Risk and Responsibility: Evaluating the Efficacy of Framed Health Communication Strategies During a Pandemic
DOI:
https://doi.org/10.61978/communica.v2i1.754Keywords:
Vaccine Hesitancy, Message Framing, Loss Frame, Prospect Theory, Health Communication, COVID-19, Behavioral InterventionAbstract
This study investigates the effectiveness of gain- versus loss-framed messaging in shaping public intentions to vaccinate during health crises such as the COVID-19 pandemic. Drawing on prospect theory and behavioral communication principles, the research examines how framing influences vaccine uptake and explores demographic and cultural moderators of framing impact. Using a randomized survey experiment, the study found that loss-framed messages increased vaccination intention by 27% compared to gain-framed messages (Cohen’s d = 0.76). The effect was particularly strong among older adults and individuals with high trust in health authorities. Practically, these results suggest that public health campaigns should prioritize loss-framed content in high-risk populations while pairing it with clear guidance on action steps. The findings highlight the ethical need to balance persuasive urgency with empathy and inclusivity. Theoretically, this study advances the application of prospect theory in health communication, while practically, it informs targeted strategies for reducing vaccine hesitancy through culturally attuned and multi channel outreach.
References
Ainiwaer, A., Zhang, S., Ainiwaer, X., & Ma, F. (2021). Effects of Message Framing on Cancer Prevention and Detection Behaviors, Intentions, and Attitudes: Systematic Review and Meta-Analysis. Journal of Medical Internet Research, 23(9), e27634. https://doi.org/10.2196/27634 DOI: https://doi.org/10.2196/27634
Ansari‐Moghaddam, A., Seraji, M., Sharafi, Z., Mohammadi, M., & Okati–Aliabad, H. (2021). The Protection Motivation Theory for Predict Intention of COVID-19 Vaccination in Iran: A Structural Equation Modeling Approach. BMC Public Health, 21(1). https://doi.org/10.1186/s12889-021-11134-8 DOI: https://doi.org/10.1186/s12889-021-11134-8
Araban, M., Divdar, M., Cheraghian, B., & Heidarabadi, A. B. (2020). Effectiveness of Message Framing to Improve Oral Health Behaviors and Dental Plaque Among Pregnant Women. https://doi.org/10.21203/rs.3.rs-16040/v1 DOI: https://doi.org/10.21203/rs.3.rs-16040/v1
Ashworth, M., Thunström, L., Cherry, T. L., Newbold, S. C., & Finnoff, D. (2021). Emphasize Personal Health Benefits to Boost COVID-19 Vaccination Rates. Proceedings of the National Academy of Sciences, 118(32). https://doi.org/10.1073/pnas.2108225118 DOI: https://doi.org/10.1073/pnas.2108225118
Choi, M., Raeside, R., Hyun, K., Partridge, S. R., Thiagalingam, A., & Redfern, J. (2021). Understanding Preferences for Lifestyle-Focused Visual Text Messages in Patients With Cardiovascular and Chronic Respiratory Disease: Discrete Choice Experiment. Journal of Medical Internet Research, 23(9), e26224. https://doi.org/10.2196/26224 DOI: https://doi.org/10.2196/26224
Chu, H., & Liu, S. (2021). Integrating Health Behavior Theories to Predict American’s Intention to Receive a COVID-19 Vaccine. Patient Education and Counseling, 104(8), 1878–1886. https://doi.org/10.1016/j.pec.2021.02.031 DOI: https://doi.org/10.1016/j.pec.2021.02.031
Divdar, M., Araban, M., Heydarabadi, A. B., Cheraghian, B., & Stein, L. A. R. (2021). Effectiveness of Message-Framing to Improve Oral Health Behaviors and Dental Plaque Among Pregnant Women. Archives of Public Health, 79(1). https://doi.org/10.1186/s13690-021-00640-1 DOI: https://doi.org/10.1186/s13690-021-00640-1
Fetter, D. S., Dharmar, M., Lawry-Hall, S., Pressman, J., Chapman, J., & Scherr, R. E. (2019). The Influence of Gain-Framed and Loss-Framed Health Messages on Nutrition and Physical Activity Knowledge. Global Pediatric Health, 6. https://doi.org/10.1177/2333794x19857405 DOI: https://doi.org/10.1177/2333794X19857405
