Messages that matter: Age differences in affective responses to framed health messages

Reducing Falls Among Community-Dwelling Older Adults From Clinicians' Perspectives: A Systems Modeling Approach

Background and Objectives

Falls among older adults are a significant health problem globally. Studies of multicomponent fall prevention programs in randomized controlled trials demonstrate effectiveness in reducing falls; however, the translation of research into the community remains challenging. Although there is an increasing interest to understand the factors contributing to implementation barriers, the dynamic relationships between factors are less well examined. Furthermore, evidence on implementation barriers from Asia is lacking as most of these studies originate from the West. As such, this study aims to engage stakeholders in uncovering the factors that facilitate or inhibit implementing community-based fall prevention programs in Singapore, with a focus on the interrelationship between those factors.

Research Design and Methods

Health care professionals familiar with fall prevention programs were invited to discuss the enablers and challenges to the implementation. This effort was facilitated using a systems modeling methodology of Group Model Building (GMB) to share ideas and create a common conceptual model of the challenges. The GMB employs various engagement techniques to draw on the experiences and perceptions of all stakeholders involved.

Results

This process led to the development of a Causal Loop Diagram (CLD), a qualitative conceptual model of the dynamic relationships between the barriers and facilitators of implementing fall prevention programs. Results from the CLD show that implementation is influenced by two main drivers: health care provider factors that influenced referrals, and patient factors that influenced referral acceptance and long-term adherence. Key leverage points for potential interventions were identified as well.

Discussion and Implications

The overall recommendation emphasized closer coordination and collaboration across providers to ensure sustainable and effective community-based fall prevention programs. This has to be supported by a national effort, involving a multidisciplinary stakeholder advisory group. These findings generated would be promising to guide future approaches to fall prevention.

Emotion, Aging, and Decision Making: A State of the Art Mini-Review

Over the past few decades, interest has begun to surge in understanding the role of emotion in decision making, and more recently in studies across the adult life span. Relevant to age-related changes in decision making, theoretical perspectives in judgment and decision making draw critical distinctions between deliberative versus intuitive/affective processes, as well as integral versus incidental affect. Empirical findings demonstrate the central role of affect in various decision-related domains such as framing and risk taking. To situate this review within an adult life-span context, we focus on theoretical perspectives in adult development regarding emotion and motivation. As a result of age differences in deliberative and emotional processes, taking a life-span perspective is critical to advance a comprehensive and grounded understanding of the role of affect in decision making. Age-related shifts in information processing from negative toward positive material also have consequential implications. By taking a life-span perspective, not only will decision theorists and researchers benefit, but so too will practitioners who encounter individuals of various ages as they make consequential decisions.

In COVID-19 Health Messaging, Loss Framing Increases Anxiety with Little-to-No Concomitant Benefits: Experimental Evidence from 84 Countries

The COVID-19 pandemic (and its aftermath) highlights a critical need to communicate health information effectively to the global public. Given that subtle differences in information framing can have meaningful effects on behavior, behavioral science research highlights a pressing question: Is it more effective to frame COVID-19 health messages in terms of potential losses (e.g., “If you do not practice these steps, you can endanger yourself and others”) or potential gains (e.g., “If you practice these steps, you can protect yourself and others”)? Collecting data in 48 languages from 15,929 participants in 84 countries, we experimentally tested the effects of message framing on COVID-19-related judgments, intentions, and feelings. Loss- (vs. gain-) framed messages increased self-reported anxiety among participants cross-nationally with little-to-no impact on policy attitudes, behavioral intentions, or information seeking relevant to pandemic risks. These results were consistent across 84 countries, three variations of the message framing wording, and 560 data processing and analytic choices. Thus, results provide an empirical answer to a global communication question and highlight the emotional toll of loss-framed messages. Critically, this work demonstrates the importance of considering unintended affective consequences when evaluating nudge-style interventions.

Exploring the Use of "Nudges" to Improve HIV and Other Sexually Transmitted Infection Testing Among Men Who Have Sex with Men

Behavioral economics and its applied branch "nudging" can improve individual choices in various health care settings. However, there is a paucity of research using nudges to improve regular testing for HIV and other sexually transmitted infections (STIs). The study examined which reminder system and message type men who have sex with men (MSM) preferred to remind them to undergo regular 3-monthly HIV and STI testing. A cross-sectional survey study was conducted among MSM attending a sexual health clinic in Melbourne, Australia between 13 January and 5 March 2020, exploring the preferred method of reminder and framing of the message. Descriptive statistics and logistic regression were used to analyze the data. A total of 309 responses were received. The majority of the participants (90%) preferred short messaging service (SMS) as the reminder method for HIV/STI testing compared to other types (e.g., email or instant messaging). More than a third of the participants (45%) showed a preference for a neutrally framed reminder message (Your next check-up is now due. Please phone for an appointment), while one-third (35%) preferred a personalized message (Hi [first name], you are due for your next check-up. Please phone for an appointment). Younger men were more likely to favor positive framed messages than older men who favored neutrally framed messages (p < .01). SMS was the preferred reminder method for regular HIV/STI testing. Reminder messages that were neutrally framed, personalized or positive framed messages were preferred over negative or social norm messages.

