Communication Studies 394-0: Undergraduate Research Seminar

Section 20: Persuasion in Health Contexts

Spring 2017




Note: None of these readings is required. A number of the readings come from this book, a copy of which is available at the Library Reserve Room (under Communication Studies 205): D. O’Keefe, Persuasion: Theory and research (3rd ed., paperback, Sage) (ISBN 978-1-4522-7667-0)



1. Health-related applications of general persuasion theory and research

1.1  General background concerning persuasion

1.2  Health-related applications of some persuasion-relevant theories

            1.2.1 Cognitive dissonance theory

            1.2.2 Functional approaches to attitude

            1.2.3 Elaboration likelihood model

            1.2.4 Reasoned action theory

1.3  Health-related research involving classic persuasion variables

            1.3.1 General background to persuasion effects research

            1.3.2 Source factors

            1.3.3 Message factors

            1.3.4 Receiver factors




1.1  General background concerning persuasion


            O’Keefe, D. J. (2016). Persuasion, attitudes, and actions. In D. J. O’Keefe, Persuasion: Theory and research (3rd ed., pp. 1-18). Los Angeles, CA: Sage. (Chapter 1)




1.2  Health-related applications of some persuasion-relevant theories


1.2.1  Cognitive dissonance theory  Background


            O’Keefe, D. J. (2016). Cognitive dissonance theory. In D. J. O’Keefe, Persuasion: Theory and research (3rd ed., pp. 76-97). Los Angeles, CA: Sage. (Chapter 5)

            Harmon-Jones, E., & Mills, J. (Eds.). (1999). Cognitive dissonance: Progress on a pivotal theory in social psychology. Washington, DC: American Psychological Association.

            Harmon-Jones, E. (2002). A cognitive dissonance theory perspective on persuasion. In J. P. Dillard & M. Pfau (Eds.), The persuasion handbook: Developments in theory and practice (pp. 99-116). Los Angeles, CA: Sage.  Some health-related applications


            Stone, J., & Fernandez, N. C. (2011). When thinking about less failure causes more dissonance: The effect of elaboration and recall on behavior change following hypocrisy. Social Influence, 6, 199-211. doi:10.1080/15534510.2011.618368

            Freijy, T., & Kothe, E. J. (2013). Dissonance-based interventions for health behaviour change: A systematic review. British Journal of Health Psychology, 18, 310-337.  doi:10.1111/bjhp.12035 

            Rodriguez, R., Marchand, E., Ng, J., & Stice, E. (2008). Effects of cognitive dissonance-based eating disorder prevention program are similar for Asian, American, Hispanic, and White participants. International Journal of Eating Disorders, 41, 618-625.

            Stice, E., Durant, S., Rohde, P., & Shaw, H. (2014). Effects of a prototype Internet dissonance-based eating disorder prevention program at 1- and 2-year follow-up. Health Psychology, 33, 1558-1567.  doi:10.1037/hea0000090

            Hwang, Y. (2010). Selective exposure and selective perception of anti-tobacco campaign messages: The impacts of campaign exposure on selective perception. Health Communication, 25, 182-190.  doi:10.1080/10410230903474027


1.2.2  Functional approaches to attitude  Background


            O’Keefe, D. J. (2016). Functional approaches to attitude. In D. J. O’Keefe, Persuasion: Theory and research (3rd ed., pp. 35-55). Los Angeles, CA: Sage. (Chapter 3)

            Carpenter, C., Boster, F. J., & Andrews, K. R. (2013). Functional attitude theory. In J. P. Dillard & L. Shen (Eds.), The Sage handbook of persuasion: Developments in theory and practice (2nd ed., pp. 104-119). Los Angeles, CA: Sage.

            Carpenter, C. J. (2012). A meta-analysis of the functional matching effect based on functional attitude theory. Southern Communication Journal, 77, 438-451. doi:10.1080/1041794X.2012.699989  Some health-related applications

            Wang, X. (2009). Integrating the theory of planned behavior and attitude functions: Implications for health campaign design. Health Communication, 24, 426-434.

