda is rele-
vant to an issues likelihood of becoming policy
agenda (Dearing & Rogers, 1996).
Characteristics of Narratives
Understanding the effects and processes of nar-
ratives alone may not be sufficient to inform nar-
rative communication of risk. Understanding the
characteristics of narratives that activate the
micro-, meso-, and macrolevel effects and pro-
cesses may be necessary. When the characteris-
tics of the message that activate the multilevel
processes and effects are identified, theory and
research on narrative will advance. Three pri-
mary characteristics of narratives may be vivid-
ness, realism, and inclusion of an exemplar.
Vividness
Vividness is one of the most frequently used
descriptors of narratives. Nisbett and Ross
(1980) posit that vivid messages may be more
impactful than “pallid and abstract propositions
of substantially greater probative and eviden-
tiary value” (p. 44). Vivid messages may be more
impactful because they are “(a) emotionally
interesting, (b) concrete and imagery- provoking,
and (c) proximate in a sensory, temporal, or
spatial way” (p. 45).
Vividness has been operationalized in various
ways; case histories or narratives are one of the
operationalizations of vividness (Taylor &
Thompson, 1982). Because narrative messages
use concrete language, exciting imagery, and are
emotionally engaging, they have been posited to
be more effective than abstract messages using
facts or statistics. Taylor and Thompson (1982)
reviewed seven studies comparing messages with
narratives and statistics and found that six
reported narrative advantage, but they did not
attribute the narrative advantage to vividness
because of the lack of evidence for the role of the
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Chapter 12 Narrative Communication of Risk—— 187
three variables (e.g., imagery, emotional engage-
ment, and concreteness).
Recent research has investigated imagery and
emotional engagement. Imagery did not emerge as
a separate facet of narrative processing (Green &
Brock, 2000; Strange & Leung, 1999). Evidence of
narrative effects on emotional reactions has been
obtained (e.g., Green & Brock, 2000). Concreteness
of narratives may facilitate message processing
when the audience members lack resources to pro-
cess abstract messages.
Taylor and Thompson (1982) suggested that
the effect of vividness may depend on its ability
to attract attention. Although earlier research did
not find support for this postulation (Frey &
Eagly, 1993), recent research found that the
effects of vividness on memory and persuasion
may be contingent upon the degree to which the
vivid elements of a message are consistent with
the message content or are central to the main
thesis of the message (Guadagno, Rhoads, &
Sagarin, 2011; Smith & Shaffer, 2000).
In extant research, vividness has been defined
in terms of both message features (e.g., concrete-
ness) and the reactions that the message evokes
(e.g., emotional engagement). Future research
using vividness as an explanation for narrative
effects may need to be specific about what is
operationalized as vividness of a given narrative
communication. In addition, although previous
research frequently treated narratives as vivid
and nonnarratives as pallid, all narratives may
not be equally vivid.
Realism
Perceived realism refers to the judgment about
the degree to which narratives reflect the real
world. Earlier research considered realism to be
the property of the message and expected that
factual narratives would be more realistic and
more effective than fictional narratives (Feshbach,
1976). Recent research, however, has found that
narratives presented as a fact or a fiction did not
have differential effects (Green & Brock, 2000;
Strange & Leung, 1999). Moreover, Pouliot and
Cowen (2007) found that fictional rather than
nonfiction narratives produced greater recall and
emotional arousal.
In addition to the fact versus fiction distinc-
tion, narratives may vary on other realism
dimensions in meaningful ways. Scholars have
argued that the realism of narratives is likely to
be multidimensional (e.g., Hall, 2003), and recent
research empirically demonstrated that realism
comprises the dimensions of plausibility, typical-
ity, factuality, narrative consistency, and percep-
tual quality, and that these subdimensions
differentially predict the processes and outcomes
of narratives relevant to risk assessment and pre-
vention (Cho, Shen, & Wilson, 2012, 2013).
Of realism dimensions, typicality is the more
stringent criterion as it concerns the representa-
tiveness of the narrative event to the population
of real-world events; plausibility, on the other
hand, is threshold-level realism as it addresses
the question whether the event in the narrative
could possibly happen in reality (Hall, 2003).
Research found that plausibility and typicality
predicted differential routes to risk assessment
and risk prevention. For risk assessment, typical-
ity was the most important predictor (Cho et al.,
2013). Typicality was more strongly associated
with personal probability estimation than any
other dimensions. Plausibility indirectly contrib-
uted to personal probability estimation only by
directly decreasing message discounting (e.g.,
“this story is exaggerated”).
