Message sensation value (MSV) is defined as the degree to which a message’s format and content features elicit sensory, affective, and arousal responses. MSV research has received considerable scholarly and professional attention for more than two decades. The seminal work, to date, has been conducted by the Kentucky School. MSV was initially operationalized as perceived message sensation value (PMSV). The activation model of information exposure (AMIE) provides the basis for explaining the functional mechanism of MSV and PMSV. The AMIE proposes that exposure is a function of the interaction between an individual’s sensation-seeking tendency and sensation-enhancing attributes of the message itself.
There are three primary types of message features that contribute to MSV: (a) the formal video dimension, (b) the formal audio dimension, and (c) the content dimension. There is an important distinction between subjective reactions to the message (PMSV) and the format and content features contributing to these reactions (MSV).
In general, messages of high relative to low in sensation value have elicited greater message processing and more favorable evaluations across a range of outcome variables in health communication. Some health communication campaigns have employed high sensation value messages to target high sensation seekers. This sensation-seeking targeting approach, SENTAR, however, has received mixed and limited support. The influence of MSV on message effectiveness might be very similar for the two groups. Recently, some scholars have attempted to situate AMIE in a broader context of persuasion. First, AMIE and the elaboration likelihood model (ELM) offer competing predictions in terms of the role of MSV in persuasion, such that AMIE stresses a straightforward attention-getting effect, whereas ELM predicts a distracting effect of MSV interfering with message’s content. The very few studies conducted thus far reveal limited and mixed findings. Second, in the integration of MSV research with the appraisal theory and excitation-transfer theory, MSV may function as an arousal generator to amplify the influence of discrete emotions on perceived message effectiveness. Third, according to the psychological reactance theory, there are challenges with implementing high sensation value (HSV) messages, in that they potentially could backfire among the target audiences. Messages with HSV may garner better-perceived effectiveness when they tone down the controlling language.
Future studies should investigate the relationships between specific MSV-enhancing features and message processing. They can expand the literature by studying the impact of MSV in a variety of media message contexts (e.g., broadcast journalism). Future experiments might also incorporate psychophysiological measures (e.g., skin response and heart-rate deceleration) to complement self-reported measures. Future studies should continue to explore other features (e.g., visual-verbal redundancy) that might affect attention and message processing jointly with MSV, and other individual difference variables, such as need for cognition, trait reactance, locus of control, and etc.
Simon Zebregs and Gert-Jan de Bruijn
Meta-analyses are becoming increasingly popular in the field of health and risk communication—meta-analyses allow for more precise estimations of the magnitude of effects and the robustness of those effects across empirical studies in a particular domain. Despite its popularity, most scholars are not trained in the basic methods involved with meta-analyses. There are advantages to meta-analysis in comparison to other forms of research synthesis. An overview of the methods involved in conducting and reporting meta-analytical research is helpful.
However, the methods involved with meta-analyses are not as clear-cut as they may first appear. Numerous issues must be considered and various arbitrary decisions are required during the process. These issues and decisions relate to various topics such as inclusion criteria, the selection of sources, quality assessments for eligible studies, and publication bias. Basic knowledge of these issues and decisions is important for interpreting the outcomes of a meta-analysis correctly.
Metaphor equates two concepts or domains of concepts in an A is B form, such that a comparison is implied between the two parts leading to a transfer of features typically associated with B (called source) to A (called target). Metaphor is evident in written, spoken, gestural, and pictorial modalities. It is also present as latent patterns of thought in the form of conceptual mappings between domains of experience called conceptual metaphor. Metaphor is found commonly in a variety of health and risk communication contexts, including public discourse, public understanding and perceptions, medical encounters, and clinical assessment. Often metaphor use is beneficial to achieving desired message effects; however, sometimes its use in a message can lead to unintended undesirable effects. There is a general consensus, although not complete agreement, that metaphors in messages are processed through engagement with corresponding conceptual mappings. This matching process can be taken as a general principle for design of metaphor-based health and risk messages.