            Wang, X. (2012). The role of attitude functions and self-monitoring in predicting intentions to register as organ donors and to discuss organ donation with family. Communication Research, 39, 26-47. doi:10.1177/0093650211424406

            Kim, A., Stark, E., & Borgida, E. (2011). Symbolic politics and the prediction of attitudes toward federal regulation of reduced-exposure tobacco products. Journal of Applied Social Psychology, 41, 381-400. doi:10.1111/j.1559-1816.2010.00718.x

            Sailors, J. J. (2011). Preventing childhood obesity by persuading mothers to breastfeed: Matching appeal type to personality. In In R. Batra, P. A. Keller, & V. J. Strecher (Eds.), Leveraging consumer psychology for effective health communications: The obesity challenge (pp. 253-271). Armonk, NY: M. E. Sharpe.


1.2.3  Elaboration likelihood model  Background


            O’Keefe, D. J. (2016). Elaboration likelihood model. In D. J. O’Keefe, Persuasion: Theory and research (3rd ed., pp. 148-175). Los Angeles, CA: Sage. (Chapter 8)

            Petty, R. E., & Cacioppo, J. T. (1986). Communication and persuasion: Central and peripheral routes to attitude change. New York: Springer-Verlag.

            Petty, R. E., & Briñol, P. (2012). The elaboration likelihood model. In P. A. M. Van Lange, A. Kruglanski, & E. T. Higgins (Eds.), Handbook of theories of social psychology (Vol. 1, pp. 224-245). London: Sage.  Some health-related applications


            Bakker, A. B. (1999). Persuasive communication about AIDS prevention: Need for cognition determines the impact of message format. AIDS Education and Prevention, 11, 150-162. 

            Dinoff, B. L., & Kowalski, R. M. (1999). Reducing AIDS risk behavior: The combined efficacy of protection motivation theory and the elaboration likelihood model. Journal of Social and Clinical Psychology, 18, 223-239.

            Trumbo, C. W. (2002). Information processing and risk perception: An adaptation of the heuristic-systematic model. Journal of Communication, 52, 367-382.

            Igartua, J. J., Cheng, L., & Lopes, O. (2003). To think or not to think: Two pathways towards persuasion by short films on AIDS prevention. Journal of Health Communication, 8, 513-528.

            Hitt, R., Perrault, E., Smith, S., Keating, D. M., Nazione, S., Silk, K., & Russell, J. (2016). Scientific message translation and the heuristic systematic model: Insights for designing educational messages about progesterone and breast cancer risks. Journal of Cancer Education, 31, 389-396. doi10.1007/s13187-015-0835-y


1.2.4  Reasoned action theory  Background


            O’Keefe, D. J. (2016). Reasoned action theory. In D. J. O’Keefe, Persuasion: Theory and research (3rd ed., pp. 98-131). Los Angeles, CA: Sage. (Chapter 6)

            Fishbein, M., & Ajzen, I. (2010). Predicting and changing behavior: The reasoned action approach. New York: Psychology Press.

Sheeran, P., Maki, A., Montanaro, E., Avishai-Yitshak, A., Bryan, A., Klein, W. M. P., & … Rothman, A. J. (2016). The impact of changing attitudes, norms, and self-efficacy on health-related intentions and behavior: A meta-analysis. Health Psychology, 35, 1178-1188. doi:10.1037/hea0000387  Some health-related applications


            Ajzen, I., Albarracin, D., & Hornik, R. (Eds.). (2007). Prediction and change of health behavior: Applying the reasoned action approach. Mahwah, NJ: Lawrence Erlbaum.

            Gratton, L., Povey, R., & Clark-Carter, D. (2007). Promoting children’s fruit and vegetable consumption: Interventions using the theory of planned behaviour as a framework British Journal of Health Psychology, 12, 639-650.
            Dean, R. N., Farrell, J. M., Kelley, M. L., Taylor, M. J., & Rhodes, R. E. (2007). Testing the efficacy of the theory of planned behavior to explain strength training in older adults. Journal of Aging and Physical Activity, 15, 1-12.

            Hassandra, M., Viachopoulos, S. P., Kosmidou, E., Hatzigeorgiadis, A., Goudas, M., & Theodorakis, Y. (2011). Predicting students’ intention to smoke by theory of planned behaviour variables and parental influences across school grade levels. Psychology & Health, 26, 1241-1258. doi:10.1080/08870446.2011.605137

            Anderson, C. N., Noar, S. M., & Rogers, B. D. (2013). The persuasive power of oral health promotion messages: A theory of planned behavior approach to dental checkups among young adults. Health Communication, 28, 304-313. doi:10.1080/10410236.2012.684275

            Roncancio, A. M., Ward, K. K., & Fernandez, M. E. (2013). Understanding cervical cancer screening intentions among Latinas using an expanded theory of planned behavior model. Behavioral Medicine, 39, 66-72. doi:10.1080/08964289.2013.799452

Conner, M., & Sparks, P. (2015). The theory of planned behaviour and the reasoned action approach. In M. Conner & P. Norman (Eds.), Predicting and changing health behaviour: Research and practice with social cognition models (3rd ed., pp. 142-188). New York: Open University Press.