While typicality was the strongest predictor of
personal probability estimation (Cho et al.,
2013), other realism dimensions may also be
relevant to narrative effects in other areas related
to risk. For example, plausibility as well as typi-
cality contributed toward risk prevention atti-
tudes, although through different paths (Cho
et al., 2012). Typicality predicted attitudes via
identification but not via emotional engagement;
plausibility predicted attitudes via emotional
engagement but not via identification. Put differ-
ently, typicality primed perceived personal relat-
edness with the character and situation in the
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188—— SECTION 5 Risk Communication Messages
narrative but had little emotional impact; plausi-
bility affected emotions without eliciting rele-
vance to personal realities. However, attitudes
toward risk prevention were predicted by both of
these paths.
Strange and Leung (1999) did not find that
typicality was necessary for societal-level infer-
ences. Specifically, despite the fact that the narra-
tive about a school dropout was not evaluated to
be typical, it still influenced the judgment about
the locus of responsibility of the dropout. Strange
and Leung (1999) attributed this effect of narra-
tives on societal-level inference to the narratives
reminding of the audiences direct or indirect
past experience, which is likely to be more simi-
lar to plausibility rather than typicality. Research
is needed to investigate how differential dimen-
sions of realism may be differentially relevant to
narrative effects (e.g., personal vs. societal-level
judgments, probability estimation vs. attitudes
toward behavior).
Exemplars
Exemplars refer to the persons, characters, or
personalities portrayed in a narrative (Zillmann &
Brosius, 2000). As narratives frequently describe
human experiences, exemplars may be an essential
component of any narrative. A growing body of
research has investigated the effects of exemplars,
and findings suggest that exemplars tend to
increase risk estimation and to increase risk pre-
vention intentions. Notably, exemplar research
also suggests that exemplars may reduce accuracy
in risk assessment.
Research has found that exemplars increase
risk estimation. For example, news narratives
containing emotionally charged interviews with
grieving family members of food poisoning and
handgun violence victims led to increased risk
perceptions compared to news narratives with
nonemotional interviews or no interviews; the
risk perceptions included the estimation of the
national importance of the issues and personal
probability of becoming a victim of the same
risks (Aust & Zillmann, 1996). Readers of a news
report with an extreme exemplar of carjacking
incidence in which the victim was killed indi-
cated a significantly higher estimation of carjack-
ing as a serious national problem and higher
estimation of the rate of fatalities in carjacking
incidences than readers of a news report with
exemplars who suffered minimal to substantial
consequences (Gibson & Zillmann, 1994). These
effects of exemplars are facilitated by emotional
reactions, and the negative emotions (e.g., fear)
elicited through exemplification motivate behav-
ior change (Zillmann, 2006; Zillmann & Brosius,
2000).
Research suggests that for risk prevention
purposes, positive exemplars’ modeling of pre-
vention behavior can improve narrative effec-
tiveness. For example, news stories with an
exemplar who successfully quit smoking were
more effective in persuading smokers to form
intentions to quit smoking than news stories
without such an exemplar (Kim, Bigman, Leader,
Lerman, & Cappella, 2012). Furthermore, narra-
tives with an exemplar who succeeded in pre-
venting a risk were more effective than narratives
with an exemplar who failed to prevent the risk
(Hoeken & Geurts, 2005).
While these studies suggest the significant
effects of exemplars, cautions have been issued by
researchers about the undesirable effects of
exemplars. The cautions are based on the fact
that exemplars do not provide a representative or
valid summary of risk information and that they
may be an unrepresentative or unreliable depic-
tion of reality. Thus, although exemplars may
endow suasory power to risk communication
through emotional processes, the power may
come at the expense of accuracy. Notably, Gibson,
Callison, and Zillmann (2011) investigated the
effects of exemplars on the accuracy of the esti-
mation of the frequency of negative events.
Different probability ratios for illnesses were
developed from a newsmagazine story about
American volunteers contracting tropical dis-
eases while on a mission trip in Nicaragua. Those
who read exemplar-only messages indicated less
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Chapter 12 Narrative Communication of Risk—— 189
accurate estimations of the ratio of diarrhea vic-
tims and parasite infection victims as compared
to those who read baseline-only or both baseline
and exemplar messages.
Risk communication research should identify
ways to prevent biased judgments arising from
unrepresentative exemplars. Evidence gathered
by some studies suggests that typicality may be
an antidote to unsafe effects of exemplars. For
example, Bodenhausen, Schwarz, Bless, and
Wanke (1995) found that the thoughts about
typicality may mitigate the effects of exemplars.
