Increasing Receptivity to COVID-19 Public Health Messages with Self-Affirmation and Self vs. Other Framing

ABSTRACT

There remains an urgent need for effective communication about the importance of widespread adherence to behavioral recommendations to control the COVID-19 pandemic that will also reduce resistance to such guidance. We examined two strategies for COVID-19 communication— (1) self-affirmation (reflecting on a personal value in order to boost self-integrity and reduce defensiveness to potentially threatening information); and (2) manipulating self/other message framing – and moderation of these strategies by COVID-19 risk. 600 participants (M_age = 32.55, 51% female) were recruited for an online study and, after assessment of risk factors for severe COVID-19 infection, were exposed to the experimental manipulations. Three classes of defensive responses were considered as outcomes of interest: reactance, attitudinal responses, and behavioral responses. We found that participants derogated the self-focused message more than the other-focused message. Further, other-focused messaging and/or self-affirmation were more likely to elicit positive responses among individuals at higher risk for COVID-19 complications. Our findings suggest having individuals affirm values prior to viewing COVID-19 messages, and framing messages in terms of the importance of protecting others, may be beneficial strategies for encouraging responsiveness – particularly if the targets of such messages are at risk of COVID-19 complications themselves.

KEYWORDS:

• COVID-19
• self-affirmation
• message framing
• health communication

Acknowledgments

This work was completed while the corresponding author was at the National Cancer Institute. She is now at the National Institute on Minority Health and Health Disparities.

Disclosure statement

The authors have no conflicts of interest to disclose.

Notes

1. We consider this hypothesis exploratory, because when conceptualizing and preregistering our study, we neglected to put forth this hypothesis a priori, although our models were designed to test it, and the assertion that self-affirmations should be most effective for individuals at high risk is clearly supported by the literature, as described above.

2. In addition to protective behavior intentions, vaccine intentions, and willingness, participants were asked whether they planned to do each of the following during the COVID-19 pandemic: (1) Get tested for COVID-19 infection if you plan to see anyone outside your household; (2) Get tested for COVID-19 antibodies; (3) Self quarantine for 14 days if returning from a trip; or (4) Self quarantine for 14 days if you have or believe you have the virus. Items were scored on a binary scale (0=I do not intend to do this, 1=I intend to do this, not applicable/not available in my area coded as missing). However, with the exception of self-quarantining if sick, there was limited guidance regarding the public health effectiveness of these measures at the time this study was conducted in August 2020. COVID-19 testing was limited in many places in the U.S., especially for those not exhibiting symptoms, guidance highlighted the relative safety of forming “pods” of individuals outside one’s household, rendering the initial wording of the testing intentions item less than optimal, as it asks about testing prior to seeing anyone outside one’s household. Scientific knowledge on antibody testing has accumulated since the development of these items, and with accumulating evidence of the time-limited benefit of antibodies after infection, the item on antibody testing is also outdated based on current guidance. As such, we do not present results for these outcomes in the current study.

3. We note that findings footnoted here (3) are not significant with a Bonferroni alpha correction considering 4 multiple comparisons for the 4 different outcome measures we consider under the category of “reactance”, p < .0125.

4. We note that findings footnoted here (4) are not significant when using a Bonferroni alpha correction for 4 multiple comparisons for the 4 measured outcomes we consider under “behavioral responses,” p < .0125.

5. Individuals at increased risk for COVID-19 are older than individuals not at increased risk (Garg et al., 2020). Thus, it is possible that the moderation effects we observed are due to differences in the effectiveness of affirmation and/or message framing for older individuals, rather than individuals at increased risk more generally. Thus, we conducted sensitivity analyses to address this potential issue. These analyses are described in our supplement (Supplemental Analysis 1).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.