The Effect of Message Framing On Attitudes and Intentions Toward Diabetes Mellitus Type II Prevention

Theoretical Background and research questions/hypothesis:  Healthcare marketers have examined various ways to effectively frame the disease prevention messages that help empower consumers to obtain healthier lifestyles. However, marketers have not yet examined the effect of message framing on Diabetes Mellitus Type II (DM2) prevention. In this study, we investigated (1) the effect of message framing (advantages of preventing DM2 vs. consequences of ignoring DM2 prevention) on people’s attitudes and instantaneous intentions toward DM2 prevention; (2) the effect of messages that highlight why, rather than how (e.g., regular exercise, healthy diet), to prevent DM2, emphasizing sex-related consequences (e.g., pregnancy complications, erectile dysfunction); (3) people who have not yet developed diabetes, thus examining the effect of message framing on DM2 prevention, rather than on DM2 complication prevention (e.g., blindness); and (4) potential gender differences in terms of participants’ attitudes and intentions when the messages targeted their own versus the opposite gender.

Methods:  A 2 x 2 x 2 between-subjects factorial design was employed to test the hypotheses, with type of message framing (message type; advantages of preventing DM2 from developing vs. consequences of ignoring DM2 prevention) and message gender (female vs. male) as the two between-subjects factors and target gender (female vs. male) as the individual difference variable. The message for female participants highlighted healthy pregnancy versus pregnancy complications and the message for male participants highlighted normal sex function versus sexual dysfunction. Participants (N=264, M=21.38 years old) were assigned to one of these four conditions for either their own or the opposite gender (i.e., same-gender message or cross-gender message). Consequently, participants were randomly assigned to one of eight conditions.

Results:  Contrary to what was predicted, the message that highlighted consequences of ignoring DM2 prevention was more effective than the message that highlighted advantages of preventing DM2 in eliciting participants’ positive attitudes and their greater intentions to prevent DM2. Similar findings hold true, but were also unexpected, in an opposite-gender message condition. Moreover, female versus male participants generally had significantly more positive attitudes and greater intentions, irrespective of the message framing (particularly in the same-gender message condition). Ex post analyses revealed that fear mediated the relationship between message type and participants’ attitudes and intentions. In addition, perceived severity also mediated the relationship between message type and intentions for the same-gender conditions.

Conclusions:  When promoting a DM2 prevention message focusing on sex-related issues, (1) a loss-framed message highlighting consequences of ignoring DM2 is more effective; (2) targeting female subjects may be more effective; (3) a tailored message for the same gender is more effective for female subjects; (4) a tailored message for the opposite gender is more effective when negative consequences are communicated.

Implications for research and/or practice: A gain-framed message is not always an effective way to communicate disease prevention. Instead, healthcare marketers may consider using the messages that focus on sex-related negative consequences and that arouse fear in DM2 prevention. Moreover, identifying the message audience remains important in DM2 prevention; in particular, promoting the message that targets their own gender is effective.