Specifically, they found that exemplar effects
vanished when individuals were given the oppor-
tunity to think about the atypicality of the exem-
plars. Furthermore, the judgment about the
typicality of the exemplar moderated the acces-
sibility of stereotypical knowledge about the
social group and the use of the knowledge to
assess a new target person who belongs to the
social group (Macrae, Bodenhausen, Milne, &
Castelli, 1999). The inclusion of base rate infor-
mation, on the other hand, did little to mitigate
exemplar effects on frequency or prevalence
estimation (Brosius & Bathelt, 1994; Zillmann,
2006; Zillmann & Brosius, 2000).
Reflections for Theory
and Research
Extant research has frequently focused on deter-
mining the relative effectiveness of narratives
and nonnarratives. The next step in this research
may be to move from the question of whether
narratives are more effective to when narratives
are more effective and what kinds of narratives
are more effective. This stream of investigation
may entail the consideration of the following fac-
tors: the goal of risk communication (e.g., accu-
racy vs. acceptance), the kinds of nonnarratives
to which narratives are compared with (e.g.,
prevalence vs. frequency statistics), and the char-
acteristics of narratives (e.g., realism and exem-
plars). Addressing this question may help identify
the characteristics of narratives that activate
intended and unintended processes and effects
related to risk communication. These findings
can guide risk communicators in determining
the situations in which the use of narratives is
appropriate and when narratives should be use-
fully integrated with and used in combination
with other forms of messages to promote accep-
tance based on accuracy.
Recommendations for Practice
Although narratives are increasingly adopted for
various communication goals and purposes, the
postulations advanced in this chapter suggest
that communicators should consider the goal of
communication and evaluate whether narratives
are the most appropriate message format for a
given communication goal. When acceptance is
the goal, narratives may be appropriate and effi-
cacious. When accuracy is the goal, however,
narratives may not be the most appropriate, as
the postulations advanced and evidence reviewed
in this chapter suggest that narratives have the
possibility of engendering inaccurate risk judg-
ments. Evaluation of risk communication should
be mindful of this possibility and should assess a
range of outcomes of risk communication rather
than just intended goals, such as acceptance. This
way, knowledge gained from practice can inform
future planning of risk communication.
Conclusions
Risk communication engages multiple goals.
Promoting acceptance of risk reduction behavior
is one of the goals, but it is not the only goal.
Another important goal of risk communication
is facilitating accurate judgment of risk. In using
narratives for risk communication, these goals
should be discerned and distinguished.
Stories may not be told to provide a represen-
tative or reliable summary of reality. Rather,
stories frequently focus on illustrating details of
particular cases. When one is emotionally
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190—— SECTION 5 Risk Communication Messages
engaged in stories, disbeliefs are suspended and
critical processing and counterarguments are
suppressed. This nature and processing of narra-
tives may support the acceptance goal of risk
communication, but may encumber the accu-
racy goal of risk communication. Acceptance
should not be encouraged at the expense of
accuracy.
Note
1. While it may be possible that these varying forms,
lengths, and platforms of narratives produce differential
effects, research has yet to investigate this possibility.
Suggested Additional Readings
Chen, S., Duckworth, K., & Chaiken, S. (1999).
Motivated heuristic and systematic processing.
Psychological Inquiry, 10, 44–49.
Larkey, L. K., & Hill, A. (2011). Using narratives to
promote health. In H. Cho (Ed.), Health commu-
nication message design: Theory and practice
(pp. 95–112). Thousand Oaks, CA: Sage.
Weinstein, N. D., & Sandman, P. M. (1993). Some cri-
teria for evaluating risk messages. Risk Analysis,
13, 103–114.
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... Narrative consistency, in turn, evokes emotional responses that energize and direct action (Cho et al., 2014). This reliance on personal, emotional resonance could mislead people from facts and truth (Cho and Friley, 2015;Van Bavel et al., 2021). ...
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Fear appeals are frequently used in health communication to persuade people to adopt a new type of behavior (e.g., practicing safe sex) because their current behavior (e.g., having unsafe sex) is likely to result in harmful consequences. A fear appeal's persuasiveness depends on the extent to which the consequences are perceived as undesirable and realistic and on the extent to which the proposed alternative behavior is considered effective and feasible. In an experiment, the perceived threat and self-efficacy were manipulated by means of an exemplar in which a person either succeeded in performing the propagated behavior (and, consequently, did not suffer the harmful consequences) or in which the person did not succeed in performing the propagated behavior (and, consequently, did suffer the harmful consequences). A total of 149 participants read one of the versions and indicated their intention to perform the propagated behavior, their perception of its feasibility, and their inclination to minimize the message. The results showed that the version in which the person succeeded in performing the behavior yielded a more positive self-efficacy perception and stronger acceptance of the message claim. The version in which the person failed to perform the behavior yielded a more negative self-efficacy perception and more negative intention to perform the behavior propagated. Further statistical analysis showed that the effects on intention were mediated by the message minimization.
