Best practice recommendations for developing persuasive health and nutrition messages: a rapid review.

Globally and in Australia, diets low in vegetables, legumes and minimally processed core foods and high in ultra-processed foods are widespread and shown to be harmful to human and planetary health(1). Research suggests that important aspects of nutrition knowledge, such as the concept of ultra-processed foods, are not widely understood by adults, hampering public health efforts at improving diet quality(2). The World Health Organization recommends sequential health communication strategies that start with awareness raising as an important first step to promote healthy behaviours(3). Therefore, the aim of this rapid review was to identify best practice recommendations for the development of persuasive and educative health and nutrition messages for awareness raising among adults. A secondary aim was to identify best practice recommendations for features of persuasive and educative messages. Four academic databases were searched in June 2024. Websites of Australian and international health organisations were searched in April-July 2024 to identify relevant grey literature. Review articles that provided evidence or recommendations for developing persuasive health or nutrition messaging for awareness raising and grey literature that proposed communication strategies or frameworks, published after 2010 were eligible for inclusion. Twenty-seven reviews and four grey literature reports were included, of which 24 reviews and four reports focused on general health messaging and five reviews were specific to nutrition. Results reveal strong support in the literature for audience segmentation and tailoring of messages to the target audience. Ongoing formative research is also consistently recommended, including research to inform audience segments, message content, testing of messages with stakeholders and consumers and refinement of messages based on feedback. Dissemination of messages in mass media channels, including traditional and social media, and use of multiple channels for message repetition is considered best practice for awareness raising messaging. Additionally, dissemination of messages through well-known, credible and trusted messengers who are relevant to the target audience was consistently recommended. There were mixed findings on whether loss or gain framed messaging should be used, and to address this, use of a combination of both framings was recommended. Communicating the gist or bottom line of information, rather than overly precise didactic facts, was advised to improve audience understanding and message acceptance. Furthermore, narrative messaging was recommended over didactic messaging because it is more engaging and preferred by audiences. Finally, health and nutrition messages that are concise, simple and constructed with plain language are considered best practice. This review provides a practical synthesis of best practice recommendations for health and nutrition messaging for use in academic research and real-world health and nutrition promotion settings. Findings can be used to inform the translation of dietary recommendations into persuasive messages, in accordance with priority work to advance the Decadal Plan for the Science of Nutrition(4).

Persuasion literatures have focused on regulatory fit effect, that a message is more persuasive if satisfying the promotion or prevention focus of recipients. However, little research has examined what message features could elicit the fit. Our study investigated whether embedding health arguments into a narrative assisted in inducing two types of regulatory construal fit, one matching the recommended health behaviors with participants’ self-construal and the other matching the behaviors with participants’ readiness for change. Findings from an experiment revealed that the combined effect of regulatory focus and construal level was contingent upon message format, as the interactions between recommended behaviors and participants’ self-construal/readiness for change were more consistent with a fit when arguments were integrated within the narrative than when presented alone. Without considering message format, participants’ interdependent self-construal and their readiness for change positively predicted attitudes toward both promotion- and prevention-focused behaviors. We discussed the theoretical implications of the findings and provided practical guidance on using narratives in health message design.

This study examined the absence of culturally appropriate films for maternal health education in Ghana, where maternal mortality remains a critical concern. Grounded in semiotics and the Persuasive Health Message (PHM) framework, this research employs studio-based and qualitative methods to develop a culturally relevant educational film. During pre-production, consultations with health officers and pregnant women helped define educational objectives, identify audience needs and preferences, and determine suitable styles and formats. Feedback was systematically integrated throughout the production to refine the film’s form and content. The final film, which blends fictional and nonfictional elements, aligns with the instructional approach commonly used in pregnancy schools. The final film’s syntagmatic structure conveys themes of threat, severity, susceptibility, efficacy, barriers, and rewards, while paradigmatic elements include relatable characters, colour schemes, lighting, sound effects, and compositing techniques that enhance cultural relevance and emotional engagement. The study concludes that the film serves as an educational resource on maternal education for maternal health officers in Ghana. Future research should assess its impact on knowledge acquisition, perceptions, and health behaviours among the target audience. This study gives insight and extends knowledge on the significance of integrating semiotics and PHM in film production practices for film-based health education production in Ghana.

