Scientific-Consensus Communication About Contested Science: A Preregistered Meta-Analysis.

Scientific-consensus communication is among the most promising interventions to minimize the gap between experts' and the public's belief in scientific facts. There is, however, discussion about its effectiveness in changing consensus perceptions and beliefs about contested science topics. This preregistered meta-analysis assessed the effects of communicating the existence of scientific consensus on perceived scientific consensus and belief in scientific facts. Combining 43 experiments about climate change, genetically modified food, and vaccination, we found that a single exposure to consensus messaging had a positive effect on perceived scientific consensus (g = 0.55) and on belief in scientific facts (g = 0.12). Consensus communication yielded very similar effects for climate change and genetically modified food, whereas the low number of experiments about vaccination prevented conclusions regarding this topic. Although these effects are small, communicating scientific consensus appears to be an effective way to change factual beliefs about contested science topics.

A Health Game Targeting Children's Implicit Attitudes and Snack Choices.

Objective: The present study investigated whether a health game can be used to affect children's implicit attitudes toward food (IAsTF) and subsequent snack choices. Materials and Methods: The health game used was based on an evaluative conditioning paradigm. The experiment followed a between-subjects design with two conditions (health game vs. control), N = 79 (12.42 years ±1.64, body mass index: 25.06 ± 7.40). IAsTF were assessed at baseline and postintervention using an implicit association test (IAT). Baseline IAT scores were used to categorize IAsTF as healthy (favoring fruits) versus unhealthy IAsTF (favoring chocolates). In addition, three digital snack choices were recorded. Results: No main effect of condition on posttest IAsTF was found. However, baseline IAsTF moderated the effect of condition on posttest IAsTF; participants with less healthy baseline IAsTF playing the health game had healthier posttest IAsTF compared to those playing the control game. Regarding the snack choices, participants playing the health game favored fruit over chocolate in one of the snack choices. Baseline IAsTF did not moderate the effect of condition on snack choices. Conclusion: Tentative support was found that health games can be used to improve IAsTF, in particular among participants with less healthy ones at baseline.

The persuasive effect of advergames promoting unhealthy foods among children: A meta-analysis.

Multiple studies have examined the effects of advergames promoting unhealthy foods on eating behavior among children. Although the individual results of the existing studies suggest that advergames have a significant influence on (predictors of) eating behavior, a lack of clarity concerning the size of the effect may impede policy actions. Therefore, a meta-analysis was conducted to examine the strength of the effect of playing advergames that promote unhealthy foods on (predictors of) eating behavior among children. Five electronic databases were searched for relevant publications (Web of Science, PsychInfo, Pubmed, JSTOR, and SCOPUS). Fifteen articles were considered eligible for inclusion and analyzed in the meta-analysis. Employing a random-effects model to estimate the composite effect of advergames yielded a small-to-moderate and significant effect of g = 0.30. Results showed that advergames promoting unhealthy foods induced unhealthy eating behavior among children. Although only a limited number of studies were included, this meta-analysis supports public health policy action that seeks to reduce children's exposure to unhealthy digital food marketing. Stricter regulation to protect children against new forms of (online) marketing techniques that promote unhealthy foods should be developed and implemented.

Investigating the impact of a health game on implicit attitudes towards food and food choice behaviour of young adults.

Improving diets by stimulating fruit and vegetable consumption might be beneficial, in particular when they substitute energy-dense products. The aim of present study was to investigate whether a health game can be used to positively affect healthy implicit attitudes (IAs) towards food and subsequent food choice behaviour of young adults. A 2 (Time: baseline vs. post-test) x 2 (Condition: health game vs. control game) x 2 (Baseline IAs: healthy IAs vs. less healthy IAs) mixed-subjects design was used with 125 participants (age: M = 20.17, SD = 1.88). IAs towards food were assessed at baseline and post-test using an Implicit Association Test (IAT). Additionally, food choice behaviour was assessed after game play. At baseline, the majority of participants had healthy IAs (i.e., favouring fruit over chocolate snacks). At post-test, significantly less healthy IAs were observed in the control condition, while this reduction was not significant in the health game condition. Regarding food choice behaviour, participants with healthy baseline IAs were more likely to select fruit in the health game condition than participants with healthy baseline IAs in the control game condition. However, participants with less healthy baseline IAs were less likely to select fruit in the health game condition than in the control condition. We found tentative support that health games can be used to influence IAs towards food and positively affect food choice behaviour. However, this influence was only observed for those with healthy baseline IAs. The current version of the health game would primarily benefit those already healthy and could negatively affect those that need the intervention most, so modifications are recommendable.

