| Background: WHO report of “Adolescents: Health Risks and Solutions(2018)” proposed that more than 1.1 million adolescents died globally in 2016,with the leading causes of death including suicide,interpersonal violence,HIV and diarrhoea diseases.In addition,“China Nutrition and Health Status Survey Report(2015)” demonstrated that the prevalence of overweight among adolescents over 18 years of age is as high as 30% in Chinese.A series of data showed that poor eating habits,mental health problems,and unhealthy sexual behaviors cause incalculable damage to adolescent health.Health education is an effective strategy to change students’ unhealthy behavior habits and improve students’ health literacy.And the degree of message receiving is one of the main effective indicators to evaluate the effect of health education.However,the research on the effect of health message acceptance among university students is very limited.Especially for medical students,who as future health service providers and health education advocates,their own health knowledge reserve and health literacy level are of great significance to intervenepeople’ unhealthy behaviors and improve people’ health literacy level.Message framing has been demonstrated that can affect the persuasiveness of message framing.When using a gain-framed or loss-framed to focus on describing the results of a given behavior,the results have a certain appeal to decision makers,resulting in a framed effect(choice preference),which is gradually applied in persuasion health education.However,with the further development of the research,the framing effect research presents the phenomenon of result differentiation.Hence,the exploration of influencing factors is the necessary way to explain these results of differentiation.Although the concept of "personal involvement" has been proposed by scholars and has been demonstrated that would moderate individual receiving message.But,few scholars have conducted it in-depth research on multiple topics.According to literature review,we found that the personal involvement related to "prospect theory","decision dual system theory","psychological attribution theory" and "risk perception" factors.The present study considered the personal involvement as the moderating variable of message persuasiveness,and defined the "personal involvement" in the definition of the degree of involvement from different angles according to the definition of the degree of involvement.So as to understand the true meaning of the degree of involvement,determine the degree of involvement,and explore the variables affecting the information persuasiveness in a more macroscopic way.Objective: In this backdrop,the study aimed to portray the selection preference of health education framed messages,which including food safety,mental health and sexual health,among medical university students.The study also aimed to explore the personal involvement,which were sorted from previous studies,whether moderate framed effect,under different health themes.Methods: Food safety health message,mental health message and sexual health message were selected in the present study.Across-section study of health education message framing was conducted among medical university students(randomly selected 1353 participants).The stimulus materials of the questionnaire refers to the code for “health education in ordinary institutions of higher learning(GB/T 34858-2017)”,which jointly issued by the National Board of Health and the Standardization Administration of China in 2017.And the evaluation of the personal involvement variable was finalized after the expert consultation.Before the formal experiment,a preliminary experiment was conducted to measure the reliability and validity of the questionnaire,and it was revised to enter the formal investigation.An online self-administered questionnaire was used to collect information.Wilcoxon Rank-Sum Test and Ordinal Logistic Regression were used for data analysis.Results: Firstly,by combing the results of food safety,mental health and sexual health,we concluded that the following messages were morepersuasively by using the gain-framed.In food safety area,including(1)knowledge of storing methods on cooked and raw food(knowledge)(P=0.05),(2)pay attention to food safety events(attitude)(P>0.05),(3)checking online food safety information(behavior)(P>0.05),and(4)washing your hands before handling food(behavior)(P>0.05).In mental health area,including(1)team learning(academic)(P<0.001),(2)listening to your friends(relationships)(P<0.001),(3)network communication(relationships)(P<0.001),(4)club activities(relationships)(P<0.001),(5)inferiority(self-rating)(P<0.001),(6)self-rating objectively(self-rating)(P<0.001),and(7)dependent character(job)(P>0.05).In sexual health area,including(1)condoms use may prevent accidental pregnancy(prevention)(P<0.05),and(2)premarital medical examination(detection)(P<0.001).Whilst,other messages are more convincing in terms of loss-framed,in food safety area,including:(1)knowledge of heating methods on leftovers(knowledge)(P<0.001),(2)knowledge of cleaning methods on pesticide residues in fruits and vegetables(knowledge)(P<0.05),(3)intention to change bad eating habits(attitude)(P<0.001),(4)frying eggs(behavior)(P<0.001),(5)reducing the number of dining out(behavior)(P<0.001),(6)checking sensory traits(behavior)(P<0.001),(7)checking food labels(behavior)(P<0.001),and(8)checking food nutrition labels(behavior)(P<0.05).In mental health area,including(1)anxiety(academic)(P<0.001),(2)arrogance(self-rating)(P>0.05),and(3)following the crowd blindly(job)(P<0.001),In sexual health area,including(1)condoms use may prevent infection STDs(prevention)(P<0.001),and(2)avoiding sex during menstruation(prevention)(P<0.001).Secondly,the study demonstrated that personal involvement would moderate the persuasiveness of message framing.In the field of food safety,including(1)to what degree are you concerned about your health condition(P<0.001),(2)did you encounter food safety incident(P<0.05),and(3)how often did you shop food online(P<0.05),would affect the persuasion of message framing.In the field of mental health,regarding(1)gender(P<0.05),(2)how do you feel about the relationships between you and your roommates(P<0.05),and(3)to what degree are you concerned about your health condition(P<0.001),would affect the persuasion of message framing.(3)In the field of sexual health,including(1)gender(P<0.05),(2)grade(P<0.05),(3)residence(P<0.05)and(4)to what degree are you concerned about your health condition(P<0.001),would affect the persuasion of message framing.Conclusion: Based on the analysis of students’ health message selection preferences,the study depicted the selection preferences of medical students on the health message framing of three topics,and found that personal involvement moderate the persuasiveness of message framing under different health topics.In the present study,the results showed thatfor most food safety framed messages,loss-framed demonstrated more convincing.For mental health message,especially interpersonal relationship dimension,the persuasiveness of gain-framed is better than that of loss-framed.For sexual health message,premarital medical examination was advocated,gain-framed message was exhibited more persuasiveness than loss-framed.While,when condom use was advocated,female and male showed different message selection preferences.Hence,we proposed that the performance of framing effect cannot be classified strictly according to the type of health education.Because that even under the unified theme,the message framing effect has different persuasiveness.Using a matched health message framing is an effective strategy for building education and public health campaigns.This study portrayed the selection preference of message framing on health education among medical university students.Public health advocates and professionals can use message framing as a strategy to enhance intervention efficacy in the process of university student’s health education. |
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