Exploring the Strategic Use of TikTok for Clinical Trial Recruitment: How audiences' Prior Short-Form Video Usage Influences Persuasive Effects

Guided by the elaboration likelihood model and framing theory, this study explores the potential of short-form video platforms (e.g. TikTok), for targeted clinical trial recruitment. An online experiment compared doctor vs. peer-led videos addressing logistical or psychological barriers to participation, mimicking common TikTok communication tactics. Results indicate that high (vs. low) TikTok users are more persuaded by recruitment messages, and they exhibit stronger intentions to participate in clinical trials. Although doctor-sourced messages generate greater credibility and a more favorable message attitude, peer-sourced messages may be more effective in increasing participation intention. Lastly, doctor-sourced videos that address logistical barriers and peer-sourced videos that discuss psychological barriers result in higher self-efficacy for clinical trial participation. This study contributes to the growing body of research on new media's role in health communication and provides insights into how to strategically utilize TikTok and other short-form video platforms for clinical trial recruitment.

How Do Gain-Loss Frames and Cultural Arguments Persuade? Designing Effective Messages to Weaken College Students' Binge-Drinking Intentions

To design effective health messages, this study investigates the effects of gain-loss framing and relevant moderating effects in the context of college students' alcohol use. Specifically, based on an online experiment, we tested the moderation effects of message-sidedness and binge-drinking behaviors using a mediation model in which the association between gain-loss framing and behavioral intentions is mediated by attitudes toward binge-drinking. Four hundred thirty-four Korean college students participated in this study. Hayes' PROCESS Macro for SPSS was employed for the analysis. The results show that loss-framing significantly increased participants' unfavorable attitudes toward binge-drinking in the one-sided message condition. Moreover, attitudes toward binge-drinking were more significantly associated with behavioral intentions to binge-drink among heavy drinkers than among non-heavy drinkers. Our findings suggest important theoretical and practical implications for the development of message-framing strategies in health campaigns designed to prevent college students' binge-drinking in collectivistic societies where the cultural meaning of drinking extends beyond the individual realm to the larger social context.

Meaningful Media Experiences and Vaccination Message Communication: An Experimental Study with Vaccine-Hesitant Individuals

Guided by the eudaimonic media and the health persuasion literature, the current study explores how meaningful emotions elicited from entertainment media exposure decreases anti-vaccination attitudes among vaccine-hesitant individuals. Results of a between-subjects experiment (N = 409) showed that participants who viewed meaningful music videos (vs. neutral videos) and vaccination messages embedded in the user-generated comments reported more empathy, less reactance, and less anti-vaccination attitudes. Multigroup analysis revealed that this association was held for participants who were hesitant about whether they would get fully vaccinated, but not for participants who were determined to not get vaccinated. Theoretical and practical implications were discussed.

Effects of Character Accent on Perceived Similarity, Transportation, and Narrative Persuasion

Guided by narrative transportation theory and the social identity approach, this study examined the effects of character accent on perceived similarity, transportation, and narrative persuasion. Cigarette smokers from Kentucky (N = 492) listened to a first-person narrative about smoking-induced lung cancer. The character spoke either with a Southern American English (SAE; ingroup) or a General American English (GAE; outgroup) accent. Opposite to predictions, the GAE-accented character was perceived as more similar overall, engendered greater transportation, elevated lung cancer risk perceptions, and promoted higher intentions to quit smoking than the SAE-accented character. Consistent with predictions, the effects of character accent on risk perceptions and intentions to quit were mediated by perceived similarity and transportation. Taken together, these findings indicate that narrative character accent is a potent cue to similarity judgments, but that actual linguistic similarity is not isomorphic with perceived overall similarity. Theoretical and practical implications for narrative persuasion are discussed.

Algorithm as Recommending Source and Persuasive Health Communication: Effects of Source Cues, Language Intensity, and Perceived Issue Involvement

Algorithms are now playing significant roles in online health information selection and recommendation. A question arises as to when and why people would be persuaded by the content they recommend. We conducted a 4 (recommending source: algorithm, other users, a friend, the CDC) x 2 (language intensity: high vs. low) experiment to find out. Participants (N = 299) were exposed to a health-related public service announcement embedded in a social media post. The results showed that overall, an algorithm induced a similar level of compliance intention compared with other recommending sources. We also found a significant three-way interaction when comparing the effects of the algorithm and the CDC: for individuals with low issue involvement, the algorithm was less persuasive when paired with a message with high language intensity. In contrast, for high-involvement individuals, the algorithm elicited more fear than the CDC when recommending an assertive message, partially leading to more compliance intention.

Extending the Knowledge Gap Hypothesis to Narrative Persuasion: Parents' Information-Seeking Intention and Learning About Adolescent Children's Covid-19 Vaccination

The gap in knowledge and information-seeking between high and low socioeconomic status (SES) has been well documented. This study extends this knowledge gap hypothesis to narrative persuasion in the context of parents' knowledge and information-seeking intention concerning adolescents' COVID-19 vaccination. It specifically tests if the gap is moderated by a message type (narrative vs. non-narrative). An online quasi-experiment, with a 2 (participants' education level: high vs. low) × 3 (message type: narrative vs. non-narrative vs. no-message) between-subject design, showed a main effect of education level (i.e., parents with a higher [vs. lower] education level rated a higher intention to seek information and provided more correct answers on questions about adolescents' COVID-19 vaccination) and an interaction between the two factors. The interaction showed that the gap between high- and low-education groups in information-seeking intention disappeared among those who read the narrative or non-narrative, and the gap in knowledge disappeared among those who read the narrative. Study findings suggest the utility of narratives in narrowing the gap in knowledge and information-seeking to improve parents' decisions on child vaccination.

Use of Persuasive Language in Communication of Risk during Prostate Cancer Treatment Consultations

BACKGROUND

Physician treatment preference may influence how risks are communicated in prostate cancer consultations. We identified persuasive language used when describing cancer prognosis, life expectancy, and side effects in relation to a physician's recommendation for aggressive (surgery/radiation) or nonaggressive (active surveillance/watchful waiting) treatment.

METHODS

A qualitative analysis was performed on transcribed treatment consultations of 40 men with low- and intermediate-risk prostate cancer across 10 multidisciplinary providers. Quotes pertaining to cancer prognosis, life expectancy, and side effects were randomized. Coders predicted physician treatment recommendations from isolated blinded quotes. Testing characteristics of consensus predictions against the physician's treatment recommendation were reported. Coders then identified persuasive strategies favoring aggressive/nonaggressive treatment for each quote. Frequencies of persuasive strategies favoring aggressive/nonaggressive treatment were reported. Logistic regression quantified associations between persuasive strategies and physician treatment recommendations.

RESULTS

A total of 496 quotes about cancer prognosis (n = 127), life expectancy (n = 51), and side effects (n = 318) were identified. The accuracy of predicting treatment recommendation based on individual quotes containing persuasive language (n = 256/496, 52%) was 91%. When favoring aggressive treatment, persuasive language downplayed side effect risks and amplified cancer risk (recurrence, progression, or mortality). Significant predictors (P < 0.05) of aggressive treatment recommendation included favorable side effect interpretation, downplaying side effects, and long time horizon for cancer risk due to longevity. When favoring nonaggressive treatment, persuasive language amplified side effect risks and downplayed cancer risk. Significant predictors of nonaggressive treatment recommendation included unfavorable side effect interpretation, favorable interpretation of cancer risk, and short time horizon for cancer risk due to longevity.