Fret not thyself: The persuasive effect of anger expression and the role of perceived appropriateness.

Anger expression is increasingly prevalent in Western mass media, particularly in messages that aim to persuade the audience of a certain point of view. There is a dearth of research, however, investigating whether expressing anger in mediated messages is indeed effective as a persuasive strategy. In the present research, the results of four experiments showed that expressing anger in a persuasive message was perceived as less socially appropriate than expressing non-emotional disagreement. There was also evidence that perceived appropriateness mediated a negative persuasive effect of anger expression (Study 2-4) and that anger expression resulted in perceptions of the persuasive source as unfriendly and incompetent (Studies 1 and 2). In all, the findings suggest that politicians and other public figures should be cautious in using anger as a persuasive instrument.

User Statistics for an Online Health Game Targeted at Children.

OBJECTIVE: Given that many households in western countries nowadays have home access to the Internet, developing health-promoting online interventions has the potential to reach large audiences. Studies assessing usage data of online health interventions are important and relevant but, as of yet, scarce. The present study reviewed usage data from Monkey Do, an existing online health game developed specifically for children from 4 to 8 years old. In addition, the effect of advertising on usage was examined. MATERIALS AND METHODS: In an observational study, a web-based analysis program was used to examine usage data of all visits to the online health game for the first 31 months following the launch. We reported descriptives for usage data. We analyzed the relationship between advertising and usage with a Mann-Whitney U test, and used a Pearson's chi-square test to investigate the association between advertising and the number of first-time visitors. RESULTS: In the period of data analysis, there were 224,859 sessions. Around 34% of the visitors played the game more than once. Compared with first-time visitors, the average session time of returning visitors was doubled. The game was most frequently accessed via search engine query, on a desktop computer (compared to mobile devices). Advertising was found to be positively related to the number of sessions and the number of first-time visitors. CONCLUSIONS: Placing a game online can reach a large audience, but it is important to also consider how to stimulate retention. Furthermore, repeated advertisement for an online game appears to be necessary to maintain visitors over time.

Does perceived risk influence the effects of message framing? Revisiting the link between prospect theory and message framing.

Health-promoting messages can be framed in terms of the beneficial consequences of healthy behaviour (gain-framed messages) or the detrimental consequences of unhealthy behaviour (loss-framed messages). An influential notion holds that the perceived risk associated with the recommended behaviour determines the relative persuasiveness of gain- and loss-framed messages. This 'risk-framing hypothesis', which was derived from prospect theory, has been central to health message-framing research for the better part of two decades and has enduring appeal to researchers and practitioners. It has found its way into several health communication handbooks and is communicated to the general public. The present article examines the validity of the risk-framing hypothesis anew by providing a review of the health message-framing literature. In spite of its ongoing appeal, we conclude that the hypothesis has severe theoretical flaws. In addition, we find that the empirical evidence in favour of the hypothesis is weak and inconsistent. It seems that, in applying prospect theory's tenets to a health-promotion context, some of the theory's key aspects have been lost in translation. At the close of the article, we offer a research agenda for the future, arguing that, above all, new methodology is needed to bring the message-framing literature further.

Testing the effects of a message framing intervention on intentions towards hearing loss prevention in adolescents.

Adolescent hearing loss is a public health problem that has eluded effective intervention. A persuasive message strategy was tested for its effectiveness on adolescents' intention to listen to music at a reduced volume. The messages manipulated both type of message frame [positive consequences of listening to music at a reduced volume (gain-framed) versus negative consequences of not listening to music at a reduced volume (loss-framed)] and type of temporal context (short-term versus long-term consequences). Participants were recruited from four vocational and secondary education schools in the Netherlands and message exposure took place online during class hours. Two weeks prior to message exposure, adolescents provided data on intention and risk perception towards hearing loss and use of (digital) music players. After message exposure, 194 adolescents (mean age = 14.71 years, SD = 1.00, 37.8% males) provided immediate follow-up data on intention. Results revealed that intention to listen to music at a reduced volume increased in those exposed to a loss-framed message with short-term consequences. No changes were found in the other conditions. Messages that emphasize negative short-term consequences of not listening to music at a moderate volume have the ability to influence adolescents' intention towards hearing loss prevention.

