Abstract
BackgroundShort and animated story-based (SAS) videos can be an effective strategy for promoting health messages. However, health promotion strategies often motivate the rejection of health messages, a phenomenon known as reactance. In this study, we examine whether the child narrator of a SAS video (perceived as nonthreatening, with low social authority) minimizes reactance to a health message about the consumption of added sugars.ObjectiveThis study aims to determine whether our SAS intervention video attenuates reactance to the sugar message when compared with a content placebo video (a health message about sunscreen) and a placebo video (a nonhealth message about earthquakes) and determine if the child narrator is more effective at reducing reactance to the sugar message when compared with the mother narrator (equivalent social authority to target audience) or family physician narrator (high social authority) of the same SAS video.MethodsThis is a web-based randomized controlled trial comparing an intervention video about sugar reduction narrated by a child, the child’s mother, or the family physician with a content placebo video about sunscreen use and a placebo video about earthquakes. The primary end points are differences in the antecedents to reactance (proneness to reactance, threat level of the message), its components (anger and negative cognition), and outcomes (source appraisal and attitude). We performed analysis of variance on data collected (N=4013) from participants aged 18 to 59 years who speak English and reside in the United Kingdom.ResultsBetween December 9 and December 11, 2020, we recruited 38.62% (1550/4013) men, 60.85% (2442/4013) women, and 0.52% (21/4013) others for our study. We found a strong causal relationship between the persuasiveness of the content promoted by the videos and the components of reactance. Compared with the placebo (mean 1.56, SD 0.63) and content placebo (mean 1.76, SD 0.69) videos, the intervention videos (mean 1.99, SD 0.83) aroused higher levels of reactance to the message content (P<.001). We found no evidence that the child narrator (mean 1.99, SD 0.87) attenuated reactance to the sugar reduction message when compared with the physician (mean 1.95, SD 0.79; P=.77) and mother (mean 2.03, SD 0.83; P=.93). In addition, the physician was perceived as more qualified, reliable, and having more expertise than the child (P<.001) and mother (P<.001) narrators.ConclusionsAlthough children may be perceived as nonthreatening messengers, we found no evidence that a child narrator attenuated reactance to a SAS video about sugar consumption when compared with a physician. Furthermore, our intervention videos, with well-intended goals toward audience health awareness, aroused higher levels of reactance when compared with the placebo videos. Our results highlight the challenges in developing effective interventions to promote persuasive health messages.Trial RegistrationGerman Clinical Trials Registry DRKS00022340; https://tinyurl.com/mr8dfenaInternational Registered Report Identifier (IRRID)RR2-10.2196/25343
Highlights
BackgroundDigital health interventions that promote educational messages to improve knowledge and change behaviors are commonly used as effective health promotion strategies
We found no evidence that the child narrator attenuated reactance to the sugar reduction message when compared with the physician and mother
Conclusions: children may be perceived as nonthreatening messengers, we found no evidence that a child narrator attenuated reactance to a SAS video about sugar consumption when compared with a physician
Summary
Digital health interventions that promote educational messages to improve knowledge and change behaviors are commonly used as effective health promotion strategies. Comparisons of digital behavior change interventions with traditional face-to-face interventions indicate that web-based health promotion is generally at least as effective as conventional approaches and has several advantages, such as low cost, feasibility, and scalability [1,2]. To further explore the effectiveness of these innovative strategies in health communication, we created a short and animated story-based (SAS) video that draws from entertainment-education media, communication theory, and the animated entertainment industry to promote healthy behaviors over social media channels [8]. SAS videos may face the same challenges faced by other traditional methods of health persuasion that often arouse a motivation to reject the health message, a phenomenon known as reactance [9]. We examine whether the child narrator of a SAS video (perceived as nonthreatening, with low social authority) minimizes reactance to a health message about the consumption of added sugars
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