Responses to persuasive messages encouraging professional help seeking for depression: comparison between individuals with and without psychological distress

Abstract

Background The persuasive effect of health messages can depend on message features, audience characteristics, and target behaviors. The objective of this study was to compare the responses to persuasive messages encouraging professional help seeking for depression between individuals with and without psychological distress. Methods A cross-sectional web-based survey was conducted on Japanese adults aged 35–45 years, who randomly received one of three persuasive messages that aimed to promote help-seeking intentions for depression. The primary message statements were as follows: (1) depression can happen to anyone, (2) depression needs treatment, and (3) depression improves with treatment. Participants rated the messages in terms of comprehensibility, persuasiveness, emotional response, and intended future use. Help-seeking intention for depression was measured using vignette methodology before and after exposure to the messages. Eligible participants who had not received medical treatment for their mental disorders were classified as either distressed (K6 score ≥ 5, N = 824) or non-distressed (K6 score < 5, N = 1133) and analyzed. Results No significant differences in comprehensibility or persuasiveness scores were observed between the messages, but the distressed group had significantly lower scores than the non-distressed group. Negative emotional responses such as surprise, anger, fear, sadness, guilt, and anxiety were significantly stronger when reading message 2, while a positive emotional response such as happiness was significantly stronger when reading message 3. These emotional responses were more prominent in the distressed than in the non-distressed group. After reading messages 1, 2, and 3, the proportions of participants in the distressed group who reported having a positive help-seeking intention increased by 35.1%, 32.1%, and 27.7%, respectively, and by 6.4%, 17.3%, and 15.2%, respectively in the non-distressed group. Multiple logistic regression analysis among participants having no help-seeking intention before exposure to the messages showed that message 2 had a significantly greater effect of increasing help-seeking intentions in the non-distressed group. Conclusion The exposure to persuasive messages may promote help-seeking intentions for depression. It seems likely that loss framing will work better than neutral and gain framing. Meanwhile, the responses to persuasive messages may differ to some extent between distressed and non-distressed individuals, as individuals with psychological distress are likely to be more susceptible to persuasive messages than those without. Trial registration Not applicable; this is not a report of intervention trial. Electronic supplementary material The online version of this article (10.1186/s12199-019-0786-8) contains supplementary material, which...

Technology-Based Interventions to Improve Help-Seeking for Mental Health Concerns: A Systematic Review

“…A few others incorporated cognitive-behavior principles [41][42][43] and the cognitive bias modification paradigm 27 to develop the intervention. King et al 38 used the motivational interviewing approach, whereas Suka et al 34 based their intervention on theories of persuasion, decision-making, and attitude-behavior relations.…”

“…The effectiveness of individual components could not be examined in these studies; however, a few studies used a single component. For example, an online educational intervention that provided information on biological causes of depression 33 and persuasive text messages 34 increased help-seeking intention, whereas information on depression provided through a case vignette significantly increased help-seeking attitude. 35 Some components, such as case vignettes, mental health literacy, destigmatizing information, and tailored feedback, were used in numerous studies.…”

Development of a rating scale for measuring resistance to persuasive health messages

“…After seeing a given message, participants were asked to what extent the message made them feel 1) surprised, 2) pleasant, 3) angry, 4) fearful, 5) happy, 6) sad, 7) guilty, 8) anxious, and 9) unpleasant [ 32 ]. Then participants filled in the persuasiveness scale and the resistance scale.…”