Jakob D. Jensen

The relative persuasiveness of gain-framed and loss-framed messages for encouraging disease prevention behaviors : A meta-analytic review

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 communicators 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.

Utilization of Internet Technology by Low-Income Adults: The Role of Health Literacy, Health Numeracy, and Computer Assistance

Objectives: To examine whether low-income adults’ utilization of Internet technology is predicted or mediated by health literacy, health numeracy, and computer assistance. Method: Low-income adults (N = 131) from the midwestern United States were surveyed about their technology access and use. Results: Individuals with low health literacy skills were less likely to use Internet technology (e.g., email, search engines, and online health information seeking), and those with low health numeracy skills were less likely to have access to Internet technology (e.g., computers and cell phones). Consistent with past research, males, older participants, and those with less education were less likely to search for health information online. The relationship between age and online health information seeking was mediated by participant literacy. Discussion: The present study suggests that significant advances in technology access and use could be sparked by developing technology interfaces that are accessible to individuals with limited literacy skills.

Do Loss-Framed Persuasive Messages Engender Greater Message Processing Than Do Gain-Framed Messages? A Meta-Analytic Review

Greater fear arousal is associated with greater engagement with persuasive messages, and negative information and events are more potent than their positive counterparts. Hence loss-framed persuasive appeals, which emphasize the undesirable outcomes of noncompliance with the communicators recommendations, should elicit greater message processing than do gain-framed appeals, which emphasize the desirable outcomes of compliance. But a meta-analytic review (based on 42 effect sizes, N = 6,378) finds that gain-framed messages engender slightly but significantly greater message engagement than do loss-framed messages. This effect is apparently not a result of whether the appeals refer to obtaining or averting negative (e.g., “skin cancer”) rather than positive (e.g., “attractive skin”) outcomes.

Effects of newspaper coverage on public knowledge about modifiable cancer risks.

This study explores the relationship between cancer newspaper coverage and public knowledge about cancer prevention, confirming self-reported associations between news exposure and cancer prevention knowledge with descriptions of newspaper coverage of modifiable cancer risks. Content analyses (N = 954) revealed that newspapers pay relatively little attention to cancer prevention. However, there is greater newspaper attention to tobacco and diet than to exercise, sun, and alcohol. Survey analysis (the National Cancer Institutes Health Information National Trends Survey) revealed that after controlling for differences based on gender, race, age, income, and education, attention to health news was significantly associated with knowledge about cancer risks associated with food and smoking but not for knowledge about exercise, sun, or alcohol. These findings conform to the findings of the content analysis data and provide a validation of a self-reported measure of media exposure, as well as evidence suggesting a threshold below which news coverage may not generate public knowledge about cancer prevention.

Making Sense of Cancer News Coverage Trends: A Comparison of Three Comprehensive Content Analyses

Cancer stories (N = 5,327) in the top 50 U.S. newspapers were analyzed by a team of four coders and the results were compared with the earliest analyses of this type (from 1977 and 1980). Using cancer incidence rates as a comparison, three cancers were found to be consistently underreported (male reproductive, lymphatic/Hodgkins, and thyroid) and four cancers were found to be consistently overreported (breast, blood/Leukemia, pancreatic, and bone/muscle). In addition, cancer news coverage consistently has focused on treatment rather than on other aspects of the cancer continuum (e.g., prevention), portrayed lifestyle choices (e.g., diet, smoking) as the most common cancer risk factor, and rarely reported incidence or mortality data. Finally, the data were compatible with the idea that personalization bias (e.g., celebrity profiles, event coverage) may explain some news coverage distortions.

Conflicting stories about public scientific controversies: Effects of news convergence and divergence on scientists’ credibility

Surveys suggest that approximately one third of news consumers have encountered conflicting reports of the same information. News coverage of science is especially prone to conflict, but how news consumers perceive this situation is currently unknown. College students (N = 242) participated in a lab experiment where they were exposed to news coverage about one of two scientific controversies in the United States: dioxin in sewage sludge or the reintroduction of gray wolves to populated areas. Participants received (a) one news article (control), (b) two news articles that were consistent (convergent), or (c) two news articles that conflicted (divergent). The effects of divergence induced uncertainty differed by news story. Greater uncertainty was associated with increased scientists’ credibility ratings for those reading dioxin regulation articles and decreased scientists’ credibility ratings for those reading wolf reintroduction articles. Unlike other manifestations of uncertainty in scientific discourse, conflicting stories seem to generate effects that vary significantly by topic. Consistent with uncertainty management theory, uncertainty is embraced or rejected by situation.