Enjoyment: A Conceptual Exploration and Overview of Experimental Evidence in the Context of Games for Health.

Enjoyment is consistently noted as important for engaging audiences in games for health. However, as a term, enjoyment is often used interchangeably with a host of other terms, some of which overlap conceptually. This obscures what does and what does not constitute enjoyment, and in turn slows scientific progress by making the study of enjoyment and the synthesis of enjoyment-related research difficult. This article is aimed at improving our understanding of enjoyment by distinguishing enjoyment from other important constructs, such as fun and engagement, and by providing an overview of the experimental evidence on the determinants of enjoyment in videogames. Competence, narrative transportation, and relevance are identified as key factors related to enjoyment, and future studies examining these factors using games for health are recommended.

Does perceived risk influence the effects of message framing? A new investigation of a widely held notion.

Health-promoting messages can be framed in terms of the beneficial consequences of healthy behaviour (gain-framed messages) or the detrimental consequences of unhealthy behaviour (loss-framed messages). An influential notion holds that the perceived risk associated with the recommended behaviour determines the relative persuasiveness of gain- and loss-framed messages. This 'risk-framing hypothesis', as we call it, was derived from prospect theory, has been central to health message framing research for the last two decades, and does not cease to appeal to researchers. The present paper examines the validity of the risk-framing hypothesis. We performed six empirical studies on the interaction between perceived risk and message framing. These studies were conducted in two different countries and employed framed messages targeting skin cancer prevention and detection, physical activity, breast self-examination and vaccination behaviour. Behavioural intention served as the outcome measure. None of these studies found evidence in support of the risk-framing hypothesis. We conclude that the empirical evidence in favour of the hypothesis is weak and discuss the ramifications of this for future message framing research.

How Effective Are Active Videogames Among the Young and the Old? Adding Meta-analyses to Two Recent Systematic Reviews.

OBJECTIVE: Two recent systematic reviews have surveyed the existing evidence for the effectiveness of active videogames in children/adolescents and in elderly people. In the present study, effect sizes were added to these systematic reviews, and meta-analyses were performed. MATERIALS AND METHODS: All reviewed studies were considered for inclusion in the meta-analyses, but only studies were included that investigated the effectiveness of active videogames, used an experimental design, and used actual health outcomes as the outcome measures (body mass index for children/adolescents [k=5] and functional balance for the elderly [k=6]). RESULTS: The average effect of active videogames in children and adolescents was small and nonsignificant: Hedges' g=0.20 (95 percent confidence interval, -0.08 to 0.48). Limited heterogeneity was observed, and no moderator analyses were performed. For the effect of active videogames on functional balance in the elderly, the analyses revealed a medium-sized and significant effect of g=0.68 (95 percent confidence interval, 0.13-1.24). For the elderly studies, substantial heterogeneity was observed. Moderator analyses showed that there were no significant effects of using a no-treatment control group versus an alternative treatment control group or of using games that were especially created for health-promotion purposes versus off-the-shelf games. Also, intervention duration and frequency, sample size, study quality, and dropout did not significantly moderate the effect of active videogames. CONCLUSIONS: The results of these meta-analyses provide preliminary evidence that active videogames can have positive effects on relevant outcome measures in children/adolescents and elderly individuals.

Sales effects of product health information at points of purchase: a systematic review.

OBJECTIVE: Information about healthy and unhealthy nutrients is increasingly conveyed at the point of purchase. Many studies have investigated the effects of product health information on attitudes and intentions, but the empirical evidence becomes sketchier when the focus of research is actual purchase behaviour. The present paper provides an overview of empirical evidence on the effectiveness of product health information for food products at the point of purchase. DESIGN: A systematic literature review was conducted. SETTING: Only studies were included that assessed the effect of product health information at the point of purchase on actual purchase behaviour, using data provided by stores' sales records or obtained by investigating customer receipts as the primary outcome measure. SUBJECTS: The included studies' target group comprised supermarket clientele. RESULTS: Several studies found no significant effects of product health information on actual purchase behaviour. Interventions were more likely to be effective when they lasted for a longer time, when they included additional intervention components, and when they targeted the absence of unhealthy nutrients instead of or in addition to the presence of healthy nutrients. CONCLUSIONS: No strong evidence for the effectiveness of product health information was found. The effect of intervention duration, additional promotional activities and targeting of healthy v. unhealthy nutrients should be closely examined in future studies.