CONCLUSIONS

Physicians use persuasive language favoring their preferred treatment, regardless of whether their recommendation is appropriate.

IMPLICATIONS

Clinicians should quantify risk so patients can judge potential harm without solely relying on persuasive language.

HIGHLIGHTS

Physicians use persuasive language favoring their treatment recommendation when communicating risks of prostate cancer treatment, which may influence a patient's treatment choice.Coders predicted physician treatment recommendations based on isolated, randomized quotes about cancer prognosis, life expectancy, and side effects with 91% accuracy.Qualitative analysis revealed that when favoring nonaggressive treatment, physicians used persuasive language that amplified side effect risks and downplayed cancer risk. When favoring aggressive treatment, physicians did the opposite.Providers should be cognizant of using persuasive strategies and aim to provide quantified assessments of risk that are jointly interpreted with the patient so that patients can make evidence-based conclusions regarding risks without solely relying on persuasive language.

Soft Skills: The Work of Communication and Persuasion Among Nurse Navigators in Hospital at Home Programs

OBJECTIVE

To assess the role of soft skills in the work of Hospital at Home (HaH) nurse navigators.

BACKGROUND

In HaH programs that employ them, nurse navigators are often responsible for identifying, assessing, referring, and educating potential HaH patients. The experiences of these navigators have gone understudied.

METHODS

Researchers conducted semistructured interviews and observations with nurse navigators (n = 7) who collectively cover 14 North Carolina-based HaH sites. Navigators were asked to keep diaries of responses to directed questions.

RESULTS

In their capacity as navigators, interviewees said they served several roles: intermediaries between hospital and HaH staff, interpreters of clinical knowledge for patients, and champions of, and educators for, the home-based program. The navigators noted that the interpersonal soft skills of building rapport, clear communication, and gentle persuasion were of the utmost importance in this work.

CONCLUSIONS

The job descriptions of nurse navigators in HaH programs should fully reflect the breadth of their responsibilities, including time performing soft skilled labor. Also, training for these roles should include techniques to develop and refine these skills.

Exploring the Use of Persuasive System Design Principles to Enhance Medication Incident Reporting and Learning Systems: Scoping Reviews and Persuasive Design Assessment

BACKGROUND

Medication incidents (MIs) causing harm to patients have far-reaching consequences for patients, pharmacists, public health, business practice, and governance policy. Medication Incident Reporting and Learning Systems (MIRLS) have been implemented to mitigate such incidents and promote continuous quality improvement in community pharmacies in Canada. They aim to collect and analyze MIs for the implementation of incident preventive strategies to increase safety in community pharmacy practice. However, this goal remains inhibited owing to the persistent barriers that pharmacies face when using these systems.

OBJECTIVE

This study aims to investigate the harms caused by medication incidents and technological barriers to reporting and identify opportunities to incorporate persuasive design strategies in MIRLS to motivate reporting.

METHODS

We conducted 2 scoping reviews to provide insights on the relationship between medication errors and patient harm and the information system-based barriers militating against reporting. Seven databases were searched in each scoping review, including PubMed, Public Health Database, ProQuest, Scopus, ACM Library, Global Health, and Google Scholar. Next, we analyzed one of the most widely used MIRLS in Canada using the Persuasive System Design (PSD) taxonomy-a framework for analyzing, designing, and evaluating persuasive systems. This framework applies behavioral theories from social psychology in the design of technology-based systems to motivate behavior change. Independent assessors familiar with MIRLS reported the degree of persuasion built into the system using the 4 categories of PSD strategies: primary task, dialogue, social, and credibility support.

RESULTS

Overall, 17 articles were included in the first scoping review, and 1 article was included in the second scoping review. In the first review, significant or serious harm was the most frequent harm (11/17, 65%), followed by death or fatal harm (7/17, 41%). In the second review, the authors found that iterative design could improve the usability of an MIRLS; however, data security and validation of reports remained an issue to be addressed. Regarding the MIRLS that we assessed, participants considered most of the primary task, dialogue, and credibility support strategies in the PSD taxonomy as important and useful; however, they were not comfortable with some of the social strategies such as cooperation. We found that the assessed system supported a number of persuasive strategies from the PSD taxonomy; however, we identified additional strategies such as tunneling, simulation, suggestion, praise, reward, reminder, authority, and verifiability that could further enhance the perceived persuasiveness and value of the system.

CONCLUSIONS

MIRLS, equipped with persuasive features, can become powerful motivational tools to promote safer medication practices in community pharmacies. They have the potential to highlight the value of MI reporting and increase the readiness of pharmacists to report incidents. The proposed persuasive design guidelines can help system developers and community pharmacy managers realize more effective MIRLS.

Persuasive Effects of Temporal Framing in Health Messaging: A Meta-Analysis

This meta-analysis investigated the persuasive effects of temporal framing in health messaging. Our analysis included 39 message pairs from 22 studies in 20 articles (N = 4,998) that examined the effects of temporal framing (i.e. present-oriented messages vs. future-oriented messages) on attitudes, intentions, and behaviors in health contexts. We found that present-oriented messages were significantly more persuasive than future-oriented messages in terms of intentions and integrated persuasive outcomes. Effects of temporal framing on attitudes and behaviors were not statistically significant. We tested six moderators of temporal framing effects (gain vs. loss framing, temporal framing operationalization, behavior type, timing of effect assessment, age, CFC levels) but none of them was statistically significant. Implications for future temporal framing research are discussed.

Dispatchers trained in persuasive communication techniques improved the effectiveness of dispatcher-assisted cardiopulmonary resuscitation

BACKGROUND

Early recognition of cardiac arrest and early initiation of bystander cardiopulmonary resuscitation can increase the survival of patients with out-of-hospital cardiac arrest (OHCA). We compared dispatcher-assisted cardiopulmonary resuscitation (DACPR) effectiveness before and after using different communication models in the dispatching center.

METHOD

We analyzed dispatch recordings of non-trauma origin OHCA cases received by the Taichung dispatch center between May 1 to September 30, 2021, and November 1, 2021, to March 31, 2022. The dispatchers underwent an 8-hour training intervention consisting of targeted education using a new communication model for DACPR. Several outcome measures were evaluated, including the sustained return of spontaneous circulation and the time to first chest compression.

RESULTS

We included 640 cases in the preintervention group and 580 cases in the postintervention group. The return of spontaneous circulation (ROSC) rate, the time to first chest compression, and good neurological outcome were significantly improved in the postintervention group (20.9% vs. 31.0%, p < 0.001;168 seconds vs. 151 seconds, p = 0.004; 2.8% vs. 5.3%, p = 0.024, respectively). In subgroup analyses, the intervention was related to a statistical improvement in ROSC rate among patients whose caller was a family member (18.7% vs. 31.4%, p < 0.001). Among patients whose caller was female, both ROSC and good neurological outcome significantly improved after the intervention (19.8% vs. 36.6%, p < 0.001; 2.7% vs. 7.5%, p = 0.006, respectively). There was a statistical difference between the pre-intervention and post-intervention group with respect to ROSC rate among patients whose caller was family (the adjusted odds ratio:1.78, 95% CI: 0.59-1.25], p < 0.001.) or female (the adjusted odds ratio:3.18,95% CI: 1.77-5.70], p = 0.008.) in the multivariable regression model.

