Loss-framed Messages Research Articles

A Tale of Framing and Screening: How Health Messaging and House Screening Affect Malaria Transmission in Ethiopia

Malaria is a major public health problem in Africa. Traditional methods of controlling malaria no longer provide adequate protection against transmission, and future approaches likely require a combination of technical solutions and behavioral change. We use a cluster randomized controlled trial to study the impacts of an intervention that combines house screening with a behavioral intervention based on health messaging. While house screening provides modest positive benefits, these benefits can be leveraged if it is combined with health messaging. We provide tentative evidence that the impact of messaging varies with the design of the choice architecture: loss-framed health messages seem to do better than gain-based messages––our data suggest they may have larger and more durable effects on behavior and health outcomes.

Lesson from the Covid-19 pandemic: do fear and anxiety lower vaccination hesitancy?

Abstract Background The prevalence of vaccination hesitancy has become one of the top ten global health problems. During the Covid-19 pandemic several studies reported negative correlation of vaccination hesitancy with fear of Covid-19 and anxiety. Therefore, the study aimed to explore how fear and anxiety can impact one’s intent to get vaccinated. Methods In 2021, data from 5999 post-secondary Slovenian students was gathered using a cross-sectional online survey. Binary logistic regression and the Sprearman correlation coefficient was used to explore the relation between Fear of Covid-19 Scale (FCOV), Generalized Anxiety Disorder Questionnaire (ANX) and a question regarding participants’ intentions to get vaccinated. Results Results showed that only 39.7% of students expressed intention to get vaccinated as soon as possible and 29.2% exhibited no intentions to do so. Logistic regression indicated that only FCOV had a mild and significant (p < 0.001) impact on students’ intentions to get vaccinated, whereas ANX was found to have only a weak significant (p < 0.01) effect on students’ intentions to do so. Similarly, ANOVA test showed significant differences with small to medium effect of FCOV on intentions to get vaccinated, but no significant differences were found for ANX. Conclusions A low percentage of Slovenian tertiary students expressed intentions to get vaccinated as soon as possible for Covid-19, with only fear having been found to have a small to mild effect on students’ intentions to do so. Anxiety, on the other hand, was found to have a small positively predictive effect on vaccination hesitancy, which could reflect affective forecasting error (i.e. believing that the negative consequences of getting vaccinated would be greater than they really are). Therefore, when considering strategies to address the increasing problem of vaccination hesitancy, one must keep in mind that the loss-framed messages might not be sufficient to prompt people to get vaccinated. Key messages • Fear of Covid-19 had only a small to medium significant positive effect on students’ expressed intentions to get vaccinated as soon as possible. • The loss-framed messages might not be sufficient to prompt people to get vaccinated.

Investigating the effects of political correctness in social marketing messaging

Purpose Obesity imposes myriad negative consequences upon society, the economy and personal well-being. This study aims to investigate the effectiveness of using political correctness (PC) in social marketing messages to persuade consumers to change their unhealthy behavior. It also explores various underlying mechanisms that drive this effect. Specifically, this research studies that messaging approach – politically correct vs politically incorrect and gain vs loss message framing – generates higher consumer intentions to change their behavior. Design/methodology/approach Four experiments were conducted with nationally representative samples to examine the effect of PC and gain vs loss message framing on consumers’ behavior changing intentions. Findings Politically correct prosocial marketing messages displayed higher persuasiveness than politically incorrect messages. Each relationship was mediated by the perceived manipulative capacity of the message and consumers’ attitudes toward the message. Message framing performed as a boundary condition for these effects. Research limitations/implications This paper sought to contribute to the literature that investigates the effectiveness of social marketing efforts. Three specific contributions related to the effects of message frames on politically correct and incorrect social marketing messages were developed. Practical implications The strategies presented in this paper benefit firms wishing to create a more prosocial approach to their business. A firm can present a prosocial message to their target market in a frame focusing on what will be gained instead of lost. Likewise, firms should welcome this type of messaging that embraces politically correct terminology instead of shying away from it. Originality/value This paper generates actionable insights for marketers and policymakers regarding how best to communicate with targeted segments about culturally- and personally sensitive topics related to obesity and weight loss. This paper also contributes to the literature that explores the effectiveness of social marketing initiatives. The findings suggest policymakers and social marketers should be cautious and, regardless of today’s sociopolitical environment, avoid falling into the temptation of developing politically incorrect and loss-framed messages.