Avoidance orientation moderates the effect of threatening messages.

This study investigated the influence of individual differences in people's dispositional avoidance orientation on the persuasive effects of low- and high-threat messages promoting moderate drinking. First, participents (N = 99) individual differences in avoidance orientation were assessed, after which they were provided with either high- or low-threat messages about the consequences of drinking too much alcohol. The primary outcome measures were information acceptance, attitude and intention. Results showed that participants low in avoidance orientation were more likely to be persuaded by the low-threat message, whereas participants high in avoidance orientation were more likely to be persuaded by the high-threat message.

Preaching to the choir? The influence of personal relevance on the effects of gain- and loss-framed health-promoting messages.

This article examines the moderating influence of personal relevance on the persuasive effects of gain- and loss-framed messages. We assessed current behaviour as a proxy for personal relevance, provided 169 participants with gain- and loss-framed messages advocating skin self-examination (SSE) and assessed intention to engage in SSE as the outcome measure. The results showed that loss-framed information was more persuasive than gain-framed information, but only for low-relevance participants. This suggests that loss-framed information might be mainly effective for recipients who need little persuading and, in fact, runs the risk of 'preaching to the choir'.

The importance of habits in eating behaviour. An overview and recommendations for future research.

There is ample evidence to suggest that a significant part of daily eating behaviours consists of habits. In line with this, the concept of habit is increasingly incorporated into studies investigating the behavioural and psychosocial determinants of food choice, yielding evidence that habit is one of the most powerful predictors of eating behaviour. Research shows that habitual behaviour is fundamentally different from non-habitual behaviour: when behaviour is habitual, people require little information to make decisions, intentions are poor predictors of behaviour, and behaviour is triggered by situational cues. These insights have vast implications for research in the food domain that are only just beginning to be addressed. Also, theorizing on habits has important implications for behaviour change interventions, yet few interventions that are based on habit theory have been tested in a food context. The present article provides an overview of habit research and discusses possibilities to increase our knowledge of the role of habits in eating behaviour. It is shown that interventions targeting habitual behaviour can try to (i) change the situation that triggers the habitual behaviour, (ii) promote or inhibit the habitual response and (iii) change relevant contingencies. These insights can act as a starting point for future intervention research.

Self-efficacy as a potential moderator of the effects of framed health messages.

This study focuses on self-efficacy as a potential moderator of the effects of gain- and loss-framed health messages. Undergraduate students (N = 124) received a gain- or loss-framed message about consuming ecological meat. The data revealed that for participants high in self-efficacy, the gain-framed message resulted in consuming more ecological meat than the loss-framed message. Moreover it was found that - within the gain-frame condition - participants low in self-efficacy scored higher on measures of defensive processing than participants high in self-efficacy. This study provides further evidence for the role of self-efficacy as a potential moderator of the effects of framed health messages.

Investigating predictors of visiting, using, and revisiting an online health-communication program: a longitudinal study.

