Elsevier

Appetite

Volume 56, Issue 1, February 2011, Pages 32-38
Appetite

Research report
The effects of tailored and threatening nutrition information on message attention. Evidence from an event-related potential study

https://doi.org/10.1016/j.appet.2010.11.139Get rights and content

Abstract

Recent evidence indicates that attention is higher for individually tailored as compared to non-tailored health communications. The present study examined whether the predicted increased attention for the tailored as opposed to general nutrition education messages is moderated by presenting high vs. low threat information about the negative consequences of an unhealthy diet. In a mixed subject experimental design, undergraduate students (N = 34) were reading tailored and non-tailored nutrition education messages with either high or low threat information about the negative consequences of an unhealthy diet. At the same time, they had to pay attention to specific odd auditory stimuli in a sequence of frequent auditory stimuli (oddball paradigm). The amount of attention allocation was measured by recording event-related potentials (ERPs; i.e., N100, MMN, P300) and reaction times. Result revealed main effects of tailoring and threat, indicating that more attention resources were allocated to tailored vs. non-tailored messages and to low threat vs. high threat messages. The findings confirm that tailoring is an effective means to draw attention to health messages, whereas threat information seems to result in a loss in message attention.

Introduction

A prerequisite for effective health education is that people have attention for the persuasive message they are exposed to (Blumberg, 2000, McGuire, 1985). The strategy of message tailoring – that is, drafting a message that closely responds to the needs of the targeted individual based on an earlier individual assessment – is often used by health educators to increase personal relevance of the health information and thus motivate people into more attentive processing of the persuasive information about recommended health behaviors. Indeed, systematic literature reviews suggest that tailoring is associated with stronger behavior change effects than generic health education, especially in nutrition education interventions (Brug et al., 2003, Kroeze et al., 2006, Noar et al., 2007), whereas a recent randomized controlled study confirmed that individually tailored nutrition education messages receive more attention from the reader than non-tailored health communications (Ruiter, Kessels, Jansma, & Brug, 2006).

Besides message tailoring, a fear appeal (Leventhal, 1971) is often thought as being an effective means to heighten attention for the health information. Several studies have hypothesized that threat perception and fear arousal heighten the relevance of threat-relevant information and, therefore, result in more attentive (systematic) processing of threat-relevant persuasive information (Baron et al., 1994, Gleicher and Petty, 1992, Ruiter et al., 2001b; see also Ruiter, Abraham, & Kok, 2001a). The findings concerning the effects of threatening information on the systematic processing of health information are, however, not conclusive. Studies that presented threatening health information to those for whom the health threat was high as opposed to low personally relevant suggest an opposite effect of threatening health information on message attention (Freeman et al., 2001, Harris and Napper, 2005, Keller, 1999, Keller and Block, 1999, Liberman and Chaiken, 1992, Sherman et al., 2000, Taubman-Ben-Ari et al., 2000). For example, Liberman and Chaiken (1992) presented coffee-drinking and non coffee-drinking participants with threatening information linking coffee-drinking to the development of fibrocystic disease (a precursor to breast cancer). The findings showed that female coffee-drinkers, for whom the message was highly relevant, were less persuaded of the link between caffeine and fibrocystic disease than female non-coffee drinkers. More importantly, coffee drinkers seemed to have systematically processed the threatening parts of the message in a defensive manner. Compared to non-coffee drinkers, they were less critical of information questioning the link between caffeine and fibrocystic disease and more critical of information supporting the link. Thus, people for whom the health message had high personal relevance seemed to process the threat information more defensively than people who already followed the recommendations (see also Harris et al., 2007, Harris and Napper, 2005, Noar et al., 2007, Sherman et al., 2000).

Defensive reactions to threatening health information have been theoretically explained with the help of cognitive dissonance theory (Festinger, 1957) and Kunda's (1990) argument for motivated reasoning. When experiencing dissonance because the self-image is threatened individuals are motivated to reduce it by changing one of the implicated cognitive or behavioral elements (e.g., perceived risk), for example through biased processing of compromising information (Liberman & Chaiken, 1992) or message derogation by refuting message claims (e.g., Brown & Locker, 2009) and evaluating recommendations as not effective (e.g., Keller, 1999).

Recently, Kessels, Ruiter, and Jansma (2010) provided neural evidence for the defensive processing of self-relevant threatening health information during message processing. Kessels et al. (2010) investigated whether reduced acceptance of self-relevant health risk information is already visible in early attention processes, i.e. attention disengagement processes. In an adapted visual selective attention paradigm combined with measures of event-related potentials (ERPs), they found that both smokers and non-smokers responded more efficiently to a target appearing on the same location as a preceding picture when this picture was a high threatening smoking picture than when this picture was a low threatening smoking picture, thus demonstrating a general attention capture effect of threatening health information. However, they also found that smokers responded more easily to a differently located target when this target was preceded by a high threat smoking picture than by a low threat smoking picture. This effect was not observed in non-smokers. The latter finding provided support for the hypothesis that threatening health information causes more efficient attention disengagement among those for whom the health threat is self-relevant (Kessels et al., 2010).

