The Influences of Message Framing, Perceived Product Innovativeness, and Consumer Health Consciousness on Advertising Effectiveness of Healthcare Products

ABSTRACT - This present study examines the most appropriate message framing to present to consumers in print commercials for healthcare products. A 2 x 2 x 2 experimental study is conducted to investigate the moderating effect of product type and innovativeness on the processing of framed advertising messages. Individual differences in health consciousness are also considered and are viewed as covariance in data analysis. The findings support the view that messages should be framed differently depending on product characteristics (prevention vs. detection) but positively framed messages may be more persuasive for both new prevention and detection product ads.



Citation:

Chun-Tuan (Debbie) Chang (2003) ,"The Influences of Message Framing, Perceived Product Innovativeness, and Consumer Health Consciousness on Advertising Effectiveness of Healthcare Products", in E - European Advances in Consumer Research Volume 6, eds. Darach Turley and Stephen Brown, Provo, UT : Association for Consumer Research, Pages: 204-211.

European Advances in Consumer Research Volume 6, 2003      Pages 204-211

THE INFLUENCES OF MESSAGE FRAMING, PERCEIVED PRODUCT INNOVATIVENESS, AND CONSUMER HEALTH CONSCIOUSNESS ON ADVERTISING EFFECTIVENESS OF HEALTHCARE PRODUCTS

Chun-Tuan (Debbie) Chang, University of Edinburgh, UK

[I would like to thank Dr. Stephanie and the anonymous reviewers for their valuable comments and suggestions.]

ABSTRACT -

This present study examines the most appropriate message framing to present to consumers in print commercials for healthcare products. A 2 x 2 x 2 experimental study is conducted to investigate the moderating effect of product type and innovativeness on the processing of framed advertising messages. Individual differences in health consciousness are also considered and are viewed as covariance in data analysis. The findings support the view that messages should be framed differently depending on product characteristics (prevention vs. detection) but positively framed messages may be more persuasive for both new prevention and detection product ads.

INTRODUCTION

Consumers are faced with a bewildering set of healthcare choices and a confusing barrage of health-related information. The question of how consumers perceive healthcare messages arises. Researchers argue that advertisers should pay attention to how ad messages are presented to consumers because the way information is labeled or framed may significantly influence consumers’ judgment and decisions about products (Smith, 1996; Ganzach and Karsahi, 1995; Woodside and Singer, 1994; Puto, 1987). The issue of framing and its implications are important in marketing communications and persuasion. For example, an understanding of framing effects can be applied to the creative and effective execution of advertising copy and layout (Arora, 2000).

This study investigates situations in which people have little experience with an innovative healthcare product, testing the idea that responses to advertising are influenced by the framing of the ad, perceptions of product innovativeness, and one individual difference factor: health consciousness. Prospect theory (Kahneman and Tversky, 1979 and 1981) and healthcare studies (Banks et al., 1995; Rothman et al., 1999) explain preference behavior based on the information obtained from decision problems that specified the formal probabilities and expected values associated with each response option when people have some prior experience. In other words, preference behaviors are based on subjective information interpretation and previous experience. However, when consumers face a new healthcare product and have no usage experience or little expectations, how do they evaluate it? How should advertisers frame messages that are intended to promote new healthcare products of varying degrees of innovativeness? Should they emphasize potential gains resulting from using the product or the negative consequences of not buying the product? Will the effectiveness of positively framed advertising differ from negatively framed advertising , and will these effects be the same for familiar and new healthcare products? In addition, taking individual difference into consideration, what could be the possible mediators of framing effects? Examining these issues will help healthcare advertisers develop appropriate message framing for particular types of products aimed at different market segments.

THEORIES AND HYPOTHESES

Message Framing

The ultimate goals of healthcare advertising are to maximize message persuasion and enhance informed choices. Various approaches exist for conveying information to enhance consumer knowledge and maximize message persuasion. Message framing is one of them. The theoretical framework for framing drawes on prospect theory. According to prospect theory (Kahneman and Tversky, 1979 and 1981), framing refers to the presentation of one of two equivalent value outcomes to different decision makers, where one outcome is presented in positive or gain terms, and the other in negative or loss terms. A positively framed message emphasizes the benefits to be gained by adopting a promoted course of action, whereas a negative frame focuses on the loss of these same benefits if the course of action is not adopted. The framing postulate of prospect theory states that people’s decisions are sensitive to how information is presented. Specifically, people are risk-seeking in their preferences when considering loss-framed information (in loss domain) but are risk averse in their preferences when considering gain-framed information (in gain domain). They will select an option to avoid a loss even at the "price" of risk-taking, but avoid risk that might turn a gain into a loss.