CONCLUSION

The new communication model has enhanced the effectiveness of DACPR in terms of the ROSC rate, particularly when the caller was a family member or female, leading to improved rates of ROSC and favorable neurological outcomes.

How Visual Aesthetics and Calorie Density Predict Food Image Popularity on Instagram: A Computer Vision Analysis

Social media have become an important source where people are exposed to visual representations of foods. This study aims to understand what content factors contribute to the popularity of food images on Instagram. We collected 53,894 images from 90 popular food influencer accounts on Instagram over two years. Applying computer vision methods, we investigated the effects of visual aesthetics and calorie density of foods on audience engagement (i.e. likes, comments) as well as if the effects of visual aesthetics varied by calorie density. Our results showed that both visual aesthetics and calorie density were important predictors of image popularity. The use of arousing, warm colors such as red, orange, and yellow, feature complexity, and repetition predicted higher likes, whereas brightness, colorfulness, and compositional complexity acted reversely. A similar pattern was observed for comments. The calorie density of foods in images positively predicted likes and comments. Also, the effects of visual aesthetics varied by calorie content and were more pronounced for low-calorie images. Health practitioners who plan to harness the power of social media to encourage certain dietary behaviors should take visual aesthetics into account when designing persuasive messages and campaigns.

Understanding the Design of Fear Appeals by Applying the Extended Parallel Process Model: A Qualitative Analysis of COVID-19 Public Service Announcements

PURPOSE

Identify how early COVID-19 public health messages incorporated in the tenets of the extended parallel process model (EPPM).

SETTING

YouTube videos developed by governmental departments, medical institutions, news organizations, and non-profit organizations in the United States were aggregated.

METHOD

This qualitative study conducted a keyword search to identify public service announcements (PSAs). The sample was further refined after searching PSAs that contained fear appeals. A thematic analysis was performed by using the constant comparative method.

SAMPLE

A total of forty-three videos was included in the final analysis.

RESULT

Two themes emerged regarding messages aimed at arousing the perceived severity of threat. These themes include emphasizing the consequences of being infected and utilizing personal narratives. Perceived susceptibility of threat was aroused by emphasizing that some groups have higher risks than others. Two themes emerged around arousing perceived response efficacy: (1) the authority of professionals; and (2) altruism and personal responsibility. One way was identified to arouse perceived self-efficacy, which is informing the protective measures.

CONCLUSION

Multiple strategies were used in PSAs about COVID-19 to arouse fear during the early stages of the pandemic. The utilization of self-efficacy was oversimplified, by not providing details about the rationale for the recommended behavior.

Intuitive advertisers: Emotionality in communication about unhealthy food

OBJECTIVE

This research tests whether people use more emotion-based language when communicating with one another about unhealthy foods than healthy foods. This matters because emotion-based language is more persuasive.

METHOD

In three observational studies, we analyzed the emotionality in 1,000 online recipe descriptions, 4,403 food reviews, and 1,184 celebrity social media posts. In two experiments (N = 398), we analyzed the emotionality when people are prompted to persuade someone to consume an unhealthy food compared with a healthy food. In one experiment (N = 192), we tested persuasiveness as a function of emotionality.

RESULTS

Speakers use more emotionality when communicating about less healthy foods. People's tendency to focus more on long-term benefits when communicating about healthy (vs. unhealthy) foods mediated the effect of food type on emotionality. Emotionality, in turn, increases persuasiveness for healthy foods.

CONCLUSIONS

People use emotionality in communicating about unhealthy (vs. healthy) foods. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The potential of generative AI for personalized persuasion at scale

Matching the language or content of a message to the psychological profile of its recipient (known as "personalized persuasion") is widely considered to be one of the most effective messaging strategies. We demonstrate that the rapid advances in large language models (LLMs), like ChatGPT, could accelerate this influence by making personalized persuasion scalable. Across four studies (consisting of seven sub-studies; total N = 1788), we show that personalized messages crafted by ChatGPT exhibit significantly more influence than non-personalized messages. This was true across different domains of persuasion (e.g., marketing of consumer products, political appeals for climate action), psychological profiles (e.g., personality traits, political ideology, moral foundations), and when only providing the LLM with a single, short prompt naming or describing the targeted psychological dimension. Thus, our findings are among the first to demonstrate the potential for LLMs to automate, and thereby scale, the use of personalized persuasion in ways that enhance its effectiveness and efficiency. We discuss the implications for researchers, practitioners, and the general public.

The persuasive effects of social cues and source effects on misinformation susceptibility

Although misinformation exposure takes place within a social context, significant conclusions have been drawn about misinformation susceptibility through studies that largely examine judgements in a social vacuum. Bridging the gap between social influence research and the cognitive science of misinformation, we examine the mechanisms through which social context impacts misinformation susceptibility across 5 experiments (N = 20,477). We find that social cues only impact individual judgements when they influence perceptions of wider social consensus, and that source similarity only biases news consumers when the source is high in credibility. Specifically, high and low engagement cues ('likes') reduced misinformation susceptibility relative to a control, and endorsement cues increased susceptibility, but discrediting cues had no impact. Furthermore, political ingroup sources increased susceptibility if the source was high in credibility, but political outgroup sources had no effect relative to a control. This work highlights the importance of studying cognitive processes within a social context, as judgements of (mis)information change when embedded in the social world. These findings further underscore the need for multifaceted interventions that take account of the social context in which false information is processed to effectively mitigate the impact of misinformation on the public.

Exploring factors to interpretation of targeted nutrition messages for people living with multiple sclerosis

OBJECTIVES

Current dietary recommendations for MS suggest following national dietary guidelines developed for the general population. The aim of this study was to explore the interpretation of MS-targeted nutrition messages.

METHODS

Using the Elaboration Likelihood Model of persuasion, three nutrition messages were developed targeting the strongest evidence for MS: vitamin D, dietary fat, and dietary diversity. Semi-structured interviews including the cognitive 'thinking-aloud' technique were used to test the messages with adults living with MS. Data were transcribed and coded thematically.

RESULTS

Theoretical saturation was reached by 15 interviews. The data corpus indicated three themes and seven subthemes. The data revealed that people living with MS changed their diet after MS diagnosis. Dietary change was due to uncertainty, fear of disease progression and risk of relapse. The admiration and scepticism of extremist MS diets depended on personal vulnerability and support from health care professionals. The unique MS journey appeared influential to message interpretation; driven by engagement, practicality, and credibility.

CONCLUSION

The interpretation of targeted nutrition messages revealed that dietary changes made after diagnosis are a coping mechanism to improve sense of control and self-management.

PRACTICAL IMPLICATIONS

The potential psychological benefit of dietary change for MS management must be prioritised using person-centred care.