Overwhelmingly, the literature on the persuasive influence of emotions has focused on individual emotions, fear in particular, though some recent attention has been given to mixed emotions in persuasive appeals. Building on this newer wave of research, this article argues that instead of focusing on singular emotional states or collections of emotions evoked by a message, it might prove valuable to explore the flow, or evolution, of emotional experience over the course of exposure to a health message. The article offers a brief introduction to the concept of emotion, followed by a review of the state of the literature on the use of emotion in health messages. The concept of emotional flow is then introduced along with a consideration of how it has been tacitly incorporated into the study of emotional health messages. Finally, the utility of the concept of emotional flow is elaborated by articulating the ways in which it might be harnessed to facilitate the creation of more effective health messages, individually as well as across campaigns. The article concludes with an agenda for future research.

Health-related norms in social networks can influence whether people are open to health behavior change. Yet, little is known about how social networks relate to the ways individual brains respond to persuasive health messaging. The current study focuses on ventromedial prefrontal cortex (VMPFC) activity as an index of neural receptivity to health messages that may be related to behavior change. The study tested whether health-related norms and perceived physical activity levels within participants' social networks are associated with neural receptivity to health messages. Adults who initially reported under 200 minutes/week of physical activity (N = 146) rated the perceived physical activity levels of, and closeness to, each person in their core social network. VMPFC activity was monitored using fMRI while participants viewed persuasive health messages promoting physical activity. Longitudinal changes in sedentary behavior were objectively logged using wrist-worn accelerometers throughout a 2-week baseline and the month following the fMRI scan. Higher levels of perceived physical activity in participants' social networks were associated with greater VMPFC activity during message exposure, which in turn were associated with greater decreases in sedentary minutes. By contrast, greater closeness to physically inactive social ties was associated with lower VMPFC activity. Perceived norms in social networks relate to neural receptivity to health messaging. In particular, closeness to physically inactive ties is associated with lower neural receptivity to health messages encouraging physical activity, which may undermine the effectiveness of health messages. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Emerging evidence in health communication and psychology suggests that a) exposure to specific persuasive health messages can have unintended effects on the mental well-being of recipients and b) recipients’ mental well-being before exposure can influence message processing. Available evidence regarding the relationship between mental well-being and exposure to specific health messages lacks consistency and is scattered across different fields. This scoping review of 24 publications summarizes what is known about mental health effects in health communication and provides a research agenda for future work. Among others, key findings suggest that particularly negative emotional appeals may have broad, negative effects on indicators of hedonic well-being. Further, humor and gain appeals may positively impact mental well-being, although positive message features are strongly understudied in this space. Lower mental well-being prior to message exposure may impact message processing, but not necessarily message effectiveness. We find that potential well-being effects of health communication have been largely ignored, especially outside the realm of mental health research. Yet, initial evidence does underline the importance of such inquiry. This review summarizes initial evidence of systematic, unintended effects of health messaging on mental well-being and highlights fruitful avenues for future work in this space.

This paper describes the first of three experiments conducted to investigate the efficacy of a proposed persuasive mHealth messaging intervention that motivates individuals to become more physically active. In order to develop a set of persuasive health messages that can be used in the principal experiment, which examines a particular message-tailoring strategy, we conducted an online survey through Amazon Mechanical Turk. In this online study participants rated a series of health messages to indicate each message’s level of persuasiveness, as well as the message’s focus. This study was essential, as disagreements exist on how to frame persuasive health messages in the context of promoting physical activity. Among the proposed 57 messages, 14 messages rated as the most persuasive were selected for the principal experiment.

An integration of message framing and sociocultural literature suggests that ethnic health disparities may be reduced by incorporating minority groups' cultural values into persuasive health messages. Framing messages with metaphors represents one promising strategy for harnessing cultural values to change health outcomes. Still, the effectiveness of metaphoric health messages in minority populations has received virtually no empirical attention. To fill this gap, the present study tested whether a health message using a cancer-screening metaphor targeting collectivism and familism values would engage individual differences in these values to predict Papanicolaou (Pap) smear intentions among Latinas. Latina women (N = 168) completed an online survey including measures of collectivism and familism. They were randomized to read a message about Pap smears featuring the metaphor the body is a family or no metaphor before reporting their Pap smear intentions. Regression analyses revealed a pattern of interactions suggesting metaphoric messages engage targeted cultural values: For Latinas reading the family metaphor message, collectivism and familism positively predicted Pap smear intentions, whereas for Latinas reading the no-metaphor message, these values did not predict intentions. This study offers a foundation for further examination of the potential for metaphoric health messages that connect to cultural values to reduce ethnic health disparities. Implications and directions for future research are discussed.

Health and Nutrition Messages in Food Advertisements: A Comparative Content Analysis of Young and Mature Australian Women's Magazines

This research applies the Witte's persuasive health message (PHM) framework to the development of creative concepts that promote sexual health strategies to senior-aged women. The PHM framework proposes an integrated approach to improving message effectiveness and maximizing persuasion in health communication campaigns. A focus group method was used to explore two research questions focused on message effectiveness and persuasion. The findings suggest the PHM framework can be a useful starting point for ensuring that health communicators identify the criteria most relevant to successful ad promotions.