A variable that may help clarify the influence of message framing on health behaviors is the nature of the behavior being promoted. Health behaviors can be thought of as performing one of two functions: prevention r detection (Rothman et al., 1993). Prevention behaviors prevent the onset of a health problem and include such activities as doing exercise, wearing a seatbelt, applying sunscreen, using a condom, and losing weight. Detection behaviors, such as breast self-examination, mammography, Pap tests, and colorectal exams, are performed to discover early signs of a disease so that treatment effectiveness and prognosis may be optimized. An important difference between prevention and detection behavior is their perceived risk (Banks et al., 1995). Although detection behaviors are performed to minimize long-term risks (i.e., finding diseases at early stage when prognosis is improved), their perceived short-term risks are great (i.e., discovering an abnormality in the breast). Because risky options are preferred when people consider losses, negatively framed messages are more likely to facilitate the performance of detection behaviors. However, prevention behaviors may not be considered risky at all. They are performed to deter the onset or occurrence of a health problem (e.g., using sunscreen to prevent skin cancer). Choosing to perform a prevention behavior is less risky or, in the language of prospect theory, a risk-averse optionCit maintains good health. Because risk-averse options are preferred when people consider benefits or gains, positively framed messages may be more likely to facilitate the performance of prevention behaviors. Of the prevention behaviors that have been investigated, researchers conclude that doing exercise (Robberson and Rogers, 1988), using infant car seats (Christophersen and Gyulay, 1981), sunscreen (Rothman et al., 1993), and intentions to use condoms (Linville, Fischer and Fischhoff, 1993) are promoted best by gained-framed messages. Investigations of detection behaviors reveal an advantage for loss-framed messages in promoting breast self-examination (Meyerowitz and Chaiken, 1987; Meyerowitz, Wilson and Chaiken, 1991), mammography screening of breasts (Banks et al., 1995), HIV-testing (Kalichman and Coley, 1995), amniocentesis (Marteau, 1989), skin cancer examinations (Block and Keller, 1995; Rothman, Pronin and Salovey, 1996), and blood-cholesterol screening (Maheswaran and Meyers-Levy, 1990). In other words, people may respond differently to gain- versus loss-framed messages depending on whether the target behavior is a prevention behavior or a detection behavior.

These concepts can be applied to healthcare advertising since most healthcare products perform either prevention or detection functions. For example, many mouth rinses may be described as a prevention productC people regularly use mouth rinses to prevent the buildup of dental plaque and the development of gum disease (Adam and Addy, 1994). However, other mouth rinses Bcalled disclosing rinses Bserve as detection products since they are used to detect the presence of dental plaque and the onset of gum disease. Healthcare marketers should choose different framed messages depending on product functions.

H1: It is expected that the impact of message framing will vary according to the nature of the product/behavior advocated. Specifically, it is expected that positive framing will have a greater favorable impact on intention to purchase prevention healthcare products while negative framing will have a greater favorable impact on detection healthcare products.

Research on the persuasive effects of positive or negative framing of ads is not conclusive (Homer and Yoon, 1992). There still exist some unresolved issues in framing research on choice behaviors. Recently, some moderators such as involvement (Maheswaran and Meyers-Levy, 1990; Donoven and Jalleh, 2000), source credibility (Grewel et al., 1994), and education of respondents (Smith, 1996) have been found in the framing literature. This study focuses on product characteristics and individual differences as moderators of healthcare product effectiveness.

Framing and Product Innovativness

Previous literature (Kahneman and Tversky, 1984) assumed that the concept of utility and value includes decision and experienced values. Decision value refers to the contribution of anticipated outcome to the overall attractiveness of an option. Experienced value is defined as the degree of pleasure or pain, satisfaction or anguish in the actual experience of an outcome. The distinction between these two values is rarely explicit in decision theory because it is tacitly assumed that decision values and experienced values coincide. The assumption is part of the conception of an idealized decision maker who is able to predict future experience with perfect accuracy and evaluate options accordingly. For ordinary decision makers, however, the correspondence between decision values and experienced values is far from perfect (March, 1978). The common mismatch of decision values and experienced values introduces an additional element of uncertainty in many decision problems.

It is this situation which interests us: people face a new healthcare product and have no usage or even similar experiences. According to prospect theory, the experienced value of using the product is hard to estimate. What if people do not have any past experience? Our proposition is that adding the risk associated with newness may tip the balance against the loss-framed messages, which traditionally have been found to be more effective in promoting the adoption of detection products. The arguments are stated as follows.

