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Promoting participation in physical activity using …

Copyright The British Psychological SocietyReproduction in any form (including the internet) is prohibited without prior permission from the SocietyPromoting participation in physical activity usingframed messages: An application of prospecttheoryAmy E. Latimer1*, Tara A. Rench1, Susan E. Rivers1,Nicole A. Katulak1, Stephanie A. Materese2, Lisa Cadmus1,2,Althea Hicks3, Julie Keany Hodorowski3and Peter Salovey11 Department of Psychology, Yale University, New Haven, USA2 Department of Epidemiology and Public Health, Yale University, New Haven, USA3 National Cancer Institute s Cancer Information Service, Memorial Sloan-KetteringCancer Center, New York, designed to motivate participation in physical activity usuallyemphasize the benefits of physical activity (gain-framed) as well as the costs of inactivity(loss-framed). The framing implications of prospect theory suggest that the effectivenessof these messages could be enhanced by providing gain-framed information only.

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1 Copyright The British Psychological SocietyReproduction in any form (including the internet) is prohibited without prior permission from the SocietyPromoting participation in physical activity usingframed messages: An application of prospecttheoryAmy E. Latimer1*, Tara A. Rench1, Susan E. Rivers1,Nicole A. Katulak1, Stephanie A. Materese2, Lisa Cadmus1,2,Althea Hicks3, Julie Keany Hodorowski3and Peter Salovey11 Department of Psychology, Yale University, New Haven, USA2 Department of Epidemiology and Public Health, Yale University, New Haven, USA3 National Cancer Institute s Cancer Information Service, Memorial Sloan-KetteringCancer Center, New York, designed to motivate participation in physical activity usuallyemphasize the benefits of physical activity (gain-framed) as well as the costs of inactivity(loss-framed). The framing implications of prospect theory suggest that the effectivenessof these messages could be enhanced by providing gain-framed information only.

2 Wecompared the effectiveness of gain-, loss-, and mixed-framed messages for promotingmoderate to vigorous physical , healthy callers to the US National Cancer Institute s CancerInformation Service (N 322) received gain-, loss-, or mixed-framed messages on threeoccasions (baseline, Week 1, and Week 5). Social cognitive variables and self-reportedphysical activity were assessed at baseline, Week 2, and Week 9. Separate regressionanalyses were conducted to examine message effects at each assessment Week 2, gain- and mixed-framed messages resulted in stronger intentionsand greater self-efficacy than loss-framed messages. At Week 9, gain-framed messagesresulted in greater physical activity participation than loss- or mixed-framed cognitive variables at Week 2 did not mediate the Week 9 framing effects onphysical activity gain-framed messages exclusively may be a means of increasingthe efficacy of physical activity people are not active enough to attain the health benefits of physical activity (World Health Organization, 2004).

3 In light of growing public health concern,* Correspondence should be addressed to Dr Amy Latimer, School of Kinesiology and Health Studies, Queen s University, 69 Union Street, Kingston, ON K7L 3N6 Canada (e-mail: Journal of Health Psychology (2008), 13, 659 681q2008 The British Psychological The British Psychological SocietyReproduction in any form (including the internet) is prohibited without prior permission from the Societyeducational campaigns have been launched in an effort to persuade sedentary adults tobecome more active (reviewed by Cavill & Bauman, 2004). The lack of behaviourchange following these campaigns has rendered unanswered the question of how tocommunicate effectively physical activity recommendations (Randolph & Viswanath,2004). Past public health initiatives aimed at increasing other health behaviours indicatethat framing messages appropriately in terms of gains or losses is necessary for achievingbehaviour change (Randolph & Vishwanath, 2004).)

4 Prospect theory suggests that individuals respond differently to factually equivalentinformation depending on whether it is framed in terms of costs (loss-framed) orbenefits (gain-framed; Tversky & Kahneman, 1981). Individuals tend to seek out riskswhen considering the potential negative consequences (or losses) associated with achoice, and tend to avoid risk when considering the benefits (or gains) associated with adecision. Applying the tenets of prospect theory to the health promotion domain,Rothman and Salovey (1997) proposed that loss-framed messages persuade individualsto engage in detection behaviours, which are inherently risky given their potential toindicate the presence of disease. This prediction has been supported in researchencouraging a variety of detection behaviours including Pap testing (Rivers, Salovey,Pizarro, Pizarro, & Schneider, 2005), HIV testing (Apanovitch, McCarthy, & Salovey,2003), and mammography (Schneideret al.)

5 , 2001). Conversely, researchers havehypothesized that gain-framed messages convince individuals to engage in preventionbehaviours which are not inherently risky. This prediction has garnered empiricalsupport in studies encouraging behaviours such as sunscreen use (Detweiler,Bedell, Salovey, Pronin, & Rothman, 1999), smoking cessation (Steward, Schneider,Pizarro, & Salovey, 2003), and dental hygiene (Rothman, Martino, Bedell, Detweiler, &Salovey, 1999). physical activity is associated with reducing the risk of chronic disease andphysical impairment in generally healthy individuals (World Health Organization,2004). Thus, using gain-framed messages should optimize the effectiveness ofcampaigns Promoting this prevention behaviour. However, research testing thishypothesis has generated mixed findings (Jones, Sinclair, & Courneya, 2003; Jones,Sinclair, Rhodes, & Courneya, 2004; McCall & Martin Ginis, 2004; Robberson &Rogers, 1988).