1.3  Health-related research involving classic persuasion variables


1.3.1  General background to persuasion effects research


            O’Keefe, D. J. (2016). The study of persuasive effects. In D. J. O’Keefe, Persuasion: Theory and research (3rd ed., pp. 176-187). Los Angeles, CA: Sage. (Chapter 9)

            Jackson, S. (1992). Message effects research: Principles of design and analysis. New York: Guilford.




1.3.2  Source factors  General background


            O’Keefe, D. J. (2016). Communicator factors. In D. J. O’Keefe, Persuasion: Theory and research (3rd ed., pp. 188-213). Los Angeles, CA: Sage. (Chapter 10)  Some health-related research


Larson, R. J., Woloshin, S., Schwartz, L. M., & Welch, H. G. (2005). Celebrity endorsements of cancer screening. Journal of the National Cancer Institute, 97, 693-695.

            Wang, Z., Walther, J. B., Pingree, S., & Hawkins, R. P. (2008). Health information, credibility, homophily, and influence via the Internet: Web sites versus discussion groups. Health Communication, 23, 358-368. doi:10.1080/10410230802229738

            Kesselheim, A. S., Robertson, C. T., Myers, J. A., Rose, S. L., Gillet, V., Ross, K. M., Glynn, R. J., Joffe, S., & Avorn, J. (2012). A randomized study of how physicians interpret research funding disclosures. New England Journal of Medicine, 367, 1119-1127. doi:10.1056/NEJMsa1202397 [

            Kareklas, I., Muehling, D. D., & Weber, T. J. (2015). Reexamining health messages in the digital age: A fresh look at source credibility effects. Journal of Advertising, 44, 88-104. doi:10.1080/00913367.2015.1018461

            Phua, J., & Tinkham, S. (2016). Authenticity in obesity public service announcements: Influence of spokesperson type, viewer weight, and source credibility on diet, exercise, information seeking, and electronic word-of-mouth intentions. Journal of Health Communication, 21, 337-345. doi:10.1080/10810730.2015.1080326

Yang, Q. H., & Beatty, M. (2016). A meta-analytic review of health information credibility: Belief in physicians or belief in peers? Health Information Management Journal, 45, 80-89. doi:10.1177/1833358316639432

1.3.3  Message factors  General background


            O’Keefe, D. J. (2016). Message factors. In D. J. O’Keefe, Persuasion: Theory and research (3rd ed., pp. 214-251). Los Angeles, CA: Sage. (Chapter 11)  Some health-related research


            Green, M. C. (2006). Narratives and cancer communication. Journal of Communication, 56, S163–S183.

            O’Keefe, D. J., & Jensen, J. D. (2009). The relative persuasiveness of gain-framed and loss-framed messages for encouraging disease detection behaviors: A meta-analytic review. Journal of Communication, 59, 296-316. doi:10.1111/j.1460-2466.2009.01417.x

            Armstrong, A. W., Watson, A. J., Makredes, M., Frangos, J. E., Kimball, A. B. & Kvedar, J. C. (2009). Text-message reminders to improve sunscreen use: A randomized, controlled trial using electronic monitoring. Archives of Dermatology, 145, 1230-1236.

            Gallagher, K. M., & Updegraff, J. A. (2012). Health message framing effects on attitudes, intentions, and behavior: A meta-analytic review. Annals of Behavioral Medicine, 43, 101-116. doi:10.1007/s12160-011-9308-7

            Suri, G., Sheppes, G., Leslie, S., & Gross, J. J. (2014). Stairs or escalator? Using theories of persuasion and motivation to facilitate healthy decision making. Journal of Experimental Psychology: Applied, 20, 295-302. doi:10.1037/xap0000026

