Evidence-Based Health Crisis Communication

BackgroundAdolescents and young adults demonstrate the highest rate of unrestrained motor vehicle fatalities, making the promotion of seat belt restraint a priority for public health practitioners. Because social media use among adolescents and young adults has proliferated in recent years, it is critical to explore how to use this tool to promote seat belt use among this population. Social media posts can contain various types of information within each post and this information can be communicated using different modalities.ObjectiveIn this study, based on the elaboration likelihood model, we aimed to examine how adolescents and young adults reacted to different appeals in various components of posts in the pilot of a promotion intervention on the Instagram BuckleUp4Life account.MethodsUsing thematic analysis, we examined different appeals in 3 components (photo, text, and caption) of 199 posts in BuckleUp4Life and compared the number of likes for different appeals.ResultsWe found that 6 appeals were used in the posts: rational, ego, social, fun, positive emotional, and fear appeals. The results of our study showed that in photos, fun appeals were the most popular. Rational and positive emotional appeals were the most appealing in text and captions. Regardless of the location of the components (photo, text, or captions), rational appeal was the most popular appeal.ConclusionsBased on the findings of our study, we recommend that public health practitioners utilize fun photos with rational and positive emotional appeals in text and captions rather than fear or social appeals, when promoting seat belt use through social media, especially Instagram.

The Healthy vs the Empty Self

Health education tools are important to stimulate responses and facilitate interaction among the participants during health education and counseling sessions. In addition to brochures, pictures and charts, exemplar is one of the most useful tools to engage participants during the sessions. Exemplar refers to a narrative or a story that elaborates on a person’s personal experience. The present study aims to examine the effects of exemplar (first and third person), message appeals (fear and motivational appeals) on the intention to stop smoking through the mediating role of narrative engagement. The study utilized a 2x2 between-subjects field experiment conducted among 16 counselling groups (with ten members in each group) who registered for the Stop Smoking Clinics under the Ministry of Health Malaysia. The result showed significant main effect of exemplars, message appeals and interaction effect of both variables on the intention to stop smoking. Narrative engagement was also found to play a significant mediating role in increasing the intention to stop smoking. The study concludes that the use of the first person exemplars with fear appeal will lead to greater narrative engagement and eventually stronger intention to stop smoking. Findings derived from the study would assist health education practitioners in choosing the most effective exemplars that can be used in health counseling sessions.

Parental communication is still relatively meaningful in Asian families with hierarchical, vertical, and authoritative relationships. Meanwhile, children's pro‐environmental behaviour in emerging Asian nations tends to be passive, leading to a need for intervention from the closest parties, often the parent, whose familial role in green communication has not been examined. This study uses social learning theory to examine the interplay of parent‐like spokespeople and message appeals in affecting young adults' cognitive and emotional responses, which is expected to influence the ad liking and believability of green advertisements and switching intention to green products, such as eco‐friendly straws. A laboratory experiment was conducted with 240 subjects. The results showed that the frame of a father‐like figure conveying a hope appeal generated the greatest enthusiasm and argument quality for young adults. Mother‐like figures speaking a fearful message frame were the best generator for young adults' anger and threat appraisal. Ad liking was significantly impacted only by a mother‐like spokesperson who spoke a fearful appeal mediated by anger and a father‐like spokesperson who delivered a hope appeal mediated by argument quality. Young adults' willingness to switch to eco‐friendly straws was indirectly influenced by the interaction effect of a mother‐like spokesperson and fear appeal type mediated by ad believability.

Purpose Research on fear and humor appeals in both social marketing and public health communication has been extensively discussed. However, with the popularity of social media platforms that allow multiple images and videos in a single post, this study aims to seek to provide effective message strategies to communicate sun safety behavior by investigating individual/combined effects and order effects of fear and humor appeals in health messages. Design/methodology/approach This study consists of two online experimental studies examining effective message strategies to communicate sun safety behavior. In Study 1, using a fictitious Instagram account with three conditions (fear vs humor vs fear with humor), this study tested the individual effect of either fear or humor versus the combined effect of fear and humor on sun safety social media posts to identify which message appeal leads to more engagement on social media and healthier decision-making process. Study 2 varied the presentation order of fear and humor in health messages to test which specific presentation order can enhance persuasion outcomes in conjunction with issue involvement. Findings Study 1 showed that humor, with or without fear, positively influenced participants’ attitude and behavioral intention toward sun safety behaviors through an increase in perceived message effectiveness. Study 2 results indicated that fear-then-humor presentation order produced greater perceived message effectiveness, resulting in a more favorable persuasion outcomes for individuals with low levels of issue involvement. Originality/value This study highlights the role of humor in public health marketing strategies by demonstrating the buffer effects of humor in fear appeals, especially for individuals with low levels of issue involvement. These findings extend the current fear and humor literature by offering significant theoretical implications for understanding individual differences in healthier decision-making.