Effects of Message Frames and Sources in TikTok Videos for Youth Vaping Cessation: Emotions and Perceived Message Effectiveness as Mediating Mechanisms

PurposeThe objective of this study was to evaluate the effect of message frames (gain vs. loss) and sources (formal expert: a health-care professional vs. informal expert: an individual who successfully quit vaping) on the persuasiveness of TikTok videos among youth who currently use e-cigarettes. Additionally, the study examined how emotional responses and perceived message effectiveness (PME) mediate the framing effect on youth intention to quit vaping. MethodsA 2 (gain frame vs. loss frame) × 2 (formal expert vs. informal expert) factorial design experiment was conducted with 378 youth aged 13 to 18 who currently use e-cigarettes. The study measured participant's emotional responses, PME of the messages, and intention to quit vaping after the video exposure. ResultsMessages from a formal expert resulted in stronger intention to quit vaping compared to messages from an informal expert. Gain-framed messages were associated with higher PME when delivered by an informal expert, whereas loss-framed messages showed stronger effects on PME from a formal expert. Positive emotional responses and increased PME mediated the relationship between gain-framed messages and youth intention to quit vaping. DiscussionTikTok could serve as an effective tool for formal experts to promote vaping cessation among youth who use e-cigarettes. Additionally, the findings suggest that gain frames may be more influential than loss frames in promoting vaping cessation among youth, by eliciting positive emotional responses from the audience. The differential impact of message frames depending on source type indicates a nuanced interaction between content and messenger.

The Effect of Combinations of Task Relevance and Message Components on Construal Level and Purchase Intent: An Experimental Study on Female Students

We conducted two experiments to determine how the combination of task relevance, loss framing, and psychological distance affects changes in construal level, emotion intensity, and purchase intent. Experiment 1 investigated how construal level fit between the loss and proximal frames affected emotion intensity and purchase intention for skin beauty items among 217 female students in their 20s using the construal matching hypothesis (CMH). Experiment 2 examined how changes in construal level caused by the combination of task relevance and loss framing affect purchase intention among 41 female students in their 20s. We discovered that combining the loss and proximal frames boosted the emotional intensity of worry and raised purchase intention for low-concept marketed products. Meanwhile, the loss frame message produced a high construal level through self-affirmation in individuals with high task relevance, lowering purchase intention for advertising that emphasized tangible facts. We provide an in-depth discussion of the implications and limitations of our findings, as well as future research prospects.

When and why do cuteness cues intensify the power of message framing in promoting pro-environmental behaviors?

Gain and loss message framing has been utilized to encourage consumers’ pro-environmental behaviors in the hospitality and tourism industries. However, little is known about when and why presenting different types of cuteness cues influences the relative effectiveness of gain-framed and loss-framed messages, despite the commonness of cuteness cues in the service environment. To address this gap, this research examines the interaction effects between message framing (gain vs. loss) and cuteness type (kindchenschema vs. whimsical) on consumers’ pro-environmental responses. Through three cross-cultural studies using the experimental design approach, our results show that when kindchenschema cuteness cues are present, loss-framed (vs. gain-framed) messages generate more favorable pro-environmental responses. In contrast, gain-framed (vs. loss-framed) messages are more effective when whimsical cuteness cues are present. Moreover, results from the mediation analyses revealed that the sense of feeling right is the underlying mechanism explaining these effects. These findings provide critical implications for theory and practice.

Constructing vaccination slogans in the late stage of vaccine launch: an experimental study based on the framing effect theory.

Vaccination is an important strategy for overcoming public health crises. Considerable studies have analyzed strategies to promote people's willingness to vaccinate, but few have explored effective strategies based on the stage of vaccine launch. This study considered the framing effect theory to explore whether egoism, altruism and loss frames can boost vaccination willingness when people feel the vaccine is effective in the late stage of vaccine launch. This study designed a scenario experiment consisting of three experimental groups (egoism, altruism and loss frames) and one control group (non-framed). Participants (N=1085) from China were randomly assigned to any of the four groups. Vaccination willingness, perceived vaccine effectiveness and control variables included perceived susceptibility, perceived severity, worry about the side effects of vaccination and socio-demographics were collected. Perceived vaccine effectiveness and message frames can increase people's willingness to be vaccinated. Message frames can amplify the positive impact of perceived effectiveness on vaccination willingness. Moreover, loss-framed messages had a stronger amplification effect than egoistic- and altruistic-framed messages. Governments and other health authorities should prioritize the loss-framed approach when constructing vaccination slogans to maximize vaccination willingness when vaccines are considered effective at the late implementation stage of the vaccine strategy.

