Abstract
BackgroundThe purpose of this study was to evaluate the effect of message framing on women’s intention to perform cytomegalovirus (CMV) prevention behaviors involving handwashing, not sharing food and eating utensils, not kissing a child on the lips and not placing a pacifier in the mouth after it was in a child’s mouth.MethodsAn online panel of women 18–40 years, who were pregnant or planning a pregnancy were randomized in a 2 × 2 factorial design to receive 1 of 4 CMV fact sheets. The fact sheets were framed as either what could be gained or be lost by following (or not) the recommendations and the likelihood of being affected by CMV (i.e., small chance or one of the most common infections in infants). The questionnaire measured CMV knowledge, participation in CMV risk or prevention behaviors, perceived severity of and susceptibly to CMV, and the perceived control over and the efficacy of recommended prevention behaviors. The dependent variable, intention to modify behavior, was an index score that ranged from 0 to 16 with higher values indicating greater intention. Linear regression was used to evaluate the association between all independent variables and overall behavioral intention.ResultsThe sample included 840 women; 15.5% were familiar with CMV. Behavioral intention was high (M = 10.43; SD = 5.13) but did not differ across the message frames (p = 0.23). Overall, behavioral intention was predicted by CMV knowledge, message credibility, perceived severity of CMV, perceived behavioral control and response efficacy. Significant interactions with gain vs. loss frame were observed for perceived behavioral control (p = 0.03) and response efficacy (p = .003).ConclusionsFraming CMV messages by what women stand to gain or lose interacts with perceived behavioral control and response efficacy to influence behavioral intention. Perceived behavioral control and response efficacy were most predictive of behavioral intention overall regardless of frame. Messaging that focuses on these two variables, particularly for avoiding kissing a child on the lips and sharing food, cups and utensils, may result in greater gains in intention to participate in CMV prevention behaviors.
Highlights
The purpose of this study was to evaluate the effect of message framing on women’s intention to perform cytomegalovirus (CMV) prevention behaviors involving handwashing, not sharing food and eating utensils, not kissing a child on the lips and not placing a pacifier in the mouth after it was in a child’s mouth
There are nearly 26,000 U.S children born with congenital CMV for a total birth prevalence of 0.64% [3]
Past research has shown that women regularly participate in behaviors that increase their risk of CMV infection through direct saliva sharing [15, 16]
Summary
The purpose of this study was to evaluate the effect of message framing on women’s intention to perform cytomegalovirus (CMV) prevention behaviors involving handwashing, not sharing food and eating utensils, not kissing a child on the lips and not placing a pacifier in the mouth after it was in a child’s mouth. In the United States, congenital cytomegalovirus (CMV) infection is one of the most common causes of birth defects and developmental delays in infants. Infants born with CMV are most commonly infected with the virus through transmission from mother to fetus during pregnancy [8]. Research has shown that behaviors that limit a woman’s contact with children’s saliva may be especially efficacious in reducing infection [13]. These include avoiding contact with saliva when kissing a child and not putting things in one’s mouth that have been in a child’s mouth ( food, cups, forks or spoons, or pacifiers) [14]. Women regularly engage in the protective behavior of handwashing [15, 16]
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