Studies of innovation and framing come to different conclusions from those researching prevention/detection behaviors and framing. Effective framing is a function of the riskiness of the behavior (Block and Keller, 1995). Product purchase is one kind of behavior. Since the "detection product" may seem high in risk, negatively framed messages seem preferred. Negative consequence information increases consumers’ need for information about the relevant attribute, its negative consequences, and ways to avoid their occurrence (Burnkrant and Sawyer, 1983). This increased need for information reflects consumers’ levels of information acquisition and elaboration. Moreover, sometimes gain-framed messages create a boomerang effect, shifting consumer attitudes in the opposite direction from that intended by the advocacy. Such boomerang effects happen when messages are highly discrepant from subjects’ prior attitudes (Dignan et al., 1985). Gain-framed messages are viewed as providing relatively weak arguments for detecting because they do not provide consumers with sufficient justification for enduring the short-term costs of the target detection behavior. In contrast, loss-framed messages are viewed as providing more powerful arguments for why consumers should endure the short-term discomfort of having a health problem possibly detected (Cox and Cox, 2001).

However, literature on framing and innovativeness appears to favor positive framing for innovations. The idea of relying on consumer perception for defining an innovation has its roots in the sociology literature. Rogers (1983) defined an innovation as "an idea, practice, or object that is perceived as new by an individual or other unit of adoption." Literature shows that consumers’ perceptions of innovations differ from those of familiar products. Cox and Locander (1987) found that attitude formation processes differ for novel or unconventional convenience goods. In particular, attitudes for novel products may depend more heavily on consumers’ affective reactions to the advertisement, and positive framing can invoke a good mood. A good mood has been linked to favorable evaluations of a target, particularly when the information describing the target is ambiguous or neutral (Mayer et al., 1992; Sedikides, 1992). This suggests that when people face an innovative product with no prior experience, positive framing should be more effective. So when innovativeness is considered as a relevant variable for detection products, it is not clear which set of studies (favoring positive or negative framing) we should pay attention to.

Because people process health relevant information actively, behavioral responses to framed information should be a function of both the framed messages and pre-existing perceptions (Cioffi, 1991; Clark, 1994). Health messages are mostly likely to be seen and received when they are believable and consistent with past experience, and salient or relevant to consumer (Weinstein, 1988). Therefore, experience with a health issue should influence one’s receptivity to information about gains or losses and whether a behavior is perceived as risky or uncertain to adopt. Framing has been shown to have a much stronger effect in the case where consumers have little or no related product experience. Hoch and Ha’s (1986) research suggests that the framing effect will be stronger when the product experience is non-diagnostic (ambiguous) and it will be weakest (or overwhelmed) when the product experience is diagnostic (unambiguous). Therefore, it is predicted that framing effects will be enhanced when applied in new product advertisements, where the viewer of an ad has no product experience to draw on.

From the discussion above, an interaction effect of product innovativeness and message framing on message effectiveness is expected in the cases of prevention and detection products separately and framing effects become stronger as product innovativeness increases. To sum up, our hypotheses are stated as follows.

H2: For prevention products, there will be a significant difference in the message effectiveness of an ad between the positive and negative framing for a familiar product, and a greater difference for a new product. Positively framed messages are more effective for both familiar and new prevention products. (Figure 1)

H3a: For detection products, there will be a significant cross-line interaction effect between framing effects and product innovativeness. Negative framing is more effective for advertising a familiar detection product, but positive framing is more effective for advertising a new detection product.

H3b: For detection products, difference between positive and negative framing effects become more significant for a new product than that for a familiar product. (Figure 2)

FIGURE 1

EXPECTED INTERACTION EFFECT OF PRODUCT INNOVATIVENESS AND MESSAGE FRAMING ON MESSAGE EFFECTIVENESS OF A PREVENTION PRODUCT

FIGURE 2

EXPECTED INTERACTION EFFECT OF PRODUCT INNOVATIVENESS AND MESSAGE FRAMING ON MESSAGE EFFECTIVENESS OF A DETECTION PRODUCT

Health Consciousness and Framing Effects

Prospect theory is a psychological theory of choice behavior that pays scant attention to individual cognition, intentions, and dispositions (Lopes, 1987). Thus, although the focus of most framing research has been on the role of positive versus negative frames (i.e., context variables), some researchers have attempted to investigate the degree to which individual differences moderate framing effects (Levin et al., 2002). Previous research has shown that effectiveness of alternative message framing manipulations is contingent on individual difference variables (Meyers-Levy and Maheswaran, 1990).

Health consciousness presents the concept of health involvement and is defined as the degree to which an individual is conscious of his or her own health (Gould, 1988, 1990; Jayanti and Burns, 1998). It reflects awareness and concern about health (Hollis et al., 1986) and refers to the degree to which health concerns are integrated into a person’s daily activities (Jayanti and Burns, 1998). Previous literature suggests that there is a positive relationship between a respondent’s level of health consciousness and their attentiveness (and exposure) to health message (Kaskutas and Greenfield, 1997). High consciousness may stimulate much attention to information processing in health messages. People who are not very involved in or concerned about a behavioral domain are predicted to process information heuristically. Positively valenced information has been shown to be more persuasive than negatively valenced information when information is not extensively processed (Petty, Cacioppo, and Schumann, 1983). Individuals who are highly involved in a behavioral domain, however, are predicted to process information systematically. Previous research has suggested that negative information has a greater influence than positive information when processed systematically (Kanouse, 1984). From the discussion above, it seems that health consciousness may be an important variable moderating framing effects. Instead of manipulating involvement during the experiments as in previous studies (e.g., Mahewaran and Meyers-Levy, 1990), health consciousness was measured as an indicator of health involvement and then used as a covariate in the data analysis.

