Showing papers by "Joseph N. Cappella published in 2019"

The Potential for Narrative Correctives to Combat Misinformation

Abstract: Misinformation can influence personal and societal decisions in detrimental ways. Not only is misinformation challenging to correct, but even when individuals accept corrective information, misinformation can continue to influence attitudes: a phenomenon known as belief echoes, affective perseverance, or the continued influence effect. Two controlled experiments tested the efficacy of narrative-based correctives to reduce this affective residual in the context of misinformation about organic tobacco. Study 1 (N = 385) tested within-narrative corrective endings, embedded in four discrete emotions (happiness, anger, sadness, and fear). Study 2 (N = 586) tested the utility of a narrative with a negative, emotional corrective ending (fear and anger). Results provide some evidence that narrative correctives, with or without emotional endings, can be effective at reducing misinformed beliefs and intentions, but narratives consisting of emotional corrective endings are better at correcting attitudes than a simple corrective. Implications for misinformation scholarship and corrective message design are discussed.

The Effects of Graphic Warning Labels' Vividness on Message Engagement and Intentions to Quit Smoking.

Abstract: The current study examined the effects of manipulating the level of vividness through the presence of various textual and visual components in the context of tobacco warning labels. An online experiment was conducted (N=2165) to examine whether increasing the vividness of warning labels, using narrative and non-narrative components, increased engagement with the messages, and the subsequent effects of vividness and engagement on intentions to quit smoking. Results showed that more vivid warning labels led to increased engagement, which in turn was linked to increased intentions to quit smoking. Specifically, the indirect effect of vividness on intentions to quit smoking was largely driven by the emotional component of engagement. Indirect effects of cognitive engagement were only apparent at higher levels of vividness.

Perceived effectiveness of objective features of pictorial warning messages

Abstract: Background Previous research shows that pictorial warning messages (PWMs) for tobacco cigarettes increase quit attempts and smoking-related knowledge. However, few studies have investigated what specific features within PWMs are most effective. The current study sought to examine the specific features of PWMs associated with effectiveness using four outcome measures as indicators. Method A sample of n=319 PWMs was collected and underwent systematic content analysis on 48 different content features. A sample of n=1392 current smokers each rated a subset of the labels on perceived effectiveness, negative emotional engagement, intentions to enact avoidance behaviours and intentions to forego a cigarette. Multilevel random-effects models were fitted with all coded content features and each of the outcome measures. Results Analysis across all four outcome measures shows that PWMs depicting diseased and damaged body parts and employing a testimonial format were most effective. Additional mediation analysis showed that image-level negative emotionality partially mediated the relationship between PWM features and perceived effectiveness. Conclusion The effectiveness of graphic imagery, testimonials and images that elicit negative emotions provides guidance for researchers as well as for future implementation of more effective PWMs.

The Impact of a Risk-Based Breast Cancer Screening Decision Aid on Initiation of Mammography Among Younger Women: Report of a Randomized Trial.

Abstract: Background. Guidelines recommend that initiation of breast cancer screening (BCS) among women aged 40 to 49 years include a shared decision-making process. The objective of this study is to evaluate the effect of a breast cancer screening patient decision-aid (BCS-PtDA) on the strength of the relationship between individual risk and the decision to initiate BCS, knowledge, and decisional conflict. Methods. We conducted a randomized clinical trial of a BCS-PtDA that included individual risk estimates compared with usual care. Participants were women 39 to 48 years of age with no previous mammogram. Primary outcomes were strength of association between breast cancer risk and mammography uptake at 12 months, knowledge, and decisional conflict. Results. Of 204 participants, 65% were Black, the median age (interquartile range [IQR]) was 40.0 years (39.0-42.0), and median (IQR) breast cancer lifetime risk was 9.7% (9.2-11.1). Women who received mammography at 12 months had higher breast cancer lifetime risk than women who had not in both intervention (mean, 95% CI): 12.2% (10.8-13.6) versus 10.5% (9.8-11.2), P = 0.04, and control groups: 11.8% (10.4-13.1) versus 9.9% (9.2-10.6), P = 0.02. However, there was no difference between groups in the strength of association between mammography uptake and breast cancer risk (P = 0.87). Follow-up knowledge (0-5) was greater in the intervention versus control group (mean, 95% CI): 3.84 (3.5-4.2) versus 3.17 (2.8-3.5), P = 0.01. There was no change in decisional conflict score (1-100) between the intervention versus control group (mean, 95% CI): 24.8 (19.5-30.2) versus 32.4 (25.9-39.0), P = 0.07. Conclusions. The BCS-PtDA improved knowledge but did not affect risk-based decision making regarding age of initiation of BCS. These findings indicate the complexity of changing behaviors to incorporate objective risk in the medical decision-making process.

