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Article

Sarah C. Vos and Elisia Cohen

Using pictures (also called images) in health and risk messages increases attention to messages and facilitates increased retention of message content, especially in low-literate populations. In risk communication, researchers have found that pictorial warnings stimulate communication and that images without text can communicate risk information as effectively (or, in some cases, more effectively) than text. However, little empirically based guidance exists for designing images for health and risk messages because most studies use an absence-presence model and compare visual communication to textual communication, rather than compare different types of visual communication. In addition, visual communication theories focus on describing the “how” aspect of communication instead of offering proscriptive guidance for message design. Further complicating the design of visual messages is that the number of possibilities for a visual message is, like text-based messages, almost infinite. Choices include colors, shapes, arrangement, and the inclusion of text, logos, icons, and so on. As a result, best practices on visual messages often draw on design recommendations. Before the widespread advent of Internet use and the adoption of social networking sites like Facebook and Twitter, using images—especially color images—could be cost prohibitive. However, these online platforms facilitate the distribution of visual content, and many public health organizations use these platforms to distribute visual messages. The need for guidance and research on using pictures effectively is growing. Although there has been increasing focus on images in health messages, many questions still exist about how visual messages should be composed and what their effect is. The existing evidence suggests that visual information can improve persuasive and, on social networking sites, diffusion outcomes. However, visual information may be prone to misinterpretation. Researchers should also evaluate ethical considerations when choosing pictures. Message testing is highly recommended.

Article

Referred to as the “most consistent and reliable method for conferring resistance to persuasion” by Miller et al. in 2013, over the past 50 years inoculation has exerted significant influence in shaping theoretical and contextual resistance research and message design. Used as a message strategy, inoculation elicits threat, or realized attitudinal/behavioral vulnerability, which motivates individuals to shore up attitudinal/behavioral defenses by providing both material and guided practice aiding the process of effective counterarguing, which in turn increases individuals’ resistance to attitudinal/behavioral challenges. The motivation is responsible for sustaining the inoculation effect over an extended period of time. Inoculation messages, however, do much more than just inspire a robust defense. They motivate individuals to engage others regarding the attitudinal/behavioral topic in an attempt to reassure and advocate their positions, thus diffusing the inoculation message over social networks. The attitudinal/behavior protection elicited by inoculation messages is not limited to the message’s target attitude/behavior, but instead spreads over related attitudes/behaviors as well, thus increasing the pragmatic utility of this message strategy. Inoculation’s effectiveness extends beyond the realm of resistance, as inoculation messages are also effective in both shaping and changing attitudes/behaviors. Because of its success, inoculation-based message strategies have been applied in numerous contexts researchers and clinicians beganand with numerous topics. Some of inoculation’s applied contexts include commercial, instruction/education, interpersonal, political, corporate, public relations, cross-cultural, health, and risk. More specifically, in the health and risk contexts, inoculation has been applied in promotion or prevention capacity on topics such as politically-motivated violent acts, smoking, drinking, unprotected sex, vaccination, and health-related policy, with current research exploring its efficacy in addiction interventions and indoor tanning-bed usage prevention. Inoculation may also be used as a strategy to reduce recidivism in criminal prison inmates and preventing verbal aggression in schools. Additional promising areas for application of inoculation-based strategies may include the promotion and protection of healthy eating habits as well as positive attitudes/behaviors toward mammograms, colonoscopies, breastfeeding, and regular exercise, just to name a few. As Ivanov suggested, the “application of the strategy [is] boundless.”

