Message Framing in Vaccine Communication: A Systematic Review of Published Literature

Abstract

Suboptimal vaccination rates are a significant problem in many countries today, in spite of improved access to vaccine services. As a result, there has been a recent expansion of research on how best to communicate about vaccines. The purpose of the present article is to provide an updated review of published, peer-reviewed empirical studies that examined the effectiveness of gain versus loss framing (i.e., goal framing) in the context of vaccine communication. To locate studies, we examined the reference list from the previous meta-analytic review (O'Keefe & Nan, 2012), and we conducted systematic searches across multiple databases. We included 34 studies in the qualitative synthesis. The relative effectiveness of goal-framed vaccine messages was often shown to depend on characteristics of the message recipient, perceived risk, or situational factors, yet most effects were inconsistent across studies, or simply limited by an insufficient number of studies. Methodological characteristics and variations are noted and discussed. The review points to several directions concerning moderators and mediators of framing effects where additional rigorous studies would be needed.

Redefining risk in prospect theory : how goal framing and efficacy difference interact to promote elderly Singaporeans’ influenza vaccination

“…This is because a person who hesitates to take vaccines can face a risk paradox -that he/she perceives vaccine uptake as both risky (i.e., side effects, needle pain) and not risky (i.e., high chance of feeling fortified) at the same time. This paradox offers potential directions for research because existing definitions of vaccine risk are mixed, which may explain why framing research has received little empirical support in the vaccine domain (Penţa & Băban, 2018).…”

“…Treating vaccines as risk-seeking tentatively supported Rothman and Salovey (1997)'s definition that risk is a behavioral attribute. However, it cannot explain the inconclusive findings with non-significant persuasiveness difference between gain and loss frames (see review in Gallagher & Updegraff, 2012;O'Keefe & Jensen, 2007;Penţa & Băban, 2018).…”

Influenza messaging is better than no messaging at all : an experimental assessment of the effects of goal framing and affected-person framing on influenza vaccination attitudes and intentions

“…Goal framing, or the framing of outcomes resulting from the presence or absence of behaviors, generally have an influence on preventive behaviors (Gallagher & Updegraff, 2012;Krishnamurthy, Carter, & Blair, 2001;Rothman & Salovey, 1997). Yet the persuasiveness of goal framing in encouraging specific preventive behaviors such as vaccination is less consistent (O'Keefe & Jensen, 2007;O'Keefe & Nan, 2012;Penţa & Băban, 2017). This study introduced the concept of affected-person framing and explored the interaction effect of goal framing and affected-person framing, as framed messages are suggested to vary in persuasiveness when behavioral outcomes are directed at oneself, close ones, and the perceived public at large (Kelly & Hornik, 2016;Penţa & Băban, 2017).…”

“…Yet the persuasiveness of goal framing in encouraging specific preventive behaviors such as vaccination is less consistent (O'Keefe & Jensen, 2007;O'Keefe & Nan, 2012;Penţa & Băban, 2017). This study introduced the concept of affected-person framing and explored the interaction effect of goal framing and affected-person framing, as framed messages are suggested to vary in persuasiveness when behavioral outcomes are directed at oneself, close ones, and the perceived public at large (Kelly & Hornik, 2016;Penţa & Băban, 2017). The present study extends recent works that tangentially or partially assessed affected-person framing effects (e.g., Fahy & Desmond, 2010;Kelly & Hornik, 2016;Lechuga, Swain, & Weinhardt, 2011).…”

“…Actual vaccination behavior was also not assessed in the scope of this experimental study. Penţa and Băban's (2017) systematic review reported that previous vaccine message framing studies did not find significant goal framing effects on vaccine uptake and most studies measured vaccination intentions as the persuasive outcome, with some of these studies additionally assessed goal framing effects on vaccination attitudes. This study's enquiry into the effects of persuasive messages with different affected persons contributes to a theoretical understanding of how goal framing may be moderated by affected-person framing in the context of vaccination.…”