Reliable, valid and efficient evaluation of media messages: Developing a message testing protocol

Abstract: In the field of public relations and communication management, message evaluation has been one of the starting points for evaluation and measurement research at least since the 1970s. Reliable and valid message evaluation has a central role in message effects research and campaign design in other disciplines as well as communication science. The purpose of this paper is to offer a message testing protocol to efficiently acquire valid and reliable message evaluation data.,A message testing protocol is described in terms of how to conceptualize and evaluate the content and format of messages, in terms of procedures for acquiring and testing messages and in terms of using efficient, reliable and valid measures of perceived message effectiveness (PME) and perceived argument strength (PAS). The evidence supporting the reliability and validity of PME and PAS measures is reviewed.,The message testing protocol developed and reported is an efficient, reliable and valid approach for testing large numbers of messages.,Researchers’ ability to select candidate messages for subsequent deeper testing, for various types of communication campaigns, and for research in theory testing contexts is facilitated. Avoiding the limitations of using a single instance of a message to represent a category (also known as the case-category confound) is reduced.,Communication campaign designers are armed with tools to assess messages and campaign concepts quickly and efficiently, reducing pre-testing time and resources while identifying “best-in-show” examples and prototypes.,Message structures are conceptualized in terms of content and format features using theoretically driven constructs. Measures of PAS and PME are reviewed for their reliability, construct and predictive validity, finding that the measures are acceptable surrogates for actual effectiveness for a wide variety of messages and applications. Coupled with procedures that reduce confounding by randomly nesting messages within respondents and respondents to messages, the measures used and protocol deployed offer an efficient and utilitarian approach to message testing and modeling.

Designing Effective Testimonial Pictorial Warning Labels for Tobacco Products.

Abstract: Warning labels on tobacco products sometimes feature images and stories of real people whose health has been affected by smoking. We examined effects of some of the design elements that may contribute to the effectiveness of these testimonial pictorial warning labels (PWLs). Beginning with a testimonial PWL that contained an image of a person and a basic warning statement (e.g., "Smoking can kill you"), we examined the impact of adding: (a) text detailing the person's name, age and health status (identifiers); and (b) explanatory statements that elaborated on the basic warning using a testimonial or non-testimonial message. In an online experiment, 1255 adult smokers in the United States were randomly assigned to one of six experimental conditions (2 [identifier: none/identifier] × 3 [explanatory statement: none/non-testimonial/testimonial]), or a control condition (text only warning labels that currently appear on packs in the United States). In each condition, participants were exposed to multiple labels each focused on a different health effect. Effectiveness was assessed using emotional responses, engagement and behavioral intentions measured immediately post-exposure, and quit attempts measured at five-week follow up. Testimonial PWLs were more effective than the text only labels. However, there was little evidence that adding identifiers or the explanatory statements enhanced effectiveness; rather, there was some evidence that testimonial explanatory statements reduced effectiveness. These findings suggest that the most effective design for testimonial PWLs may be to combine a basic warning statement with an image of a real person, without any additional textual components.

Regulating language, not inference: an examination of the potential effectiveness of Natural American Spirit advertising restrictions

Abstract: Objective In 2017, the United States Food and Drug Administration (FDA) reached an agreement with Santa Fe Natural Tobacco Company (SFNTC) stipulating that SFNTC will remove ‘natural’ and ‘additive-free’ from Natural American Spirit (NAS) marketing to combat misperceptions that NAS is a healthier cigarette. The purpose of this study was to assess experimentally the potential effectiveness of the agreement in addressing NAS misperceptions. Methods In an online experiment, 820 current and former smokers were assigned randomly to advertising conditions with existing claims from NAS advertisements, modified claims or a no-exposure control. Advertising conditions included (1) ‘original’ NAS advertising text before the agreement; (2) ‘2017 agreement’ language permissible under the FDA–SFNTC agreement (removing ‘natural’, ‘additive-free’); (3) more restrictive (‘stricter’) language representing additional regulation (removing ‘natural’ from the brand name and the phrases ‘tobacco+water’, ‘no chemicals’). Participants completed outcome measures assessing misinformed beliefs and intentions towards NAS. Results One-way ANOVA showed that relative to the ‘original’ language, the ‘2017 agreement’ language reduced misconceptions about NAS addictiveness, but not about health or constituent composition. Yet ‘stricter’ language significantly reduced all categories of misinformed beliefs, which in turn mediated effects on (lower) intentions to use NAS. Conclusion The 2017 agreement helps dispel some misconceptions about NAS addictiveness, but does not sufficiently rectify misinformation about health or composition. Since ‘stricter’ language more effectively corrects misinformed beliefs, our results suggest the need for further regulations in addressing misinformation that drives intentions towards NAS.