Article

Message sensation value (MSV) is defined as the degree to which a message’s format and content features elicit sensory, affective, and arousal responses. MSV research has received considerable scholarly and professional attention for more than two decades. The seminal work, to date, has been conducted by the Kentucky School. MSV was initially operationalized as perceived message sensation value (PMSV). The activation model of information exposure (AMIE) provides the basis for explaining the functional mechanism of MSV and PMSV. The AMIE proposes that exposure is a function of the interaction between an individual’s sensation-seeking tendency and sensation-enhancing attributes of the message itself. There are three primary types of message features that contribute to MSV: (a) the formal video dimension, (b) the formal audio dimension, and (c) the content dimension. There is an important distinction between subjective reactions to the message (PMSV) and the format and content features contributing to these reactions (MSV). In general, messages of high relative to low in sensation value have elicited greater message processing and more favorable evaluations across a range of outcome variables in health communication. Some health communication campaigns have employed high sensation value messages to target high sensation seekers. This sensation-seeking targeting approach, SENTAR, however, has received mixed and limited support. The influence of MSV on message effectiveness might be very similar for the two groups. Recently, some scholars have attempted to situate AMIE in a broader context of persuasion. First, AMIE and the elaboration likelihood model (ELM) offer competing predictions in terms of the role of MSV in persuasion, such that AMIE stresses a straightforward attention-getting effect, whereas ELM predicts a distracting effect of MSV interfering with message’s content. The very few studies conducted thus far reveal limited and mixed findings. Second, in the integration of MSV research with the appraisal theory and excitation-transfer theory, MSV may function as an arousal generator to amplify the influence of discrete emotions on perceived message effectiveness. Third, according to the psychological reactance theory, there are challenges with implementing high sensation value (HSV) messages, in that they potentially could backfire among the target audiences. Messages with HSV may garner better-perceived effectiveness when they tone down the controlling language. Future studies should investigate the relationships between specific MSV-enhancing features and message processing. They can expand the literature by studying the impact of MSV in a variety of media message contexts (e.g., broadcast journalism). Future experiments might also incorporate psychophysiological measures (e.g., skin response and heart-rate deceleration) to complement self-reported measures. Future studies should continue to explore other features (e.g., visual-verbal redundancy) that might affect attention and message processing jointly with MSV, and other individual difference variables, such as need for cognition, trait reactance, locus of control, and etc.

Article

Nancy Grant Harrington

The study of persuasive health messages—their design, dissemination, and impact—is ubiquitous in the communication discipline. Words, sounds, and images—alone or in combination—can move people to change their minds and their bodies. Micro-level topics surround questions of message content (argumentation scheme, evidence, qualifying language, and figurative language), structure (message sidedness, standpoint articulation, inoculation, and sequential strategies), and format (channel and audiovisual effects). Macro-level topics in this area include message sensation value, narrative, framing, emotional appeals, and tailoring. Central theoretical frameworks used to guide message design research, include health behavior change theories, information processing theories, and theories/frameworks for message design. In addition, some of the methodoligical issues inherent in message design research are questions of analysis, validity, and measurement. Four streams of past scholarship that inform persuasive health message design research: Greek rhetoric, mass communication research begun during World War II, the development of health communication as a research focus within the communication discipline, and the development of computer and telecommunications technology. Directions and challenges for future research include the need for a clear, coherent, and comprehensive taxonomy to classify message characteristics and attention to several methodological issues.