6 For example, Robberson and Rogers found that among sedentaryfemale college students some gain-framed messages elicited stronger intentions toengage in physical activity than loss-framed messages. Whether or not this effectextended to behaviour is unclear; the follow-up survey was administered immediatelyafter message delivery and did not assess actual physical activity . Accounting for thislimitation, Jones and colleagues used a 2-week prospective design to examine theeffects of framed messages on participation in physical activity among undergradu-ates. Gain-framed messages delivered by a credible source resulted in greater physicalactivity participation rates than loss-framed messages. However, Jones and colleaguesfailed to replicate this finding perhaps because prior to receiving the interventionalmost half of the participants met the current physical activity activity messages are most effective among sedentary individuals (Kroeze,Werkman, & Brug, 2006; Vandelanotte, De Bourdeaudhuij, Sallis, Spittaels, & Brug,2005).

7 Thus, the active participants might have been less receptive to the messages,reducing the likelihood of detecting message framing effects and accounting for theinconsistent behavioural inconsistent findings may also be attributable to the sample (college students),short follow-up durations (2 weeks), or single message exposures. McCall and Martin660 Amy E. Latimer et The British Psychological SocietyReproduction in any form (including the internet) is prohibited without prior permission from the Society(2004) examined message framing using a longitudinal design and prolonged messageexposure in a population for whom participation in physical activity is particularlyrelevant patients recovering from coronary artery bypass graft surgery who wererecommended to engage in cardiac rehabilitation. Patients who received gain-framedmessages (both in a pamphlet and on a magnet for their home refrigerator) attendedmore cardiac rehabilitation sessions over a 3-month period than participants whoreceived loss-framed messages; however, this difference was not statistically in the gain-framed group did attend significantly more sessions thanparticipants in a no-message control group.

8 The inclusion of a control groupstrengthened the study design by demonstrating the advantages of gain-framedmessages over standard and hypothesesThe findings from the extant research suggest possible positive results from the useof gain-framed messages in Promoting physical activity participation ; however, moreresearch is needed to account for the limitations of previous studies. Specifically,there is a need to test framed physical activity messages in a receptive audience using (a) multiple message exposures; (b) an extended follow-up period; and (c) a standardmessage control group. The present experiment was designed to address these primary objective was to compare the effectiveness of gain-, loss-, and mixed-framed messages for Promoting moderate to vigorous physical activity over a 9-weekperiod following multiple message exposures. In accordance with the framingpostulates of prospect theory, we hypothesized that the effectiveness of physicalactivity messages would be enhanced by providing gain-framed information secondary objective of the current study was to identify the social cognitivemechanisms underlying the effectiveness of framed messages.

9 Little research has beenconducted in this area. Understanding the factors mediating the link between themessage and the behaviour is necessary to advance message framing theory and practice(Frazier, Tix, & Barron, 2004). Investigating social cognition as a potential mediator is agood starting-point. Substantial evidence indicates that self-efficacy, outcomeexpectancies, and intentions are important determinants of health behaviour andspecifically physical activity (Sallis & Owen, 1998). Furthermore, preliminary evidencesuggests that social cognitive variables ( self-efficacy, outcome expectancies,intentions) derived from self-efficacy theory (Bandura, 1997) may be potential mediatorsof framing effects. For example, among some participants, the effects of gain-framedsmoking cessation messages on intentions to quit were mediated by self-efficacy ( thebelief that one has the ability to perform the requisite behaviour; Stewardet al.)

10 , 2003).Within the message framing and physical activity domain, mediationalrelationships with social cognitive variables have not been established. However,gain-framed messages have resulted in more positive outcome expectancies (beliefsabout whether or not a given behaviour produces a given outcome; Joneset al.,2004; McCall & Martin, 2004) and stronger intentions to engage in physical activity (Joneset al., 2003; Robberson & Rogers, 1988) than loss-framed messages. In thecurrent study, self-efficacy, outcome expectancies, and intentions were tested asmediators of the effects of framed messages on physical activity , we predicted that gain-framed messages would result in greater physicalactivity outcome expectancies, self-efficacy, and intentions, which in turn would leadto greater participation in physical activity and message framing661 Copyright The British Psychological SocietyReproduction in any form (including the internet) is prohibited without prior permission from the SocietyMethodParticipantsFive hundred and seventeen sedentary ( no more than 2 days/week of moderateto vigorous physical activity for greater than 20 min/day; Rodgers & Gauvin, 1998)men and women were recruited from the National Cancer Institute s (NCI) CancerInformation Service (CIS) in the United States.


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