METHOD

Overview

The experiment tested the relative effectiveness of gain- and loss-framed messages to promote prevention and detection behaviors with different degrees of product innovativeness in a 2 (message framing: gain, loss) x 2 (product category: prevention, detection product) x 2 (degree of product innovativeness: familiar, new product) factorial design. Participants were instructed that the purpose of the study was about dental care behavioral research and were given a three-part booklet containing the stimulus materials. The first part was a premanipulation questionnaire, followed by a gain- or loss-framed advertisement that described for either a new or familiar oral hygiene product that either prevented or detected dental health problems. The third part was a post-manipulation questionnaire sought for their attitudes and intentions concerning the product. Participants followed the instructions in the booklet, answered the questions in order and were instructed to take as much time as they wanted.

Product category

It was important to choose a product that consumers could evaluate on attributes that facilitate information processing. Two additional criteria were that the products should vary in perceived innovativeness for our subject sample, and be involving. Based on these considerations and the results of a preliminary test with 13 products, dental care products were selected as the product class of interest. Mouthrinse was chosen as the familiar prevention product (existing in the current market) and rinse tablets as the innovative prevention product (a fictional product). For detection, the familiar existing product was disclosing gum; the innovative detection device was disclosing strips (a fictional product).

Participants

Since participants were required to have a basic familiarity with the product category, students were selected for the subject pool. In fact, students are present or potential consumers of this product category and represent a profitable market segment for manufacturers. In fact, 95% of the sample had bought dental care products. The experiment was a between-subjects design. The participants consisted of 202 undergraduate students (104 men; 98 women) from a large southwestern university at the United States. Participates were assigned randomly to one of eight conditions with 26, 25, 25, 24, 26, 26, 26, and 24 subjects in each condition. Age ranged from 19B39 years. 31.2% of participants’ ethnic backgrounds were White, 12.9% were African American, 16.3% were Hispanic, 29.2% were Asian, 10.4% were others, which reflected the ethnic mix of the university.

Advertisements

The dental health information was presented in a one-page print advertisement that was designed to appear professional. Eight different advertisements were developed as follows:

1. Mouthrinse (familiar, existing prevention product), positive framing

2. Mouthrinse (familiar, existing prevention product), negative framing

3. Rinse tablets (new prevention product), positive framing

4. Rinse tablets (new prevention product), negative framing

5. Disclosing gum (familiar, existing detection product), positive framing

6. Disclosing gum (familiar, existing detection product), negative framing

7. Disclosing strips (new detection product), positive framing

8. Disclosing strips (new detection product), negative framing

Care was taken to ensure that the positively and negatively framed versions of the advertisements provided the same information. Aside from specific details about the particular product promoted, all advertisements presented the same general information about how the product could improve dental health.

Measures

Premanipulation measures. There were three groups of premanipulation measures.

1. Health consciousness. A series of items assessed participants’ dental hygiene practices: frequency of brushing and flossing the teeth, and frequency of visiting a dentist for routine examinations. Adding responses to these three questions formed an index of health consciousness. A higher number indicates higher level of health consciousness.

2. Perceived risk of gum disease. Participants rated the likelihood of developing some form of gum disease if continuing their current dental hygiene practices, how worried they were about developing gum disease, and how serious a problem developing gum disease would be for people who develop it. Each rating was made on a 7-point scale ranging from 1 (not at all) to 7 (extremely).

3. Demographics. A series of items assessed general demographic information, including participants’ age, gender, ethnic background, and length of stay in the U.S.

Postmanipulation measures. There were seven groups of postmanipulation measures. The first two were manipulation checks, following by one confounding variable check, two possible mediators previous literature suggests (Banks et al., 1995, Rothman et al., 1999), and then the measure of the dependent variable.

1. Manipulation check on framing. Two questions assessed the difference of the information framing. In each question, the rating was made on a 9-point scale ranging from B4 (mostly negative/ costs) to +4 (mostly positive/ benefits).

2. Manipulation check on product innovativeness. Two questions assessed the differences between the perception of familiar product and that of new product. In each question, the rating was made on a point-scale ranging from 1 (strongly disagree) to 7 (strongly agree).

3. Opinions of the advertisement. Four questions assessed participants’ evaluation of the advertisement. Participants indicated how interesting, appealing, informative and persuasive they found the advertisement. In each case, ratings were made on a 9-point scale ranging from 1 (not at all) to 9 (extremely). The latter two questions were reverse-coded. An index was created by calculating the mean of the four items.