Article

Kathryn E. Anthony, Timothy L. Sellnow, Steven J. Venette, and Sean P. Fourney

Much current scholarship in the realm of information processing and decision making, particularly in the context of health risks, is derived from the logical-empiricist paradigm, involving a strong focus on cognition, routes of psychological processing of messages, and message heuristics. The message convergence framework (MCF), derived heavily from the writings of Perelman and Olbrechts-Tyteca, contributes to this body of literature by emphasizing the fact that people make decisions on health risks while being exposed to arguments from multiple sources on the same topic. The MCF offers an explanation for how people reconcile myriad messages to arrive at decisions. MCF differs from other theories of message processing because of its distinct and unique focus on arguments, messages, and the ways various arguments interact to create “convergence” in individuals’ minds. The MCF focuses on the ways that multiple messages converge to create meaning and influence in the minds of listeners. Convergence occurs when messages from multiple sources overlap in ways recognized by observers, creating perceptions of credibility and influencing their risk decisions. Perelman and Olbrechts-Tyteca explain that convergence occurs when “several distinct arguments lead to a single conclusion.” Individuals assess the strengths and weaknesses of the claims, and according to the scholars, the “strength” of the arguments “is almost always recognized.” Three key propositions focusing on message convergence articulate that audiences recognize message convergence, that they actively seek convergence in matters of concern, such as health risk, and that this convergence is potentially fleeting as new messages are introduced to the discussion. Conversely, Perelman and Olbrechts-Tyteca also discuss message divergence, and the rationale for wanting to intentionally create divergence among interacting arguments. Divergence is particularly appropriate in the realm of health and risk messages when scholars must challenge potentially harmful beliefs or correct misinformation. Some strategies for invoking divergence in include: dissociation, in which the speaker attempts to reframe the argument to create novel understandings; identification of the stock, hackneyed, and obsolete, where the speaker attempts to make existing claims appear commonplace or obsolete to the listener; refutation of fallacies, where the speaker points out the fallacious reasoning of the opponent; clash of interpretation, where the speaker publicly articulates that individuals have understood the convergence to mean different things; weakening through reaction, which involves the speaker’s attempting to incite a reactionary approach by the opponent; and finally, highlighting the consequence of invalid convergence, where the speaker describes the negative outcomes that may occur from following a false convergence based on incorrect information. For message design, environmental scanning enables scholars and practitioners to assess the messages in a particular health-risk context. This assessment can assist practitioners in emphasizing or building convergence among reputable sources and in introducing divergence in cases where misunderstanding or a lack of evidence has contributed to an unproductive perception of convergence. Ultimately, the MCF can assist practitioners in scanning their health-risk environments for opportunities to establish or bolster convergence based on credible evidence and for introducing divergence to challenge inaccurate or misleading interpretations and evidence.

Article

Self-efficacy is the personal belief in one’s ability to meet a goal or perform a specific task. Although it can be applied to any type of human endeavor, the construct of self-efficacy is thought to be central to changing behaviors to improve health outcomes. For this reason, message designers have been attempting to understand how messages detract from or enhance self-efficacy. Persuasive messages have and can be used to enhance perceived self-efficacy related to health and risk behavior. Self-efficacy-strengthening messages and interventions in health promotion can be assessed in general or specfically in regards to fear appeals. Other aspects of self-efficacy interventions include collective efficacy and professional self-efficacy.

Article

Jessica Gasiorek and R. Kelly Aune

A majority of the extant literature in health and risk message processing focuses—for obvious reasons—on social influence and compliance-gaining. Interpersonal and relational issues with doctors and patients are a secondary focus. In contrast, research that specifically addresses comprehension of health and risk messaging is somewhat scant. However, other domains (e.g., cognitive psychology, reading studies) offer models and studies of comprehension that address message processing more generally. This material can usefully inform research in a health and risk context. An important aspect of any communicative event is the degree to which that event allows interactivity. This can be described in terms of a continuum from static messaging to dynamic messaging. Message features may affect simple comprehension (in the former case) and active understanding (in the latter case) of messaging along this continuum. For static messaging, text features are the dominant focus; for dynamic messaging, how communicators cooperate, collaborate, and adjust their behavior relative to each other’s knowledge states is the focus. Moderators of these effects, which include sources’ dual goals informing and influencing targets, are also important to consider. Examples of this include direct-to-consumer-advertising (DTCA) of pharmaceutical medicines and pharmaceutical companies, which must meet the demands of the government regulatory bodies (e.g., fair and balanced presentation of benefits and risks) while simultaneously influencing the message processing experience of the target to minimize negative perceptions of their products. Impediments to creating understanding can arise in both the highly interactive setting of the face-to-face doctor-patient context as well as more static messaging situations such as PSAs, pamphlets, and pharmaceutical package inserts. Making sense of message comprehension in health and risk communication is complex, and it is complex because it is broad in scope. Health and risk communication runs the gamut of static to dynamic messaging, employing everything from widely distributed patient information leaflets and public service announcements, to interactive web pages and massively connected social networking sites, to the highly interactive and personalized face-to-face meeting between doctor and patient. An equally comprehensive theoretical and methodological tool box must be employed to develop a thorough understanding of health and risk communication.

