Effects of Character Accent on Perceived Similarity, Transportation, and Narrative Persuasion.

Guided by narrative transportation theory and the social identity approach, this study examined the effects of character accent on perceived similarity, transportation, and narrative persuasion. Cigarette smokers from Kentucky (N = 492) listened to a first-person narrative about smoking-induced lung cancer. The character spoke either with a Southern American English (SAE; ingroup) or a General American English (GAE; outgroup) accent. Opposite to predictions, the GAE-accented character was perceived as more similar overall, engendered greater transportation, elevated lung cancer risk perceptions, and promoted higher intentions to quit smoking than the SAE-accented character. Consistent with predictions, the effects of character accent on risk perceptions and intentions to quit were mediated by perceived similarity and transportation. Taken together, these findings indicate that narrative character accent is a potent cue to similarity judgments, but that actual linguistic similarity is not isomorphic with perceived overall similarity. Theoretical and practical implications for narrative persuasion are discussed.

Promoting Oral Health in Appalachia: Effects of Threat Label and Source Accent on Message Acceptance.

This study examined the effects of threat label (i.e., the name assigned to a health threat) and source accent (i.e., the source's manner of pronunciation) on Appalachian residents' acceptance of oral health promotion messages. Participants (N = 348) listened to an audiotaped oral health promotion message about tooth decay or Mountain Dew Mouth; the message was delivered either in a standard American English or a Southern accent. Compared to the label Mountain Dew Mouth, the label tooth decay elevated perceptions of threat susceptibility, threat severity, and response-efficacy and resulted in higher message acceptance. The effect of threat label on message acceptance was mediated by severity perceptions. Participants attributed more status to the source and agreed more with her message when she spoke in a standard than a Southern accent. The effect of source accent on message acceptance was mediated by status perceptions. These findings suggest that the success of persuasive health messages depends not only on message content (i.e., what is said), but also on how that content is linguistically framed and delivered (i.e., how it is said).

Bacteria as bullies: effects of linguistic agency assignment in health message.

When describing health threats, communicators can assign agency to the threat (e.g., "Hepatitis C has infected 4 million Americans") or to humans (e.g., "Four million Americans have contracted hepatitis C"). In an online experiment, the authors explored how assignment of agency affects perceptions of susceptibility and severity of a health threat, response efficacy, self-efficacy, fear arousal, and intentions to adopt health-protective recommendations. Participants were 719 individuals recruited through Mechanical Turk ( www.mturk.com ), a crowdsource labor market run by Amazon ( www.amazon.com ). The participants were assigned randomly to read 1 of 8 flyers defined by a 2×4 (Agency Assignment×Topic) factorial design. Each flyer examined 1 health threat (E. coli, necrotizing fasciitis, salmonella, or Carbapenem-resistant Klebsiella pneumoniae) and was written in language that emphasized bacterial or human agency. Perceived susceptibility and severity were highest when bacterial agency language was used. Response efficacy, self-efficacy, and fear arousal were not significantly affected by agency assignment. Participants reported stronger intentions to adopt recommendations when bacteria agency language was used, but this effect did not reach conventional standards of significance (p < .051). The authors concluded that health communicators can increase target audiences' perceptions of susceptibility and severity by assigning agency to the threat in question when devising health messages.

Vicious viruses and vigilant vaccines: effects of linguistic agency assignment in health policy advocacy.

Studying the effect of a fictitious policy editorial advocating mandatory vaccination of youth against human papillomavirus (HPV), the authors hypothesized that linguistic assignment of agency to HPV (e.g., "HPV preys on millions of people") would increase perceptions of its severity, relative to a comparable message that assigned agency to humans (e.g., "Millions of people contract HPV"). In addition, the authors predicted that HPV vaccines would be perceived as more effective when agency was assigned to vaccination (e.g., "Vaccination guards people") rather than to humans (e.g., "People guard themselves through vaccination"). University students (N = 361) were randomly assigned to read one of four versions of the editorial defined by a 2 ×2 (Threat Agency × Immunization Agency) factorial design and thereafter completed a questionnaire. When agency was assigned to the virus or the vaccine, HPV was perceived as a more severe threat, vaccination was perceived as more effective, and people were more in favor of mandatory HPV vaccination. The authors concluded that linguistic agency assignment bestows potency to the agent, thereby making threats more alarming and medical interventions seem more effective.

Physician communication regarding prostate cancer screening: analysis of unannounced standardized patient visits.

PURPOSE: Prostate cancer screening with prostate-specific antigen (PSA) is a controversial issue. The present study aimed to explore physician behaviors during an unannounced standardized patient encounter that was part of a randomized controlled trial to educate physicians using a prostate cancer screening, interactive, Web-based module. METHODS: Participants included 118 internal medicine and family medicine physicians from 5 health systems in California, in 2007-2008. Control physicians received usual education about prostate cancer screening (brochures from the Center for Disease Control and Prevention). Intervention physicians participated in the prostate cancer screening module. Within 3 months, all physicians saw unannounced standardized patients who prompted prostate cancer screening discussions in clinic. The encounter was audio-recorded, and the recordings were transcribed. Authors analyzed physician behaviors around screening: (1) engagement after prompting, (2) degree of shared decision making, and (3) final recommendations for prostate cancer screening. RESULTS: After prompting, 90% of physicians discussed prostate cancer screening. In comparison with control physicians, intervention physicians showed somewhat more shared decision making behaviors (intervention 14 items vs control 11 items, P <.05), were more likely to mention no screening as an option (intervention 63% vs control 26%, P <.05), to encourage patients to consider different screening options (intervention 62% vs control 39%, P <.05) and seeking input from others (intervention 25% vs control 7%, P<.05). CONCLUSIONS: A brief Web-based interactive educational intervention can improve shared decision making, neutrality in recommendation, and reduce PSA test ordering. Engaging patients in discussion of the uses and limitations of tests with uncertain value can decrease utilization of the tests.