An Efficient Message Evaluation Protocol: Two Empirical Analyses on Positional Effects and Optimal Sample Size.

Abstract: Reliable and valid message evaluation has a central role in effective health communication and message effects research. The authors have employed a message testing protocol to efficiently acquire valid and reliable message evaluation results: (a) use multiple messages, (b) recruit evaluators from the target population, (c) use valid and reliable effectiveness measures, (d) expose an evaluator to multiple messages, and (e) ensure enough evaluations per message. Two secondary analyses of anti-tobacco message evaluation studies provide evidence for reliability and validity regarding points (d) and (e). Seven studies where adult smokers evaluated the effectiveness of various anti-smoking campaign messages were examined. The first analysis shows that the position in which a message appears has little or no impact on its evaluation, supporting the validity of multiple-exposure design. The second analysis suggests having 25 evaluations per message can achieve a fair balance between accuracy and efficiency.

Temporal Effects of Message Congruency on Attention to and Recall of Pictorial Health Warning Labels on Cigarette Packages.

Abstract: Objectives Recent research has shown that message congruency is beneficial to recall of pictorial health warning label (PWL) content after initial exposure. Despite less attention to the text warning, smokers exposed to congruent PWLs were more likely to recall the text and the message. This study aimed to replicate these findings and to examine whether congruency also affects recall after multiple exposures over time. Methods A total of 320 daily smokers (39.7% female; cigarettes/day: M = 15.31, SD = 7.15) were randomized to one congruent or incongruent PWL and attended 4 laboratory sessions over 10 days. During each session, eye movements were recorded while viewing the PWL and open-ended recall of label content was assessed after exposure. Results Smokers who were exposed to a congruent PWL were more likely to recall the text (p = .01) and the message (p = .02) and less likely to recall the image (p = .003) of the PWL after initial exposure. By day 4, incongruent PWLs were recalled equally well as congruent PWLs. Independent of condition, image recall was initially high and remained high whereas text and message recall was relatively low initially but increased over time. It was not until day 7 that about 80% of text and message recall was observed. Conclusions Even when exposed to the same PWL over time, smokers require multiple exposures to recall the text and the message of a PWL. More research on the effects of congruency in the natural environment, where smokers are exposed to multiple PWLs, is needed. Implications The findings of this study, and of previous work showing that message congruency in PWLs is beneficial to initial recall of PWL content, could potentially help to address legal challenges regarding the implementation of PWLs in the United States. Factually correct text warnings have been uncontested on US cigarettes packages since 1966. Congruent PWLs simply provide a means to visually support the same information as the existing text using a medium that better garners attention to the health information. Investigating and understanding longer-term effects of congruency are important and can empirically inform future warning label development, both in the United States via the Family Smoking Prevention and Tobacco Control Act, and via other governing bodies.

An experimental study of recommendation algorithms for tailored health communication

Abstract: Recommendation algorithms are widely used in online cultural markets to provide personalized suggestions for products like books and movies. At the heart of the commercial success of recommendation algorithms is their ability to make an accurate prediction of a target person’s preferences for previously unseen items. Can these algorithms also be used to predict which health messages an individual will evaluate favorably, and thereby provide effective tailored communication to the person? Although there is evidence that message tailoring enhances persuasion, little research has examined the effectiveness of recommendation algorithms for tailored health interventions aimed at promoting behavior change. We developed a message tailoring algorithm to select smoking-related public service announcements (PSAs) smokers, and experimentally test its effectiveness in predicting a target smoker’s evaluations of PSAs and encouraging smoking cessation. The tailoring algorithm was constructed using multiple levels of data on smokers’ PSA rating history, individual differences, content features of the PSAs, and other smokers’ PSA ratings. We conducted a longitudinal online experiment to examine its efficacy in comparison to two non-tailored methods: best-in-show (choosing messages most preferred by other smokers) and random selection. The results showed that the tailoring algorithm produced more accurate predictions of smokers’ message evaluations than the simple-average method used for the best-in-show approach. Smokers who viewed PSAs recommended by the tailoring algorithm were more likely than those receiving a random set to evaluate the PSAs favorably and quit smoking. There was no significant difference between the best-in-show and random-selection methods in message assessment and quitting behavior.

Does Interest in Smoking Affect Youth Selection of Pro-smoking Videos? A Selective Exposure Experiment.