The present study addressed how individuals in high versus low need for cognition react to a persuasive message (concerning safer sexual conduct) presented either in a written format or in a comic-strip format. A control group that did not receive any persuasive message was also included. With reference to the Theory of Reasoned Action, we analyzed participants’ instrumental attitude and instrumental norm toward the use of condoms. Results indicated that, compared to participants in the control group, providing participants with the persuasive message bolstered their instrumental attitude and norm. More importantly, participants high in need for cognition displayed higher levels of both instrumental attitude and norm when the message was in a written, as compared to a comic-strip, format. In contrast, participants low in need for cognition reported a stronger level of both instrumental attitude and norm in reaction to a comic-strip than a written message. Results are discussed with respect to their theoretical and practical implications.

Two longitudinal studies were conducted to examine how habits and goal-related constructs determine toothbrushing behavior from a dual-process perspective. We aimed to describe the variations of habit strength, intention, and attitude and to test their associations with actual behavior at both inter- and intraindividual levels. In addition, toothbrushing behavior was measured both by self-report and sensors with the goal to compare these measures. In Study 1, 40 young adults were instructed to brush their teeth twice a day, and their behaviors were measured by accelerometers for 3 weeks. Participants also self-reported their instrumental and affective attitude, habit strength, and behavior frequency weekly. Effects of interest were estimated using structural equation modeling. Study 2 replicated Study 1 with a larger and more diverse sample (N = 79), adding a measure of behavioral intention. Supporting the dual-process account, habit strength predicted future behavior in addition to goal-related constructs. Habit strength also attenuated the influences of goal-related constructs on behavior, but this pattern only emerged interindividually and for self-reported behavior. In addition, toothbrushing behavior was more strongly driven by affective rather than instrumental attitude. In both studies, associations among variables were weaker within-person and when sensor-measured behavior was modeled. The partial support for the dual-process account suggests the need of using habit-based interventions to complement intention-based interventions when attempting to change oral health routines. Our findings also highlight the importance of affective aspects of toothbrushing behavior and the potential to incorporate sensor-based objective measures in research and interventions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Effect of combining fear and anger in anti-smoking messages to discourage young smokers

The aims of the study were to elicit the perceptions of young people in Tanzania on the role of fear appeals in HIV-prevention messages and to identify important contextual factors that may influence young people's perceptions of HIV-prevention posters. A total of 10 focus groups were conducted to investigate the role of fear appeals using the extended parallel process model (EPPM) as a guide. Young people were shown a series of images (mostly posters) with alternating high and low-threat messages (fear appeals), and then asked questions about their overall beliefs about HIV and AIDS, as well as about their response in terms of perceived susceptibility to HIV infection, the severity of the message, and their perceptions of self-efficacy and response efficacy. The images and messages that specifically targeted young people were highest in inducing perceived susceptibility to HIV infection, while pictorial descriptions of the physical consequences of HIV infection and those messages related to the stigma and discrimination faced by HIV-infected or affected people induced greater perceptions of severity. The information-based posters rated high in inducing response efficacy, while none of the images seemed to convince young people that they had the self-efficacy to perform the recommended health behaviours. The young people expressed a preference for fear-based appeals and a belief that this could work well in HIV-prevention efforts, yet they also stated a desire for more information-based messages about how to protect themselves. Finally, the messages evoking the most emotional responses were those that had been locally conceived rather than ones developed by large-scale donor-funded campaigns. Finding the appropriate balance between fear and efficacy in HIV-prevention messages is imperative. Further research is needed to better understand how and when fear appeals work and do not work in African settings, especially among young people.