4. Perception of risk and severity of gum disease. The three items included in the premanipulation measures were repeated in the postmanipulation questionnaire, and the mean of the three items form an index of perception of risk and severity of gum disease.

5. Affective reactions to advertisements. Participants indicated how they felt while reading the advertisement in seven positive (assured, calm, cheerful, happy, hopeful, relaxed, relieved) and seven negative (anxious, afraid, discouraged, disturbed, sad, troubled, worried) adjectives scales. Negative items were reverse scored.

6. Behavioral intentions. Two questions assessed participants’ intentions regarding the behavior about which they had read. Participants rated the likelihood of buying and using the product on 7-point scales.

RESULTS

An initial set of analyses was conducted to determine whether any of the demographic variables moderated behavioral intentions. Because no moderating effects were obtained, all analyses are presented collapsed over these factors.

The reliability of the scales was checked and the following Cronbach’s alphas were obtained: framing=.739, opinions of the ad=.5979, positive reactions to ad=.8604, negative reactions to ad=.9132, and behavioral intention=.9156 with two highly-correlated questions which are about the likelihood of buying and using the product (correlation coefficient=0.8444).

Health Consciousness

Participants’ frequency of brushing, flossing, and visits to dentists formed an index of health consciousness. The range was from 3 to 13 with a mean of 8.1 and a standard deviation of 2.41. The higher the number, the more dental care routines were practiced, which could indicate higher level of health consciousness.

Manipulation Checks

Participants’ evaluations of the advertisement were examined to confirm that advertisements differed in terms of how the information was framed and perception of product innovativeness. Both were tested with post hoc tests with Boferroni adjustment for alpha=.05. To assess whether the framing manipulation was perceived as intended, participants rated whether the advertisement placed more emphasis on the benefits associated with using the product or the costs associated with not using the product. In general, as hoped, participants in the negative framing condition judged the advertisements as emphasizing costs more than benefits, whereas participants in the positive framing condition judged the advertisements as emphasizing benefits over costs, F(1, 200)=63.731, p<.000. An examination of participants’ ratings of the information in the advertisements revealed similar patterns. Participants who read positively framed information judged the tone of the advertisements to be significantly more positive than did those who read negatively framed information, F(1, 200)=69.302, p<.000. Examinations of product innovativeness indicated that participants identified the two levels of product innovativeness; new products were perceived as less familiar than existing ones (prevention products: F(1, 99)=72.234 with p<.000; detection products: F(1, 101)=33.56 with p<.08 which is marginally significant).

Opinions of Advertisements

The eight versions of the advertisement were rated as comparably interesting, appealing, informative, and persuasive, F (7, 180)=.948, p<.471. Post hoc tests with Boferroni adjustment for alpha=.05 were also executed and none of the pairwise comparison was statistically significant. Subjects in the eight conditions had comparable understanding of the basic information presented in the ad. This suggested that opinions of the advertisements were very similar across conditions and would not confound the experiment’s results.

Perceptions of Risk and Severity of Gum Disease

Three items assessed participants’ perceptions of the likelihood that they would develop some form of gum disease and the perceived severity of its development. The perceived risk after viewing the ad depended very little on the ad conditions (p<.988).

Affective Reactions to Advertisements

No significant condition difference was found to have either positive or negative emotional reactions among the eight groups with consideration of missing data (positive affective reactions: F(7, 189)=1.374, p<.218; negative affective reactions: F(7, 189)=1.117; p<.354). Affective reactions to the ads do not mediate the experiment results.

Behavioral Intention

Participants first reported their intentions to buy the product within a week. H1 stated that positive framing would have greater impact on intention of purchasing prevention healthcare products while negative framing would have greater impact on detection products, which was partially supported. For familiar prevention products, the message framed in positive terms led to higher intention to purchase than that framed in negative terms ( F(1, 51)=9.56 , p<.05). However, for familiar detection products, the impact of message framing had no statistically significant effect on intention to purchase ( F(1, 52)=1.69, p<.711).

Two indicators assessed participants’ intentions regarding the dental hygiene product featured in the advertisements. It was predicted that participants who read a positively framed ad promoting new prevention (rinse tablets) or new detection products (disclosing strips) would report stronger intentions to purchase and make use of the product than would those who read negatively framed versions of the ad. To be specific, H2 predicted the interaction effect between product innovativeness and framing effects in prevention products. Consistent with the predictions, the interaction between message frame and product innovativeness was significant and framing effects were stronger in the new product ad, F(3, 96)=12.134, p<.000, that is depicted in Figure 3. Pairwise comparisons were analyzed across the four groups in prevention products and the differences were all found significant. H2 was fully supported.

