Does message framing affect changes in behavioural intentions in people with psoriasis? A randomized exploratory study examining health risk communication

Abstract

Message framing is important in health communication research to encourage behaviour change. Psoriasis, a long-term inflammatory skin condition, has additional comorbidities including high levels of anxiety and cardiovascular disease (CVD), making message framing particularly important. This experimental study aimed to: (1) identify whether health messages about psoriasis presented as either gain-or loss-framed were more effective for prompting changes in behavioural intentions (BI), (2) examine whether BI were driven by a desire to improve psoriasis or reduce CVD risk; (3) examine emotional reactions to message frame; and (4) examine predictors of BI. A two by two experiment examined the effects on BI of message frame (loss vs. gain) and message focus (psoriasis symptom reduction vs. CVD risk reduction). Participants with psoriasis (n = 217) were randomly allocated to one of four evidence-based health messages related to either smoking, alcohol, diet or physical activity, using an online questionnaire. BI was the primary outcome. Analysis of variance tests and hierarchical multiple regression analyses were conducted. A significant frame by focus interaction was found for BI to reduce alcohol intake (p = .023); loss-framed messages were more effective for CVD risk reduction information, whilst gain-framed messages were more effective for psoriasis symptom reduction information. Message framing effects were not found for BI for increased physical activity and improving diet. High CVD risk was a significant predictor of increased BI for both alcohol reduction (β = .290, p < .01) and increased physical activity (β = −.231, p < .001). Message framing may be an important factor to consider depending on the health benefit emphasised KEYWORDS Psoriasis; risk communication; health behaviour; behavioural intentions; message framing ARTICLE HISTORY

The psychosocial adaptation of patients with skin disease: a scoping review

“…20 Table 4 shows the PA interventions of skin disease included cognitive behavioral therapy, 80–86 educational training, 82, 87–89 self-help programs, 80, 81, 84 psychotherapy 84 and communication. 90…”

The complexity of adverse event assessment and counseling for patients on biologic treatment

“…This is because patients fear being part of the 2% (when being told the rate of side effects) but find more reassuring being part of the 98% (when being told the rate of no side effects). Telling a patient the risk for a specific adverse event while on a specific treatment is less common than getting hit by a lightning [14] Message-framing [11] Gain-frame message: By wearing sunscreen the risk of skin cancer decreases [11,14] Loss-frame message: By not wearing sunscreen the risk of sun-damaged skin and actinic lentigos (liver spots) increase [11,13,14]…”

“…However, after getting that picture of a drug's safety, we have to communicate the risk to patients, yet another hurdle to address. Patients' fear of side effects may be out of proportion to real risk [9][10][11]. Many strategies have been proposed to address this problem; however, there is no 'one fits all' strategy.…”

“…While a gain-frame message would be to tell patients that by quitting smoking you will live longer; a loss-framed message would be to tell patients that by not quitting smoking you will die sooner. Framing messages as a loss tends to be a stronger motivator as humans are averse to losses [11,13,14].…”

The effect of risk communication on periodontal treatment outcomes: A randomized controlled trial

“…As the vast body of message‐framing literature has shown, shaping how health information is presented to patients may influence their subsequent health behavior where loss‐framed messages, in some contexts, might lead to fear . Although the use of fear to motivate behavior change has recently been questioned, psychological models such as Protection Motivation Theory (PMT) propose that, fear, coupled with discussion of coping strategies may be beneficial in eliciting behavior change in patients .…”