Reactance to Social Authority in a Sugar Reduction Informational Video: Web-Based Randomized Controlled Trial of 4013 Participants

Abstract

Background Short and animated story-based (SAS) videos can be an effective strategy for promoting health messages. However, health promotion strategies often motivate the rejection of health messages, a phenomenon known as reactance. In this study, we examine whether the child narrator of a SAS video (perceived as nonthreatening, with low social authority) minimizes reactance to a health message about the consumption of added sugars. Objective This study aims to determine whether our SAS intervention video attenuates reactance to the sugar message when compared with a content placebo video (a health message about sunscreen) and a placebo video (a nonhealth message about earthquakes) and determine if the child narrator is more effective at reducing reactance to the sugar message when compared with the mother narrator (equivalent social authority to target audience) or family physician narrator (high social authority) of the same SAS video. Methods This is a web-based randomized controlled trial comparing an intervention video about sugar reduction narrated by a child, the child’s mother, or the family physician with a content placebo video about sunscreen use and a placebo video about earthquakes. The primary end points are differences in the antecedents to reactance (proneness to reactance, threat level of the message), its components (anger and negative cognition), and outcomes (source appraisal and attitude). We performed analysis of variance on data collected (N=4013) from participants aged 18 to 59 years who speak English and reside in the United Kingdom. Results Between December 9 and December 11, 2020, we recruited 38.62% (1550/4013) men, 60.85% (2442/4013) women, and 0.52% (21/4013) others for our study. We found a strong causal relationship between the persuasiveness of the content promoted by the videos and the components of reactance. Compared with the placebo (mean 1.56, SD 0.63) and content placebo (mean 1.76, SD 0.69) videos, the intervention videos (mean 1.99, SD 0.83) aroused higher levels of reactance to the message content (P<.001). We found no evidence that the child narrator (mean 1.99, SD 0.87) attenuated reactance to the sugar reduction message when compared with the physician (mean 1.95, SD 0.79; P=.77) and mother (mean 2.03, SD 0.83; P=.93). In addition, the physician was perceived as more qualified, reliable, and having more expertise than the child (P<.001) and mother (P<.001) narrators. Conclusions Although children may be perceived as nonthreatening messengers, we found no evidence that a child narrator attenuated reactance to a SAS video about sugar consumption when compared with a physician. Furthermore, our intervention videos, with well-intended goals toward audience health awareness, aroused higher levels of reactance when compared with the placebo videos. Our results highlight the challenges in developing effective interventions to promote persuasive health messages. Trial Registration German Clinical Trials Registry DRKS00022340; https://tinyurl.com/mr8dfena International Registered Report Identifier (IRRID) RR2-10.2196/25343

Electronically Delivered Nudges to Increase Influenza Vaccination Uptake in Older Adults With Diabetes

“…24 Because individuals with diabetes are frequently prompted to change their lifestyle and adhere to medication by their health care practitioners, they may have a higher degree of psychological reactance or nudge fatigue. Prior studies 25,26 have highlighted the difficulties in designing behavioral nudges to avoid arousing . 15 NA reactance in individuals with diabetes.…”

“… 24 Because individuals with diabetes are frequently prompted to change their lifestyle and adhere to medication by their health care practitioners, they may have a higher degree of psychological reactance or nudge fatigue. Prior studies 25 , 26 have highlighted the difficulties in designing behavioral nudges to avoid arousing reactance in individuals with diabetes. Alternative and more targeted strategies, such as packaging vaccination as part of diabetes care, a multimodel approach with communication tailored specifically for persons with diabetes, or in-home vaccination, may be effective in this group and require further study.…”

Public’s preferences for health science popularization short videos in China: a discrete choice experiment

“…As a type of health communication, health science popularization short videos disseminate health information to the public in an understandable way about healthy diet and lifestyle, vaccination, rational drug use, disease prevention, and other topics. Compared with medical books and newspapers, short videos combine text, images, and sound to make health information more interesting and understandable, which may influence viewers' attitudes and behavior more easily (11)(12)(13)(14). In addition, short videos make it possible to spread health information in just 1 min, which can achieve a large-scale spread among viewers, greatly enhancing the efficiency of health communication.…”

“…Studies have shown that the public's information adoption behaviors for short videos are closely related to the attributes of the short video. In terms of information sources, it has been demonstrated that the public's perception of health information can be influenced by the source and channel credibility of Internet content (17), and that doctors are perceived to be more qualified, reliable, and professional (12). Regarding information content, highly engaging, clinically relevant stories may be persuasive to patients in changing health attitudes or behaviors (18).…”