Fu, L., Sun, H., & Xu, K. (2022). Whether Social Participation Can Affect the Central Government Public Policy Response to the COVID-19 in China. Frontiers in Public Health, 10. https://doi.org/10.3389/fpubh.2022.842373 DOI: https://doi.org/10.3389/fpubh.2022.842373
Gantiva, C., Jiménez‐Leal, W., & Urriago-Rayo, J. (2021). Framing Messages to Deal With the COVID-19 Crisis: The Role of Loss/Gain Frames and Content. Frontiers in Psychology, 12. https://doi.org/10.3389/fpsyg.2021.568212 DOI: https://doi.org/10.3389/fpsyg.2021.568212
Guidry, J. P. D., Carlyle, K. E., LaRose, J. G., Perrin, P. B., Ryan, M., Messner, M., & Adams, J. (2018). Framing and Visual Type: Effect on Future Zika Vaccine Uptake Intent. Journal of Public Health Research, 7(1). https://doi.org/10.4081/jphr.2018.1162 DOI: https://doi.org/10.4081/jphr.2018.1162
Hayashi, Y., Romanowich, P., & Hantula, D. A. (2022). Predicting Intention to Take a COVID-19 Vaccine in the United States: Application and Extension of Theory of Planned Behavior. American Journal of Health Promotion, 36(4), 710–713. https://doi.org/10.1177/08901171211062584 DOI: https://doi.org/10.1177/08901171211062584
Heffner, J., Vives, M., & FeldmanHall, O. (2021). Emotional Responses to Prosocial Messages Increase Willingness to Self-Isolate During the COVID-19 Pandemic. Personality and Individual Differences, 170, 110420. https://doi.org/10.1016/j.paid.2020.110420 DOI: https://doi.org/10.1016/j.paid.2020.110420
Jensen, U. T., Ayers, S. L., & Koskan, A. (2022). Video-Based Messages to Reduce COVID-19 Vaccine Hesitancy and Nudge Vaccination Intentions. Plos One, 17(4), e0265736. https://doi.org/10.1371/journal.pone.0265736 DOI: https://doi.org/10.1371/journal.pone.0265736
Kecojevic, A., Basch, C. H., Sullivan, M., Chen, Y.-T., & Davi, N. (2021). COVID-19 Vaccination and Intention to Vaccinate Among a Sample of College Students in New Jersey. Journal of Community Health, 46(6), 1059–1068. https://doi.org/10.1007/s10900-021-00992-3 DOI: https://doi.org/10.1007/s10900-021-00992-3
Kim, H. K., & Lee, T. K. (2017). Conditional Effects of Gain–Loss-Framed Narratives Among Current Smokers at Different Stages of Change. Journal of Health Communication, 22(12), 990–998. https://doi.org/10.1080/10810730.2017.1396629 DOI: https://doi.org/10.1080/10810730.2017.1396629
Lee, M. J., & Cho, J. (2017). Promoting HPV Vaccination Online: Message Design and Media Choice. Health Promotion Practice, 18(5), 645–653. https://doi.org/10.1177/1524839916688229 DOI: https://doi.org/10.1177/1524839916688229
Lucas, T., Hayman, L. W., Blessman, J., Asabigi, K., & Novak, J. M. (2015). Gain Versus Loss‐framed Messaging and Colorectal Cancer Screening Among African Americans: A Preliminary Examination of Perceived Racism and Culturally Targeted Dual Messaging. British Journal of Health Psychology, 21(2), 249–267. https://doi.org/10.1111/bjhp.12160 DOI: https://doi.org/10.1111/bjhp.12160
Macapagal, K., Janssen, E., Matson, M., Finn, P., & Heiman, J. R. (2015). The Impact of Gain- And Loss-Framed Messages on Young Adults’ Sexual Decision Making: An Experimental Study. Archives of Sexual Behavior, 46(2), 385–394. https://doi.org/10.1007/s10508-015-0679-x DOI: https://doi.org/10.1007/s10508-015-0679-x
Mavandadi, S., Wright, E., Klaus, J., & Oslin, D. W. (2018). Message Framing and Engagement in Specialty Mental Health Care. Psychiatric Services, 69(3), 308–314. https://doi.org/10.1176/appi.ps.201700251 DOI: https://doi.org/10.1176/appi.ps.201700251
Mays, D., & Evans, W. D. (2017). The Effects of Gain-, Loss-, and Balanced-Framed Messages for Preventing Indoor Tanning Among Young Adult Women. Journal of Health Communication, 22(7), 604–611. https://doi.org/10.1080/10810730.2017.1332119 DOI: https://doi.org/10.1080/10810730.2017.1332119
Mays, D., Turner, M. M., Zhao, X., Evans, W. D., Luta, G., & Tercyak, K. P. (2014). Framing Pictorial Cigarette Warning Labels to Motivate Young Smokers to Quit. Nicotine & Tobacco Research, 17(7), 769–775. https://doi.org/10.1093/ntr/ntu164 DOI: https://doi.org/10.1093/ntr/ntu164