H3 concerned the interaction effect between product innovativeness and framing effects in detection products and increasing framing effects in new detection products. For detection products, consistent with the predictions, the interaction between message frame and product innovativeness was significant, F(3, 98)=12.368, p<.000, as depicted in Figure 4. H3a was partially supported since the difference in message effectiveness due to framing was not statistically significant in the familiar detection product (3.81 vs. 3.96). H3b was supported because framing effects were much stronger for the new product than for familiar one (2.71 vs. 0.16) (2.71=5.15-2.46; 0.16=3.96-3.81).

GENERAL DISCUSSION

The purpose of the present study is to provide some insights to marketers interested in persuading the general population to purchase healthcare products. The research draws on prospect theory (Kahneman and Tversky, 1979) to explain why the strength of the relationship between advertised information and persuasion depends on product characteristics (product functions and innovativeness). The results supported the predicted relation between product innovativeness and message frame for both prevention and detection products. Specifically, subjects showed higher intention to purchase or use the new promoted products in the positively framed ad, and the framing effects were stronger in promoting new products than in promoting familiar products. This research extends knowledge about the effect of framed advertising in consumer purchase decisions, particularly those involving healthcare products, and suggests that it is advisable to communicate with consumers in different ways depending on product characteristics. When the product is new to consumers, positively framed messages would be more effective than negatively framed ones.

The findings that the hypotheses 1 and 3a were not completely supported due to subjects already having considerable experiences of the products and were knowledgeable about them. There is little framing effect for highly involved people (Donoven and Jalleh, 1999, 2000; Krishnamurthy et al., 2001) or for the people who have diagnostic (familiar) product experience (Hoch and Ha, 1986). However, when the subjects face new products, they have not formed their knowledge about the products and positive framing appeals to them by focusing on the potential benefits of buying the products. Another possible reason for the non-significant results may result from the inappropriate scale development and measure for the behavioral intentions. Changing to a 9-point scale (more sensitive scale) and adding some other questions to measure intention could increase the opportunity of finding significance. The other improvement for future studies should move the manipulation check of product innovativeness to the pre-manipulation questionnaire because subjects’ perception of newness could change after viewing the ad.

One limitation of this study was that it only manipulated two levels of product of innovativeness (existing familiar vs. new), a categorization that could be oversimplified. Different levels of product innovativeness could be incorporated in the future research. The other measurement limitation of the research is about health consciousness. Health Consciousness Scale (Gould, 1988; Gould, 1990) could be used to measure individual differences in health consciousness directly. The last limitation might be the unusual ethnicity of the sample with over-representation of Asians (29.2% participants) and under-representation of white (31.2%). Further study should be conducted with different samples to increase the validity.

There is a need to go beyond prospect theory in identifying critical factors underlying differences in framing effects. This research provides some insights into individual difference in framing effects by considering health consciousness, and suggests that health consciousness is an important variable. Instead of manipulation, health consciousness was measured and observed directly from actual behaviors/routines. Future research should consider other individuals factors (e.g., perceived health status) and establish a more complicated model in healthcare product adverting effectiveness. Even with the limitations discussed above, this research has contributed to the framing literature because it sheds light on how various degrees of newness influence consumer evaluations of a product and examines how framing effects influence consumers’ intentions to purchase. It is the first research combining framing and perceived product characteristics and its findings should be of interest to healthcare product advertisers.

FIGURE 3

COMPARISON OF MESSAGE EFFECTIVENESS FOR PREVENTION PRODUCTS USING POSITIVE VS. NEGATIVE FRAMING

FIGURE 4

COMPARISON OF MESSAGE EFFECTIVENESS FOR DETECTION PRODUCTS USING POSITIVE VS. NEGATIVE FRAMING

REFERENCES

Adams, D., and Addy, M. (1994), "Mouthrinses," Advanced Dental Research, 8, 291-301.

Arora, R. (2000), "Message Framing and Credibility: Application in Dental Services," Health Marketing Quarterly, 18 (1/2), 29-44.

Banks, S.M., Salovey, P., Greener, S., Rothman, A.J., Moyer, A., Beauvais, J., and Epel, E. (1995), "The Effects of Message Framing on Mammography Utilization," Health Psychology, 14, 178-84.

Block , L.G., and Keller, P.A. (1995), "When to Accentuate the Negative: The Effects of Perceived Efficacy and Message Framing on Intentions to Perform a Health-Related Behavior," Journal of Marketing Research, 32 (2), 192-203.

Burnkrant, Robert E. and Alan G. Sawyer (1983), "Effects of Involvement and Message Content on Information Processing Intensity," in Information Processing Research in Advertising, ed. Richard J. Harris, Hillsdale, NJ: Erlbaum, 43-64.

Christopherson, E. R., and Gyulay, J. E. (1981), "Parental Compliance with Car Seat Usage: A Positive Approach with Long-Term Follow-Up," Journal of Pediatric Psychology, 6, 301-12.

