BackgroundOnline health communication has the potential to reach large audiences, with the additional advantages that it can be operational at all times and that the costs per visitor are low. Furthermore, research shows that Internet-delivered interventions can be effective in changing health behaviors. However, exposure to Internet-delivered health-communication programs is generally low. Research investigating predictors of exposure is needed to be able to effectively disseminate online interventions.ObjectiveIn the present study, the authors used a longitudinal design with the aim of identifying demographic, psychological, and behavioral predictors of visiting, using, and revisiting an online program promoting physical activity in the general population.MethodsA webpage was created providing the public with information about health and healthy behavior. The website included a “physical activity check,” which consisted of a physical activity computer-tailoring expert system where visitors could check whether their physical activity levels were in line with recommendations. Visitors who consented to participate in the present study (n = 489) filled in a questionnaire that assessed demographics, mode of recruitment, current physical activity levels, and health motivation. Immediately after, participants received tailored feedback concerning their current physical activity levels and completed a questionnaire assessing affective and cognitive user experience, attitude toward being sufficiently physically active, and intention to be sufficiently physically active. Three months later, participants received an email inviting them once more to check whether their physical activity level had changed.ResultsAnalyses of visiting showed that more women (67.5%) than men (32.5%) visited the program. With regard to continued use, native Dutch participants (odds ratio [OR] = 2.81, 95% confidence interval [CI] = 1.16-6.81, P = .02) and participants with a strong motivation to be healthy (OR = 1.46, CI = 1.03-2.07, P = .03) were most likely to continue usage of the program. With regard to revisiting, older participants (OR = 1.04, CI = 1.01-1.06, P = .01) and highly educated participants (OR = 4.69, CI = 1.44-15.22, P = .01) were more likely to revisit the program after three months. In addition, positive affective user experience predicted revisiting (OR = 1.64, CI = 1.12-2.39, P = .01).ConclusionsThe results suggest that online interventions could specifically target men, young people, immigrant groups, people with a low education, and people with a weak health motivation to increase exposure to these interventions. Furthermore, eliciting positive feelings in visitors may contribute to higher usage rates.

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Objective: Information about healthy and unhealthy nutrients is increasingly conveyed at the point of purchase. Many studies have investigated the effects of product health information on attitudes and intentions, but the empirical evidence becomes sketchier when the focus of research is actual purchase behaviour. The present paper provides an overview of empirical evidence on the effectiveness of product health information for food products at the point of purchase. Design: A systematic literature review was conducted. Setting: Only studies were included that assessed the effect of product health information at the point of purchase on actual purchase behaviour, using data provided by stores' sales records or obtained by investigating customer receipts as the primary outcome measure. Subjects: The included studies' target group comprised supermarket clientele. Results: Several studies found no significant effects of product health information on actual purchase behaviour. Interventions were more likely to be effective when they lasted for a longer time, when they included additional intervention components, and when they targeted the absence of unhealthy nutrients instead of or in addition to the presence of healthy nutrients. Conclusions: No strong evidence for the effectiveness of product health information was found. The effect of intervention duration, additional promotional activities and targeting of healthy v. unhealthy nutrients should be closely examined in future studies.

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Enjoyment is consistently noted as important for engaging audiences in games for health. However, as a term, enjoyment is often used interchangeably with a host of other terms, some of which overlap conceptually. This obscures what does and what does not constitute enjoyment, and in turn slows scientific progress by making the study of enjoyment and the synthesis of enjoyment-related research difficult. This article is aimed at improving our understanding of enjoyment by distinguishing enjoyment from other important constructs, such as fun and engagement, and by providing an overview of the experimental evidence on the determinants of enjoyment in videogames. Competence, narrative transportation, and relevance are identified as key factors related to enjoyment, and future studies examining these factors using games for health are recommended.

Health-promoting messages can be framed in terms of the gains that are associated with healthy behaviour (gain frame) or the losses that are associated with unhealthy behaviour (loss frame). In the present research, we examined the role of positive and negative affect in the persuasive effects of gain-and loss-framed health-promoting information. Experiment 1 (N ¼ 98) showed that gain-framed information resulted in higher levels of information acceptance than loss-framed information and that this effect was mediated by positive affect. The results of Experiment 2 (N ¼ 129) showed that gainframed information resulted in higher levels of information acceptance and attitude, an effect that was again mediated by positive affect. In addition, loss-framed information resulted in more negative affect than gain-framed information and negative affect increased participants' intention to engage in the healthy behaviour. These results suggest that affect may be of great importance in the persuasion process and may be particularly helpful to explain the underlying mechanisms of message framing effects. The findings also suggest that gain-and loss-framed messages offer distinct pathways to persuasion.

Health-promoting messages can be framed in terms of the beneficial consequences of healthy behaviour (gain-framed messages) or the detrimental consequences of unhealthy behaviour (loss-framed messages). An influential notion holds that the perceived risk associated with the recommended behaviour determines the relative persuasiveness of gain- and loss-framed messages. This ‘risk-framing hypothesis’, as we call it, was derived from prospect theory, has been central to health message framing research for the last two decades, and does not cease to appeal to researchers. The present paper examines the validity of the risk-framing hypothesis. We performed six empirical studies on the interaction between perceived risk and message framing. These studies were conducted in two different countries and employed framed messages targeting skin cancer prevention and detection, physical activity, breast self-examination and vaccination behaviour. Behavioural intention served as the outcome measure. None of these studies found evidence in support of the risk-framing hypothesis. We conclude that the empirical evidence in favour of the hypothesis is weak and discuss the ramifications of this for future message framing research.