Background E-cigarette use was associated with health effects, including lung injury. This cross-sectional study aimed to assess the university students' health belief in e-cigarette use associated with lung injury based on the Health Belief Model (HBM). Methods We collected data using an online self-administered questionnaire from December 2020 to February 2021 from university students at two universities in northern Thailand who were currently using e-cigarettes. The HBM was measured using questions with a 4-Likert-scale answer (1=strongly disbelieve,2=disbelieve,3=believe,4=strongly believe), then the answers were categorized into 2 groups (belief and disbelief). Results Of 306 students (61% men, the mean age of 21.8 ± 3.0 years), 53% used both e-cigarettes and conventional cigarettes, and 47% used only e-cigarettes. It showed that 74% of students believed that if they used e-cigarettes, they were at risk of lung injury (HBM: perceived susceptibility), and 68% believed that they had a chance to die from lung injury caused by using e-cigarettes (HBM: perceived severity), and 76% believed that quitting e-cigarettes could reduce the chance of death from lung injury (HBM: perceived benefits). Most students (62%) believed that the strongest barrier for quitting e-cigarettes was that it required a high effort and strong intention (HBM: perceived barriers of quitting e-cigarette), and 76% of students perceived their self-efficacy and believed that when they intended to quit e-cigarettes, they would be successful (HBM: perceived self-efficacy). Most participants believed that family members (78%), lovers (75%), and university restrictions (53%) exerted a positive influence in quitting e-cigarettes (HBM: cues to action). Conclusions The HBM helps us to understand using e-cigarettes associated with lung injury among university students. The university should initiate health promotion activities concerning reducing e-cigarettes use among adolescents and young adults. Key messages Using e-cigarettes is dangerous for health including lung injury, and university students should stop using e-cigarettes. The university should initiate or enhance prevention and health promotion activities concerning reducing e-cigarettes use among adolescent and young adults.

Educational accountability policies have led to a growth in the use of high-stakes examinations for a number of important educational decisions, including the evaluation of teacher effectiveness. As such, educators are under increasing pressure to raise student test performance. In an attempt to prepare students for a high-stakes exam, teachers often resort to using threat-based messages that focus on the negative consequences of test failure rather than messages highlighting students’ ability or expectation for high performance. However, the relative influence of teacher messaging (threat-based or facilitating) under different testing conditions is unknown. The present investigation examined the use of fear and efficacy appeals with 487 university students. Anxiety, motivation, and test performance data were collected during a typical, lower stakes testing situation and a higher-stakes, final course examination. A two-way mixed ANOVA and a mediation analysis were used to examine between (i.e. fear and efficacy appeals) and within (i.e. different testing conditions) subject factors. Results suggest that fear appeals significantly harm student test performance relative to efficacy appeals, even when controlling for the impact of intrinsic motivation on test anxiety. Contrary to prediction, student anxiety did not appear to explain the relationship between fear appeals and lowered test performance. The potential implications of findings are discussed, including the importance of instructional context with regards to teacher instructional practices and student success.

To understand how different types of cues in vaccine education messages affect attitude toward campaign messages and vaccination intention, this study examined the impact of the presence of social norm appeals (individual vs. group cues) and the presence of fear appeals in coronavirus disease 2019 (COVID-19) vaccine campaign posters on perceived communication quality and vaccination intention. A 2 (social norm appeal: individual cue vs. group cue) × 2 (fear appeal: absence vs. presence) × 3 (repetition) within-subject factorial design experiment was conducted in China. Findings demonstrated that the presence of fear appeals in COVID-19 vaccine campaign posters elicited lower levels of perceived communication quality and vaccination intention than those without fear appeals. The interactive effect of fear appeals and social norm appeals was also found to be significant. Specifically, positive-framed messages (i.e., absence of fear appeals) with group cues and fear appeal messages with individual cues elicited higher perceived information quality and stronger vaccination intention than other types of messages. Understanding how these cues function jointly in COVID-19 vaccine campaign messages will help public health practitioners create more effective intervention strategies.

