Narratives of Prevention and Affliction in Type 2 Diabetes: Mechanisms of Influence in a Sample of Middle-aged Women

Abstract

Research suggests that readers identify more with a competent protagonist who acts to prevent diabetes than with a less competent protagonist whose inaction leads to disease. We sought a better understanding of the mediators of this protagonist competence effect. Middle-aged women (45–55) read a prevention narrative depicting a protagonist at risk for type 2 diabetes (T2D) who prevents diabetes through lifestyle changes or an affliction narrative in which protagonist inaction leads to disease (N = 315). The prevention narrative elicited more identification than the affliction narrative for participants at low risk of T2D, but less identification for higher risk participants. Identification’s impact on intentions to adopt self-protective behaviors was partially mediated by self-referencing. Protagonist competence did not affect transportation, but transportation had a direct effect on behavioral intentions and an indirect effect on intentions mediated by self-referencing. Fear arousal predicted behavioral intentions and was highest among those who read the affliction narrative and rated self as at risk for T2D. Protagonist competence had an indirect effect on intentions mediated by attributions of trustworthiness in response to the affliction narrative. This study contributes to our understanding of how narratives work and underscores the importance of tailoring narratives to the risk profile of individuals.