The moderating role of objective and subjective numeracy in attribute framing.

Previous research has found that objective numeracy moderates framing effects: People who are less numerate were found to be more susceptible to goal-framing and attribute-framing effects than people who are highly numerate. This study examined the possibility that subjective numeracy likewise moderates attribute framing in contexts where participants are presented with percentages of success or failure. The results show that compared with highly numerate participants, less numerate participants were more susceptible to the effect of attribute framing. Interestingly, this moderating effect was revealed only when using objective numeracy measures, and not when subjective numeracy measures were used. Future research is suggested to replicate these findings, to establish the generalizability of numeracy as a moderator of other cognitive biases, and to examine several possible theoretical explanations for the differential moderation of attribute-framing bias.

Assessing the longevity of attribute framing in attenuating the nocebo effect to brand and generic medication.

The perception of taking a generic, relative to brand, medication has been demonstrated to exacerbate the nocebo effect. Conversely, positive attribute framing has been shown to attenuate the nocebo effect. However, little is known about the longevity of positive attribute framing nor how it interacts with generic versus brand treatment cues. Healthy participants (N = 205) were randomised to receive either sham-modafinil capsules with a brand or generic appearance, in conjunction with standard negative side effect framing (brand-negative: N = 42; generic-negative: N = 41) or positive side effect framing (brand-positive: N = 40; generic-positive: N = 40). The remainder were randomised to a no-treatment control (N = 42). Participants were informed that modafinil could enhance alertness and cognitive performance and reduce fatigue. Critically, modafinil was described as having several potential side effects. Treatment-related side effects, alertness, fatigue and cognitive performance were measured at baseline, 30-min post-treatment and 24 h later. Nocebo and placebo effects were observed across modafinil-treated participants relative to control. Positive framing significantly reduced warned side effects for 24 h. Perceived side effect likelihood, severity, and worry mediated the nocebo, but not framing, effect. Results have important implications for the presentation of side effect information, providing a potential route to reduce unwanted negative effects of generic medication.

The impact of side effect framing on COVID-19 booster vaccine intentions in an Australian sample.

OBJECTIVE: To evaluate the effect of presenting positively attribute-framed side effect information on COVID-19 booster vaccine intention relative to standard negatively-framed wording and a no-intervention control. DESIGN AND PARTICIPANTS: A representative sample of Australian adults (N = 1204) were randomised to one of six conditions within a factorial design: Framing (Positive; Negative; Control) × Vaccine (Familiar (Pfizer); Unfamiliar (Moderna)). INTERVENTION: Negative Framing involved presenting the likelihood of experiencing side effects (e.g., heart inflammation is very rare, 1 in every 80,000 will be affected), whereas Positive Framing involved presenting the same information but as the likelihood of not experiencing side effects (e.g., 79,999 in every 80,000 will not be affected). PRIMARY OUTCOME: Booster vaccine intention measured pre- and post-intervention. RESULTS: Participants were more familiar with the Pfizer vaccine (t(1203) = 28.63, p <.001, Cohen's dz = 0.83). Positive Framing (M = 75.7, SE = 0.9, 95% CI = [73.9, 77.4]) increased vaccine intention relative to Negative Framing (M = 70.7, SE = 0.9, 95% CI = [68.9, 72.4]) overall (F(1, 1192) = 4.68, p =.031, ηp2 = 0.004). Framing interacted with Vaccine and Baseline Intention (F(2, 1192) = 6.18, p =.002, ηp2 = 0.01). Positive Framing was superior, or at least equal, to Negative Framing and Control at increasing Booster Intention, irrespective of participants' pre-intervention level of intent and vaccine type. Side effect worry and perceived severity mediated the effect of Positive vs. Negative Framing across vaccines. CONCLUSION: Positive framing of side effect information appears superior for increasing vaccine intent relative to the standard negative wording currently used. PRE-REGISTRATION: See: aspredicted.org/LDX_2ZL.

Positive Attribute Framing Increases COVID-19 Booster Vaccine Intention for Unfamiliar Vaccines.

Positive framing has been proposed as an intervention to increase COVID-19 vaccination intentions. However, available research has examined fictitious or unfamiliar treatments. This pre-registered study (aspredicted#78369) compared the effect of standard negatively framed EU patient information leaflets (PILs), with new positively framed PILs, on booster intentions (measured pre- and post-intervention) for AstraZeneca, Pfizer, and Moderna COVID-19 vaccines. A representative sample of 1222 UK-based adults was randomised to one of six groups in a factorial design with framing (Positive vs. Negative) and vaccine familiarity (same (as previous), familiar, unfamiliar) as factors. The benefit of positive framing was hypothesised to be strongest for the least familiar vaccine (Moderna). Framing was moderated by familiarity, where only the unfamiliar vaccine showed a benefit of positive relative to negative Framing. Framing and familiarity also interacted with baseline Intention with the effect of framing on the unfamiliar vaccine especially pronounced at low baseline Intent. Conversely, standard negative framing appeared to increase intentions for familiar vaccines at low baseline intent. Findings provide important evidence that positive framing could improve vaccine uptake globally when switches or new developments require individuals to receive less familiar vaccines. Positive framing of familiar vaccines, however, should be treated with caution until better understood.

