Interactive Health Messages Work Better for Those Who Feel Less in Control: The Role of External Health Locus of Control and Risk Perception.

Interactive websites, which provide greater user control over a site's interface, are commonly employed in health communication campaigns to deliver risk information in more vivid and engaging ways. The present study explored whether interactive health websites could increase risk perception and encourage systematic processing (i.e. analytical review of persuasive arguments based on prior knowledge and experience) and information seeking and sharing intentions of anti-sugar consumption content. We further investigated whether the effect of interactivity could be moderated by individuals' beliefs in the role of external factors such as sheer luck in determining their health outcomes. A between-subjects design experiment compared a high interactive website (n = 94) to a low interactive website (n = 73). Results showed that interactivity increased risk perception regarding sugar consumption, especially for the individuals who reported a higher level of external health locus of control. Risk perception was a positive predictor of systematic processing, as well as information seeking and sharing intentions. Theoretical and practical implications of this study are discussed.

Interactivity Can Enhance the Effectiveness of Threat Appeals: Implications for Preventive Health Websites.

Interactive health websites where threat appeals are incorporated have become a popular strategy to engage users in preventive health behaviors. The current study examines how website interactivity enhances the effectiveness of threat appeals and thus encourages preventive health behaviors in the context of an anti-sugar campaign. A single factor design experiment (N = 109) with two conditions (high vs. low interactivity) was employed to investigate the effects of website interactivity on sugar control intentions. The results demonstrated that higher interactivity elicited greater fear and disgust, which then subsequently increased perceived threats of sugar intake. Perceived threats heightened by interactivity led to greater preventive behavioral intentions. Theoretical and practical implications are discussed.

Imagine That You Died. Would You Still Smoke?: How Death Reflection Affects Health Message Reception Through Personal Growth and Identification.

Terror management research has found that mortality salience increases self-esteem preservation, which tends to produce counter-persuasive effects in the health context. The present study examines the persuasive potentials of an alternative mortality prime, death reflection, in a between-subjects online experiment with current smokers (N = 92). We tested the effects of two death primes on their posttraumatic growth, identification with a story character, and quitting intentions after exposure to an anti-smoking PSA. The results showed that only death reflection significantly affected quitting intentions through two serial mediators. First, death reflection promoted a greater sense of posttraumatic growth than the control condition, whereas mortality salience did not. Second, the increased sense of growth enhanced identification with a testimonial character in the anti-smoking PSA, which, in turn, lowered quitting intentions. Implications for health communication are discussed.

Source Interactivity Enhances Sense of Community and Reduces Psychological Reactance: Effects of the Like Button on Smoking Message Evaluations and Attitudes.

This study investigates the psychological mechanism by which source interactivity influences health message evaluations. Combining health communication and interactivity literature, two theoretical routes to persuasion were proposed: enhanced sense of community and reduced psychological reactance. A 2 × 2 (source interactivity: absence vs. presence X smoking status: nonsmoker vs. current smoker) factorial-design experiment (N = 343) was conducted on an anti-smoking website. Result revealed that the endorsing and sharing features that resembled the Like button on Facebook enhanced self-as-source perceptions and sense of community, which exerted significant effects on message credibility for smokers and message enjoyment for nonsmokers. Among smokers, self-as-source perceptions reduced psychological reactance, which promoted greater message credibility and more negative attitudes toward smoking behavior.

How Interactive Data Visualization and Users' BMI (Body Mass Index) Influence Obesity Prevention Intentions: The Mediating Effect of Cognitive Absorption.

The current study examines how interactive data visualization can augment the persuasive potential of health information. In an experiment using an obesity-awareness website (N = 248), we manipulated the level of interactivity in a data visualization tool that featured obesity prevalence in the U.S. and measured participants' absorption into the website, perceived issue severity, content perceptions, and intentions to prevent/treat obesity. Our data demonstrated that lower BMI participants reported greater cognitive absorption when highly interactive data visualization was available on the website. Subsequently, greater cognitive absorption into the website led to higher perceived issue severity, greater content perceptions, and higher obesity prevention intentions among lower BMI participants but not among higher BMI participants.