Introduction: The 2018 Basic Health Research showed a high prevalence of anemia (32%), Chronic Energy Deficiency (36.3%), and overweight and obesity (16.0%) among adolescents. Nutrition education is crucial to be taught to adolescents from an early age. However, there is a lack of research on content related to nutrition education in textbooks of school policies on nutrition and health. This study aimed to evaluate the nutrition education on senior high schools in Mamuju Regency.Methods: This qualitative study examined word by word of high school students textbooks’ content of nutrition and health education. The main study material was textbooks used by high school students in Mamuju Regency. The research informants were students and teachers. The analysis was done through content analysis by examining words and pictures in the textbooks. Data was classified into the same categories to answer the research objectives.Results: Only a small proportion of textbooks (0.17%) contain nutrition and health messages. The nutrition and health messages included the nutritional content of food, food labels, and physical activity such as how to do long jump. Informants did not get information on adolescent health and nutrition at school. In addition, there is currently no school policy regarding breakfast or healthy snacks in the school environment.Conclusion: Balanced nutrition messages had not been published in textbooks and delivered regularly in schools. Policy makers should review the school curriculum to include nutrition and health messages for adolescents in the textbooks used.

This study examines the influence of source and message characteristics on cancer prevention behavior in Ghana within the context of a social media platform. Drawing from the Information Processing Theory (IPT) and Health Belief Model (HBM), the research investigates the relationships between source credibility, message characteristics, social media usage, and key indices related to cancer prevention behavior. In this cross-sectional study, we surveyed 401 respondents across two social media platforms, namely Facebook and WhatsApp, which are the primary platforms utilized by the Zurak Cancer Foundation. We also chose to focus on these platforms because they reflect the dominant patterns of social media use in Ghana. Utilizing variables from the HBM and IPT, we conducted correlation and multiple regression analyses to examine how message, source, and channel characteristics influence cancer prevention behaviors. Additionally, we determined how IPT constructs, including perceived susceptibility, perceived severity, and self-efficacy, shape individual perceptions. Furthermore, we investigated the impact of both theories on cancer prevention behavior. The results demonstrate associations between constructs from the Health Belief Model and Information Processing Theory and outcomes related to cancer prevention behavior. Notable associations were observed between social media usage and perceptions of source credibility, highlighting the role of digital engagement in shaping source evaluations. Additionally, message characteristics were linked to perceived message influence and behavioral outcomes, underscoring the importance of how health messages are framed and presented. The study also identified associations between the perceived usefulness of social media as a health information source and indicators of message influence and behavioral change. This research offers valuable insights for both scholars and practitioners involved in health communication and intervention strategies. It underscores the significance of selecting credible, attractive, and knowledgeable sources in the domain of cancer prevention for effective health campaigns. By tailoring messages to align with these source characteristics, practitioners can enhance the reach and effectiveness of their health communication efforts. Additionally, media organizations and content creators can leverage source credibility to amplify their social media presence, thereby attracting a broader audience and maximizing the impact of health-related content dissemination in an era dominated by social media.

ABSTRACTGuided by the psychological reactance theory, this study predicted that gain-framed messages and audiovisual content could counteract state reactance and increase the persuasiveness of weight management health messages. Data from a 2 (message frame: gain/loss) × 2 (modality: audiovisual/text) × 2 (message repetition) within-subjects experiment (N = 82) indicated that in the context of weight management messages for college students, gain-framed messages indeed mitigate psychological reactance. Furthermore, the modality and the frame of the health message interacted in such a way that gain-framed messages in an audiovisual modality generated the highest motivations to comply with the recommendations in the persuasive health messages.

The Power of Grassroots Commitment

Research has shown that framing messages in terms of benefits or detriments can have a substantial influence on intended behavior. For prevention behaviors, positively framed messages have been found to elicit stronger behavioral intentions than negatively framed messages. Research also seems to indicate that certain contextual features contribute to the persuasiveness of a message. In the present research we test how message framing, contextually presented affect and the number of argument factors interact and contribute to the persuasiveness of a health related message. Consistent with our hypothesis, we found that, in our prevention focused task, increasing the number of arguments increased behavioral intentions (BI) for positively framed messages when subjects were cued, via negative affect, to be attentive to the message. This resulted in a significant framing effect for messages with the maximum number of arguments and a negative background picture. An account of contextual influence in persuasive health messages is discussed.