A randomized trial of computer-based communications using imagery and text information to alter representations of heart disease risk and motivate protective behaviour

Abstract

Advances in web-based animation technologies provide new opportunities to develop graphic health communications for dissemination throughout communities. We developed imagery and text contents of brief, computer-based programmes about heart disease risk, with both imagery and text contents guided by the common-sense model (CSM) of self-regulation. The imagery depicts a three-dimensional, beating heart tailored to user-specific information. A 2 × 2 × 4 factorial design was used to manipulate concrete imagery (imagery vs. no imagery) and conceptual information (text vs. no text) about heart disease risk in prevention-oriented programmes and assess changes in representations and behavioural motivations from baseline to 2 days, 2 weeks, and 4 weeks post-intervention. Sedentary young adults (N= 80) were randomized to view one of four programmes: imagery plus text, imagery only, text only, or control. Participants completed measures of risk representations, worry, and physical activity and healthy diet intentions and behaviours at baseline, 2 days post-intervention (except behaviours), and 2 weeks (intentions and behaviours only) and 4 weeks later. The imagery contents increased representational beliefs and mental imagery relating to heart disease, worry, and intentions at post-intervention. Increases in sense of coherence (understanding of heart disease) and worry were sustained after 1 month. The imagery contents also increased healthy diet efforts after 2 weeks. The text contents increased beliefs about causal factors, mental images of clogged arteries, and worry at post-intervention, and increased physical activity 2 weeks later and sense of coherence 1 month later. The CSM-based programmes induced short-term changes in risk representations and behaviour motivation. The combination of CSM-based text and imagery appears to be most effective in instilling risk representations that motivate protective behaviour.