Melissa J. Robinson and Silvia Knobloch-Westerwick
In today’s media-saturated environment, individuals may be exposed to hundreds of media messages on a wide variety of topics each day. It is impossible for individuals to attend to every media message, and instead, they engage in the phenomenon of selective exposure, where certain messages are chosen and attended to more often than others. Health communication professionals face challenges in creating messages that can attract the attention of targeted audiences when health messages compete with more entertaining programming. In fact, one of the greatest obstacles for health campaigns is a lack of adequate exposure among targeted recipients. Individuals may avoid health messages completely or counterargue against persuasive attempts to change their health-related attitudes and behaviors. Once individuals have been exposed to a health message, their current mood plays an important role in the processing of health information and decision making. Early research indicated that a positive mood might actually be detrimental to information processing because individuals are more likely to process the information heuristically. However, recent studies countered these results and suggested that individuals in positive moods are more likely to attend to self-relevant health information, with increased recall and greater intent to change their behaviors.
Since mood has the ability to influence exposure to health messages and subsequent message processing, it is important for individuals to be able to manage their mood prior to health information exposure and possibly even during exposure. One way individuals can influence their moods is through media use including TV shows, movies, and music. Mood management theory predicts that individuals choose media content to improve and maintain positive moods and examines the mood-impacting characteristics of stimuli that influence individuals’ media selections. Therefore, an individual’s mood plays an important role in selection of any type of communication (e.g., news, documentaries, comedies, video games, or sports).
How can health message designers influence individuals’ selection and attention to health messages when negative moods may be blocking overtly persuasive attempts to change behaviors and a preference for entertaining media content? The narrative persuasion research paradigm suggests that embedding health information into entertainment messages may be a more effective method to overcome resistance or counterarguing than traditional forms of health messages (e.g., advertisements or articles). It is evident that mood plays a complex role in message selection and subsequent processing. Future research is necessary to examine the nuances between mood and health information processing including how narratives may maintain positive moods through narrative selection, processing, and subsequent attitude and/or behavior change.
In health and risk communication, evidence is a message feature that can add credibility, realism, and legitimacy to health and risk messages. Evidence is usually defined into two types: statistical or narrative. Statistical evidence employs quantifications of events, places, phenomena, or other facts, while narrative evidence involves stories, anecdotes, cases, or testimonials. While many health and risk messages employ statistical or factual information, narrative evidence holds appeal for health and risk communication for its utility in helping individuals learn their risks and illnesses through stories and personal experiences. In particular, narratives employed as evidence in a health or risk message especially hold value for their ability to communicate experiences and share knowledge, attitudes, beliefs, and ideas about complex health issues, propose behavior change, and assist individuals coping with disease. As a result, the personal experiences shared, whether they are from first-hand knowledge, or recounting another’s experience, can focus attention, enhance comprehension for risks, and recall of health and risk information. Furthermore, readers engage with the story and develop their own emotional responses which may align with the purpose of the health and risk message. Narratives, or stories, can occur in many ways or through various points of view, but the stories that “ring true” to readers often have a sense of temporality, coherence, and fidelity. As a result, formative research and pre-testing of health and risk messages with narratives becomes important to understand individual perceptions related to the health issue and the characters (or points of view). Constructs of perceived similarity, interest, identification, transportation, and engagement are helpful to assess in order to maximize the usefulness and persuasiveness of narratives as evidence within a health and risk message. Additionally, understanding the emotional responses to narratives can also contribute to perceptions of imagery and vividness that can make the narrative appealing to readers. Examining what is a narrative as evidence in health and risk messages, how they are conceptualized and operationalized and used in health and risk messages is needed to understand their effectiveness.
Holley A. Wilkin
This is an advance summary of a forthcoming article in the Oxford Research Encyclopedia of Communication. Please check back later for the full article.
Individuals who live in low income communities are at an increased risk for several health issues, such as obesity and obesity-related diseases like hypertension and diabetes; asthma; cancers; etc., compared to those who live in higher income communities. Contributing to these disparities are individual factors, such lower education, income, health literacy, health self-efficacy, social support, and a lack of health insurance and/or healthcare access. A combination of these individual-level factors and neighborhood-level constraints like a lack of transportation and primary healthcare options, can lead to a higher reliance on emergency medical services for health issues. Lower income neighborhoods often lack health enhancing resources. For example, they have fewer doctor’s offices, healthcare centers, health organizations, and gyms, and are often considered food deserts due to a lack of healthy food options. Where grocery stores are absent, convenience stores and fast food restaurants provide access to primarily unhealthy food options. When a grocery store is present, studies have shown a more prominent display of unhealthy products (e.g., cigarettes, cigarillos, and alcohol) and fewer/lower quality fruits and vegetables than found in higher income community stores. Additionally, unhealthy products like tobacco and fast food are marketed specifically to lower income communities through billboards and other point-of-purchase advertisements and incentives.