“Here’s what you can do to stop the spread”: Frames and mobilizing information in CDC’s social media messages during the COVID-19 pandemic

ABSTRACT Although there is a body of research on message frames and mobilizing information (MI), not enough attention has been paid to whether public health organizations are benefiting from the research in their social media messages during a public health crisis. To fill this research gap, this study aimed to examine how the CDC in the U.S. used gain and loss frames and MI in their Instagram posts about COVID-19 prevention and whether the use of such message strategies changed throughout the pandemic. A mixed-methods content analysis of a sample of 565 posts showed that the CDC overwhelmingly relied on gain frame, interactive MI, and tactical MI as their message strategies. The use of frames and MI was mostly consistent throughout the pandemic, although the target behavior changed. The supplemental analysis also revealed that loss-framed or gain- and loss-framed messages led to more user engagement. The findings highlighted the need for an evidence-based approach in social media messages by public health organizations. Theoretical and practical implications are discussed.

Effectiveness of a Mobile Phone Messaging-Based Message Framing Intervention for Improving Maternal Health Service Uptake and Newborn Care Practice in Rural Jimma Zone, Ethiopia: Protocol for a Cluster Randomized Controlled Trial.

Ethiopia has high rates of maternal and neonatal mortality. In 2019 and 2020, the maternal and newborn mortality rates were estimated at 412 per 1,000,000 births and 30 per 10,000 births, respectively. While mobile health interventions to improve maternal and neonatal health management have shown promising results, there are still insufficient scientific studies to assess the effectiveness of mobile phone messaging-based message framing for maternal and newborn health. This research aims to examine the effectiveness of mobile phone messaging-based message framing for improving the use of maternal and newborn health services in the Jimma Zone, Ethiopia. A 3-arm cluster-randomized trial design was used to evaluate the effects of mobile phone-based intervention on maternal and newborn health service usage. The trial arms were (1) gain-framed messages (2) loss-framed messages, and (3) usual care. A total of 21 health posts were randomized, and 588 pregnant women who had a gestational age of 16-20 weeks, irrespective of their antenatal care status, were randomly assigned to the trial arms. The intervention consisted of a series of messages dispatched from the date of enrolment until 6-8 months. The control group received existing care without messages. The primary outcomes were maternal health service usage and newborn care practice, while knowledge, attitude, self-efficacy, iron supplementation, and neonatal and maternal morbidity were secondary outcomes. The outcomes will be analyzed using a generalized linear mixed model and the findings will be reported according to the CONSORT-EHEALTH (Consolidated Standards of Reporting Trials of Electronic and Mobile HEalth Applications and onLine TeleHealth) statement for randomized controlled trials. Recruitment of participants was conducted and the baseline survey was administered in March 2023. The intervention was rolled out from May 2023 till December 2023. The end-line assessment was conducted in February 2024. This trial was carried out to understand how mobile phone-based messaging can improve maternal and newborn health service usage. It provides evidence for policy guidelines around mobile health strategies to improve maternal and newborn health. Pan African Clinical Trials Registry PACTR202201753436676; https://tinyurl.com/ykhnpc49. DERR1-10.2196/52395.

