Framing Effects Moderates Acceptance And Dissemination Of Health-Promting Messages

Background Health is a national and livelihood issue,and many guidance documents have pointed out that it is urgent to improve the health literacy of the whole people.Health-promoting messages are the kind of information that emphasizes that positive results will be obtained after carrying out a healthy behavior or negative results will be obtained after taking an unhealthy behavior.The use of health-promotion messages is closely related to the improvement of public health knowledge,attitude,and behavior.The dissemination of health-promoting messages depends on the media.With the rapid development of information technology,healthpromoting messages have gradually changed from the traditional media communication paradigm to the new media communication paradigm.The audience has also changed from the role of passive acceptance of healthpromoting messages to the user of "receiving and integrating".In the traditional media communication paradigm,the audience’s acceptance of health message is particularly important.However,in the new media communication paradigm,how health-promoting messages can be widely disseminated in the complex network environment becomes particularly important.At the same time,health-promoting messages face some problems and challenges in both traditional and new media.Health-promoting messages are different from general information because it contains standardized,objective,and strictly written medical sentences.Acceptance of healthpromoting messages to many audiences is limited.Because the overall health information literacy of Chinese residents is low,many audiences believe that health message on the Internet is too complex and difficult to understand.The complex content nature of information hinders people’s willingness to interact in new media.As a classic stimulation strategy in the field of communication,framing effects has great potential in improving audience acceptance and information dissemination.In health message dissemination,what kind of message framework to use to help health-promoting messages dissemination still needs specific analysis.The use of appropriate frameworks may help audiences better receive health messages and help health-promoting messages spread widely.Objective This paper aims to explore whether the framing effects can improve the acceptance of health-promoting messages in the traditional media paradigm and the dissemination of health-promoting messages under the new media paradigm.At the same time,the influence of target characteristics,information scene,and information expression factors on the framing effects on health-promoting messages was analyzed.Methods Through literature review and expert group discussion,we selected three health themes with urgency,commonness,and attention:childhood obesity,smoking and tumour.Using message framing as the main variable and target characteristics factors,information scene factors and information expression factors as the moderating variables.The effects of framing effects on the acceptance and dissemination of healthpromoting messages were evaluated.In the traditional media communication paradigm,we used convenient sampling method to conduct a self-filled questionnaire survey on health messages related to childhood obesity among 592 caregivers in 8 kindergartens.A literature survey was conducted to investigate the role of framing effects in the themes of "smoking" and "tumour".In the new media communication paradigm,crawlers are used to obtain health messages in Weibo,supplemented by artificial classification and text analysis.The effects of framing effects on the acceptance and dissemination of health promotion information were investigated.Before the questionnaire survey was officially carried out,a preliminary experiment was conducted to measure the reliability and validity of the questionnaire.SPSS20.0 statistical software was used to conduct data analysis on the samples.Data analysis included descriptive statistical analysis,chi-square test and binary Logistic regression.Results Firstly,in the survey of childhood obesity health-promoting messages acceptance,the majority of caregivers found the gain-framed message most salient for acceptance in three scenes: dietary habits,physical activities and sleep factors.However,more than half of the caregivers(50.1%)found that the loss-framed message had the highest acceptability in dietary behavior.In the literature research of smoking health-promoting messages,Schneider et al.pointed out that the gainframed message is better than the lost-framed message,and many subsequent research results also support the universality of this conclusion.In the literature research of tumour health-promoting messages,Sataia clearly pointed out that the gain-framed can significantly improve the audience’s acceptance of health-promoting messages.Secondly,in the framing effects binary logistic model,the factors of target characteristics(gender,education background),information scene(specific theme)and information expression(using negative words and temporal framing)were statistically significant(P<0.05).Compared with the theme of dietary habits,the caregivers in the theme of sleep factors were more willing to accept the gain-framed message.When message is combined with present-oriented expression,the caregivers were more willing to accept the gain-framed message.Women,low educational background,dietary behavior theme and negative words in the messages would make the caregivers more willing to accept the loss-framed message.Thirdly,in the study of health-promoting messages dissemination,the use of gain-framed message in the three health themes of childhood obesity,smoking and tumour can significantly improve the dissemination of healthpromoting messages(P<0.05).Fourthly,we analyzed three different health messages themes and found that target characteristics and information scene factors have no effect on message dissemination.For childhood obesity health-promoting messages,information expression factors(the use of statistical expression)have a significant impact on the dissemination.The message accurately described by statistical numbers has a higher degree of dissemination(P<0.05).For smoking health-promoting messages,two kinds of information expression factors(the use of statistical expression and the use of videos)have an impact on the degree of message dissemination.The message accurately described by statistical numbers has higher degree of dissemination(P<0.05).The message with corresponding video has a higher degree of dissemination than that without video(P<0.05).For tumour health-promoting messages,information expression factors(the use of statistical expression)have a significant impact on the dissemination.The message accurately described by statistical numbers has a higher degree of dissemination(P<0.05).Conclusion The results of this study showed that the use of gainframed in health-promoting messages can maximize the acceptance and dissemination of health-promoting messages.Target characteristics can influence the acceptance of health-promoting framework messages,but it cannot influence the dissemination of health-promoting framework messages.This research showed that gender and knowledge level have a moderating effect on acceptance of framework messages.Information scene factors have a limited impact on acceptance of framework messages,but no impact on dissemination of framework messages.Only in the dietary behavior scene,the caregivers found the loss-framed message most salient for acceptance.Information expression factors have a significant impact on the acceptance and dissemination of framework messages.The use of negative words may weaken the effect of loss-framed on message acceptance.The gain-framed message and present-oriented message were most salient for stimulating the majority of caregivers to accept healthpromoting messages.The use of statistical expressions significantly improves the dissemination of health-promoting messages.Although adding videos to messages significantly improve the dissemination of messages only about smoking,we still contend that adding appropriate pictures and videos as much as possible when producing health-promoting messages is a good strategy.