Threading the Needle in Health-Risk Communication: Increasing Vulnerability Salience While Promoting Self-Worth

Abstract

Health interventions often draw attention to the risks associated with unhealthy choice but in the process produce a boomerang effect such that those targeted become more committed to risky behavior. In 2 studies designed to promote condom use among sexually active college students, the authors document strategies for highlighting risk while promoting healthy choices. Study 1 demonstrated that optimistic perceptions regarding the likelihood of contracting sexually transmitted diseases (STDs) can be counteracted by drawing attention to the emotional consequences of contracting STDs, instead of its likelihood. Rather than promoting condom use, however, this procedure generated a boomerang effect: It decreased commitment to using condoms, especially among high self-esteem individuals. Study 2 showed that this unwanted effect could be reversed when emotional vulnerability was paired with a self-affirmation. This finding suggests that there can be benefits to adding threatening content to health interventions, provided that the message also contains elements designed to protect feelings of self-worth.

Notes

¹The origins of this effect appear to be linked to the accessibility of relevant cognitions. When people think about the likelihood of such events occurring, they tend to focus on their own (low) chances of experiencing the event overall. In contrast, when people think about their ability to cope with such events, they tend to focus on their own (high) chances of being distressed (see Kruger, 1999; Kruger & Burrus, 2004; Weinstein & Lachendro, 1982).

Note: Probability was rated from −10 to + 10, with negative values suggesting optimistic appraisal of self, relative to other. Coping was rated from −10 to + 10, with positive values indicating pessimistic appraisal of self, relative to other.

Note. Regression analyses predicting willingness to have unprotected sex. Probability optimism is the dummy code indicating whether a participant is in the probability optimism condition (0 = information-only control or coping vulnerability condition; 1 = probability optimism salience group). Coping pessimism is the dummy code indicating if someone is in the coping vulnerability condition (0 = information-only control or probability optimism condition; 1 = coping vulnerability condition). Self-esteem is the mean-centered value of self-esteem, using Rosenberg's (1979) Self-Esteem Inventory, with an 11-point response scale.

²Analyses also indicated that men were more willing to have unprotected sex (M = 6.20, SD = 5.01) than women (M = 3.68, SD = 3.77), t(160) = 13.97, p < .001. When gender and all the interaction terms in Table 2 were entered in the regression equation, a significant interaction was also found between gender and the dummy code for adjustment pessimism, B = −2.99, p < .05. The nature of this effect was that that the boomerang effect was larger for men than women, but the interaction between self-esteem and coping adjustment remained significant, B = 1.25, p < .05, controlling for gender and all gender interactions.

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