Frontiers in Public Health (Oct 2015)
Designing Gain- and Loss-Framed Messages to Increase Physical Activity among University Students Living in two Different Cultures
Abstract
BACKGROUND Widespread evidence indicates that physical activity has positive effects on physical health in long-run. Therefore, adopting exercising habits at early ages is essential for reducing risk of developing chronic diseases. As a result, prevention studies frequently focus on informing young people about possible consequences of engaging or not engaging in physical activity to encourage them to develop a healthy lifestyle. Gain- and loss-framed health messages (Rothman & Salovey, 1997) have been frequently used to inform individuals on consequences of performing certain health behaviours or unhealthy habits, and to encourage people to change their unhealthy behaviours. However, designing persuasive health messages is regarded as a complex process requiring careful and evidence-based preparation. It is important that the message design process involves identifying the characteristics of the targeted audience and tailoring messages based on these characteristics. Culture is one of the main factors which can influence individuals' health-related values, beliefs, norms, and behaviours. Thus, cultural characteristics of recipients could potentially moderate health-related message framing effects. Although there are extensive information on applications of framed health messages in Western cultures, relatively few studies have been conducted in different cultures. Therefore, influence of framed physical activity messages need to be tested in different cultures to identify the determinants of behaviour change. AIMS The aim of the project is to design culturally-tailored, persuasive and effective physical activity messages for university students. To achieve this aim, a systematic review and preliminary studies are being conducted to gather information on physical activity habits, stress levels, life stressors, and barriers to and benefits of physical activity among undergraduate students living in the UK and Turkey. METHODS Step 1: Systematic review of the literature The systematic review sought to answer what the impact of message framing on intentions and attitudes towards physical activity among university students is. Relevant literature search was conducted through using PsycINFO, PsycARTICLES, PubMed/MEDLINE, ERIC, and EMBASE databases up to October 2014, and screening references of related articles. Step 2: Pilot testing of messages The gain- and loss-framed physical activity messages were designed based on the Extended Parallel Process Model (Witte, Meyer & Martell., 2001), and tested in terms of message quality, manipulation check, and their effects on intentions and attitudes towards physical activity among university students in the University of St Andrews. Participants were also allowed to give written feedbacks on the messages. Step 3: Focus group discussions A focus group discussion was held with university students in Turkey. The participants were asked for sharing their thoughts on how they conceptualize and experience stress both physically and emotionally, effects of engaging in physical activity and its role in stress management, barriers to engaging in regular exercise, what type of messages can encourage them to be more physically active, and what makes a physical activity message more persuasive. The focus group discussion will be held with university students in the UK including same questions. Students’ own statements will be used in physical activity messages to increase message effectiveness. Step 4: Quantitative data collection To obtain more information on Turkish university students’ physical activity habits, perceived benefits of and barriers to physical activity, stress levels, and primary stress sources, an online cross-sectional study is being conducted among Turkish university students from five universities through using validated Turkish versions of the International Physical Activity Questionnaire-Short Form (Saglam et al., 2010), Perceived Stress Scale (10-item) (Eskin et al., 2013), Exercise Benefits/Barriers Scale (Ortabag et al., 2010), and Daily Stressors Survey for College Students (Seaward, 2014). RESULTS Step 1: Systematic review of the literature Of two hundred and four abstracts reviewed, only two studies met the inclusion criteria. Review of these studies demonstrated that gain-framed message emphasizing intrinsic outcomes and loss-framed message emphasizing extrinsic outcomes were more effective on changing attitudes toward physical activity of participants who were more likely to spend cognitive effort on processing messages. In addition, the main effect of message framing on intentions towards engaging in physical activity among university students in advantage of gain-framed messages. There were no differences between narrative and informative-style messages in terms of intentions towards physical activity. Step 2: Pilot testing of messages The forty-one students were participated to the study. There were no significant differences between the gain- and loss-framed messages in terms of message tone and personal relevance. Although the messages were found credible and easy to understand, participants’ feedbacks showed that messages were found didactic, authoritative and unengaging. The results of the study revealed a need for further investigation on university students’ level of knowledge on stress and physical activity, and factors influencing message persuasiveness. The findings also emphasized importance of allowing participants to give feedbacks on the messages during the piloting and manipulation check process. Step 3: Focus group discussions The six undergraduate students from Yildirim Beyazit University, Turkey were participated to the focus group discussion. Image of the physical activity was dominated by lacking of knowledge on its physical and mental effects. Participants’ suggested lacking of time, inadequate facilities, and financial problems as main barriers to physical activity. Self-report measurement showed that although physical activity was regarded as valuable and beneficial, it was also found unpleasant and unenjoyable. The UK study will be finalized by January 2016. Step 4: Quantitative data collection The study will be finalized by January 2016. CONCLUDING REMARKS The primary aim of this project is to gather information through using different methods and investigate the determinants of message persuasiveness in university students from the British and Turkish cultures in order to design effective physical activity messages leading intention, attitude and behaviour change. The results of the finalized studies showed the importance of using both qualitative and quantitative methods in message design process.
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