The Framing Preference for Large and Increasing Components in Static and Dynamic Descriptions.

Describing sets in terms of a two-valued variable, either value can be chosen: exam results may be referred to by pass rates or fail rates. What determines such framing choices? Building on work by McKenzie and colleagues on reference points in the production and interpretation of framed information, we investigate two determinants of frame choice. One is that speakers tend to focus on the component that has increased vis-à-vis a previous state, the other is the tendency to choose the component larger than 50%. We propose to view reference points as pointing to different kinds of communicative relevance. Hence the use of the previous state and the 50% reference points by speakers is not just a function of the information, but is co-determined by a communicative cue in the context: the question being asked about this information. This line of thought is supported by two experiments containing items offering two-sided distribution information at two points in time. Our first experiment employs a static task, requiring a description of the most recent situation. The second experiment uses a dynamic task, asking participants to describe the development between the two time points. We hypothesize that in static tasks the component size is the strongest frame choice determinant, while in dynamic tasks frame choice is mainly driven by whether a component has increased. The experiments consist of 16 different scenarios, both with symmetrical contrasts (i.e., dogs vs. cats) and with asymmetrical ones (i.e., winning vs. losing). Both experiments support the hypotheses. In the static task, the size effect is the only consistent effect; in the dynamic task, the effect of direction of change is much larger than that of size. This pattern of differences between size and change effects applies across symmetrical and asymmetrical contrasts. Our experiments shed light on cognitive and communicative regularities involved in the production of framed messages: people do tend to prefer larger and increasing components when choosing a frame, but the relative strength of both these preferences depends on the communicative task.

Cultural Variability in the Attribute Framing Effect.

An intriguing phenomenon that arises from decision making is that the decision maker's choice is often influenced by whether the option is presented in a positive or negative frame, even though the options are, de facto, identical to one another. Yet, the impact of such differential framing of equivalent information, referred to as the attribute framing effect, may not be the same for every culture; rather, some cultures may be more readily influenced by the differentially valenced frames than others (i.e., showing a greater difference in evaluation in a positive vs. negative frame). The present study investigates to what extent and why cultures may differ in their sensitivity to the attribute framing effect. Participants were recruited from South Korea and the United States, cultures characterized by their focus on prevention and promotion, respectively, to test for the cultural variability in the attribute framing effect. The results revealed that Korean participants were markedly more influenced by the valence of the frame than North American participants. Regulatory focus explained why Koreas showed a greater sensitivity toward the attribute framing effect than North Americans. Specifically, a greater prevention (vs. promotion) orientation of Korean participants led them to show a greater evaluation gap in the positive and negative frames. Implications for cultural significance on the attribute framing effect are discussed.

Focus to an attribute with verbal or numerical quantifiers affects the attribute framing effect.

People find positive attribute frames (e.g., 75% lean) more persuasive than negative ones (e.g., 25% fat). In three pre-registered experiments, we tested whether this effect would be magnified by using verbal quantifiers instead of numerical ones (e.g., 'high % lean' vs. '75% lean'). This moderating effect of quantifier format was predicted based on previous empirical work and two non-exclusive accounts of framing effects. First, verbal quantifiers are presumed to be a more intuitive format than numerical quantifiers, so might predispose people more to judgement biases such as the framing effect. Second, verbal quantifiers draw a greater focus to the attributes they describe. This could provide a linguistic signal that the positive frame is better than the negative one. In three experiments, we manipulated the attribute frame (positive or negative) and the quantifier format (verbal or numerical) between-subjects, and quantity pairs (e.g., 5% fat and 95% lean or 25% fat and 75% lean) within-subjects. We also tested if participants focused more on the attributes in the frame, by measuring whether participants selected causal sentence completions about the beef that focused on why it had fat meat or lean meat. Results showed a robust framing effect, which was partially mediated by the focus of the sentence completions. However, the verbal format did not increase the magnitude of the framing effect. These results suggest that a focus on the attribute contributes to the framing effect, but contrary to past work, this focus is not different between verbal and numerical quantifiers.

"Alive" or "not dead": The contribution of descriptors to attribute-framing bias.

Attribute-framing bias (AFB) refers to bias in evaluating positively framed objects more favourably than the same objects framed negatively. In most AFB studies, framing is manipulated by contrasting the positive and negative outcomes, using the corresponding positive (success) or negative (failure) labels as descriptors. This study examined the unique contributions of the outcomes of the scenario and the labels describing these outcomes by manipulating them orthogonally. In three experiments, framing scenarios were presented to participants with either positive outcomes rendered with positive (65% passed) or negative (65% didn't fail) descriptors, or negative outcomes rendered with positive (35% didn't pass) or negative (35% failed) descriptors. All experiments revealed a strong effect for the outcome with a weaker effect for the descriptor valence, suggesting that outcomes have a stronger influence on AFB than do descriptors. We discuss the results within a theoretical framework that maps the outcome effects onto attention mechanisms and descriptor effects onto association-activation mechanisms.