The health-economy trade-off during the Covid-19 pandemic: Communication matters

How do people balance concerns for general health and economic outcomes during a pandemic? And, how does the communication of this trade-off affect individual preferences? We address these questions using a field experiment involving around 2000 students enrolled in a large university in Italy. We design four treatments where the trade-off is communicated using different combinations of a positive framing that focuses on protective strategies and a negative framing which refers to potential costs. We find that positive framing on the health side induces students to give greater relevance to the health dimension. The effect is sizeable and highly effective among many different audiences, especially females. Importantly, this triggers a higher level of intention to adhere to social distancing and precautionary behaviors. Moreover, irrespective of the framing, we find a large heterogeneity in students' preferences over the trade-off. Economics students and students who have directly experienced the economic impact of the pandemic are found to give greater value to economic outcomes.

Getting to the Heart of the Matter in Later Life: The Central Role of Affect in Health Message Framing

BACKGROUND AND OBJECTIVES

Adopting healthy behaviors is often influenced by message framing; gain-framed messages emphasize the benefits of engaging in a behavior, whereas loss-framed messages highlight the consequences of not engaging in a behavior. Research has begun to uncover the underlying affective pathways involved in message framing. In the current study, we examined the role of affect in message framing to encourage exercise program enrollment among older adults.

RESEARCH DESIGN AND METHODS

We mailed flyers to 126 volunteers assigned to a gain- or loss-framed condition and measured their affective reactions to the flyer and enrollment intentions. After the call, participants had the opportunity to contact us to enroll.

RESULTS

Gain versus loss framing led to more positive affect toward the flyer, which predicted intentions and enrollment effort. In indirect effect analyses, frame indirectly influenced intentions and enrollment effort via positive affect.

DISCUSSION AND IMPLICATIONS

Although message framing plays an indirect role in influencing behavior, affect plays a central role.

The psycholinguistic and affective processing of framed health messages among younger and older adults

How health-related messages are framed can impact their effectiveness in promoting behaviors, and messages framed in terms of gains have been shown to be more effective among older adults. Recent findings have suggested that the affective response to framed messages can contribute to these effects. However, the impact of demands associated with psycholinguistic processing for different frames is not well understood. In this study, exercise-related messages were gain or loss framed and with a focus on either desirable or undesirable outcomes. Participants read these messages while their eye movements were monitored and then provided affective ratings. Older adults reacted less negatively than younger adults to loss-framed messages and messages focusing on undesirable outcomes. Eye-movement measures indicated both younger and older adults had difficulty processing the most complex messages (loss-framed messages focused on avoiding desirable outcomes). When gain-framed messages were easily processed, they engendered more positive affect, which in turn, was related to better recall. These results suggest that affective and cognitive mechanisms are interdependent in comprehension of framed messages for younger and older adults. An implication for translation to effective health communication is that simpler message framing engenders a positive reaction, which in turn supports memory for that information, regardless of age. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The impact of age on goal-framing for health messages: The mediating effect of interest in health and emotion regulation

Messages to promote health behavior are essential when considering health promotion, disease prevention, and healthy life expectancy. The present study aimed to examine whether (1) positive and negative goal-framing messages affect message memory and behavioral intention differently in younger, middle-aged, and older adults, (2) framing effects are mediated by interest in health (health promotion and disease prevention) and emotion regulation (cognitive reappraisal and expressive suppression), and (3) mediation effects differ between positive and negative frames. Participants (N = 1248) aged 20 to 70 years were divided into positive and negative frame conditions. Framing demonstrated interactive effects on message memory; all age groups showed higher recognition accuracy in the positive than the negative frame. The accuracy of younger adults was higher than that of older adults in the negative frame, while older adults showed higher accuracy than younger adults in the positive frame. Additionally, recognition accuracy was higher in the positive frame, as participants had higher interest in health promotion and used cognitive reappraisal more frequently. Contrariwise, emotion regulation and interest in health promotion did not have significant effects on memory in negative frames. Moreover, regardless of the message valence, age did not influence behavioral intention directly but was mediated by interest in health and emotion regulation, while the older the participants were, the higher their interest in health, resulting in higher intention. For emotion regulation, intention increased with higher reappraisal scores and decreased with increasing suppression. Our results suggest that interest in health and emotion regulation should be considered when examining the relationship between age and goal-framing for health messages.