Factors of the built environment also contribute to health disparities. Aspects that encourage physical activity—sidewalks, trails, parks, and walking or biking paths—may be absent, unkempt, or unsafe. Vacant houses and lots become overgrown, attracting disease-carrying rodents and the illegal dumping of trash, and they can become the site of drug activity. It can be dangerous for children to walk past these houses on their way to school or if they were to play outside in their neighborhoods, increasing their stress levels and removing opportunity for physical activity. This type of urban blight also has an impact on the mental health of residents. There also tends to be a higher level of outdoor environmental toxins due to the increased presence of factories, transportation systems (e.g., trains, highways), nuclear power plants, and the like in lower income communities. A lack of green space and tree coverage leads to increased heat as the concrete gets hot in the summer, increasing emissions and smog levels. There are also increased levels of indoor environmental pollutants in the form of lead-based paint, asbestos, and cockroaches in lower income neighborhoods. To affect health outcomes, health communication interventions and messages need to take into account the neighborhood-level factors that contribute to health disparities.
Priscila G. Brust-Renck, Julia Nolte, and Valerie F. Reyna
The complexity of numerical information about health risks and benefits places demands on people that many are not prepared to meet. For example, much information about health is communicated numerically, such as treatment risks and effectiveness, lifestyle benefits, and the chances of side effects from medication. However, many people—especially the old, the poor, and the less educated—have difficulty understanding numerical information that would enable them to make informed health decisions. Some evidence also suggests cultural and gender differences (although their causes have been disputed). The ability to use and understand numbers (i.e., numeracy) plays an important role in how information should be displayed and communicated.
Measuring differences in numeracy provides a standard to guide one’s approach when communicating risk. Several surveys have been developed to allow for a descriptive assessment of basic and analytical mathematical skills in nationally representative samples (e.g., NAEP, NAAL, PISA, PIACC). Other measures assess specific skills, such as perception of numbers (e.g., number line, approximation, dots tasks), individual perception of one’s own ability (i.e., Subjective Numeracy Scale), and arithmetic computation ability (i.e., Objective Numeracy Scales, Abbreviated Numeracy Scale, and Berlin Numeracy Test).
Difficulties associated with low numeracy extend well beyond the inability to understand place value or perform computations. Understanding and remediating low numeracy requires getting below the surface of errors in judgment and decision making to the deeper level of scientific theory. Despite the relevance of numbers in decision making, there is a certain level of disagreement regarding the psychological mechanisms involved in numeracy. Studies show that people have a basic mental representation of numbers in which the discriminability of two magnitudes is a function of their ratio rather than their difference (psychophysical approaches). Numerical reasoning has been identified with quantitative and analytical processes, and such computation is often seen as an accurate and objective way to process information (traditional dual-process approaches as applied to numeracy). However, these approaches do not account for the contradictory evidence that reliance on analysis is not sufficient for many decisions and has been associated with worse performance for some decisions. Studies supporting a more recent dual-process approach—one that accounts for standard and paradoxical effects of numeracy on risk communication—emphasize the role of intuition: this is a kind of advanced thinking that operates on gist representations, which capture qualitative understanding of the meaning of numbers that is relevant in decision making (Fuzzy Trace Theory). According to Fuzzy Trace Theory, people encode both actual numbers (verbatim representations) and qualitative interpretations of their bottom-line meaning (gist representations) but prefer to rely on the qualitative gist representations when possible. Thus, potential difficulties in decision making arising from deficits in numeracy can be resolved through meaningful communication of risk. Creating narratives that emphasize the contextually relevant underlying gist of risk and using methods that convey the meaning behind numeric presentations (e.g., use of appropriate arrays to communicate linear trends, meaningful relations among magnitudes, and inclusion relations among classes) improve understanding and decision making for both numerate and innumerate individuals.
