Zhongguo quanke yixue (Jan 2023)
Effect of Message Framing on Stroke Pre-hospital Delay Behavior Intention in Residents
Abstract
Background Message framing (gain-framed message vs loss-framed message) plays a major role in health education, but its significance in public stroke education is still unclear. Objective To compare the impact of gain- and loss-framed messages about "Stroke 1-2-0" (a kind of stroke educational video) on residents' intention to delay seeking care in the situation of identifying pre-stroke symptoms. Methods From January to September 2021, the gain-framed message video and loss-frame message video based on "Stroke 1-2-0" were developed through three steps: script writing, video production, and video evaluation. Then during October to November 2021, 81 residents aged 35-80 selected by convenience sampling from Guangzhou, Guangdong Province were randomized into a gain-framed message video intervention group (n=40) and a loss-framed message video intervention group (n=41) , to watch the gain-framed message video and loss-framed message video, respectively. The impact of the intervention was appraised by comparing pre- and post-intervention status of correct recognition and management of pre-stroke symptoms assessed using a self-developed Pre-stroke Symptom Recognition and Management Questionnaire, and pre- and post-intervention total score and domains scores of the Stroke Pre-hospital Delay Behavior Intention (SPDBI) scale. Results A total of 75 cases (37 in the gain-framed message video intervention group and 38 in the loss-framed message video intervention group) who completed the study were finally included. Two groups had no significant differences in pre-intervention rates of correct recognition and management of pre-stroke symptoms (P>0.05) . There were no significant intergroup differences in mean pre-intervention total score and each domain score of the SPDBI scale (P>0.05) . After intervention, significantly increased rates of correct recognition and management of various pre-stroke symptoms, and significantly lowered mean total score and domain scores (except the non-treatment justification) of the SPDBI scale were found in the gain-framed message video intervention group (P<0.05) . In the loss-framed message video intervention group, the correct recognition rate of various pre-stroke symptoms significantly improved (P<0.05) , and the rate of correct management of pre-stroke symptoms (except the deviated mouth) was also notably improved (P<0.05) . Moreover, the total score and each domain score of the SPDBI scale were lowered notably (P<0.05) . Post-intervention intergroup comparison demonstrated that the loss-framed message video intervention group had lower mean total score of the SPDBI scale and lower mean scores of three domains (non-treatment justification, symptom attributions, habitual response style) of the scale (P<0.05) . Conclusion The loss-framed message had stronger persuasive impact on reducing residents' intention to delay accessing of care when pre-stroke symptoms occurred. Thus, the loss-framed message can be used as an expression form of health education on pre-hospital delay in stroke, focusing on the relationship between pre-stroke symptoms and the time of triggering an emergency call on the phone, and highlighting the importance and urgency of seeking medical treatment quickly.
Keywords