What Happens When You Click and Drag: Unpacking the Relationship between On-Screen Interaction and User Engagement with an Anti-Smoking Website.

Interactive media provide a physically active experience for users to click, slide, mouseover, and zoom-in/out, but how this increased amount of on-screen interaction is associated with cognitive and attitudinal outcomes has remained unexplored. We tackled this issue by conducting an online study where we recorded the amount of on-screen interaction on a targeted interactive feature, sliders, and correlated it with user engagement, attitudes toward anti-smoking messages, and smoking outcome beliefs, while controlling their baseline smoking outcome beliefs (N = 149). We found that the number of clicks and drags on sliders was positively associated with their attitudes toward anti-smoking messages and smoking outcome belief, but only among nonsmokers who are power users of technology. An increase in perceptual bandwidth influenced by interacting with the slider was significantly correlated with greater user engagement among these users. In contrast, for smokers who are not power users, greater on-screen interaction showed a negative correlation with their user engagement mediated by an increase in defensive processing.

Can Liking, Commenting, and Sharing Enhance Persuasion? The Interaction Effect between Modality Interactivity and Agency Affordances on Smokers' Quitting Intentions.

This article examines whether the persuasive potential of modality interactivity on anti-smoking websites can be harnessed by adding agency affordances, such as the like, comment, and share features. Using a 2 × 2 factorial experiment with a current smoker sample (N = 154), we investigated the interaction effects between modality interactivity (low vs. high) and agency affordances (absence vs. presence) on persuasion outcomes. The results showed that the effects of modality interactivity on telepresence, systematic processing, and change in quitting intentions varied depending on the existence of agency affordances on the website. Agency affordances on the anti-smoking website led to a greater sense of agency and systematic processing on the website content. Only in the presence of agency affordances did modality interactivity enhance the feeling of telepresence, which led to greater quitting intentions than in the control condition. Without agency affordances, modality interactivity diminished systematic processing, leading to lower quitting intentions.

Correction: Predictors of Playing Augmented Reality Mobile Games While Walking Based on the Theory of Planned Behavior: Web-Based Survey.

[This corrects the article DOI: 10.2196/mhealth.8470.].

Staying-at-Home with Tragedy: Self-expansion Through Narratives Promotes Positive Coping with Identity Threat.

The COVID-19 pandemic created a historic opportunity to study the link between identity threat and individuals' temporary expansion of the boundaries of the self (TEBOTS) through stories. Concurrently, the relationship between eudaimonic entertainment processes and self-expansion, particularly feeling moved and self-awareness, was examined. A quasi-experiment was conducted with an online sample (N = 172) that was randomly assigned to watch either a tragic drama or comedy. Results showed that key TEBOTS predictions were largely confirmed for boundary expansion and the outcomes of narrative engagement and entertainment gratifications. Although identity threat was negatively associated with positive coping with the pandemic, this relationship turned positive when mediated by boundary expansion. Further, exposure to tragedy raised feelings of "being moved," which, in turn, was linked to self-perceptual depth and expanded boundaries of the self downstream. The present findings suggest that self-expansion through story consumption could benefit viewers' positive reframing of challenging life experiences.

Nonpharmacologic Pain Management Among Hospitalized Inpatients: A Randomized Waitlist-Controlled Trial of Standard Virtual Reality (CGI VR) Versus Video Capture VR (360 degrees 3D/Stereoscopic Video Capture VR).