Bullshit can be harmful to your health: Bullibility as a precursor to poor decision--making

Bullshitting is characterized by sharing information with little to no regard for truth, established knowledge, or genuine evidence. It involves the use of various rhetorical strategies to make one's statements sound knowledgeable, impressive, persuasive, influential, or confusing in order to aid bullshitters in explaining things in areas where their obligations to provide opinions exceed their actual knowledge in those domains. Distinct from gullibility (i.e., a propensity to accept a false premise in the presence of untrustworthiness cues), we highlight the research on bullibility (i.e., believing bullshit even in the face of social cues that signal something is bullshit) and its links to erroneous judgments and decisions. A deeper understanding of bullibility is critical to identifying and correcting poor decision-making.

Two-Sided Messages Promote Openness for a Variety of Deeply Entrenched Attitudes

Prior research showed that people holding attitudes on relatively moral topics became more open to two- rather than one-sided messages as the moral basis of their attitudes increased. Across three studies (N = 963), we extend this finding to relatively non-moral topics by demonstrating that two-sided messages can encourage people with strong attitudes indexed by various non-moral attitude strength measures to be more open to contrary positions. Study 1 demonstrated this for four indicators of attitude strength (e.g., certainty). As the strength of one's attitude increased, two-sided messages increased in relative effectiveness over one-sided communication. This was mediated by perceived appreciation for the speaker acknowledging one's view. Study 2 replicated this finding in a preregistered experiment. Study 3 conceptually replicated and extended it to people holding attitudes based on their political identity. Finally, evidence was obtained supporting perceived appreciation (rather than source evaluation) as the key driver of this interactive effect.

Changing Attitudes About a Pro-Environmental Proposal Concerning Solar Power: The Self-Validating Role of Ingroup Versus Outgroup Sources

BACKGROUND

In this study, we examined whether a persuasive message in favor of a pro-environmental proposal could influence attitude change through a self-validation process when individuals were told that the source of the proposal belonged to their ingroup (vs. their outgroup).

METHOD

Participants read a message that advocated for the use of solar power. Immediately following the message, participants were asked to list their thoughts regarding the persuasive proposal. A thought favorability index was created for each participant. Following the thought-listing task, participants received the experimental manipulation (i.e., ingroup vs. outgroup source) based on the minimal group paradigm, after which they reported their attitudes towards the proposal.

RESULTS

A regression analysis showed the predicted interaction between thought favorability and type of source (i.e., ingroup vs. outgroup) on attitudes towards the solar power proposal. According to our expectations, thought favorability was a better predictor of attitudes for participants in the ingroup (vs. outgroup) source condition.

CONCLUSIONS

Attitudes can be polarized as a function of ingroup versus outgroup differentiation through a self-validation process.

The working memory approach of persuasion: Induced eye movements lead to more social media self-control behaviours

In the framework of prevention of social media addiction, persuasive messages can be used to stimulate people to engage in social media self-control behaviours. However, the effects of these messages may be weakened by defensive reactions. In the Working Memory account of Persuasion, these defensive self-regulatory actions in the Working Memory (WM) are activated to lower a given threat. Because the WM has limited capacity, and these defensive processes take WM capacity, they can be inhibited by inducing eye movements (EMi). Adults (N = 117) from the general population listened in an online experiment to an auditory message on the negative consequences of social media use (SMU). Half of the participants were randomly assigned to the EMi condition; they were asked to keep watching a moving red square on their screen during the exposure to the auditory message. SMU self-control behaviour was the outcome measure, assessed by self-report 2 weeks later. The effects of EMi on SMU self-control behaviour were moderated by individual differences, indicating defensive self-regulatory actions: EMi significantly increased behaviour in participants who scored low on Cognitive Self-affirmation Inclination, high on SMU-control-failure, and, unexpectedly, low in SMU. This study detected defensive reactions towards persuasive information concerning SMU, using the EMi research paradigm.

Will ChatGPT's Free Language Editing Service Level the Playing Field in Science Communication?: Insights from a Collaborative Project with Non-native English Scholars

ChatGPT has been widely heralded as a way to level the playing field in scientific communication through its free language editing service. However, such claims lack systematic evidence. A writing scholar (LL) and six non-native English scholars researching health professions education collaborated on this Writer's Craft to fill this gap. Our overarching aim was to provide experiential evidence about ChatGPT's performance as a language editor and writing coach. We implemented three cycles of a systematic procedure, describing how we developed our prompts, selected text for editing, incrementally prompted to refine ChatGPT's responses, and analyzed the quality of its language edits and explanations. From this experience, we offer five insights, and we conclude that the optimism about ChatGPT's capacity to level the playing field for non-native English writers should be tempered. In the writer's craft section we offer simple tips to improve your writing in one of three areas: Energy, Clarity and Persuasiveness. Each entry focuses on a key writing feature or strategy, illustrates how it commonly goes wrong, teaches the grammatical underpinnings necessary to understand it and offers suggestions to wield it effectively. We encourage readers to share comments on or suggestions for this section on Twitter, using the hashtag: #how'syourwriting?

"Look After Each Other"- Ethical Concerns in the Use of Communicative Appeals to Solidarity in the Face of a Pandemic

During the recent COVID-19 pandemic international organizations and national and local governments employed appeals to solidarity or "we-messages" for the purpose of encouraging the public to adopt mitigation measures and to help more vulnerable others. Since appeals to solidarity inherently aim to influence people's views and practices, they raise ethical concerns similar to concerns associated with health communication persuasive campaigns (e.g. respect for autonomy, personal responsibility, stigmatization) and concerns more specifically associated with appeals to solidarity (e.g. divisiveness). The first part of the paper introduces a conceptual distinction between two types of approaches to solidarity according to an instrumental or moral emphasis. Appeals to solidarity according to this distinction are illustrated with examples from the COVID-19 pandemic. The second part summarizes normative justifications and advantages for employing appeals to solidarity. The third part presents ethical concerns associated with appealing to solidarity in the time of a pandemic. Drawing on these concerns, the final part presents propositions for normative conditions for employing solidarity appeals in a time of a pandemic and notes the importance of research needed to identify additional ethical concerns and conceptions of solidarity in multicultural societies. It concludes with noting the importance of employing appeals to solidarity that go beyond mitigating the pandemic and of conducting a critical discourse on the mandate of the state to make "top-down" moral demands.

Making patients political: Narrating, curating, enacting, and navigating the 'idealised policy patient'

In this article we develop the concept of the 'idealised policy patient' to contribute to a better understanding of patient-family activism and the mechanisms through which powerful and persuasive patient narratives are facilitated and mobilised. The context through which we explore the idealised policy patient is the UK debates about the legalisation of mitochondrial donation, which primarily took place between 2011 and 2015. In our example, the idealised policy patient was constructed around a culturally persuasive narrative of patient suffering, where mitochondrial donation was presented as a desirable and ethical solution. We draw on interviews with patient-families and stakeholders, and documentary analysis to identify four dimensions of the idealised policy patient - narrating, curating, enacting and navigating. Narrating describes how the idealised policy patient appears in public and policy spaces, as a culturally available narrative which conveys certain meanings and is designed to invoke an emotional and practical response. Curating identifies the multiple forms of labour and facilitation involved in supporting patient-families in activist activities which strengthen the dominant narrative and its embodiment. Enacting focuses on the work of patient-families themselves in supporting and contributing to the idealised policy patient in a way that enlivens and embodies the specifically curated narrative. Finally, navigating considers how those offering an opposing viewpoint position themselves in relation to the idealised policy patient. To conclude, we argue that medical sociology has often given insufficient scrutiny to how the capacity of patients to leverage their status for political ends is bolstered through alignment with existing powerful groups, particularly in hegemonic campaigns. We encourage future researchers to examine how the idealised policy patient is reproduced and reorientated within different policy contexts.