Abstract: BACKGROUND Many pro-smoking videos on YouTube reach view counts in the hundreds of thousands and more. Yet, there is limited information on who is viewing these potentially misleading videos. This study attempts to understand the viewership of online pro-smoking videos to examine if youth at high risk for smoking are more likely to watch these videos. METHODS We conducted a selective exposure experiment with a national sample of youths (ages 15-21 years; n = 614) to identify characteristics that make individuals more likely to select pro-smoking videos. During a 10-min browsing session, participants were given a set of 16 videos (eight smoking and eight nonsmoking) and were asked to view video(s) of their choice. Exposure to videos was unobtrusively logged. View count was manipulated such that smoking videos had either high or low views. RESULTS Behavioral data revealed that youth with higher interest in smoking were more likely to select and spend more time watching pro-smoking videos than youth with lower interest in smoking. The view count manipulation did not affect selection patterns. However, exposure to high view count smoking videos was associated with more positive attitudes toward smoking. CONCLUSIONS The findings of this study call into question the existence and prominence of pro-smoking videos on YouTube and bring to attention the need for regulatory or monitoring efforts of such content. IMPLICATIONS Given the presence and prevalence of misleading pro-smoking videos online, this is the first study to ask the practical and important question of who is viewing these videos. Using behavioral data, we are able to demonstrate that youth who are high at risk for smoking are more susceptible to select and spend more time viewing pro-smoking videos than youth who are low at risk for smoking. Findings also show that when pro-smoking videos appear to be "popular," they affect attitudes toward smoking. Our findings provide policy implications regarding regulation of smoking promotion videos online.

Communication Regulatory Science: Mapping a New Field.

Abstract: Communication regulatory science is an emerging field that uses validated techniques, tools, and models to inform regulatory actions that promote optimal communication outcomes and benefit the publ...

Connectivity between visual and auditory cortices mediates the influence of argument strength on the effectiveness of smoking-cessation videos among smokers low in sensation seeking

Abstract: Purpose Argument strength (AS) is a validated measure of persuasiveness that has been identified as one of the key variables determining the effectiveness of video ads. Smoking-cessation videos with high AS are more effective at reducing smoking behavior than videos with low AS. The neural processes that mediate the effects of AS on subsequent smoking have not been identified. In the present study, we tested whether the efficacy of high-AS smoking-cessation videos is determined by the level of integration of visual and auditory (ie, multisensory) processes. In addition, we tested differences in sensation seeking, which is repeatedly associated with smokers' sensitivity to cessation interventions. Patients and methods Using functional magnetic resonance imaging (fMRI), we recorded the brain response of 66 smokers randomly assigned to view either 16 high-AS or 16 low-AS smoking-cessation videos. Multisensory processing was assessed by the functional connectivity between brain regions that encoded visual and auditory information in the videos. Smoking behavior was indexed by the urine level of cotinine, a nicotine metabolite, immediately before and approximately 30 days after the fMRI session. Results We found a significant moderated mediation effect, such that the connectivity between visual and auditory cortices mediated the effect of AS on subsequent smoking, but only for smokers lower in sensation seeking. The prediction performance of the model was confirmed by leave-one-out cross-validation. Conclusion Our study suggests that audiovisual integration underlies the greater efficacy of high- vs low-AS smoking-cessation videos for individuals lower in sensation seeking. High-sensation-seeking smokers may be responsive to other characteristics of smoking-cessation videos.

Attitudinal Spillover from Misleading Natural Cigarette Marketing: An Experiment Examining Current and Former Smokers’ Support for Tobacco Industry Regulation

Abstract: This research examined the influence of natural cigarette advertising on tobacco control policy support, and the potential for misbeliefs arising from exposure to cigarette marketing to affect such support. Ample research indicates that natural cigarettes such as Natural American Spirit (NAS) are widely and erroneously perceived as safer than their traditional counterparts because of their marketed “natural” composition. Yet regulatory action regarding natural cigarette marketing has been limited in scope, and little research has examined whether misleading product advertising affects support for related policy, an important component of the policy process. Here, we administered a large-scale randomized experiment (n = 1128), assigning current and former smokers in the United States to an NAS advertising condition or a control group and assessing their support for tobacco industry regulation. Results show that exposure to NAS advertising reduces support for policies to ban potentially misleading terminology from cigarette advertising, and these effects are stronger for daily smokers. Further, misinformed beliefs about the healthy composition of NAS partially mediate effects on policy support. Yet interestingly, exposure to NAS marketing does not reduce support for policies to establish standards for when certain terms are permissible in cigarette advertising. The results of this analysis indicate potential spillover effects from exposure to NAS advertising in the realm of support for regulatory action pertaining to tobacco industry marketing.