BACKGROUND: Online health communication has the potential to reach large audiences, with the additional advantages that it can be operational at all times and that the costs per visitor are low. Furthermore, research shows that Internet-delivered interventions can be effective in changing health behaviors. However, exposure to Internet-delivered health-communication programs is generally low. Research investigating predictors of exposure is needed to be able to effectively disseminate online interventions. OBJECTIVE: In the present study, the authors used a longitudinal design with the aim of identifying demographic, psychological, and behavioral predictors of visiting, using, and revisiting an online program promoting physical activity in the general population. METHODS: A webpage was created providing the public with information about health and healthy behavior. The website included a "physical activity check," which consisted of a physical activity computer-tailoring expert system where visitors could check whether their physical activity levels were in line with recommendations. Visitors who consented to participate in the present study (n = 489) filled in a questionnaire that assessed demographics, mode of recruitment, current physical activity levels, and health motivation. Immediately after, participants received tailored feedback concerning their current physical activity levels and completed a questionnaire assessing affective and cognitive user experience, attitude toward being sufficiently physically active, and intention to be sufficiently physically active. Three months later, participants received an email inviting them once more to check whether their physical activity level had changed. RESULTS: Analyses of visiting showed that more women (67.5%) than men (32.5%) visited the program. With regard to continued use, native Dutch participants (odds ratio [OR] = 2.81, 95% confidence interval [CI] = 1.16-6.81, P = .02) and participants with a strong motivation to be healthy (OR = 1.46, CI = 1.03-2.07, P = .03) were most likely to continue usage of the program. With regard to revisiting, older participants (OR = 1.04, CI = 1.01-1.06, P = .01) and highly educated participants (OR = 4.69, CI = 1.44-15.22, P = .01) were more likely to revisit the program after three months. In addition, positive affective user experience predicted revisiting (OR = 1.64, CI = 1.12-2.39, P = .01). CONCLUSIONS: The results suggest that online interventions could specifically target men, young people, immigrant groups, people with a low education, and people with a weak health motivation to increase exposure to these interventions. Furthermore, eliciting positive feelings in visitors may contribute to higher usage rates.

Self-efficacy moderates message-framing effects: The case of skin-cancer detection.

Health-promoting messages can be framed in terms of the gains associated with healthy behaviour, or the losses associated with unhealthy behaviour. Studies show inconsistent results as to which type of framing is more effective. In this study, we examined the influence of self-efficacy to perform skin self-examination on the effects of gain- and loss-framed skin-cancer detection messages among 124 university students. For participants with high self-efficacy, a loss-framed message resulted in a higher intention to perform skin self-examination than a gain-framed message. For participants with low self-efficacy, there were no differences in intention between the gain- and loss-framed message conditions. Our results suggest that self-efficacy levels play an important role in message-framing effects. For health communication strategies promoting the active detection of skin-cancer symptoms, messages stressing losses may be more effective than messages stressing gains, but only in persons with high self-efficacy. In addition, our results suggest that health promoting messages can be framed to match recipients' self-efficacy levels.

Investigating message-framing effects in the context of a tailored intervention promoting physical activity.

Health-promoting messages can be framed in terms of the gains associated with healthy behaviour or the losses associated with unhealthy behaviour. It has been argued that gain-framed messages promoting physical activity (PA) are more effective than loss-framed messages, but empirical findings are inconsistent. Also, no previous studies investigated the effects of gain- and loss-framed messages in the context of a computer-tailored PA intervention. In this study, we provided participants with computer-generated tailored feedback concerning their PA levels. In total, 787 participants entered in the study, of whom 299 completed all measures at a 3-month follow-up. We investigated whether gain- and loss-framed messages promoting PA affected information acceptance, attitude, intention and behaviour differently. The results showed that gain-framed messages resulted in stronger intentions to be physically active than loss-framed messages. This did not result in a significant increase in actual PA, however, as measured by a 3-month follow-up assessment. For information acceptance and attitude, a non-significant advantage of gain-framed messages was found. All effects had small effect sizes. Thus, whereas gain-framed information might be more persuasive than loss-framed information when it comes to promoting PA, the differences between gain- and loss-framed messages are likely to be small.

Clusters of lifestyle behaviors: results from the Dutch SMILE study.

OBJECTIVE: This study aimed to identify differences and similarities in health behavior clusters for respondents with different educational backgrounds. METHODS: A total of 9449 respondents from the 2002 wave of the Dutch SMILE cohort study participated. Latent class analyses were used to identify clusters of people based on their adherence to Dutch recommendations for five important preventive health behaviors: non-smoking, alcohol use, fruit consumption, vegetable consumption and physical exercise. RESULTS: The distribution of these groups of behaviors resulted in three clusters of people: a healthy, an unhealthy and poor nutrition cluster. This pattern was replicated in groups with low, moderate and high educational background. The high educational group scored much better on all health behaviors, whereas the lowest educational group scored the worst on the health behaviors. CONCLUSION: The same three patterns of health behavior can be found in different educational groups (high, moderate, low). The high educational group scored much better on all health behaviors, whereas the lowest educational group scored the worst on the health behaviors. Tailoring health education messages using a cluster-based approach may be a promising new approach to address multiple behavior change more effectively.