Brick Cameron, McCully Scout N, Updegraff John A, Ehret Phillip J, Areguin Maira A, Sherman David K
Psychological & Brain Sciences, University of California, Santa Barbara, CA (CB, PJE, MAA, DKS)
Department of Psychology, Kent State University, Kent, OH (SNM, JAU)
Med Decis Making. 2016 Oct;36(7):834-43. doi: 10.1177/0272989X15570114. Epub 2015 Feb 5.
Health messages are more effective when framed to be congruent with recipient characteristics, and health practitioners can strategically choose message features to promote adherence to recommended behaviors. We present exposure to US culture as a moderator of the impact of gain-frame versus loss-frame messages. Since US culture emphasizes individualism and approach orientation, greater cultural exposure was expected to predict improved patient choices and memory for gain-framed messages, whereas individuals with less exposure to US culture would show these advantages for loss-framed messages.
223 participants viewed a written oral health message in 1 of 3 randomized conditions-gain-frame, loss-frame, or no-message control-and were given 10 flosses. Cultural exposure was measured with the proportions of life spent and parents born in the US. At baseline and 1 week later, participants completed recall tests and reported recent flossing behavior.
Message frame and cultural exposure interacted to predict improved patient decisions (increased flossing) and memory maintenance for the health message over 1 week; for example, those with low cultural exposure who saw a loss-frame message flossed more. Incongruent messages led to the same flossing rates as no message. Memory retention did not explain the effect of message congruency on flossing.
Flossing behavior was self-reported. Cultural exposure may only have practical application in either highly individualistic or collectivistic countries.
In health care settings where patients are urged to follow a behavior, asking basic demographic questions could allow medical practitioners to intentionally communicate in terms of gains or losses to improve patient decision making and treatment adherence.
当健康信息的框架与接收者的特征相一致时，其效果会更佳，并且健康从业者可以策略性地选择信息特征来促进对推荐行为的依从性。我们提出接触美国文化是收益框架信息与损失框架信息影响的调节因素。由于美国文化强调个人主义和进取导向，预计更多地接触美国文化会预示患者对收益框架信息的选择和记忆得到改善，而接触美国文化较少的个体在损失框架信息方面会表现出这些优势。
223名参与者在三种随机条件之一（收益框架、损失框架或无信息对照）下观看了一条书面口腔健康信息，并获得了10根牙线。用在美国生活的时间比例和父母在美国出生的情况来衡量文化接触程度。在基线和1周后，参与者完成回忆测试并报告近期使用牙线的行为。
信息框架和文化接触相互作用，预测患者决策的改善（增加使用牙线）以及对健康信息的记忆在1周内得以维持；例如，文化接触程度低且看到损失框架信息的人使用牙线更多。不一致的信息导致的牙线使用频率与无信息时相同。记忆保持并不能解释信息一致性对使用牙线的影响。
牙线使用行为是自我报告的。文化接触可能仅在高度个人主义或集体主义国家具有实际应用价值。
在敦促患者遵循某种行为的医疗环境中，询问基本的人口统计学问题可以让医疗从业者根据收益或损失进行有意的沟通，以改善患者的决策和治疗依从性。
