A Picture Worth a Thousand Texts? Investigating the Influences of Visual Appeals in a Text Message-Based Health Intervention

Niu, Zhaomeng; Jeong, David C.; Brickman, Jared; Nam, Yujung; Liu, Shuang; Stapleton, Jerod L.

doi:10.1080/10810730.2020.1731631

Cited by 13 publications

(16 citation statements)

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“…They discovered that participants’ cognitive responses did not differ between gain-framed and loss-framed messages, that is, there was no observable difference because of framing. However, there are at least 3 factors that may explain the discrepancy in findings between this study and the study by Niu et al [ 25 ]. First, the studies had different aims; this study sought to understand one’s choices, and the other examined one’s cognitive processes.…”

Section: Discussioncontrasting

confidence: 99%

“…Finally, the samples were different demographically and clinically; this study examined an older cohort with chronic disease, and the other study examined a group of young, healthy undergraduates. These three factors may explain why this paper discovered a strong response to framing and why Niu et al [ 25 ] saw virtually no response to framing.…”

Section: Discussionmentioning

confidence: 76%

“…In discussing framing effects, one study found little impact because of message framing. Niu et al [ 25 ] examined the impact of framed SMS text messages on encouraging healthy eating practices. They discovered that participants’ cognitive responses did not differ between gain-framed and loss-framed messages, that is, there was no observable difference because of framing.…”

Section: Discussionmentioning

confidence: 99%

“…As the digital age advances, capturing and communicating photographs will become easier and can be used in mobile health (mHealth) interventions. Although it is understood that visual media can impact the processes leading to behavior change [ 19 , 25 ], no studies to date have examined whether the type of image might have a different impact. This study found preferences for real images over nonreal ones in a population of cardiac and pulmonary rehabilitation patients.…”

Section: Discussionmentioning

confidence: 99%

“…However, there is a paucity of research investigating how visual aids may look like in a mobile messaging format. To the best of our knowledge, only one other study [ 25 ] has examined whether visual-based mobile phone messages could be used to support healthy lifestyle behavior change. However, this was tested in a cohort of young, healthy university students with no chronic disease, and the messages were stylistically simple.…”

Section: Introductionmentioning

confidence: 99%

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Understanding Preferences for Lifestyle-Focused Visual Text Messages in Patients With Cardiovascular and Chronic Respiratory Disease: Discrete Choice Experiment

et al. 2021

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Background Supporting healthy lifestyle changes is a key aim of cardiovascular and pulmonary rehabilitation programs. SMS text messaging programs have demonstrated effectiveness in cardiovascular disease risk reduction, weight loss, increasing physical activity, and smoking cessation. The optimization of SMS text messaging programs may deliver greater population benefits as mobile phone use becomes ubiquitous. Visual messaging (ie, image-based messages) has the potential to communicate health messages via digital technology and result in enhanced engagement. Objective This study aims to determine and understand patient preferences for lifestyle-focused visual text messages that support cardiovascular and pulmonary rehabilitation. Methods A discrete choice experiment was conducted in a 4-stage iterative process to elicit patient preferences for visual message features. Attribute and level development yielded 3 attributes (purpose, image type, and web address), and 16 choice sets were subsequently constructed according to a full factorial design. Patients participating in cardiovascular and pulmonary rehabilitation were surveyed (on the web) for their preferences regarding the visual message choice sets. Respondents were asked to choose among 16 pairs of visual messages regarding key lifestyle behaviors, namely, physical activity and nutrition. The data were analyzed using a conditional logit model. Results There was a total of 1728 observations from 54 unique respondents. Two factors that were associated with patient preference were gain-framed purpose compared with no purpose (odds ratio [OR] 1.93, 95% CI 1.40-2.65) and real images compared with cartoon images (OR 1.26, 95% CI 1.04-1.54). A loss-framed purpose was less preferred than no purpose (OR 0.55, 95% CI 0.42-0.74). Overall, patients preferred positive images that were colorful and engaged with text that supported the image and had a preference for images of real people rather than cartoons. Conclusions A discrete choice experiment is a scientific method for eliciting patient preferences for a visual messaging intervention that is designed to support changes in lifestyle behaviors. SMS text messaging programs that use visual aids may result in greater patient satisfaction by using a gain frame, using real images, and avoiding a loss frame. Further research is needed to explore the feasibility of implementation and the health and behavioral outcomes associated with such visual messaging programs.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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