Abstract. Currently, social media has become something taht cannot be separated from everyday life where social media is used as a medium for communication information, one of which is the dissemination of cancer therapy information. This research aims to dertemine the types of message, message appeal, communication style and motivation of content creator as cancer fighter in sharing his experience fighting cancer on his social media accounts. This research use a constructivist paradigm with qualitative case study research methods, in-deph interview data collection techniques and document studies, using informant namely Shella Selpi Lizah, owner of the account social media Tiktok @Shellasl and Instagram @Shellasl_3 as the main informant. The results of this research (1) Obtained 61 types of persuasive messages, 89 types of informatif messages and 16 of types entertainment messages on instagram and tiktok social media. (2) There were messages with emmotional appeals as well as the arrangement of images and the use of typography as message appeal. (3) There was a communication style passive-aggressive and aggressive. (4) Choosing social media instagram and tiktok because they have fast and wide dissemination of information and can provide material benefits as motivation. Abstrak. Saat ini media sosial menjadi sesuatu yang tidak terlepas dari kehidupan sehari-hari dimana media sosial digunakan sebagai media informasi komunikasi, salah satunya ialah penyebaran informasi terapi kanker. Penelitian ini bertujuan untuk mengetahui jenis pesan, daya tarik pesan, gaya komunikasi dan motivasi content creator as cancer fighter dalam membagikan pengalamannya melawan cancer pada akun media sosialnya. Penelitian ini menggunakan paradigma konstruktivis dengan metode penelitian kualitatif studi kasus, teknik pengumpulan data wawancara mendalam dan studi dokumen, menggunakan informan utama yakni Shella Selpi Lizah pemilik akun media sosial tiktok @Shellasl dan instagram @Shellasl_3 sebagai informan utama. Hasil penelitian ini (1) Didapati 61 jenis pesan persuasif, 89 jenis pesan informatif dan 16 jenis pesan hiburan pada media sosial instagram dan tiktoknya. (2) Terdapat pesan dengan emmotional appeals serta penyusunan gambar menggunakan typografi sebagai daya tarik pesan. (3) Memiliki gaya komunikasi pasif-agresif dan agresif. (4) Pemilihan media sosial instagram dan tiktok karena memiliki persebaran informasi yang cepat dan luas serta dapay memberikan keuntungan materi sebagai motivasi.

Customers receive a large amount of information from today?s online world. It has been increasingly difficult for the marketers to monitor and respond to different types of messages affecting their brand. At the same time, marketers also need to communicate with customers through various types of messages. It is interesting to understand the roles of message appeals have while customers expose to different types of online news about the brand. We conduct an experiment with 240 randomly selected subjects on a 2 message appeals (rational and emotion) X 4 online news exposure (no exposure, positive news exposure, negative news exposure and both positive and negative news exposure) factorial design to explore their effects on five aspects of consumer responses: attitude toward the ad, credibility, persuasion, attitude toward the brand and purchase intention. The results revealed both message appeals and online news exposure significantly affect attitudes toward the ad and the brand. Message appeals have a significant effect on persuasion and only the interactions of both factors affect purchase intention. Discussion and implications on the findings will be provided.

The onset of parenthood has been identified as a critical risk period for physical inactivity, yet limited research has examined the correlates of physical activity (PA) using theoretical models in longitudinal designs with comparison groups of couples without children. The purpose of this study was to predict PA across 12 months among cohorts of couples with and without children using the theory of planned behavior (TPB). Participants were 314 adults (102 not expecting a child, 136 expecting first child, and 76 expecting second child) who completed baseline demographics, measures of the TPB, and 7-day accelerometry, followed by assessments at six and 12 months. Hierarchical linear modeling showed some TPB relationships were moderated by parental status and gender. Most notable, time-varying covariate analyses showed perceived behavioral control and intention decreased for new mothers compared to women without children across time. PA was predicted by intention for all cohorts, and intention was predicted by affective and instrumental attitudes and perceived behavioral control for husbands and wives, whereas subjective norm predicted intention only in husbands. For wives, the relationship between intention and instrumental attitudes and perception of behavioral control varied by parental status, and was larger for couples without children compared to second-time parents. Overall, there was considerable coordination in slopes and intercepts among couples, yet individual cognitions were better predictors than partner cognitions. The findings provide helpful information for targeting PA interventions among young adults, and suggest that interventions for new mothers may require greater effort to raise the absolute values of control when compared to women without children.