Can Positive Framing Reduce Nocebo Side Effects? Current Evidence and Recommendation for Future Research.

Although critical for informed consent, side effect warnings can contribute directly to poorer patient outcomes because they often induce negative expectations that trigger nocebo side effects. Communication strategies that reduce the development of nocebo side effects whilst maintaining informed consent are therefore of considerable interest. We reviewed theoretical and empirical evidence for the use of framing strategies to achieve this. Framing refers to the way in which information about the likelihood or significance of side effects is presented (e.g., negative frame: 30% will experience headache vs. positive frame: 70% will not experience headache), with the rationale that positively framing such information could diminish nocebo side effects. Relatively few empirical studies (k = 6) have tested whether framing strategies can reduce nocebo side effects. Of these, four used attribute framing and two message framing. All but one of the studies found a significant framing effect on at least one aspect of side effects (e.g., experience, attribution, threat), suggesting that framing is a promising strategy for reducing nocebo effects. However, our review also revealed some important open questions regarding these types of framing effects, including, the best method of communicating side effects (written, oral, pictorial), optimal statistical presentation (e.g., frequencies vs. percentages), whether framing affects perceived absolute risk of side effects, and what psychological mechanisms underlie framing effects. Future research that addresses these open questions will be vital for understanding the circumstances in which framing are most likely to be effective.

How consumers are affected by product descriptions in online shopping: Event-related potentials evidence of the attribute framing effect.

Due to the limitations of the human ability to process information, e-consumers' decisions are likely to be influenced by various cognitive biases, such as the attribute framing effect. This effect has been well studied by numerous scholars; however, the associated underlying neural mechanisms with a critical temporal resolution have not been revealed. Thus, this study applies the measurement of event-related potentials (ERPs) to directly examine the role of attribute framing in information processing and decision-making in online shopping. The behavioral results showed that participants demonstrated a higher purchase intention with a shorter reaction time under a positive framing condition compared to participants under a negative framing condition. Compared with positive framing messages, the results of ERPs indicated that negative framing messages attracted more attention resources at the early stage of rapid automatic processing (larger P2 amplitude) and resulted in greater cognitive conflict and decision difficulty (larger P2-N2 complex). Moreover, compared with negative messages, positive framing messages allowed consumers to perceive a better future performance of products and classify these products as a categorization of higher evaluation (larger LPP amplitude) at the late cognitive processing stage of evaluation. Based on these results, we provide evidence for a better understanding of how different attribute framing messages are processed and ultimately lead to the framing effect.

The asymmetrical force of persuasive knowledge across the positive-negative divide.

In two experimental studies we explore to what extent the general effects of positive and negative framing also apply to positive and negative persuasion. Our results reveal that negative persuasion induces substantially higher levels of skepticism and awareness of being subjected to a persuasion attempt. Furthermore, we demonstrate that in positive persuasion, more claims lead to stronger persuasion, while in negative persuasion, the numerosity of claims carries no significant effect. We interpret this finding along the lines of a satiety-model of persuasion. Finally, using diluted, or low strength claims in a persuasion attempt, we reveal a significant interaction between dispositional reactance and dilution of claims on persuasion knowledge. The interaction states that diluted claims increase the awareness of being subjected to a persuasion attempt, but only for those with a high dispositional level of reactance.

Effective or ineffective: attribute framing and the human papillomavirus (HPV) vaccine.

OBJECTIVE: To experimentally test whether presenting logically equivalent, but differently valenced effectiveness information (i.e. attribute framing) affects perceived effectiveness of the human papillomavirus (HPV) vaccine, vaccine-related intentions and policy opinions. METHODS: A survey-based experiment (N=334) was fielded in August and September 2007 as part of a larger ongoing web-enabled monthly survey, the Annenberg National Health Communication Survey. Participants were randomly assigned to read a short passage about the HPV vaccine that framed vaccine effectiveness information in one of five ways. Afterward, they rated the vaccine and related opinion questions. Main statistical methods included ANOVA and t-tests. RESULTS: On average, respondents exposed to positive framing (70% effective) rated the HPV vaccine as more effective and were more supportive of vaccine mandate policy than those exposed to the negative frame (30% ineffective) or the control frame. Mixed valence frames showed some evidence for order effects; phrasing that ended by emphasizing vaccine ineffectiveness showed similar vaccine ratings to the negative frame. CONCLUSION: The experiment finds that logically equivalent information about vaccine effectiveness not only influences perceived effectiveness, but can in some cases influence support for policies mandating vaccine use. PRACTICE IMPLICATIONS: These framing effects should be considered when designing messages.