The sure thing: The role of integral affect in risky choice framing

When faced with a decision, certain aspects of the decision itself shape our affective responses to choice options, which, in turn, influence our choices. These integral affective influences manifest as immediate feelings about choice options as well as the feelings that we anticipate we will feel after certain potential outcomes. We examined whether the effect of framing on risk taking can be explained through the mediating roles of immediate and anticipated affect. Two experiments were conducted using a gambling task. On each trial, participants were endowed a sum of money (e.g., $25) then presented with a choice between a sure option (leaving them with a portion of the initial endowment) and a gamble option (that could result in either keeping or losing the entire endowment). The sure option was framed differently across two within-participant conditions: as a gain (keep $20 from $25) or loss (lose $5 from $25). Experiment 1 examined whether immediate feelings toward choice options explain how framing the sure option as a loss versus a gain increases risk taking. Experiment 2 examined whether immediate and/or anticipated affect explain how framing guides risk taking. We found that the tendency to take risks to avoid sure losses was explained by immediate (not anticipated) affective evaluations of the sure option only. Individuals tended to take more risks when faced with sure losses due to greater negative immediate feelings that were evoked by sure losses relative to sure gains. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Me Time, or We Time? Age Differences in Motivation for Exercise

BACKGROUND AND OBJECTIVES

Increasing exercise continues to be an important health issue for both older and younger adults. Researchers have suggested several methods for increasing exercise motivation. Socioemotional selectivity theory (SST) posits that people's motivation shift from future-oriented instrumental goals to present-oriented emotionally meaningful goals as we age, which provides insight into how people's motivations for exercise may differ for older versus younger adults. The aim of our study was to examine how exercise motivation differs for older versus younger adults.

RESEARCH DESIGN AND METHODS

Older (greater than 59 years old) and younger (aged 18-26 years) adults participated in focus groups. They discussed exercise motivation (or lack thereof), motivators and barriers to exercise, and preferences about when, where, and with whom they exercise. Focus group transcripts were analyzed using direct content analysis and iterative categorization.

RESULTS

Consistent with SST, younger adults generally preferred to exercise alone to achieve instrumental fitness goals, whereas older adults preferred to exercise with others. Additionally, older adults tend to consider peripheral others (e.g., strangers, acquaintances), as a positive rather than a negative influence.

DISCUSSION AND IMPLICATIONS

SST provides a framework for exploring age-related shifts in exercise motivation. Additionally, the positivity effect was reflected in how older adults evaluated the influence of peripheral others. Motivational messages could be tailored to increase health behavior changes by focusing on instrumental exercise goals for younger adults and exercise focused on meaningful relationships for older adults.

Doing What Makes You Happy: Health Message Framing for Younger and Older Adults

Background: Health-related messages, framed in terms of gains or losses, can impact decision-making differently across the adult life span. The focus of this study was on the emotional responses evoked by such framing and their relationship to perceived effectiveness, as mechanisms that may underpin how health messages impact health decisions. Methods: A web-based study using Amazon's Mechanical Turk platform was conducted with a sample of 132 younger adults and 106 older adults. Participants were asked to read exercise-related messages framed in terms of gains or losses, and to rate each message for affect and effectiveness. Results: Relative to younger adults, older adults showed less negative reactions to loss-framed messages and to messages that described undesirable outcomes. Importantly, younger and older adults differentially used affective cues to gauge effectiveness of framed messages: for gain-framed messages (which tended to evoke positive affect), older adults found messages that made them feel good to be more effective; but for loss-framed messages (which tend to evoke negative affect), younger adults found messages that made them feel bad to be more effective. Conclusions: These results suggest that in processing health messages, older adults may be more motivated by positive affect, while younger adults may be more motivated by negative affect.