Effectiveness of self-management program for gastric cancer patients: A randomized controlled trial comparing gain vs. loss message framing

ObjectiveThis study aims to evaluate the effectiveness of a self-management program using gain/loss-framed messages in patients with gastric cancer. MethodsIn this randomized controlled trial, 69 patients with gastric cancer who underwent gastrectomy at a university hospital were assigned to the gain- or loss-framed message group. The self-management program consisted of: 1) face-to-face education, 2) gain/loss-framed text messages, and 3) self-monitoring of health behaviors. Health outcomes (i.e., nutritional status, physical activity, exercise intensity, and distress), and health behaviors (i.e., dietary habits, physical activity performance, and distress management) were measured, and a generalized estimating equation was used for the analysis. ResultsNutritional status and dietary habits in the loss framed message group were statistically higher after the intervention compared to the counterpart (β = −1.72, p = .049; β = 0.36, p = .033, respectively). There was no time-group interaction effect on physical activity, exercise intensity, physical activity performance, distress or distress management. ConclusionsA self-management program employing loss-framed messages was effective in promoting nutrition-related self-management among patients with gastric cancer. Practice implicationsMessage-framing is an effective communication technique that can be easily used in clinical settings, and a loss-message-framing strategy may enhance nutrition-related self-management in patients with gastric cancer.

Effectiveness of Message Framing in Changing Restaurant Diners’ Plant-Based Meat Consumption

Drawing on regulatory fit theory, construal level theory, and means-end theory, this research examined the effects of message framing, message information, and message description on restaurant diners’ consumption intentions (CI) and the amount more they would be willing to pay ($WTP) for a plant-based diet. The study employed a mixed between-within-group methodology with a micro-longitudinal 2 (gain vs. loss framing) × 2 (health vs. environment information) × 2 (attribute-based vs. benefit-based description) scenario-based experimental design. An analysis of 361 survey responses revealed that health information should be conveyed through gain-framed messages with benefit-based descriptions, whereas environment information should be conveyed through loss-framed messages with attribute-based descriptions. These results enriched our understanding of diners’ attitudes towards plant-based meat consumption. The findings lay a theoretical foundation for future studies and present practical implications for the hospitality industry.

Examining the Impact of Six Pro-Vaccination Messages on MMR Vaccine Hesitancy Among Mothers in Ukraine

The Ukrainian government began delivering mandatory MMR vaccination letters to parents across the country in 2019. In this two-phase online RCT, we aimed to test the effectiveness of this national mandatory vaccination letter against five behavioural science-informed letters, in terms of their effects on the vaccination attitudes, intentions and behaviours of Ukrainian mothers (N = 738). One letter was focused on the simplicity and accessibility of vaccination procedures; one contained a testimonial from a family doctor; two letters contained pro-vaccination social norm statements (one signed by a family doctor and one by a school director); and one contained a loss-framed message underlining the risks of non-vaccination. The results showed no difference between the conditions in terms of change in vaccination attitudes and intentions but there was an effect on behaviour (measured through clicking a link to schedule a vaccination). The letters signed by a family doctor, outlining how vaccination is a social norm, were most effective in encouraging positive vaccination behaviours. We conclude that the national template used by Ukrainian public health authorities is unlikely to reduce vaccine hesitancy or increase vaccination rates, and that letters emphasising the normative nature of vaccination could increase uptake in the Ukrainian context.

Educational intervention based on the extended parallel process model improves adherence to diabetic diet and glycaemic control indices: a randomised, double-blind, controlled, factorial field trial.

Nutritional education is pivotal in the medical nutritional therapy of type 2 diabetes mellitus (T2DM). The extended parallel process model (EPPM) is a health education method for inducing desirable health behaviours. The present study aimed to investigate the effect of nutritional education based on the EPPM in T2DM patients on knowledge, attitude, practice, anthropometric indices, glycaemic factors, lipid profile and adherence to the diabetic diet. A randomised, double-blind, controlled, factorial field trial was designed for T2DM patients aged 30-59 years (n 88). Participants were randomly allocated into four groups to receive EPPM-based nutritional education through gain framed message (GFM), loss framed message (LFM), their combination (G\LFM) or usual diabetic education in the control group (CG). Participants were assessed before and after the study duration. After 3 months of intervention, eighty participants finished the study. The EPPM-based intervention increased participants' knowledge, behavioural intention, perceived sensitivity, severity, self-efficacy (P < 0·001 for all) and response efficacy (P = 0·029) in comparison with CG. GFM (P = 0·004) and G\FLM (P = 0·034) reduced carbohydrate intake and LFM (P = 0·034) and G\LFM (P = 0·047) decreased fat intake. Between-group analysis indicated interventions reduced weight (P = 0·046), BMI (P = 0·038), fasting blood sugar (P = 0·030), 2-hour postprandial blood glucose (P = 0·027) and TAG (P = 0·002) in comparison with the CG. Results were NS for protein intake, waist and hip circumference, waist:hip ratio, HbA1c, total cholesterol, LDL and HDL. Nutritional education based on EPPM could increase the knowledge and awareness of T2DM patients. Also, it could be beneficial for blood glucose amendment. Further investigations are recommended.

