Characteristics of narrative interventions and health effects: A review of the content, form, and context of narratives in health-related narrative persuasion research

Abstract

In recent years, many studies have been conducted on persuasive effects of narratives in a health context. A striking feature of this research area is the diversity of the narratives that are used in the various studies. Narratives that convey a health message differ widely on a large number of dimensions related to the content, form and context. We expect that these characteristics are potential explanatory factors in the effectiveness of the narratives. To provide an overview of the different characteristics of narratives in health effects research and of the persuasive effects that were found, we review 153 experimental studies on health-related narrative persuasion with a focus on the narrative stimuli. The results show that: a) with regard to the content, showing the healthy behavior in a narrative (as opposed to the unhealthy behavior with negative consequences) may be associated with effects on intention. Narratives that contain high emotional content are more often shown to have effects. b) With regard to the form, for print narratives, a first-person perspective is a promising characteristic in light of effectiveness. c) With regard to the context, an overtly persuasive presentation format does not seem to inhibit narrative persuasion. And d) other characteristics, like character similarity or the presentation medium of the narrative, do not seem to be promising characteristics for producing health effects. In addition, fruitful areas for further research can be found in the familiarity of the setting and the way a health message is embedded in the narrative. Because of the diversity of narrative characteristics and effects that were found, continued research effort is warranted on which characteristics lead to effects. The present review provides an overview of the evidence for persuasive narrative characteristics so far.

The power of narrative health communication: Exploring possible effects of first-hand experiential stories on cancer awareness amongst university students

“…In line with the existing literature, the aspects that participants mentioned as having affected them most, involved strong emotions as shown here, emphasising that highly emotional narratives are effective. 4,10 It is important to note that whereas the given studies involved constructed stories and took a quasi-experimental approach, the results were similar to this study in which participants spontaneously related their experiences without being scripted. Three strong emotions arose out of the narratives, that is, sadness, contentment and fear.…”

“…The effects of the narratives mostly lay in the emotions that were provoked amongst the participants, which are in line with literature. 4,9 Some responses by participants show that they were transported into the experiences of the speakers, thus making the narratives more memorable to them 4 buoyed by the fact that the speakers live to tell their stories. 1 Reactions by students detailing the behavioural changes that they intend to make show that they did not merely listen to the narratives, but that they adapted them with the intention of making necessary changes to their lives.…”

“…3 Research has yet to establish the most effective modality, content and format regarding the use of narratives for cancer-related health communication. In terms of content, a meta-analysis of 153 experimental studies on the use of narratives for health communication 4 indicates that narratives proved to be more effective when they involved the use of highly emotional content. Specifically, regarding narrative content and emotional effects, narrative warnings are capable of generating transportation and identification, 5 both of which relate directly to perceived effectiveness through the emotion of sadness.…”

“…8 For health-related narratives, healthy behaviour rather than unhealthy behaviour leading to negative consequences could better be associated with effects on intentions to change health-related behaviour. 4 These authors posit that the diversity of narrative characteristics and effects that have been found in experimental studies make it imperative for research efforts to continue, to determine which characteristics lead to effects. Five types of narrative communication are identified for different communication purposes.…”

Can A Funny Story about Tooth Brushing Decrease Plaque Scores in Children? A Longitudinal Field Experiment

“…In entertainment education narratives, the embedded message is often communicated via the protagonist's behavior. Such behaviors can be framed in a positive way, by showing the positive consequences of a recommended behavior such as positive emotions and social acceptance; in a negative way, by showing the negative consequences of undesired behavior such as negative emotions and social rejection (De Graaf et al, 2016). Several studies have shown that positively framed narratives, i.e., narratives that show the positive consequences of a recommended behavior, increased children's character strengths (Du & Hao, 2018;Lee et al, 2014;Talwar et al, 2016).…”