Communicating Antibiotic Resistance via Linguistic Agency Assignment

Antibiotic resistance is a serious health threat that healthcare providers must communicate to the public to decelerate its development. Prior studies have shown that linguistic agency assignment is a viable strategy to frame health threats in a way that both conveys their severity and preserves audience members' sense of self-efficacy. In the current study, we examined this messaging strategy in the context of antibiotic resistance. Individuals' perceptions of the threat and efficacy, behavioral intentions, fear appeals, and evaluations of the educational fact sheet were explored. Participants (N = 449) were randomly assigned to one of the eight conditions crossing threat agency (bacteria/human), temporal agency (antibiotic resistance/human) and imagery agency (taking antibiotics/antibiotics). The results revealed that individuals' perceived severity, susceptibility, response efficacy, and self-efficacy were positively associated with their intentions to use antibiotics judiciously. The interaction effects between perceived threat and efficacy predicted behavioral intentions and the persuasiveness of the fact sheet. Relative to bacteria threat agency, human agency assignment led to significantly higher behavioral intentions. Also, readers of the human temporal agency condition reported higher persuasiveness toward the fact sheet than readers of the resistance condition. The implications, limitations, and future research directions of the study are discussed.

A Meta-Analysis Comparing the Effectiveness of Narrative vs. Statistical Evidence: Health vs. Non-Health Contexts

This study is a meta-analysis of primary studies that make a direct comparison between narrative and statistical evidence in both health- and non-health-related communication contexts. The meta-analysis included 50 studies with 65 experimental pairs (k = 65) based on 13,113 (20-1270) participants. We examined the overall persuasiveness of evidence type by computing the correlations (r's) for all pairs, based on the random-effects model, which revealed an effect size of 0.016 (95% CI, -0.014 to 0.045, p = 0.296). Two types of evidence did not significantly differ in effectiveness under either communicative context. The moderation analysis indicated that narrative evidence had a significant advantage over statistical evidence for health messages advocating for prevention behaviors. Compared to non-student samples, the narrative evidence trumped statistical evidence for health-related issues. As communication research continues to investigate the implications for message persuasiveness derived by narrative and statistical appeals, our study suggests that the relative effectiveness is likely a complicated and nuanced matter. Practical implications and limitations have also been outlined.

Pain sensitivity predicts support for moral and political views across the aisle

We live in a time of exacerbating political polarization. Bridging the ideological divide is hard. Although some strategies have been found effective for interpersonal persuasion and interaction across the aisle, little is known about what intrapersonal attributes predict which individuals are more inclined to support their ideological opponent's views. The present work identifies a low-level attribute-sensitivity to physical pain-that robustly predicts individual variations in support for moral and political views typically favored by one's ideological opponent. We first summarize a psychophysical validation of an established pain sensitivity measure (n = 263), then report a series of exploratory and preregistered confirmatory studies and replications (N = 7,360) finding that more (vs. less) pain-sensitive liberal Americans show greater endorsement of moral foundations typically endorsed by conservatives (Studies 1a-1c), higher likelihood of voting for Trump over Biden in the 2020 presidential election, stronger support for Republican politicians, and more conservative attitudes toward contentious political issues (Studies 2a and 2b). Conservatives show the mirroring pattern. These "cross-aisle" effects of pain sensitivity are driven by heightened harm perception (Study 3). They defy lay intuitions (Study 4). They are not attributable to multicollinearity or response set. The consistent findings across studies highlight the value of deriving integrative predictions from multiple previously unconnected perspectives (social properties of pain, moral foundations theory, dyadic morality theory, principle of multiple determinants in higher mental processes). They open up novel directions for theorizing and research on why pain sensitivity predicts support for moral and political views across the aisle. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Testing the Effect of an Interactive Narrative: The Mediating Role of Transportation and the Moderating Roles of Narrative Ending and Issue Involvement

There has been a growing literature focusing on the persuasive effect of interactive narratives, but the findings are mixed. Furthermore, very few studies have examined how the impact of interactive narratives varies depending on story features and characteristics of the recipients. Informed by the research of interactive narratives and message framing, the current study empirically tests the indirect effect of an interactive narrative on attitude change using a digital anti-indoor tanning game, with transportation as a mediator and narrative ending and issue involvement as two second-stage moderators. Findings suggested a moderated moderated mediation relationship in which the indirect effect of the interactive narrative was the strongest for low-involvement participants when they experienced a loss-framed ending and was the weakest for high-involvement participants when they encountered the same type of ending. Theoretical and practical implications were discussed.

Gain/loss framing moderates the VMPFC's response to persuasive messages when behaviors have personal outcomes

Activity within the ventral medial prefrontal cortex (VMPFC) during encoding of persuasive messages has been shown to predict message-consistent behaviors both within scanner samples and at the population level. This suggests that neuroimaging can aid in the development of better persuasive messages, but little is known about how the brain responds to different message features. Building on past findings, the current study found that gain-framed persuasive messages elicited more VMPFC activation than loss-framed messages, but only when messages addressed outcomes that would be experienced by participants directly. Participants also perceived gain-framed messages as more effective than loss-framed messages, and self-reported perceptions of message effectiveness were positively correlated with VMPFC activation. These results support theories that VMPFC activity during message encoding indexes perceptions of value and self-relevance and demonstrate that established theories of persuasion can improve the understanding of the neural correlates of persuasion.

Designing a Mobile e-Coaching App for Immigrant Informal Caregivers: Qualitative Study Using the Persuasive System Design Model

BACKGROUND

Informal caregivers are vital in caring for their family and friends at home who may have illnesses or disabilities. In particular, the demands for caregiving can be even more challenging for those with limited resources, support systems, and language barriers, such as immigrant informal caregivers. They face complex challenges in providing care for their relatives. These challenges can be related to sociocultural diversity, language barriers, and health care system navigation. Acknowledging the global context of the increasing number of immigrants is essential in designing inclusive mobile health apps.

OBJECTIVE

This study aims to investigate the needs of immigrant informal caregivers in Sweden and discuss the application of the Persuasive System Design Model (PSDM) to develop an e-coaching prototype. By addressing the unique challenges faced by immigrant informal caregivers, this study will contribute to the development of more effective and inclusive mobile health apps.

METHODS

The participants were considered immigrants and included in the study if they and their parents were born outside of Sweden. Through various channels, such as the National Association of Relatives, rehabilitation departments at municipalities, and immigrant groups, we recruited 13 immigrant informal caregivers. These immigrant informal caregivers were primarily women aged 18 to 40 years. Most participants belonged to the Middle Eastern region whereas some were from North Africa. However, all of them spoke Arabic. We used semistructured interviews to gather data from the participants in Arabic, which were translated into English. Data were analyzed using thematic analysis and discussed in relation to the extended PSDM. The needs of the caregivers were compared with the description of persuasive design principles, and a design principle was chosen based on the match. The PSDM was extended if the need description did not match any principles. Several brainstorming and prototyping sessions were conducted to design the mobile e-coaching app.