The role of conspiracy mentality, reactance, and anxiety in the effectiveness of gain- vs. loss-framed messages promoting COVID-19 protective measures: Is vaccination different?

We explore how conspiracy beliefs change the effectiveness of gain- vs. loss-framed messages in promoting health-protective behavior. We focused on various recommended COVID-19 protective measures, not only vaccinations but also other preventive (like wearing masks) and detection behaviors (like testing). Our results indicate that conspiracy beliefs moderate the effectiveness of gain vs. loss framing. When participants endorse conspiracy worldviews above the average level, the gain frame may be more effective than the loss frame. In other words, in the loss frame condition, conspiracy beliefs negatively and significantly predicted attitudes toward the behavior recommended. However, in the case of the gain frame, the relationship between conspiracist views and attitudes toward promoted behavior was weaker or even nonsignificant. We also found, although only in the case of one behavior, that when participants' eagerness to look for conspiracies almost does not exist, the loss frame may be a better option than the gain frame. Finally, neither of these effects was mediated by emotional reactance or anxiety.

How Does VR Affect Emotional Appeal and Persuasiveness of Gain Versus Loss-Framed Messages?

Can virtual reality (VR) lead to more desirable persuasion effects than videos in communicating the science of contentious issues like climate change? And, will these effects differ between messages that offer hope versus fear? We addressed these questions with a 2 (Modality: Desktop VR vs. Unidirectional video) × 2 (framing: Gain vs. Loss) between-subjects experiment ( N = 130), and found that VR triggered more fearful responses, which in turn led to more persuasive outcomes. It also increased individuals’ attitudes toward climate change mitigation policy when the experience was loss-framed, but backfired when the experience was gain-framed. Theoretical and practical implications are discussed.

How (de)motivating teaching styles shape message framing outcomes on students’ self-efficacy, emotions, and grades

In this study, a mixed method and prospective design was followed to achieve two objectives: code student responses to an open-ended question about their teachers’ teaching and examine how this classification relates with the associations among students’ self-reports on teachers’ message framing (gains or losses), their self-efficacy, academic achievement emotions, and teacher reported grades. 1107 Spanish students in grades 9 to 12 participated in the study. GPT-4 was used to code the open-ended question responses on teachers’ teaching style. Structural equation modeling (SEM) tested the hypothesized relations among variables accounting for the teaching styles. Results from the SEM revealed that gain-framed messages related positively with student outcomes, as opposed to loss-framed messages, but only when teachers displayed a motivating teaching style. For demotivating teachers, messages did not relate with students’ outcomes except for gain-framed messages and student adaptive emotions. Directions for future research and implications for educational practice are discussed. Educational relavance statementThese findings bridge critical gaps in the field, incorporating a self-determination theory lens into a qualitative design, and concurrently addressing message framing and its interaction with teaching style on student outcomes. The study’s exploration of a wide range of emotions and its direct examination of teaching’s predictive value on student emotions further enrich the existing scholarship. In practical terms, the results provide valuable insights for educators, highlighting that cultivating a motivating teaching style and employing gain-framed messages can positively influence students’ emotions, self-efficacy beliefs, and grades. This research not only contributes to theoretical advancements in educational psychology but also offers a tangible and straightforward resource for teachers to enhance their instructional practices and positively relation with student outcomes. The major findings discussed above underscore the significance of these insights in informing both educational theory and classroom practices. For instance, the evidence gathered could be useful to develop interventions targeting teaching practices or those targeting students’ behavioural change regarding following teachers’ advice. Telling a teacher how to frame their messages is simple, does not require much time, expertise, or budget. Thus, it denotes the best scenario to conduct school-based interventions.

Influence of Age and Message Frame on COVID-19 Vaccination Willingness Early in the Pandemic.