            Lally, M., Goldsworthy, R., Sarr, M., Kahn, J., Brown, L., Peralta, L., & Zimet, G. (2014). Evaluation of an intervention among adolescents to reduce preventive misconception in HIV vaccine clinical trials. Journal of Adolescent Health, 55, 254-259. doi:10.1016/j.jadohealth.2014.01.006

Bryan, C. J., Yeager, D. S., Hinojosa, C. P., Chabot, A., Bergen, H., Kawamura, M., & Steubing, F. (2016). Harnessing adolescent values to motivate healthier eating. PNAS, 113, 10830-10835. doi:10.1073/pnas.1604586113

Cook, P. F., Schmiege, S. J., Mansberger, S. L., Sheppler, C., Kammer, J., Fitzgerald, T., & Kahook, M. Y. (2017). Motivational interviewing or reminders for glaucoma medication adherence: Results of a multi-site randomised controlled trial. Psychology and Health, 32, 145-165. doi:10.1080/08870446.2016.1244537


1.3.4  Receiver factors  General background


            O’Keefe, D. J. (2016). Receiver and context factors. In D. J. O’Keefe, Persuasion: Theory and research (3rd ed., pp. 252-267). Los Angeles, CA: Sage. (Chapter 12)  Some health-related research  Receiver sensation-seeking


            Morgan, S. E., Palmgreen, P., Stephenson, M. T., Hoyle, R. H., & Lorch, E. P. (2003). Associations between message features and subjective evaluations of the sensation value of antidrug public service announcements. Journal of Communication, 53, 512-526.

Stephenson, M. T., & Southwell, B. G. (2006). Sensation seeking, the activation model, and mass media health campaigns: Current findings and future directions for cancer communication. Journal of Communication, 56, S38–S56.

            Niederdeppe, J., Davis, K. C., Farrelly, M. C., & Yarsevich, J. (2007). Stylistic features, need for sensation, and confirmed recall of national smoking prevention advertisements. Journal of Communication, 57, 272-292.

            Morgan, S. E. (2012). Designing high sensation value messages for the sensation seeking audience. In H. Cho (Ed.), Health communication message design: Theory and practice (pp. 231-247). Los Angeles: Sage.

Xu, J. (2015). Designing messages with high sensation value: When activation meets reactance. Psychology and Health, 30, 423-440. doi:10.1080/08870446.2014.977280  Receiver regulatory focus


            Zhao, G., & Pechmann, C. (2007). The impact of regulatory focus on adolescents’ response to antismoking advertising campaigns. Journal of Marketing Research, 44, 671-687.

Kees, J., Burton, S., & Tangari, A. H. (2010). The impact of regulatory focus, temporal orientation, and fit on consumer responses to health-related advertising. Journal of Advertising, 39, 19-34.

            Pfeffer, I. (2013). Regulatory fit messages and physical activity motivation. Journal of Sport & Exercise Psychology, 35, 119-131.

Bosone, L., Martinez, F., & Kalampalikis, N. (2015). When the model fits the frame: The impact of regulatory fit on efficacy appraisal and persuasion in health communication. Personality and Social Psychology Bulletin, 41, 526-539. doi:10.1177/0146167215571089

            Ludolph, R., & Schulz, P. J. (2015). Does regulatory fit lead to more effective health communication? A systematic review. Social Science and Medicine, 128, 142-150. doi:10.1016/j.socscimed.2015.01.021

Averbeck, J. M., & Nisbett, G. S. (in press). Regulatory focus and persuasive sleep messages. Communication Reports.  doi:10.1080/08934215.2016.1247901  Creating resistance to persuasion  Inoculation


            Godbold, L. C., & Pfau, M. (2000). Conferring resistance to peer pressure among adolescents: Using inoculation theory to discourage alcohol use. Communication Research, 27, 411-437.

            Ivanov, B. (2012). Designing inoculation messages for health communication campaigns. In H. Cho (Ed.), Health communication message design: Theory and practice (pp. 73-93). Los Angeles: Sage.

            Richards, A., & Banas, J. A. (2015). Inoculating against reactance to persuasive health messages. Health Communication, 30, 451-460. doi:10.1080/10410236.2013.867005

            Wong, N. C. H. (2016). “Vaccinations are safe and effective”: Inoculating positive HPV vaccine attitudes against antivaccination attack messages. Communication Reports, 29, 127-138. doi:10.1080/08934215.2015.1083599 

            Compton, J., Jackson, B., & Dimmock, J. A. (2016). Persuading others to avoid persuasion: Inoculation theory and resistant health attitudes. Frontiers in Psychology, 7, 122. doi:10.3389/fpsyg.2016.00122  Refusal-skill training


            Donaldson, S. I., Graham, J. W., Piccinin, A. M., & Hansen, W. B. (1995). Resistance-skills training and onset of alcohol use: Evidence for beneficial and potentially harmful effects in public schools and in private Catholic schools. Health Psychology, 14, 291-300.

