‘The Effects of Message Framing Within the Stages of
Change on Smoking Cessation Intentions and
Behaviours’
This study examines two commonly used and accepted theoretical models
in health communication – the stages of change and message framing – to
determine whether gain of loss frames messages are more effective at
getting people to intend to quit smoking depending on their current stage
of change. Message believability, message processing and stage
movement were measured to see if any differences existed as a function
on the individuals base stage of change and message frame exposure.
Results indicated that all participants, regardless of stage and frame,
engaged in more central than peripheral message processing. Additionally,
gain-framed messages were most influential at getting individuals to
progress from contemplation to the preparation stage.
The stages of change model (SCM) has been used successfully to study
and facilitate changes in addictive behaviours, such as smoking. The
model suggests that behaviours change involves progression through 5
stages:
1. Precontemplation
there is no intention to change behaviour in the next six months.
Often, these people are forced into therapy and attempts frequently
fail because they are not yet ready to change.
2. Contemplation
individuals are aware a problem exists, they are seriously thinking
about addressing it, but have not yet committed action. These
people weigh pros and cons of the problem and solution
3. Preparation
In this stage individuals plan to take action in the next month, or
have taken action and failed in the past year.
4. Action
this occurs when individuals engage in, and are committed to, overt
behavioural change. The problem behaviour must be absent for 1
day to 6 months to classify one is in this stage.
5. Maintenance
this stage is characterized by relapse prevention. Individuals must
remain free of the addictive behaviour and engage in a competing
healthy behaviour for at least 6 months to be in the maintenance
stage.
Behavioural and cognitive goals are specified at each stage, with the
overall goal being to progress to the next stage of change. An intervention
method that works for someone who is ready to change will likely be
ineffective for someone who is not aware that a problem exists. Behaviour
change is not linear but instead a continual process.
, Positive social and self-evaluative consequences are important to move
individuals to the preparation stage from contemplation; this helps
individuals see themselves as capable of behaviour change. To move form
preparation to action entails encouraging people to identify and plan
solutions to obstacles and messages to increase self-efficacy and
reinforcement of appropriate behaviours. Movement from action to
maintenance requires more reinforcement and self-efficacy including the
long-term positive consequences of behaviour change.
Slater suggests emphasizing the efficacy of responses to a threat and
increasing the salience of the threat to be crucial message features in
getting individuals to move to the preparation stage from contemplation,
finally slater states that using quantitative evidence, reinforcing beliefs
and increasing attitude accessibility are useful in getting individuals to
move from preparation to action stage.
Individuals in different stages of change need different intervention
approaches, including tailored messages. The effects of message frames
may not be uniform across stages. One way to better instantiate the SCM
is by using specific message frames, these can emphasize the costs or
benefits of engaging in a particular behaviour. Gain-framed messages
are more effective for prevention behaviours (effective in early stages) and
loss-framed messages are more effective for detection behaviours
(effective in later stages), however the effect of frames messages depend
on one’s intention to change.
A kernel state is the basic root state mentioned and it can be stated in
terms of something to be attained/avoided or as a desirable/undesirable
outcome.
Prospect theory suggests that when the potential outcomes are risky,
people prefer loss-framed messages, but when the potential outcomes are
less risky people prefer gain-framed messages.
Because the SCM emphasizes a tailored approach to behaviour change,
different frames may be more effective at raising issue awareness,
enhancing response efficacy, or reinforcing smoking cessation attitudes,
depending on the individual’s current stage. Fear can be characterized as
a loss-framed message because it highlighted the severe consequences
and vulnerability of getting skin cancer. Negative message frames would
be more effective for those with high issue involvement, and positively
framed messages would have greater effects for those with low issue
involvement and no intentions to quit smoking. All smokers are aware of
the negative consequences of smoking, so positively framed information
was seen as new information that required scrutiny, especially for those
with no intention to quit. Messages containing different frames should be
processed differently at different stages of change. There are two routes to
persuasion:
Central
This is characterized by high involvement and by extensive issue
relevant thinking.
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