Cioffi, D. (1991), "Beyond Attentional Strategies: A Cognitive-Perceptual Model of Somatic Interpretation," Psychological Bulletin, 109, 25-41.

Clark, L F. (1994), "Social Cognition and Health Psychology," In R. S. Wyer, Jr., and T. K. Srull (Eds), Handbook of Social Cognition (Vol. 2, pp.239-88), Hillsdale, NJ: Erlbaum.

Cox, D., and Cox, A. D. (2001), "Communicating the Consequences of Early Detection: The Role of Evidence and Framing," Journal of Marketing, 65, 91-103.

Cox, D. S., and Locander, W. B. (1987), "Product Novelty: Does It Moderate the Relationship Between Ad Attitudes and Brand Attitudes?" Journal of Advertising, 16 (3), 39-44.

Dignan, M. B., Block, A. S., and Cosby, M. (1985), "Evaluation of the North Carolina Risk Reduction Program for Smoking and Alcohol," Journal of School Health, 55, 103-6.

Donoven, R.J., and Jalleh, G. (1999), "Positively versus Negatively Framed Product Attributes: The Influence of Involvement," Psychology and Marketing, 16(7), 613-30.

Donoven, R.J., and Jalleh, G. (2000), "Positive Versus Negative Framing of a Hypothetical Infant Immunization: The Influence of Involvement," Health Education & Behavior, 27, 82-95.

Ganzach, Y. and Karsahi, N. (1995), "Message Framing and Buying Behaviors: A Field Experiment," Journal of Business Research, 32, 11-7.

Gould, S. J. (1988), "Consumer Attitudes Toward Health and Health Care: A Different Perspective," Journal of Consumer Affairs, 22(1), 96-118.

Gould, S. J. (1990), "Health Consciousness and Health Behavior: The Application of a New Health Consciousness Scale," American Journal of Preventive Medicine, 6(4), 228-37.

Grewel, D., Gotlieb, J. and Marmostein, H. (1994), "The Moderating Effects on Message Framing and Source Credibility on the Price-Perceived Risk Relationship," Journal of Consumer Research, 21(June), 145-53.

Hoch, S. J., and Ha, Young-Won (1986), "Consumer Learning: Advertising and the Ambiguity of Product Experience," Journal of Consumer Research, 13, 221-33.

Hollis, J. F., and Carmody, T. P., Connr, S. L., Fey, S. G., and Matarazzo, J. D. (1986), "The Nutrition Attitude Survey: Associations With Dietary Habits, Psychological and Physical Well-Being, and Coronary Risk Factors," Health Psychology, 5(4), 359-74.

Homer, P. M., and Yoon, S. G. (1992), "Message Framing and the Interrelationships Among Ad-Based Feelings, Affect, and Cognition," Journal of Advertising, 21(1), 19-33.

Jayanti, R.K., and Burns, A.C. (1998), "The Antecedents of Preventive Health Care Behavior: An Empirical Study," Journal of the Academy of Marketing Science, 26(1), 6-15.

Kahneman, D., and Tversky, A. (1979), "Prospect Theory: An Analysis of Decision Under Risk," Econometrica, 47, 263-91.

Kahneman, D., and Tversky, A. (1984), "Choices, Values, and Frames," American Psychologist, 39, 341-50.

Kalichman, S. C., and Coley, B. (1995), "Context Framing to Enhance HIV-Antibody-Testing Message Targeted to African American Women," Health Psychology, 14, 247-54.

Kanourse, D. E. (1984), "Explaining Negativity Biases in Evaluation and Choice Behavior Theory and Research," In T. C. Kinnear (Ed.), Advances in Consumer Research, (11, pp.703-8). Provo, UT: Associates for Consumer Research.

Kaskutas, L. A., and Greenfield, T. K. (1997), "The Role of Health Consciousness in Predicting Attention to Health Warning Messages," American Journal of Health Promotion, 11(3), 186-93.

Krishnamurthy, P., Carter, P., and Blair, E. (2001), "Attribute Framing and Goal Framing Effects in Health Decisions," Organizational Behavior and Human Decision Processes, 85 (July), 382-99.

Levin, P. I., Gaeth, G. J., Schreiber, J., Lauriola, M. (2002), "A new look at framing effects: Distribution of effect sizes, individual differences, and independence of types of effects," Organizational Behavior and Human Decision Processes, 88 (1), 411-29.

Linville, P. W., Fisher, G. W., and Fischhoff, B. (1993), "AIDS Risk Perceptions an Decision Biases," in J.B. Pryor & G.D. Reder (Eds.), The Social Psychology of HIV Infection, Hillsdale, NJ: Erlbaum, 5-38.

Lopes, L. L. (1987), "Between Hope and Fear: The Psychology of Risk," Advances in Experimental Social Psychology, 20, 255-95.