RESULTS

Immigrant informal caregivers have various needs in their caregiving role. They reported a need for training on the illness and future caregiving needs, assistance with understanding the Swedish language and culture, and help with accessing internet-based information and services. They also required recognition and appreciation for their efforts, additional informal support, and easy access to health care services, which can be important for their mental health. The PSDM was adapted to the informal caregiving context by adding "facilitating conditions" and "verbal encouragement" as additional persuasive design principles. This study also presents the subsequent mobile e-coaching app for immigrant informal caregivers in Sweden.

CONCLUSIONS

This study revealed important immigrant informal caregivers' needs based on which design suggestions for a mobile e-coaching app were presented. We also proposed an adapted PSDM, for the informal caregiving context. The adapted PSDM can be further used to design digital interventions for caregiving.

How to debunk misinformation? An experimental online study investigating text structures and headline formats

OBJECTIVES

Misinformation is a crucial problem, particularly online, and the success of debunking messages has so far been limited. In this study, we experimentally test how debunking text structure (truth sandwich vs. bottom-heavy) and headline format (statement vs. questions) affect the belief in misinformation across topics of the safety of COVID vaccines and GMO foods.

DESIGN

Experimental online study.

METHODS

A representative German sample of 4906 participants were randomly assigned to reading one of eight debunking messages in the experimentally varied formats and subsequently rated the acceptance of this message and the agreement to misinformation statements about the mentioned topics and an unrefuted control myth.

RESULTS

While the debunking messages specifically decreased the belief in the targeted myth, these beliefs and the acceptance of the debunking message were unaffected by the text structures and headline formats. Yet, they were less successful when addressing individuals with strong pre-existing, incongruent attitudes and distrust in science.

CONCLUSIONS

The risk of backfire effects in debunking misinformation is low. Text structure and headline format are of relatively little importance for the effectiveness of debunking messages. Instead, writers may need to pay attention to the text being comprehensive, trustworthy and persuasive to maximize effectiveness.

How I do it: brainwashing for purulent ventriculitis

BACKGROUND

The management of ventriculitis remains controversial, with no single management strategy that can provide a good outcome. There are few articles describing the brainwashing technique, and most for neonatal intraventricular hemorrhage. This technical note is important because it describes a practical way to perform brainwashing in case of ventriculitis, and it is more feasible compared to endoscopic lavage in developing countries.

METHOD

We describe in a stepwise fashion the surgical technique of ventricular lavage.

CONCLUSION

Ventricular lavage is a neglected technique that can help to improve ventricular infection and hemorrhage prognosis.

Examining the Persuasive Effects of Health Communication in Short Videos: Systematic Review

BACKGROUND

The ubiquity of short videos has demonstrated vast potential for health communication. An expansion of research has examined the persuasive effect of health communication in short videos, yet a synthesis of the research is lacking.

OBJECTIVE

This paper aims to provide an overview of the literature by examining the persuasive effect of health communication in short videos, offering guidance for researchers and practitioners. In particular, it seeks to address 4 key research questions: What are the characteristics of short videos, samples, and research designs in short video-based health communication literature? What theories underpin the short video-based health communication literature? What are the persuasive effects of health communication in short videos? and What directions should future research in this area take?

METHODS

Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, an electronic search of 10 databases up to March 10, 2023, generated 4118 results. After the full-text screening, 18 articles met the eligibility criteria.

RESULTS

The current research lacks a uniform definition of short videos, demonstrates sample biases in location and education, and adopts limited methodologies. Most studies in this synthesis are theoretically grounded or use theoretical concepts, which are predominantly well examined in persuasion research. Moreover, relevant topics and suitable themes are effective in persuasive health communication outcomes, whereas the impact of diverse narrative techniques remains ambiguous.

CONCLUSIONS

We recommend that future research extends the definition of short videos beyond time constraints and explores non-Western and less-educated populations. In addition, researchers should consider diverse methods to provide a more comprehensive examination and investigate the impact of audience targeting and narrative techniques in short video health communication. Finally, investigating how the unique aspects of short videos interact with or challenge traditional persuasion theories is essential.

Persuasive Appeals in Genetic Biobank Recruitment Campaigns: Social and Ethical Implications

The social and ethical implications of large-scale biobank donor recruitment campaigns have remained understudied. We use two recent campaigns of the population-based genetic biobank in Estonia as an example to demonstrate how campaign spokespersons try to persuade potential donors by appealing to (1) gaining self-knowledge, (2) gaining control over one's health, (3) fear of illness, (4) contributing to healthcare, (5) contributing to science, and (6) contributing to one's country. While these campaigns succeeded in recruiting 15 percent of the country's adult population as donors, we explain how the use of some of these appeals may (a) create unrealistic expectations regarding the benefits donors could receive and (b) conceal the risks regarding health data. The study lays a necessary groundwork for future empirical research on the ethics of biobank recruitment campaigns.

Latin America and the Caribbean Code Against Cancer 1st edition: Formative research on the comprehension and persuasiveness of the recommendations by the general population

BACKGROUND

Cancer prevention is the most efficient and cost-effective strategy in cancer control. One prevention strategy is giving credible, clear, and evidence-based recommendations to the individual; however, it is key that these messages are accepted and understood properly by the public. This study aimed to pilot the draft recommendations developed as part of the Latin America and the Caribbean (LAC) Code Against Cancer 1st edition, in terms of comprehension and persuasion of each message.

METHODS

A mixed method two-wave study, in which two versions of the messages were presented to the general population in five LAC countries. We used an ad-hoc questionnaire and interviews that followed the cognitive-pretesting methodology.

RESULTS

Findings suggest that the messages were generally well understood, especially in Spanish speaking countries, and that the messages were generally more understandable than persuasive. We adapted and revised the recommendations based on the findings of the first Wave and held a second iteration in the Spanish speaking countries. We observed a better understanding of most messages in Wave 2.

CONCLUSION

The LAC Code Against Cancer is a valuable tool of well understood messages for the public, with concrete actions everyone can take to prevent cancer. Further research should assess particularities of the region for further efficient dissemination of these important health messages, identify key messages for certain population groups and future interventions that strengthen health literacy in rural and less educated populations to increase behavior change.

Narrative persuasion and psychological distance: Analyzing the effectiveness of distance-framed narratives in communicating ocean plastic pollution

Narratives have been identified as an effective tool to communicate seemingly abstract and uncertain risks. This study integrates the construal level theory of psychological distance and narrative persuasion to examine how distance-framed narratives influence young adults' attitude, behavioral intention, and policy support related to ocean plastic pollution. Results from an experimental survey (N = 889) indicate that the narrative featuring socially close characters and spatially close location is least effective in producing persuasive effects. Instead, the narrative depicting socially close characters' encounters at a spatially distant location is more persuasive. Within narrative conditions, the findings support the mediating role of identification and transportation in facilitating narrative effects. Serial mediation of identification/transportation and psychological distance perception was also observed. Findings from this study offer meaningful theoretical and practical implications for strategic communication on ocean plastic pollution.

Promoting COVID-19 booster vaccines in Macao: A psychological reactance perspective

RATIONALE

The booster vaccine plays a key role in ending COVID-19 crisis. However, promoting COVID-19 booster vaccination often interferes with individuals' freedom of choice and leads to psychological reactance.