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Background. Decision aids often provide statistical information and patient testimonials to guide treatment choices. This raises the possibility that the testimonials will overwhelm the statistical information. Methods. Prospective jurors in Philadelphia County were presented with hypothetical statistical information about the percentage of angina patents who benefit from angioplasty and bypass surgery (50% and 75%, respectively). They were also given written testimonials from hypothetical patents who had benefited or not benefited from each of the two treatments. The numbers of patients benefiting and not benefiting were varied to be either proportionate to the statistical information or disproportionate. In study 1, all participants received 1 testimonial from a patient who had benefited from angioplasty and 1 from a patient who had not. Participants receiving the proportionate questionnaire version were also given 3 testimonials from patents who benefited from bypass surgery and 1 from a patient who did not, coinciding with the hypothetical statistical information. In contrast, participants receiving the disproportionate questionnaire version received only I testimonial from a patent who benefited from surgery and I from a patient who did not. In study 2, all participants received 2 examples of patients who benefited from angioplasty and 2 who did not. Participants with the proportionate questionnaire version received the same testimonials regarding surgery as in study 1. Those receiving the disproportionate questionnaire version received 2 testimonials from patients who benefited from bypass and 2 from patients who did not. Finally, a separate set of participants in study 2 received a questionnaire with no testimonials. Results. In study 1, 30% of participants receiving the disproportionate questionnaire version chose bypass surgery versus 44% of those receiving the proportionate questionnaire (P = 0.002 by chi (2)). In study 2, 34% of participants receiving the disproportionate questionnaire version chose bypass surgery versus 37% of those receiving the proportionate questionnaire (P = 0.59 by chi (2)). Of those receiving no patent testimonials, 58% chose bypass surgery. Conclusions. The inclusion of written patient testimonials significantly influenced hypothetical treatment choices. Efforts to make the mix of positive versus negative testimonials proportionate to statistical information may, under some circumstances, affect choices in ways that cannot automatically be assumed to be optimal.
Article
After exposure to statistical information and/or samplings of exemplifying cases in a news report on health risks, quantitative impressions and associated affective dispositions were examined in persons differing in arithmetic competence. Whereas the variation of such competence was without appreciable effect on incidence estimates, it markedly influenced affect-mediated assessments of empathy with victims, safety risks, and protective concerns. Specifically, exposure to sets of pertinent exemplars fostered higher assessments by persons of lower numeric ability than by persons of higher numeric ability. In addition, all presentations involving exemplars fostered stronger affective assessments than did the presentation of statistical data alone. The findings suggest that variation in numeric competence is associated with distinct differences in information processing that serves the formation of affect-mediated risk-related assessments. Implications for cognitive processing styles are considered and applied to the design of informative and persuasive media campaigns.
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Two broadcast news stories were manipulated to show victimization (food poisoning, handgun violence) in one of three versions: without victim exemplification, with exemplification by unemotional victims, and with exemplification by highly emotional victims. Male and female respondents, whose empathic sensitivity had been predetermined, recorded their own perceptions of each issue addressed: its severity as a national problem, the likelihood of it becoming a local problem, and the likelihood that they themselves might be placed at risk. They also indicated their reaction to each news story. Emotional victim exemplification fostered perceptions of greater problem severity than unemotional and no victim exemplification. Additionally, emotional victim exemplification, compared with no exemplification, fostered perceptions of increased victimization risk to self, whereas unemotional victim exemplification failed to do so. Empathic sensitivity did not interact with exemplar emotionality, but produced a main effect. Highly empathic persons perceived the severity of danger and risk to themselves as greater than did less empathic persons. Respondent gender similarly produced a main effect without interacting with exemplar emotionality. Female respondents assessed all dangers and risks as higher than did their male counterparts. Finally, exposure to emotional exemplification, but not unemotional exemplification, fostered reports of greater distress reactions than did exposure to the news stories without exemplification. Women reported greater distress than did men, and highly empathic persons reported greater distress than did less empathic persons.