            Wynn, S. R., Schulenberg, J., Maggs, J. L., & Zucker, R. A. (2000). Preventing alcohol misuse: The impact of refusal skills and norms. Psychology of Addictive Behaviors, 14, 36-47.

            Heyne, T. R., & Bogner, F. X. (2009). Strengthening resistance self-efficacy: Influence of teaching approaches and gender on different consumption groups. Journal of Drug Education, 39, 439-457. doi:10.1348/014466509X468421

            Pan, W., & Bai, H. (2009). A multivariate approach to a meta-analytic review of the effectiveness of the D.A.R.E. program. International Journal of Environmental Research and Public Health, 6, 267-277. doi:10.3390/ijerph6010267

Smith, D. C., Tabb, K. M., Fisher, D., & Cleeland, L. (2014). Drug refusal skills training does not enhance outcomes of African American adolescents with substance use problems. Journal of Substance Abuse Treatment, 46, 274-279. doi:10.1016/j.jsat.2013.07.004  Reactance and other defensive reactions  Reactance


Dillard, J. P., & Shen, L. (2005). On the nature of reactance and its role in persuasive health communication. Communication Monographs, 72, 144-168.

            Quick, B. L., Shen, L., & Dillard, J. P. (2013). Reactance theory and persuasion. In J. P. Dillard & L. Shen (Eds.), The Sage handbook of persuasion: Developments in theory and practice (2nd ed., pp. 167-183). Thousand Oaks, CA: Sage Publications.

Stok, F. M., de Vet, E., de Wit, J. B. F., Renner, B., & de Ridder, D. T. D. (2015). Communicating eating-related rules. Suggestions are more effective than restrictions. Appetite, 86, 45-53. doi:10.1016/j.appet.2014.09.010

            Richards, A., & Banas, J. A. (2015). Inoculating against reactance to persuasive health messages. Health Communication, 30, 451-460. doi:10.1080/10410236.2013.867005

            Aspden, T., Ingledew, D. K., & Parkinson, J. A. (2015). Effects of motives on reactions to safe sun messages. Psychology, Health, and Medicine, 20, 274-286. doi:10.1080/13548506.2014.936882  Defensive reactions generally


            Miller, W. R., & Rollnick, S. (2002). Motivational interviewing: Preparing people for change (3rd ed.). New York: Guilford Press.

            Thevos, A. K., Quick, R. E, & Yanduli, V. (2000). Motivational interviewing enhances the adoption of water disinfection practices in Zambia. Health Promotion International, 15, 207-215.

            Knight, K. M., McGowan, L., Dickens, C., & Bundy, C. (2006). A systematic review of motivational interviewing in physical health care settings. British Journal of Health Psychology, 11, 319-332.
            Pavey, L. J., & Sparks, P. (2012). Autonomy and defensiveness: Experimentally increasing adaptive responses to health-risk information via priming and self-affirmation. Psychology & Health, 27, 259-276. doi:10.1080/08870446.2011.556251

            Zhao, X., Peterson, E. B., Kim, W., & Rolfe-Redding, J. (2014). Effects of self-affirmation on daily versus occasional smokers’ responses to graphic warning labels. Communication Research, 41, 1137-1158. doi:10.1177/0093650212465433

Epton, T., Harris, P. R., Kane, R., van Koningsbruggen, G. M., & Sheeran, P. (2015). The impact of self-affirmation on health-behavior change: A meta-analysis. Health Psychology, 34, 187-196. doi:10.1037/hea0000116

Sweeney, A. M., & Moyer, A. (2015). Self-affirmation and responses to health messages: A meta-analysis on intentions and behavior. Health Psychology, 34, 149-159. doi:10.1037/hea0000110

            May, D., & Zhao, X. (2016). The influence of framed messages and self-affirmation on indoor tanning behavioral intentions in 18- to 30-year-old women. Health Psychology, 35, 123-130. doi:10.1037/hea0000253



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