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Stories are often used in health communication because of accumulating evidence of their potential to affect people’s attitudes and health behavioral intentions. Similarity between the reader and the story’s protagonist appears to positively influence narrative persuasion, but the exact role of similarity on persuasive outcomes is debated, as some research finds clear effects of similarity manipulations whereas others do not. Possibly, these mixed results were found because the similarity manipulations were not always relevant to the topic of the story. We conducted an experiment (N = 582) in which we varied the age and gender of the protagonist, features that were of central relevance to the story’s topic, namely breast cancer versus testicular cancer. There were two groups of participants: 324 students (mean age: 21.46 years) and 258 older adults (mean age: 56.83 years). Age similarity (but not gender similarity) had an effect on identification with the protagonist, transportation (i.e. the experience of being absorbed into a story), and the intention to donate, but only for students. For older adults, age or gender of the protagonist did not seem to matter, as nearly no differences in persuasive measures were found. As far as the underlying mechanism is concerned, the results of structural equation modeling showed that the concept of ‘perceived similarity’ would be a relevant addition to models of narrative persuasion, as it was significantly related to the narrative processes of transportation and identification, which, in turn, predicted attitudes and behavioral intentions, both directly—in the case of transportation—or indirectly, via the emotion of compassion. We conclude that both manipulated and perceived similarity are important for narrative persuasion, and that it should be kept on the research agenda of health communication. [ABSTRACT FROM AUTHOR]

Participants from the Netherlands (n = 52), China (n = 50), and South Africa (n = 166) either read a self-targeted or a family-targeted fear appeal message about chlamydia. Seven aspects of individual cultural orientation were measured, and six effects of the different messages. Interactions between nationality and target of threat were found on perceived severity, perceived susceptibility, and danger control. Only for perceived susceptibility, a difference in cultural orientation partly explained this interaction. The outcomes add to the doubts about claims in earlier literature about the relevance of receivers' nationality and cultural orientation for developing a fear appeal message. [ABSTRACT FROM AUTHOR]

Recent studies suggest that health-related fotonovelas—booklets that portray a dramatic story using photographs and captions—may be effective health communication tools, especially for readers with a low level of literacy. In this experiment, effects on knowledge and behavioral intentions were assessed of a fotonovela originally developed for a Latin-American audience. Dutch readers from a low literacy group (N = 89) and a high literacy group (N = 113) were randomly assigned to one of three conditions: a fotonovela condition (all captions translated into Dutch), a traditional brochure condition (also in Dutch), and a control condition. On knowledge about diabetes, participants in the fotonovela condition outperformed participants in both other conditions. This finding was consistent across literacy levels. On behavioral intentions, however, readers of the fotonovela did not score significantly higher than participants in the other conditions. We also evaluated hypotheses proposed in the Entertainment Overcoming Resistance Model (EORM; Moyer-Gusé, 2008) on the possible mechanisms underlying persuasion through narratives. No support was found for the mechanisms proposed in the EORM. The outcomes of this study suggest that a fotonovela may be a valuable health education format for adults with varying levels of literacy, even if it was developed for a target group with a different cultural background. [ABSTRACT FROM PUBLISHER]

Successful doctor–patient communication relies on appropriate levels of communicative health literacy, the ability to deal with and communicate about health information. This article aims to describe the development of a narrative- and picture-based health literacy intervention intended to support older patients with limited health literacy when communicating during their primary care consultations. We performed a formative evaluation that included a review of the literature and interviews with stakeholders on relevant health literacy issues, qualitative studies with the target group, intervention planning, and a small-scale evaluation. Cocreation with the target group was a major component. Seven photo stories were developed incorporating principles from narrative and social learning theory and covering communication themes and strategies identified during focus group discussions and role-play exercises. The intervention was developed in 3 different formats: 1-page photo stories, narrated video clips using the original photo story pictures, and interactive video clips covering participation and communication during primary care consultations. In our small-scale evaluation, older adults considered the cocreated intervention appealing and comprehensible. The intervention shows promise for improving the health of older adults but needs further evaluation. This study provides a rigorous template for the participatory development of health literacy interventions. [ABSTRACT FROM AUTHOR]