Article

Tamara D. Afifi, Ariana Shahnazi, and Kathryn Harrison

Rumination is typically thought of as pessimistic, repetitive thinking or mulling that is deleterious for one’s health. Rumination, however, can take several forms and is not always harmful. In fact, it could actually be helpful in certain circumstances. It is common and often helpful when something stressful happens, like a health scare or problematic health diagnosis, for people to ponder or reflect on why it happened and brainstorm potential solutions to it. This is referred to as reflective rumination. Rumination affects people’s risk perceptions related to their personal and relational health and decision-making about their health. Research on negative rumination and health and positive rumination and health focuses on the impact of these patterns of thinking on health outcomes such as mental health, physical health, and relational health and as perceptions of health messages and risk likelihood.

Article

Monique Mitchell Turner

Shame and guilt are distinct emotional experiences that are often confused by lay people as similar. Yet, shame and guilt are aroused by distinct cognitive appraisals and lead to distinct emotional, cognitive, and behavioral outcomes. There are distinctions between shame and guilt in psychology and communication. Differences are correlated with personality and individual proneness for shame and/or guilt.

Article

Ann Bostrom

Mental models of health risks are the causal beliefs that comprise one’s inference engines for the interpretation and prediction of health and illness experiences and messages. Mental models of health risks can be parsed into a handful of common elements, including beliefs about causes, consequences, and cures as well as identifying information such as symptoms and timing. Mental models research deriving from a risk and decision analysis framework emphasizes exposure sources and pathways as part of causal thinking as well as how interventions may reduce or increase the risk. Mental models can be developed as a function of one’s goals or the problem in a specific context, rather than as coherent, stable knowledge structures in long-term memory. For this reason they can be piecemeal and inconsistent in the absence of expertise or experience with the risk. Derived often by analogy with more familiar risks, mental models of health risks can lead to effective health behaviors but also to costly inaction or misplaced action. Assessing mental models of hazardous processes can contribute to the design of effective risk communications by identifying the concrete information message recipients need to cope with health risks, thereby making or strengthening common-sense links between risk and action representations. Although a wide variety of research methods are used to investigate mental models, achieving this level of specificity requires attention to substantive details. Researchers are beginning to better understand the interactions between mental models of risk and their social, cultural, and physical contexts, but much remains to explore.

Article

People who communicate health and risk information are often trying to determine new and innovative ways to reach members of their target audience. Because of the nearly ubiquitous use of mobile phones among individuals in the United States and the continued proliferation of such devices around the world, communicators have turned to mobile as a possible channel for disseminating health information. Mobile health, often referred to as mHealth, uses mobile and portable devices to communicate information about health and to monitor health issues. Cell phones are one primary form of mHealth, with the use of cell phone features such as text messaging and mobile applications (apps) often used as a way to provide health information and motivation to target audience members. Text messaging, or short message service (SMS), is a convenient form for conveying health information, as most cell phone owners regularly send and receive text messages. mHealth offers benefits over other channels for communicating health information, such as convenience, portability, interactivity, and the ability to personalize or tailor messages. Additionally, mHealth has been found to be effective at changing attitudes and behaviors related to health. Research has found mobile to be a tool useful for promoting healthy attitudes and behaviors related to a number of topic areas, from increased sexual health to decreased alcohol consumption. Literature from health communication and research into mHealth can provide guidance for health communicators looking to develop an effective mHealth intervention or program, but possible concerns related to the use of mobile need to be considered, such as concerns about data security and participant privacy.

Article

Claude H. Miller and Reinaldo Cortes Quantip

Within a range of health communication contexts, anger can be either a detriment to the receptivity of health promotion messages when poorly controlled, or a benefit to information processing when appropriately directed. In the former case, anger can disrupt cognitive processing, leading to a range of negative outcomes, including emotional turbulence and a preoccupation with anger-eliciting events that can severely limit the receptivity of health promotion and risk prevention messages. However, when properly directed and elicited in moderation, anger can motivate greater purpose and resolve in response to health threats, stimulate more active processing of health warnings, sharpen focus on argument quality, and direct greater attention to coping-relevant information concerning harmful health risks.