Nutrition Labeling in the United States and the Role of Consumer Processing, Message Structure, and Moderating Conditions
J. Craig Andrews, Scot Burton, and Laurel Aynne Cook
It has been since 1990 that the landmark Nutritional Labeling Education Act (NLEA) was passed in the United States, and since 1969 that the first White House Conference on Food, Nutrition and Health occurred. In the time since these important events, considerable research has been conducted on how U.S. consumers process and use nutritional labeling. An up-to-date review of nutritional labeling research must address key findings on the processing and use of nutrition facts panels (NFPs), restaurant labeling, front-of-pack (FOP) symbols, health and nutrient content claims, new labeling efforts (e.g., for meat products), and claims not regulated by the U.S. Food and Drug Administration (FDA). Message structure mediates the ways in which consumers process nutritional labeling while moderating conditions affect research outcomes associated with labeling efforts.
The most recent policy issues and problems to be considered (e.g., by the FDA) include nutritional labeling as well as identifying opportunities for consumer research in helping to promote healthy lifestyles and reducing obesity in the United States and throughout the world. For example, several unanswered research questions remain regarding how the proposed changes to the NFPs—beef, poultry, and seafood labeling; restaurant chain calorie labeling; alternative FOP formats; and regulated and unregulated health and nutrient content claims—will affect consumers. Researchers have yet to examine not only these different labeling and nutrition information formats, but also how they might interact with one another and the role of key moderating conditions (e.g., one’s motivation, ability opportunity to process nutrition information) in affecting consumer processing and behavior.
May O. Lwin, Jerrald Lau, Andrew Z. H. Yee, and Cyndy Au
Populated by a diverse spread of cultures, Southeast Asia is represented by the Association of Southeast Asian Nations (ASEAN), a regional organization comprising some 622 million people in ten countries. While food and beverage labeling policies differ across ASEAN member states, organizations such as the ASEAN Food and Beverage Alliance (AFBA) have pushed for standardization in the interest of facilitating interregional trade. Set against this backdrop of economic growth, nutrition labeling as a means of influencing consumer choices has become a significant area of focus for health authorities and researchers over the past two decades due to rising chronic disease levels within the region’s increasingly urbanized communities.
Food retail trends facing Southeast Asia challenge the state of existing regulations governing, as well as research on food labeling practices in the region. Two main points stand out. First, legislation has remained disparate among the ASEAN nations despite repeated calls for standardization by academics as well as other relevant bodies, with only Malaysia adopting mandatory regulations on food labeling and nutritional claims. Second, existing nutrition labeling research in ASEAN is sorely lacking. In addition, there is a lack of theoretical and methodological diversity in existing studies, leading to an incomplete understanding of nutritional label use in Asia and a crucial research gap that remains to be filled.
Responding to health messages about environmental risks and risky behaviors requires adjustments to what individuals do: how they organize and perform occupations, and their understanding of what occupations mean—for themselves and others. Encouraging people to make a change means influencing what they want to do, the possibilities open to them, and societal support and demand for healthful ways of life. Bringing an occupational perspective to the design of risk messages will generate new insights into the complexities of everyday occupations, revealing the dynamic territory into which health messages are targeted. Occupation, or everyday doing, is described as the means by which people experience their very nature, become what they have the potential to be, and sustain a sense of belonging in family, community and society. To influence what people do, designers of health messages are encouraged to consider what engages people in occupations and keeps them engaged; the identity and cultural meanings expressed through occupation; the exhilaration of challenge and risk; the satisfactions of competence and flow experiences that keep people engaged in what they are doing; whether or not people are fit and prepared for the occupations they embark on and what happens when they are not; and the pull of habits and routines, which hold existing patterns of occupation in place. Equally, health message designers need to engage with the occupational science literature, which recognizes how people are shaped toward particular occupations and occupational identities by social policy, institutional practices, and media messages. That means questioning the rhetoric that occupations are freely chosen, rather than shaped and patterned by the historical, sociocultural, political, and geographic context. Simultaneously, health message designers need to recognize that individuals incorporate specific occupations and occupational patterns into their lifestyle and sense of self, believing they have a measure of control over what they do while rationalizing failure to make health-supporting changes.