Maheswaran, D., and Meyers-Levy, J. (1990), "The Influence of Message Framing and Issue Involvement," Journal of Marketing Research, 27(3), 361-7.

March, J. G. (1978), "Bounded Rationality, Ambiguity, and the Engineering of Choice," Bell Journal of Economics, 9, 587-608.

Marteau, T. M. (1989), "Framing on Information: Its Influence upon Decisions of Doctors and Patients," British Journal of Social Psychology, 28, 89-94.

Mayer, J. D., Gaschke, Y. N., Braverman, D. L., and Evans, T. W. (1992), "Mood-Congruent Judgment is a General Effect," Journal of Personality and Social Psychology, 64, 317-26.

Meyerowitz, B. E., and Chaiken, S. (1987), "The Effect of Message Framing on Breast Self-Examination Attitudes, Intentions, and Behavior," Journal of Personality and Social Psychology, 52(3), 500-10.

Meyerowitz, B. E., Wilson, D.K., and Chaiken, S. (1991), "Loss- Framed Messages Increase Breast Self-Examination for Women Who Perceive Risk," Paper presented at the annual convention of the American Psychological Society, Washington, D.C.

Meyers-Levy, J., and Maheswaran, D. (1990), "Investigating Message Framing Effects on Consumer Judgments: The Influence of Personal Relevance and Product Risk," in Advances in Consmer Research, 17, Eds. Meyers-Levy, J. and Maheswaran, D. (Provo, UT: Association for Consumer Research), 531-4.

Petty, Richard E., John T. Cacioppo, and David Shumann (1983), "Central and Peripheral Routes to Advertising Effectiveness: The Moderating Role of Involvement," Journal of Consumer Research, 10(2), 135- 47.

Puto, C. P. (1987), "The Framing of Buying Decisions," Journal of Consumer Research, 14(December), 301-15.

Robberson, M. R., and Rogers, R.W. (1988), "Beyond Fear Appeals: Negative and Positive Persuasive Appeals to Health and Self-Esteem," Journal of Applied Social Psychology, 13, 277-87.

Rogers, E. M., Diffusion of Innovations, 3rd. New York: The Free Press, 1983.

Rothman, A. J., Salovey, P., Antone, C., Keough, K., and Martin, C. D. (1993), "The Influence of Message Framing on Intentions to Perform Health Behaviors," Journal of Experimental Social Psychology, 29, 408-33.

Rothman, A. J., Pronin, E., and Salovey P. (1996), "The Influence of Prior Concern on the Persuasiveness of Loss-Framed Messages about Skin Cancer," Paper presented at the annual meeting of the Society of Experimental Social Psychology, Sturbridge, MA.

Rothman, A. J., Martino, S. C., Bedell, B. T., Detweiler, J. B., and Salovey, P. (1999), "The Systematic Influence of Gain- and Loss Framed Messages on Interest in and Use of Different Types of Health Behavior," Personality and Social Psychology Bulletin, 22, 257-68.

Sedikides, C. (1992), "Change in the Valence of the Self as a Function of Mood," in Margaret Clark (Ed), Review of Personality and Social Psychology, 14, Newbury Park, CA: Sage, 271-311.

Smith, G. E. (1996), "Framing in Advertising and the Moderating Impact of Consumer Education," Journal of Advertising Research, 51, 49-64.

Tversky, A., and Kahneman, D. (1981), "The Framing of Decisions and the Psychology of Choice," Science, 211, 453-8.

Weinstein, N. D. (1988), "The Precaution Adoption Process," Health Psychology, 7(4), 355-86.

Woodside, A.G., and Singer, A. E. (1994), "Social Interaction Effects in the Framing of Buying Decisions," Psychology and Marketing, 11(1), 27-34.

----------------------------------------

Authors

Chun-Tuan (Debbie) Chang, University of Edinburgh, UK



Volume

E - European Advances in Consumer Research Volume 6 | 2003



Share Proceeding

Featured papers

See More

Featured

J12. The Influence of Pet-Ownership on Consumer Behavior

Lei Jia, Ohio State University, USA
Xiaojing Yang, University of Wisconsin - Milwaukee, USA
Yuwei Jiang, Hong Kong Polytechic University

Read More

Featured

D2. When a Negative Review Can Help the Company: the Role of the Unfairness and Empathy

Maria Alice Pasdiora, UFRGS
Cristiane Pizzutti, UFRGS
Natalia Englert, UFRGS

Read More

Featured

The Victory Effect: Is First-Place Seeking Stronger than Last-Place Aversion?

David Hardisty, University of British Columbia, Canada
Steven Shechter, University of British Columbia, Canada

Read More

Engage with Us

Becoming an Association for Consumer Research member is simple. Membership in ACR is relatively inexpensive, but brings significant benefits to its members.