Article

Kristin Page Hocevar, Miriam Metzger, and Andrew J. Flanagin

Our understanding and perceptions of source credibility significantly drive how we process health and risk messages, and may also influence relevant behaviors. Source credibility is believed to be impacted by both perceptions of source trustworthiness and expertise, and the effect of credibility on changes in attitudes and behavior has been studied for decades in the persuasion literature. However, how we understand and define source credibility—particularly the dimension of expertise—has changed dramatically as social media and other online platforms are increasingly used to design and disseminate health messages. While earlier definitions of source credibility relied heavily on the source’s credentials as indicators of expertise on a given topic, more recent conceptualizations must also account for expertise held by laypeople who have experience with a health concern. This shifting conceptualization of source credibility may then impact both why and when people select, as well as how they perceive, process, and judge, health messaging across both novel and more traditional communication contexts.

Article

Health and risk message design theories do not currently incorporate a lifespan view of communication. The lifespan communication perspective can therefore advance theorizing in this area by considering how the fundamental developmental differences that exist within and around individuals of different ages impact the effectiveness of persuasive message strategies. Designing health messages for older adults therefore requires an examination of how theoretical frameworks used in health and risk message design can be adapted to be age sensitive and to effectively target older adults. Additionally, older adults often make health decisions in conjunction with informal caregivers, including their adult children or spouses, and/or formal caregivers. Message design scholars should thus also consider this interdependent influence on health behaviors in older adults. Strategic messages targeting these caregivers can appeal to, for example, a caregiver’s perception of responsibility to care for the older adult. These messages can also be designed to not only promote the older adults’ health but also to alleviate caregiver stress and burden. Importantly, there is an unfounded stereotype that all older adults are alike, and message designers should consider the most beneficial segments of the older adult audience to target.

Article

Matthew W. Savage, Sarah E. Jones, Jenna E. Reno, and Shari Veil

University students, faculty, and staff are among those most vulnerable to cybersecurity risks due to their reliance on modern technologies, the nature of their online activities, and the open infrastructure of institutional networks. Furthermore, cyberbullying has emerged as a public health concern by the Centers for Disease Control and Prevention (CDC), which first warned of electronic aggression in 2008, or any type of harassment or bullying that occurs via email, chat, instant messaging, websites, blogs, or text messaging. Roberto and Eden emphasized the communicative nature of cyberbullying, defining it as the “deliberate and repeated misuse of communication technology by an individual or group to threaten or harm others” in 2010 (p. 201). In response to serious cybersecurity concerns and growing evidence of cyberbullying behavior, the national Stop.Think.Connect. (STC) campaign was developed to educate Americans on cybersecurity risks and equip citizens with tools for safe, respectful, and appropriate online behavior; however, it lacks targeted messaging for those on university campuses. Formative research is needed to ascertain the specific cybersecurity risks and challenges identified by those living and working on large university campuses. Research by Noar in 2006 demonstrates that formative evaluation leads to more successful campaigns. The process involves learning about target populations, discovering communicative determinants of behavior change, and testing message concepts. To that end, this case study is a first step in targeting STC campaign messages to university students, faculty, and staff. Specifically, we sought to identify the distinct cybersecurity needs faced by university students and personnel, their perceptions of the saliency of the problem, and potential motives for increasing their cybersecurity-enhancing behaviors. These activities are needed to implement the campaign on college campuses and to increase the likelihood of any future outcome evaluation efforts that yield evidence of campaign effectiveness. Currently, we are unaware of any outcome evaluation. Focus group methodology was conducted to examine the target audiences’ knowledge, interests, needs, and attitudes regarding the management of cybersecurity threats. Additionally, practical recommendations for enhancing STC campaign implementation on university campuses were ascertained. Results emphasized key ways to improve the theoretical underpinnings of the campaign using the Integrated Behavioral Model (IBM). We identified how determinants of behavior change can be utilized to strengthen campaign messaging. Students displayed laissez-faire attitudes toward cybersecurity, while faculty and staff attitudes demonstrated a much higher level of concern. Social norms for personal cybersecurity action taking were notably low among students as well as faculty and staff. Students displayed limited personal agency in regards to enacting cybersecurity measures, while faculty and staff had greater knowledge of steps they could take, but little faith that these actions would be efficacious. Finally, thematic recommendations for implementing an effective cybersecurity campaign on a university campus were identified.