The cancer information overload (CIO) scale: Establishing predictive and discriminant validity

OBJECTIVE Survey data suggests that approximately three-fourths of adults are overwhelmed by cancer information - a construct we label cancer information overload (CIO). A significant limitation of existing research is that it relies on a single-item measure. The objective of the current study is to develop and validate a multi-item measure of CIO. METHODS Study 1 (N=209) surveyed healthcare and manufacturing employees at eight worksites. Colonoscopy insurance claims data were culled eighteen months later to evaluate the predictive validity of CIO. Study 2 (N=399) surveyed adults at seven shopping malls. CIO and cancer fatalism were measured to examine the properties of the two constructs. RESULTS Study 1 identified a reliable 8-item CIO scale that significantly predicted colonoscopy insurance claims 18 months after the initial survey. Study 2 confirmed the factor structure identified in Study 1, and demonstrated that CIO, cancer fatalism about prevention, and cancer fatalism about treatment are best modeled as three distinct constructs. CONCLUSION The perception that there are too many recommendations about cancer prevention to know which ones to follow is an indicator of CIO, a widespread disposition that predicts colon cancer screening and is related to, but distinct from, cancer fatalism. PRACTICE IMPLICATIONS Many adults exhibit high CIO, a disposition that undermines health efforts. Communication strategies that mitigate CIO are a priority. In the short-term, health care providers and public health professionals should monitor the amount of information provided to patients and the public.

Including Limitations in News Coverage of Cancer Research: Effects of News Hedging on Fatalism, Medical Skepticism, Patient Trust, and Backlash

Past research has demonstrated that news coverage of cancer research, and scientific research generally, rarely contains discourse-based hedging, including caveats, limitations, and uncertainties. In a multiple message experiment (k = 4 news stories, N = 1082), the authors examined whether hedging shaped the perceptions of news consumers. The results revealed that participants were significantly less fatalistic about cancer (p = .039) and marginally less prone to nutritional backlash (p = .056) after exposure to hedged articles. Participants exposed to articles mentioning a second researcher (unaffiliated with the present study) exhibited greater trust in medical professions (p = .001). The findings provide additional support for the inclusion of discourse-based hedging in cancer news coverage and suggest that news consumers will use scientific uncertainty in illness representations.

Dispositional Cancer Worry: Convergent, Divergent, and Predictive Validity of Existing Scales

Past research has suggested that dispositional cancer worry may be a key predictor of health behavior. The current study examined seven measures of dispositional cancer worry to see if they were significantly related (convergent validity), significantly different from similar but distinct traits (divergent validity), and capable of predicting cancer-relevant outcomes (predictive validity). Four hundred and eighty nine undergraduate students completed a survey measuring dispositional worry, dispositional cancer worry, and perceived cancer risk. Factor analysis identified four underlying dimensions that explained 67.3% of the variance in dispositional cancer worry: severity (42.8%), frequency (12.3%), psychological reactance (6.9%), and worry impact (5.3%). Four existing measures of dispositional cancer worry were found to represent each of these dimensions. In general, dispositional cancer worry measures were highly correlated with one another and only moderately correlated with measures of dispositional worry, supporting strong convergent and divergent validity. Hierarchical regression analyses revealed that dispositional cancer worry measures predicted significant variance in cancer-relevant outcomes above and beyond dispositional worry. The results of the current study support the notion that dispositional cancer worry and dispositional worry are distinct constructs. Furthermore, two dimensions of dispositional cancer worry (severity and frequency) seemed to have the strongest convergent, divergent, and predictive validity.

The Health Belief Model as an Explanatory Framework in Communication Research: Exploring Parallel, Serial, and Moderated Mediation

The Health Belief Model (HBM) posits that messages will achieve optimal behavior change if they successfully target perceived barriers, benefits, self-efficacy, and threat. While the model seems to be an ideal explanatory framework for communication research, theoretical limitations have limited its use in the field. Notably, variable ordering is currently undefined in the HBM. Thus, it is unclear whether constructs mediate relationships comparably (parallel mediation), in sequence (serial mediation), or in tandem with a moderator (moderated mediation). To investigate variable ordering, adults (N = 1,377) completed a survey in the aftermath of an 8-month flu vaccine campaign grounded in the HBM. Exposure to the campaign was positively related to vaccination behavior. Statistical evaluation supported a model where the indirect effect of exposure on behavior through perceived barriers and threat was moderated by self-efficacy (moderated mediation). Perceived barriers and benefits also formed a serial mediation chain. The results indicate that variable ordering in the Health Belief Model may be complex, may help to explain conflicting results of the past, and may be a good focus for future research.