A randomised trial of the effect of appearance versus health-framed messages on engagement with an online brief screening and alcohol reduction intervention

Objectives: To compare the impact of appearance versus health-framed messages on engagement in a brief web-based risk screening and alcohol reduction intervention. Design: Randomised trial delivered via Drinkaware's website. Visitors were exposed to appearance (n = 51,588) or health-framed messages (n = 52,639) directing them towards an AUDIT-C risk screening questionnaire. Users completing this questionnaire were given feedback on their risk level and extended frame-congruent information. Outcomes: The primary outcome is completion of the AUDIT-C questionnaire. The secondary outcome is whether the participant accessed any of four further resources. Results: The appearance-framed message led to a small but significant increase in the number of users completing the AUDIT-C compared to the health-framed message (n = 3,537, 6.86% versus n = 3,355, 6.37%, p < 0.01). Conversely, following subsequent risk feedback, users exposed to extended health-framed information were more likely to access further resources (n = 1,146, 2.17% versus n = 942, 1.83%, p < 0.01). Conclusions: Physical appearance-framed messages increased the likelihood of engagement with an online alcohol screening and brief intervention tool, whereas health-framed messages increased the likelihood of accessing further resources. This highlights the potential for the use of multi-level approaches in alcohol reduction interventions.

Messaging for Interventions Aiming to Improve Calcium Intake in Young Adults-A Mixed Methods Study

Social media channels are the preferred communication tools for many young adults and therefore may have applications in health promotion. The framing of messages is important, as an intervention must resonate with the target group. The aim of this study was to determine what type of messaging is preferred by young adults to improve their calcium intake. A cross-sectional web-based survey was conducted and young adults aged 18 to 25 years recruited. A 14-item survey collected information on the participants’ demographics, ranking of text messages, mock Facebook posts with images, preferences related to type of posts they find personally relevant, and frequency and likelihood of engagement with posts and polls in social media. In addition, optional responses from participants about factors that motivate them to consume more calcium-rich foods were included and thematically analysed using NVivo. Eighty-one participants (17 males) completed the survey. No significant difference in ranking of the text messages and Facebook posts were found. Participants indicated that recipe demonstrations (n = 71), cost-saving tips (n = 70), and information on recommended daily intake (n = 62) were personally relevant, while meal inspiration (n = 70), awareness-raising posts (n = 41), and messages about obtaining enough calcium from non-dairy sources (n = 38) would encourage them to eat more calcium-rich foods. The qualitative replies indicated the tone (in young adults’ language) and length (short) of messages preferred, and the messaging they perceived would motivate young adults. In conclusion, short, aesthetically pleasing and personally relevant messages written in the language of young adults were recommended.

Motivated Cognition: Effects of Reward, Emotion, and Other Motivational Factors Across a Variety of Cognitive Domains

A growing body of literature has demonstrated that motivation influences cognitive processing. The breadth of these effects is extensive and span influences of reward, emotion, and other motivational processes across all cognitive domains. As examples, this scope includes studies of emotional memory, value-based attentional capture, emotion effects on semantic processing, reward-related biases in decision making, and the role of approach/avoidance motivation on cognitive scope. Additionally, other less common forms of motivation–cognition interactions, such as self-referential and motoric processing can also be considered instances of motivated cognition. Here I outline some of the evidence indicating the generality and pervasiveness of these motivation influences on cognition, and introduce the associated ‘research nexus’ at Collabra: Psychology.

Attitudes and Attitude Change

This review covers research on attitudes and attitude change published between 2010 and 2017. We characterize this period as one of significant progress toward an understanding of how attitudes form and change in three critical contexts. The first context is the person, as attitudes change in connection to values, general goals, language, emotions, and human development. The second context is social relationships, which link attitude change to the communicator of persuasive messages, social media, and culture. The third context is sociohistorical and highlights the influence of unique events, including sociopolitical, economic, and climatic occurrences. In conclusion, many important recent findings reflect the fact that holism, with a focus on situating attitudes within their personal, social, and historical contexts, has become the zeitgeist of attitude research during this period.

Adult age differences in the interpretation of surprised facial expressions

Research on adult age differences in the interpretation of facial expressions has yet to examine evaluations of surprised faces, which signal that an unexpected and ambiguous event has occurred in the expresser's environment. The present study examined whether older and younger adults differed in their interpretations of the affective valence of surprised faces. Specifically, we examined older and younger participants' evaluations of happy, angry, and surprised facial expressions. We predicted that, on the basis of age-related changes in the processing of emotional information, older adults would evaluate surprised faces more positively than would younger adults. The results indicated that older adults interpreted surprised faces more positively than did their younger counterparts. These findings reveal a novel age-related positivity effect in the interpretation of surprised faces, suggesting that older adults imbue ambiguous facial expressions-that is, expressions that lack either positive or negative facial actions-with positive meaning. (PsycINFO Database Record