OBJECTIVE

To promote the public's intention to receive COVID-19 booster dose, this study aimed to investigate the effectiveness of different message designs from psychological reactance theory's perspective.

METHOD

A 2 × 2 × 2 factorial experiment was conducted in Macao in January 2022 (N = 469). Partial least squares structural equation modeling and a complementary three-way ANOVA were performed to examine the effects of message frame (gain frame vs. loss frame), freedom restoration postscripts (present vs. absent), and other-referencing cues (present vs. absent) on reducing psychological reactance.

RESULTS

The present study has successfully broadened the scope of the psychological reactance theory by examining its applicability to the context of COVID-19 booster vaccination promotion. Our findings indicate that the gain-framed promotion messages tend to be the most effective in reducing perceived reactance. However, freedom restoration postscripts, other-referencing cues, and mixed message design were found to be ineffective in alleviating reactance. Besides, the insignificance of direct effect from message frame to intention suggests that the message design itself cannot influence people's vaccination intentions; rather, it must rely on reducing perceived threat, reactance, and further improving vaccination intentions.

CONCLUSIONS

Our study offered valuable insights from psychological reactance perspective, identifying message features that can be effective in health promotions. Furthermore, message design specifically aimed at reducing the threat to freedom may yield unexpected persuasive effects, an aspect currently overlooked in health promotion strategies.

Perceived gender and political persuasion: a social media field experiment during the 2020 US Democratic presidential primary election

Women have less influence than men in a variety of settings. Does this result from stereotypes that depict women as less capable, or biased interpretations of gender differences in behavior? We present a field experiment that-unbeknownst to the participants-randomized the gender of avatars assigned to Democrats using a social media platform we created to facilitate discussion about the 2020 Primary Election. We find that misrepresenting a man as a woman undermines his influence, but misrepresenting a woman as a man does not increase hers. We demonstrate that men's higher resistance to being influenced-and gendered word use patterns-both contribute to this outcome. These findings challenge prevailing wisdom that women simply need to behave more like men to overcome gender discrimination and suggest that narrowing the gap will require simultaneous attention to the behavior of people who identify as women and as men.

Persuasive Language in ELT-Related Ads on Social Media

In line with the concept of mobile learning in English Language Teaching (ELT), the aim of this research is to explore how Iranian ELT practitioners take advantage of social media to propose supportive and impactful language learning programs by adhering to persuasive linguistic devices. The research design is nonexperimental and explorative. ELT-related commercial videos and pictures were identified on social media platforms, including Instagram, Facebook, TikTok, and YouTube. We delved into the syntactic and pragmatic features of the data on ELT-related ads to identify the persuasive techniques and strategies these ads resort to for attracting language learners to online classes and services. To analyze the data, the widely-used and acknowledged Cialdini's (The psychology of persuasion, Quill William Morrow, 1984) principles of persuasion are employed. The results manifested that 'reciprocity' and 'scarcity' were the most used persuasive strategies, while 'commitment and consistency' and 'consensus' were the least favorable persuasion principles in these ads. The analysis of the Iranian ELT-related ads indicated that the language used within this context is purposeful and strategic. A contextual investigation of the ELT-related ads on social media can meaningfully contribute to social practices underlying English language pedagogy and digital literacy.

How research on persuasion can inform dual-process models of judgment

De Neys makes some useful points regarding dual-process models, but his critique ignores highly relevant theories of judgment from the persuasion literature. These persuasion models predate and often circumvent many of the criticisms he makes of the dual-process approaches he covers. Furthermore, the persuasion models anticipated some of the correctives to dual-process models that he proposes.

Optimizing appreciation and persuasion of embodied conversational agents for health behavior change: A design experiment and focus group study

Embodied Conversational Agents (ECAs) can increase user engagement and involvement and can strengthen the effect of an intervention on health outcomes that is provided via an ECA. However, evidence regarding the effectiveness of ECAs on health outcomes is still limited. In this article, we report on a study that has the goal to identify the effect of a match between a health topic and the ECAs' appearance on ratings of personality characteristics, persuasiveness and intention to use. We report on an online experiment with three different ECAs and three different health topics, conducted among 732 older adults. We triangulated the quantitative results with qualitative insights from a focus group. The results reveal that older adults prefer an ECA that has an appearance matching a certain health topic, resulting in higher ratings on persuasiveness and intention to use. Personality characteristics should be measured embedded within a health topic, but are not rated higher because of a match. We furthermore provide guidelines for designing the content of the ECA.

"It Happened to Me and It's Serious": Conditional Indirect Effects of Infection Severity Narrated in Testimonial Tweets on COVID-19 Prevention

The health crisis caused by COVID-19 resulted in societal breakdowns around the world. Our research is based on determining which features of testimonial messages are most relevant in increasing persuasive impact. An online experiment with a 2 (severity infection narrative: low vs. high) × 2 (infection target: narrative's protagonist vs. protagonist's father) between-subject factorial design was carried out. Young people between 18 and 28 years (N = 278) were randomly assigned to one of the four experimental conditions, where they were asked to read a narrative message in the form of a Twitter thread describing a COVID-19 infection (with mild or severe symptoms) that affected either the protagonist of the message (a 23-year-old young person) or their father. After reading the narrative message, the mediating and dependent variables were evaluated. A message describing a severe COVID-19 infection affecting their protagonist to increase the perception of personal risk increased the persuasive impact through an increase in cognitive elaboration and a reduction in reactance. Our study highlights that creating persuasive messages based on social media targeted at young people that describe a careless behavior resulting in a severe COVID-19 infection can be an appropriate strategy for designing prevention campaigns.

Narrative Messages and the Use of Emotional Appeals on Endometriosis Screening Intention: The Mediating Role of Positive Affect

Endometriosis affects around 10% of women globally, yet the awareness and screening rates for this condition are relatively low. Utilizing an online survey-based experiment with a sample of 18-30-year-old young women (N = 326), this study aimed to investigate the efficacy of narrative messages vs. non-narrative messages for promoting endometriosis screening intention, as well as to evaluate the effectiveness of hope appeal vs. fear appeal in narrative messages. The study also examined the potential mediating mechanisms through self-efficacy and positive affect responses that may help elucidate the effect of emotional appeals on behavioral intentions, while taking into account an individual's readiness to change. Findings indicated that narrative and non-narrative messages did not produce significantly different screening intentions. Compared to the use of fear appeal, the hope appeal in narrative messages predicted a higher level of positive affect responses, which was associated with increased endometriosis screening intentions. Individual difference in readiness to engage in endometriosis screening was not found to be a significant moderator. These results have implications for future research utilizing hope appeals in narrative health messaging. The observed significant mediational pathway through positive affect advances understanding of positive discrete emotions as facilitators to health-related cognition and behavior changes.