Two related studies were performed aimed at finding if and how prior knowledge of threat and efficacy information in a fear appeal message is associated with message outcomes (attitude and behavioural intentions). the extended Parallel Process model (ePPm) (Witte 1992; 1998) served as theoretical framework for one study about a chlamydia fear appeal (n = 57) and another about an alcohol abuse fear appeal (n = 59). Findings from both studies suggest that prior knowledge of threat information is hardly relevant for readers’ reactions to a fear appeal message. Prior knowledge of efficacy information, however, proved to play a more important role, most often in a positive way. Findings from both studies furthermore suggest that the ePPm may be incorrect in assuming that individual differences – in this case, in prior knowledge – may only affect fear appeal outcomes in an indirect way, that is through different perceptions of threat and efficacy. [ABSTRACT FROM PUBLISHER]

A systematic review was conducted to assess the available evidence for the effectiveness of interventions aiming to improve the comprehensibility of health-related documents in older adults (≥50) with different levels of health literacy. Seven databases were searched (2005 forward), and references in relevant reviews were checked. The selection procedure was conducted by 2 independent reviewers. Data extraction and assessment of the quality of the resulting studies were conducted by 1 reviewer and checked for accuracy by a 2nd reviewer. A total of 38 intervention studies had a study population of older adults (n = 35) or made an explicit comparison between age groups, including older adults (n = 3). Inconsistent evidence was found for the importance of design features to enhance the comprehensibility of health-related documents. Only for narratives and multiple-feature revisions (e.g., combining revisions in textual and visual characteristics) did the included studies provide evidence that they may be effective for older adults. Using narrative formats and/or multiple-feature revisions of health-related documents seem to be promising strategies for enhancing the comprehensibility of health-related documents for older adults. The lack of consistent evidence for effective interventions stresses the importance of (a) replication and (b) the use of standardized research methodologies. [ABSTRACT FROM PUBLISHER]

Fear appeals are frequently used in health communication, for example in anti-smoking campaigns. Of the different theoretical models that predict and explain how fear appeals work, the Extended Parallel Process Model (EPPM; Witte, 1992) is probably used most often. However, most propositions of the EPPM were not explicitly tested, or received mixed empirical support (Popova, 2012). To clarify the relationships between the variables of the EPPM, four of the EPPM's propositions were tested by performing correlational and mediation analyses. The results (n = 116) show that a large part of the relationships between the concepts of the EPPM and the outcomes of fear appeals differ from what the EPPM claims: threat and intention did not prove to be related, threat did not mediate the effect of fear on intention, and fear did not prove to influence the fear control responses. The findings from this study raise questions regarding the appropriateness of the EPPM. [ABSTRACT FROM AUTHOR]

Health communication campaigns today often use messages which include verbal and/or visual rhetorical figures. Rhetorical figures may be used with the intention of puzzling audiences, and ultimately provoking discussions about the addressed health-related issues. This study investigates the effects of using deliberately puzzling verbal and visual rhetorical figures in health messages targeted at South African youth. It explores which message variables may predict the audience's willingness to engage in discussions with friends or older people. Four different HIV and AIDS posters, in four different versions of rhetorical figures, were presented to 160 young South Africans. The verbal rhetorical figures that were used significantly and negatively affected the receivers’ (actual and perceived) comprehension, the perceived comprehension by friends, the perceived personal relevance, as well as their willingness to discuss the message with friends. No significant main effects were found of the visual rhetorical figures used. One significant interaction effect was found of verbal and visual rhetorical figures: the absence of both verbal and visual rhetorical figures led to the highest level of willingness to discuss messages with older people. Significant positive predictors of the receivers’ willingness to discuss messages with friends proved to be perceived comprehension by friends, perceived personal relevance, and perceived own comprehension. Willingness to discuss messages with older people was positively related to perceived comprehension by older people, and to perceived personal relevance. [ABSTRACT FROM AUTHOR]

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Focuses on how medical record design can assist correct interpretation of words, tables, and graphs can limit clinical errors. The cognitive processes of perception, attention, and memory; Interpretation of textual and numeric data; Use of computers to aid interpretation; Conclusions.