Article

Natoshia Askelson and Erica Spies

Parents can be the target of health and risk messages about their children and can be a channel by which children hear health messages. This dual role can make parents powerful agents for change in children’s health. Parents receive health messages from a variety of sources including health care providers, schools, the media, the government, and family. Parents tend to be a more frequent target for health messages when their children are infants or young. They receive many messages related to keeping their children safe. Most of these messages are not developed as part of a rigorous data-driven and theory-based intervention and often lack sophisticated message development and design. Furthermore, instead of segmenting parents and tailoring messages, parents are frequently treated as a monolith, with no diversity related to behavior or communication. As children age, parents can become the channel by which children can hear a health message. Parents of school-age children and adolescents are continually communicating messages to their children and are often targeted to communicate messages related to health or risk behaviors. Intentional efforts to encourage parents to talk to their children are often related to risk behaviors among older children. Specifically, parents are asked to convey messages about sexual health, alcohol and drug use, and driving. Evidence points to parent–child communication in general and communication about specific risk behaviors as protective for children. Research has also suggested that adolescents want to hear health messages from their parents. Parents are a natural choice to communicate about health and risk throughout childhood and adolescence due to the parent–child relationship and the influence parents can have over children. However, this special relationship does not automatically translate into parents having good communication skills. Messages designed to encourage parents to communicate with their children about a health topic have often been developed with the assumption that parents know what to communicate and how to effectively communicate with their children. Deficits in communication skills among parents have been recognized by some campaign developers, and an emphasis on developing those skills has been a significant part of some messages targeting parents. Health communication campaigns have been developed to inform parents about when and how to talk to their children about health issues such as alcohol, drugs, and sex. Unfortunately, not all parent–child communication is positive or effective and this can have potential unintended consequences. Treating parents as an audience in a more nuanced manner, with greater emphasis on evidence-based message development, could result in more effective messages and better health outcomes.

Article

Video games are a very popular form of entertainment media and have been the subject of much debate since their meteoric rise to popularity in the 1980s. Similar to the criticisms leveraged against other forms of media, video games have often been scrutinized for their potential to negatively influence those who play them. However, since the beginning of the 21st century, many new genres of video games have emerged and as a result, both public dialogue and research attention have shifted more toward understanding how certain games can be used for prosocial purposes. Exercise-based and active video games (AVGs) are a type of game which requires players to get up and move instead of simply sitting in front of the TV and pushing buttons. These types of games have received a lot of popular press and scholarly attention due to the fact that they encourage movement and may be used as a health intervention tool, especially to combat problems like obesity and overweight. Even though there has been significant research attention focused on the potential health benefits of playing these types of games, there is still much work to be done. While researchers have advanced a general understanding of why certain AVGs are effective or ineffective, there needs to be a greater emphasis on understanding the process by which these games can be motivating and influential. Shedding light on what makes AVGs potentially effective health management and intervention tools will not only be important for motivating people to become more active, but may also help inform research which focuses on how video games may be used in the health domain more generally.

Article

Fatalism is a set of beliefs that encompasses such dimensions as predestination, pessimism, and attribution of one’s health (life events) to luck. Locus of control refers to the extent to which individuals believe they are in control of events that affect them. Individuals with an external locus of control perceive their life is controlled by environmental factors they can’t change, or by chance or fate. Fatalism and external locus of control are both negatively associated with health behaviors and health outcomes; and contribute to health disparities due to the link between culture and socio-economic factors.