Objective: This study examined whether age would moderate the association between a brief message frame intervention and COVID-19 vaccine willingness. Methods: Data were collected in Australia between 25 June and 5 July 2021. Participants (N = 187) aged 18-85years had not yet received a dose of COVID-19 vaccine. After random assignment to a gain- or loss-framed message, participants reported COVID-19 vaccine willingness, general anti-vaccine attitudes, approach and avoidance motivation, and COVID-19 illness risk perception. Results: Message frame did not influence COVID-19 vaccine willingness. However, greater COVID-19 illness risk perception and older age increased the odds of Pfizer vaccine willingness, while lower avoidance motivation increased the odds of AstraZeneca vaccine willingness. Greater anti-vaccine ideology decreased the odds of willingness to receive either of the COVID-19 vaccines. Conclusions: A brief message frame intervention did not influence COVID-19 vaccine willingness across the adult lifespan.

Effects of Framed Mobile Messages on Beliefs, Intentions, Adherence, and Asthma Control: A Randomized Trial.

We aimed to examine the effects of framed mobile messages (messages emphasizing losses or gains because of a behavior) on young adults' beliefs about their daily Inhaled Corticosteroids (ICS), intentions to take their ICS, adherence, and asthma control. College students (18-29 years) who owned a mobile phone and had a diagnosis of asthma with a prescription for an ICS were recruited. Participants (n = 43) were randomized to receive either gain- or loss-framed mobile messages three times per week for eight weeks. Engagement rates with messages were calculated. Outcomes included beliefs, intentions, adherence, and asthma control. Data collection was performed at baseline, week 4, and week 8. Mixed-design ANOVA assessed whether outcomes improved differentially from baseline to week eight between gain- and loss-framed groups. Twenty-two participants were randomly assigned to the gain-framed group and 21 to the loss-framed group. There was a 100% retention rate. The engagement rate with the text messages was 85.9%. There was a significant difference in participants' intentions to take medication and asthma control from baseline. There were no significant changes in other outcomes from baseline. There was no difference in changes in all outcomes between participants receiving gain- versus loss-framed messages. Framed mobile messages improved young adults' asthma control and intentions to take their medication as prescribed.

What's in a Message? Effects of Mental Fatigue and Message Framing on Motivation for Physical Activity.

Many adults worldwide do not meet current physical activity (PA) guidelines. Mental fatigue decreases the likelihood of choosing to engage in PA. Message framing may enhance PA motivation when fatigued. We examined the effects of mental fatigue and message framing on PA motivation with additional focus on the messaging "congruency effect." Three hundred and twenty undergraduates completed measures of dispositional motivational orientation and were exposed to either gain-framed or loss-framed messages before completing an effort discounting questionnaire. Results showed lower motivation to engage in PA of higher intensities and longer durations. Direct effects of message framing on PA motivation were not significant. Interaction effects revealed that participants receiving messages congruent with their dominant motivational orientation showed increased motivation for light-intensity PA and decreased motivation for vigorous-intensity PA as mental fatigue increased. Findings suggest that providing messages congruent with one's dominant motivational orientation may increase motivation for engaging in light-intensity PA when fatigued.

Issue Involvement Moderates the Effect of Gain- and Loss-Framed Messages on Mothers’ Intentions to Give 5 Portions of Fruits and Vegetables to Their Children Every Day

Research suggests that issue involvement moderates the efficacy of gain and loss frames, yet the extent to which this is true across behaviors and contexts is an open question. In this study, I examined the moderating role of issue involvement in the context of fruit and vegetable intake in Lima, Peru. Only 11.3% of the Peruvian population 15 years old or older consume five servings of fruits and vegetables every day, even though this health behavior prevents the onset of chronic diseases, including diabetes and hypertension. Guided by the Reasoned Action Approach and research about the effects of gain and loss frames, I conducted an experiment (N=253, three conditions: gain-framed messages condition; loss-framed messages condition; and no-message, control condition) to assess the effect of gain- and loss-framed messages on mothers’ intentions to increase fruits and vegetables consumption among their 1- to 5-year-old children in Lima. Results indicated that mothers who saw gain-framed messages reported greater intentions than those who did not see any messages (control condition). However, issue involvement moderated the effect of gain frames, such that mothers low in issue involvement reported greater intentions after seeing the gain-framed messages. Theoretical and practical implications are discussed.