Mikels, J. A., Shuster, M. M., Thai, S., Smith-Ray, R. L., Waugh, C. E., Roth, K., Keilly, A., & Stine‐Morrow, E. A. L. (2016). Messages That Matter: Age Differences in Affective Responses to Framed Health Messages. Psychology and Aging, 31(4), 409–414. https://doi.org/10.1037/pag0000040 DOI: https://doi.org/10.1037/pag0000040
Murayama, H., Sasaki, S., Yuta, T., Takase, M., & Taguchi, A. (2023). Message Framing Effects on Attitude and Intention Toward Social Participation in Old Age. BMC Public Health, 23(1). https://doi.org/10.1186/s12889-023-16555-1 DOI: https://doi.org/10.1186/s12889-023-16555-1
Okuhara, T., Ishikawa, H., Okada, H., & Kiuchi, T. (2014). Identification of Gain- And Loss-Framed Cancer Screening Messages That Appeared in Municipal Newsletters in Japan. BMC Research Notes, 7(1), 896. https://doi.org/10.1186/1756-0500-7-896 DOI: https://doi.org/10.1186/1756-0500-7-896
Pavey, L., & Churchill, S. (2014). Promoting the Avoidance of High-Calorie Snacks: Priming Autonomy Moderates Message Framing Effects. Plos One, 9(7), e103892. https://doi.org/10.1371/journal.pone.0103892 DOI: https://doi.org/10.1371/journal.pone.0103892
Peng, J., Zhang, W., Wang, J., Li, L., Lai, W., Yang, Q., Zhang, B., Li, X., Du, Y., Liu, H., Wang, J., Cheng, Z., Wang, L., Wang, S., Wang, J., Chou, S., Liu, H., & Dou, S. X. (2021). Processing Rusty Metals Into Versatile Prussian Blue for Sustainable Energy Storage. Advanced Energy Materials, 11(44). https://doi.org/10.1002/aenm.202102356 DOI: https://doi.org/10.1002/aenm.202102356
Prakash, A., Nathan, R. J., Kini, S., & Victor, V. (2022). Message Framing and COVID-19 Vaccine Acceptance Among Millennials in South India. Plos One, 17(7), e0269487. https://doi.org/10.1371/journal.pone.0269487 DOI: https://doi.org/10.1371/journal.pone.0269487
Rao, Q., Zhang, Z., Lv, Y., Zhao, Y., Bai, L., & Hou, X. (2020). Factors Associated With Influential Health-Promoting Messages on Social Media: Content Analysis of Sina Weibo. Jmir Medical Informatics, 8(10), e20558. https://doi.org/10.2196/20558 DOI: https://doi.org/10.2196/20558
Sasaki, S., Kurokawa, H., & Ohtake, F. (2021). Effective but Fragile? Responses to Repeated Nudge-Based Messages for Preventing the Spread of COVID-19 Infection. Japanese Economic Review, 72(3), 371–408. https://doi.org/10.1007/s42973-021-00076-w DOI: https://doi.org/10.1007/s42973-021-00076-w
Soofi, M., Najafi, F., & Matin, B. K. (2020). Using Insights From Behavioral Economics to Mitigate the Spread of COVID-19. Applied Health Economics and Health Policy, 18(3), 345–350. https://doi.org/10.1007/s40258-020-00595-4 DOI: https://doi.org/10.1007/s40258-020-00595-4
Steffen, J., & Cheng, J. (2021). The Influence of Gain-Loss Framing and Its Interaction With Political Ideology on Social Distancing and Mask Wearing Compliance During the COVID-19 Pandemic. https://doi.org/10.31234/osf.io/4wc5d DOI: https://doi.org/10.31234/osf.io/4wc5d
Tiffany, B., Blasi, P. R., Catz, S. L., & McClure, J. B. (2018). Mobile Apps for Oral Health Promotion: Content Review and Heuristic Usability Analysis. Jmir Mhealth and Uhealth, 6(9), e11432. https://doi.org/10.2196/11432 DOI: https://doi.org/10.2196/11432
Yadav, R., Yadav, M., & Mittal, A. (2021). Effects of Gain-Loss-Framed Messages on Virtual Reality Intervened Fitness Exercise. Information Discovery and Delivery, 50(4), 374–386. https://doi.org/10.1108/idd-04-2021-0051 DOI: https://doi.org/10.1108/IDD-04-2021-0051
Ye, W., Li, Q., & Yu, S. (2021). Persuasive Effects of Message Framing and Narrative Format on Promoting COVID-19 Vaccination: A Study on Chinese College Students. International Journal of Environmental Research and Public Health, 18(18), 9485. https://doi.org/10.3390/ijerph18189485 DOI: https://doi.org/10.3390/ijerph18189485
Zampetakis, L. A., & Melas, C. D. (2021). The Health Belief Model Predicts Vaccination Intentions Against COVID‐19: A Survey Experiment Approach. Applied Psychology Health and Well-Being, 13(2), 469–484. https://doi.org/10.1111/aphw.12262 DOI: https://doi.org/10.1111/aphw.12262