OBJECTIVES: Nonpharmacologic pain management strategies are needed because of the growing opioid epidemic. While studies have examined the efficacy of virtual reality (VR) for pain reduction, there is little research in adult inpatient settings, and no studies comparing the relative efficacy of standard animated computer-generated imagery (CGI) VR to Video Capture VR (360 degrees 3D/stereoscopic Video Capture VR). Here, we report on a randomized controlled trial of the relative efficacy of standard CGI VR versus Video Capture VR (matched for content) and also compared the overall efficacy of VR to a waitlist control group. MATERIALS AND METHODS: Participants (N=103 hospitalized inpatients reporting pain) were randomized to 1 of 3 conditions: (1) waitlist control, (2) CGI VR, or (3) Video Capture VR. The VR and waitlist conditions were 10 minutes in length. Outcomes were assessed pretreatment, post-treatment, and after a brief follow-up. RESULTS: Consistent with hypotheses, both VR conditions reduced pain significantly more relative to the waitlist control condition (d=1.60, P<0.001) and pain reductions were largely maintained at the brief follow-up assessment. Both VR conditions reduced pain by ∼50% and led to improvements in mood, anxiety, and relaxation. Contrary to prediction, the Video Capture VR condition was not significantly more effective at reducing pain relative to the CGI VR condition (d=0.25, P=0.216). However, as expected, patients randomized to the Video Capture VR rated their experience as more positive and realistic (d=0.78, P=0.002). DISCUSSION: Video Capture VR was as effective as CGI VR for pain reduction and was rated as more realistic.

Building a health communication brand for University of Texas System tobacco control.

Objective: Despite declining cigarette smoking rates in the US, there is a continued need for tobacco prevention education campaigns to reach young adults. Recognizing the need for improved tobacco control messaging, the University of Texas (UT) System engaged The University of Texas at Austin Center for Health Communication to develop a brand and message that would strengthen tobacco control efforts at its 14 institutions. Methods: This article describes the iterative process involved in creating a brand for tobacco control, including an environmental scan, identifying potential message themes, and creating and refining logos. Results: This article highlights the process of developing a system-wide tobacco control brand. Specifically, the process included coordinating an interdisciplinary team with content and design experts, and presenting ideas to stakeholders for serial feedback and refinement, among others. Conclusions: Ultimately, this project offers a model for other systems of higher education interested in pursuing similar initiatives.

Predictors of Playing Augmented Reality Mobile Games While Walking Based on the Theory of Planned Behavior: Web-Based Survey.

BACKGROUND: There has been a sharp increase in the number of pedestrians injured while using a mobile phone, but little research has been conducted to explain how and why people use mobile devices while walking. Therefore, we conducted a survey study to explicate the motivations of mobile phone use while walking. OBJECTIVE: The purpose of this study was to identify the critical predictors of behavioral intention to play a popular mobile game, Pokemon Go, while walking, based on the theory of planned behavior (TPB). In addition to the three components of TPB, automaticity, immersion, and enjoyment were added to the model. This study is a theory-based investigation that explores the underlying mechanisms of mobile phone use while walking focusing on a mobile game behavior. METHODS: Participants were recruited from a university (study 1; N=262) and Amazon Mechanical Turk (MTurk) (study 2; N=197) in the United States. Participants completed a Web-based questionnaire, which included measures of attitude, subjective norms, perceived behavioral control (PBC), automaticity, immersion, and enjoyment. Participants also answered questions regarding demographic items. RESULTS: Hierarchical regression analyses were conducted to examine hypotheses. The model we tested explained about 41% (study 1) and 63% (study 2) of people's intention to play Pokemon Go while walking. The following 3 TPB variables were significant predictors of intention to play Pokemon Go while walking in study 1 and study 2: attitude (P<.001), subjective norms (P<.001), and PBC (P=.007 in study 1; P<.001 in study 2). Automaticity tendency (P<.001), immersion (P=.02), and enjoyment (P=.04) were significant predictors in study 1, whereas enjoyment was the only significant predictor in study 2 (P=.01). CONCLUSIONS: Findings from this study demonstrated the utility of TPB in predicting a new behavioral domain-mobile use while walking. To sum up, younger users who are habitual, impulsive, and less immersed players are more likely to intend to play a mobile game while walking.