Measuring information overload and message fatigue toward COVID-19 prevention messages in USA and China

COVID-19 prevention messages are a crucial component of disease mitigation strategies and the primary driver of health decision-making during the global pandemic. However, the constant and repetitive nature of COVID-19 messaging may cause unintended consequences. Among the commonly observed phenomena are information overload and message fatigue, which might be experienced differently depending on cultural background. Using measurement invariance testing, this study compared how individuals from two countries-USA (n = 493) and China (n = 571)-experienced information overload and message fatigue toward COVID-19 prevention messages. Findings revealed that people in China showed significantly lower level of information overload and message fatigue than those in the USA. This study explores the extent of the unintended persuasive effects that people have experienced during the COVID-19 pandemic in different societies, a comparison which has never been studied before, even outside of the context of COVID-19. The study also provides much-needed practical insights to develop public health initiatives that improve COVID-19 prevention communication, which can further reduce these unintended effects in both countries, and has implications for other countries as well.

Intervention studies to encourage HPV vaccination using narrative: A scoping review

OBJECTIVE

This review aimed to provide an overview of intervention studies that aimed to encourage HPV vaccination using narratives.

METHODS

We searched MEDLINE, CINAHL, PsycINFO, and PsycARTICLES for English language articles that quantitatively examined the persuasive effect of narratives on encouraging HPV vaccination through interventions.

RESULTS

A total of 25 studies were identified. Most studies were conducted in the United States of America, adopted a convenient sampling of university students, measured vaccination intention as the primary outcome, and used text messages in the interventions. A minority of the studies measured vaccination behavior and examined the long-term effects of persuasion. Narratives were as effective as didactics and statistics in encouraging HPV vaccination in most included studies. The findings were mixed or scarce for the effect of combining narratives and statistics, and the person (the first vs. third), narrator, framing, and content of narratives.

CONCLUSION

More findings from a broader range of well-designed studies are needed to determine which narratives can encourage HPV vaccination across different populations.

PRACTICE IMPLICATIONS

Findings indicated using narratives can be a part of repertoire of messages encouraging HPV vaccination.

Defensive Confidence and Certainty in Unchanged Attitudes: The Role of Affect-Cognition Matching

Despite much prior research on matching appeals to the affective-cognitive orientation of attitudes, little attention has focused on the consequences of affect-cognition (mis)matching when individuals resist persuasion. We propose that unlike a matched attack, an attack that is mismatched to the affective-cognitive orientation of attitudes would result in low defensive confidence individuals holding onto their unchanged attitudes with less certainty than high defensive confidence individuals. As hypothesized, low defensive confidence participants were less certain after an affective than a cognitive attack for a cognitive issue (Study 1), and the opposite was true for an affective issue (Study 2). Both patterns occurred again when the affective-cognitive orientation of attitudes was manipulated (Study 3) or measured as an individual difference (Study 4). Moreover, perceived knowledge mediated the effects on attitude certainty (Study 4). We end by discussing implications for our understanding of affect-cognition matching and attitude certainty.

Personalized persuasion: Quantifying susceptibility to information exploitation in spear-phishing attacks

Many cyberattacks begin with a malicious email message, known as spear phishing, targeted at unsuspecting victims. Although security technologies have improved significantly in recent years, spear phishing continues to be successful due to the bespoke nature of such attacks. Crafting such emails requires attackers to conduct careful research about their victims and collect personal information about them and their acquaintances. Despite the widespread nature of spear-phishing attacks, little is understood about the human factors behind them. This is particularly the case when considering the role of attack personalization on end-user vulnerability. To study spear-phishing attacks in the laboratory, we developed a simulation environment called SpearSim that simulates the tasks involved in the generation and reception of spear-phishing messages. Using SpearSim, we conducted a laboratory experiment with human subjects to study the effect of information availability and information exploitation end-user vulnerability. The results of the experiment show that end-users in the high information-availability condition were 2.97 times more vulnerable to spear-phishing attacks than those in the low information-availability condition. We found that access to more personal information about targets can result in attacks involving contextually meaningful impersonation and narratives. We discuss the implications of this research for the design of anti-phishing training solutions.

Waiting for a Match: Mitigating Reactance in Prosocial Health Behavior Using Psychological Distance

This study examined how psychological distance, both social and temporal, can be leveraged in prosocial health behavior messages to mitigate perceived psychological reactance. Following the construal level and psychological reactance theories, we conducted a 2 × 2 between-subjects factorial design (N = 245), which manipulated naturalistic messages regarding a prosocial communications campaign. Structural equation modeling showed that far temporal distance combined with far social distance could significantly reduce threat to freedom and therefore positively affect attitudes and behavioral intentions toward prosocial health topics. The effect of social distance was found not significant, differing from past findings. Further, intertwined and parallel psychological reactance models were tested and discussed. We suggest the need for more psychological reactance research, particularly examining prosocial health behavior. Strategies for practical persuasion strategies in prosocial messages are proposed.

The Emotional Effects of Gain-Loss Frames in Persuasive Messages about Sun Protection on Health Promotional Outcomes: Evidence from an Experimental Study

Although the importance of emotions for the effects of gain-loss framed messages has been supported, the emotional effects of mixed frames have not been sufficiently investigated. To fill this gap, this experimental study exposed participants (N = 154) to single gain- or loss-framed vs. mixed frame messages about sun-protection outcomes. Integrating the idea of mixed frames with the concept of emotional flow, data were analyzed using a serial mediation model with emotional experience (as indexed by valence and arousal) and intention as factors mediating the effect of shifts on actual behavior, measured two weeks after message exposure. Results demonstrate that mixed messages and their impact on emotional experiences are not generally more effective than pure gain or pure loss messages. However, the application of mixed frame or purely loss-framed messages offers a higher potential to increase behavioral health intentions (resulting in respective behaviors) than messages simply focusing on gain frames.

Self-esteem influences the willingness to engage in COVID-19 prevention behavior and persuasion efficacy

RATIONALE

Behaviors such as hand-washing and vaccination save human lives during the COVID-19 pandemic and beyond. Yet, people differ widely in their willingness to engage in them. This investigation examines whether people's willingness to protect themselves physically from contracting coronavirus depends on their self-esteem. Based on self-verification theory, we propose that people who hold negative self-views are less motivated to protect their health which reduces their willingness to engage in recommended preventive measures such as mask-wearing and social-distancing.

OBJECTIVE

We set out to test (i) whether self-esteem predicts people's willingness to engage in COVID-19 prevention behaviors, (ii) whether this relationship is due to variance in motivation to protect one's health (as well as alternative mechanisms), and (iii) whether health messages can more successfully persuade low self-esteem people to follow preventive measures by framing those behaviors around protecting the health of others (vs. oneself).

METHODS

Four studies were conducted with U.S. and German residents. In Study 1, we examine the association between self-esteem, willingness to engage in self-protection behavior, health motivation, and several alternative accounts. In Study 2, we manipulate state self-esteem, and in Studies 3 and 4, we vary the target of COVID-19 prevention behaviors (self vs. other).

RESULTS

People with chronic or temporarily induced low self-esteem report a lower willingness to engage in COVID-19 prevention behaviors because they lack motivation to protect their health. Varying the protection target of preventive behaviors (self vs. others) interacts with self-esteem: Low self-esteem people are more willing to follow preventive measures (e.g., vaccination) when they are framed as protecting others (vs. oneself).

CONCLUSIONS

Self-esteem impacts people's behavior during a global pandemic and needs to be considered when designing health communications. Public health messages can increase compliance among individuals with lower self-esteem by framing prevention behaviors as a way to protect the health of others.