Article

Before health and risk messaging can have the best possible effect, there needs to be an understanding of what might influence health and associated risky behaviors. A wide range of elements needs to be considered, given the many possible influences on health habits and risky exposures. Since “ecology” is defined as the relationship between organisms and their environments, ecological models enable this consideration to be made. As a result ecological approaches have been widely used in health behavior, health planning, and health education. Ecological theory, with a communication focus, has also been developed, emerging specifically from the field of “information behavior.” Grounded in the work of Bronfenbrenner, on the experimental ecology of human development, the theory grew out of a study of older adults’ information and communication needs and uses, undertaken in the 1990s. The ecological model, as developed, enabled a wide range of personal and social influences on information seeking and communication to be explored with people aged 60 and older. Analysis of the impact of multilevel factors is facilitated by an ecological approach, increasing its value for the task of designing the content of health and risk messages. The “how” of designing health messaging is not addressed specifically by this approach. Following the study of older adults, the ecological model was broadened, modified, and applied to the study of the information and communication behavior of different community groups, involving a range of topics. The flexibility of the approach is a key strength. A study of information seeking, by women with breast cancer, indicated that several “ecological” elements, such as age, ethnicity, and stage of disease, played a part in the type of information sought and in preferences for how information was communicated. Health and risk avoidance implications emerged from a study of information seeking for online investment, providing another good example of the ways in which the model can be adapted. A range of ecological factors were shown to influence investing behavior, including level of risk taking. A study of people in the Fourth Age (the last stage of life) resulted in a further refined and extended model, as well as making a contribution to the already substantial body of accumulated gerontological knowledge.

Article

Ilona Fridman and E. Tory Higgins

Regulatory Focus Theory differentiates between two motivational orientations: promotion and prevention. Promotion-oriented individuals focus on advancements, growth, and making progress toward their hopes and aspirations, whereas prevention-oriented people are more concerned about safety, security, and fulfilling their responsibilities. Promotion-oriented individuals tend to focus on moving toward a better state ensuring gains and improvements. In contrast, prevention-oriented people tend to focus on ensuring against making mistakes and maintaining a current satisfactory state rather than moving to something worse. When individuals pursue desired ends using their preferred means (ensuring gains for promotion, and ensuring against losses for prevention), they experience regulatory fit, which makes them “feel right” about what they are doing. Regulatory fit is associated with strengthening engagement and intensifying evaluative judgments. The advantages of regulatory fit could be utilized in communications to motivate individuals’ healthy behavior. The messages that encourage healthy behavior could be framed in a way that fits recipients’ personal goal orientations. For instance, to increase motivation among promotion-oriented people for getting vaccinations, the message might state, “A flu vaccine helps you to continue achieving your goals even during a flu season.” This message emphasizes advancements and gains that fit a promotion orientation. To increase motivation among prevention-oriented people to choose healthy options, the messages could instead highlight avoiding losses: “A flu vaccine helps you avoid strength-sapping illness during a flu season.” Past studies on health communications have demonstrated that regulatory fit tends to facilitate participants’ willingness to follow the message and engage in healthy behavior. Could regulatory non-fit messages also work? When individuals pursue desired ends using non-preferred means—ensure gains for prevention-oriented individuals or ensure against losses for promotion-oriented individuals—they experience regulatory non-fit. Non-fit makes them “feel wrong” about what they are doing. Regulatory non-fit is associated with weakening engagement and de-intensifying evaluative judgments. How might a non-fit health message be helpful? What if individuals’ initial attitudes toward a healthy option were negative, even anxiety producing, despite that option serving their interests better than alternative options? It would be better if the individuals could thoughtfully consider the potential benefits of the option without their negative feelings rejecting it. For a thoughtful decision to be made, the intensity of the initial negative feelings could be decreased. A regulatory non-fit message, in this case, could be an effective tool. By making people “feel wrong” about their initial reaction, it could weaken their engagement and de-intensify the negative reactions, for example, reduce anxiety about the option. Thus, the regulatory non-fit message could help an individual to reconsider potential advantages of the initially disliked option. While the ways in which Regulatory Focus and Regulatory Fit theories can be applied to improve health communications are known, important questions remain. For example, are there circumstances when fit or non-fit messages could make people feel that their decision-making autonomy is being threatened? Can fit or non-fit messages create resistance? If so, how can this be avoided? Both fit and non-fit messages are persuasive techniques. Is there a downside to these techniques? What can be done to ensure that these persuasive techniques are not just effective but are also ethical?