The effect of the combined use of message tailoring and threatening health information on the extent of message attention has not been tested yet and is subject of the present research. At a more general level, the present study links applied research questions with basic cognitive neuroscience methods to gain more understanding of the cognitive mechanisms that underlie persuasion (cf. Taylor, 2008). The goal of the present study was to investigate the effect of the combined use of message tailoring and threatening health information on attention allocation processes. Similar to the attention paradigm and stimulus materials used in a previous study, nutrition education messages were presented in an oddball attention paradigm (Ruiter et al., 2006). In order to measure attention allocation processes in message tailoring, participants processed two streams of information during the experiment: auditory and textual information. Participants were instructed to read the textual information combining the tailoring and threat manipulation from a screen, and at the same time they were asked to push a button whenever they heard a rare high-frequency tone (i.e., a target stimulus) and to withhold the response whenever a standard low-frequency tone (i.e., a non-target stimulus) was presented. Response latencies and event-related brain potentials were recorded to quantify the amount of attention allocation to the auditory task.

Event related potentials (ERPs) are generated from a continuous measure of brain activity by means of an electroencephalogram (EEG) (for an introduction, see Fabiani, Gratton, & Coles, 2000). ERP components frequently elicited in oddball paradigms are the N100, the MMN and the P300. The early N100 has a negative amplitude that has a maximum peak around 100 ms after stimulus onset and is usually interpreted as reflecting the distribution of perceptual resources to task-relevant stimulus processing (Coull, 1998, Hillyard et al., 1995, Näätänen, 1992). The N100 shows larger amplitudes whenever the target stimulus is attended to, compared to when there is less or no attention to the target. The Mismatch Negativity (MMN) has a negative peak with a latency of 100–200 ms after stimulus onset and has been proposed to reflect comparison of incoming stimuli to a short-lived sensory memory trace of preceding stimuli. The MMN is assumed to be a neural correlate of automatic and pre-attentive change detection, showing larger amplitudes to the extent that the stimuli (targets versus non-targets) are more discriminable (Fabiani et al., 2000, Garrido et al., 2009). The P300 has a maximum positive peak around 300 ms after stimulus onset and is functionally related to later conscious, decisional and premotor response related stages (Bentin, Mouchetant-Rostaing, Giard, Echallier, & Pernier, 1999). The P300 component shows larger amplitudes whenever the target stimulus is attended to and as such provides an index for more controlled attention processes (Coull, 1998, Näätänen, 1992).

Based on previous findings that suggest that people attend more to personally relevant information (Ruiter et al., 2006), we expected that tailored nutrition messages attract more attention than non-tailored messages. This in turn – as predicted by resource allocation theory (Kok, 1997, Sanders, 1997) – leads to fewer resources left for carrying out the auditory task. We therefore hypothesized that because of limited resources there should be less auditory attention paid to the target tones during the reading of the tailored nutrition message than during the reading of the non-tailored nutrition message. As a result, we predicted that the mean amplitudes of the N100, MMN and P300 effects would be lower and the reaction times in response to the auditory targets would be slower for the tailored than for the non-tailored intervention group. In addition, Kessels et al. (2010) found automatic attention capture effects of threatening health information under conditions of both high and low personal relevance of health information, but also more controlled attention disengagement processes in response to high as opposed to low threatening information only among those for whom the health information was personally relevant. These findings thus suggest that, although high threat information automatically attracts more attention than low threat information in early processing stages, in later stages threatening information negatively affects the beneficial effects of message tailoring on attention allocation processes. We therefore expect a main effect of threatening health information on message attention in early stages of attention allocation, reflected in lower mean amplitude scores on the N100 and MMN ERP components in response to the auditory targets in the high vs. low threat condition. In addition, as a result of more defensive responses to personal relevant threatening information in later processing stages an interaction effect between tailoring and threat is expected on the P300 component. That is, the effect of message tailoring on the P300 component in response to the auditory targets will be smaller in the high threat condition than in the low threat condition.

Section snippets

Participants and experimental design

Forty-one students participated in the experiment. Participants were 19–28 years of age (low threat condition: M = 21.30; SD = 2.54; high threat condition: M = 22.14; SD = 2.57; t(29) = 1.06, p = .30, d = .39). All participants were female and reported normal or corrected-to-normal vision and had no medical history of hearing problems. They received course credits or €15 gift voucher for their participation. In the first ERP-study that measured attention processes for tailored information, tailoring was

Results

Because the data sets of four participants in the high threat condition and three participants in the low threat condition could not be used because of technical problems or too many mistakes, 34 participants remained in the sample and were included in the analyses with 17 participants in the high threat condition and 17 in the low threat condition.

Discussion

In the present study, we examined the effects of combining the methods of tailoring and threat information on attention processes for nutrition information. The P300 ERP results showed that tailored nutrition information as well as low threat nutrition information motivates people into more attentive information processing. Adding to the findings of the first ERP-study on tailoring and message attention (Ruiter et al., 2006), the attention enhancement for the tailored nutrition information was

References (38)

  • S. Bentin et al.

    ERP manifestations of processing printed words at different psycholinguistic levels: time course and scalp distribution

    Journal of Cognitive Neuroscience

    (1999)
  • Beringer, J. (1987). Experimental Run Time System (Version 3.32c). Frankfurt, Germany: Berisoft...
  • S.J. Blumberg

    Guarding against threatening HIV prevention messages: an information-processing model

    Health Education and Behavior

    (2000)
  • S. Brown et al.

    Defensive responses to an emotive anti-alcohol message

    Psychology and Health

    (2009)
  • M. Fabiani et al.

    Event-related brain potentials

  • L. Festinger

    A theory of cognitive dissonance

    (1957)
  • M.A. Freeman et al.

    Defensive evaluation of antismoking messages among college-age smokers: the role of possible selves

    Health Psychology

    (2001)
  • P.R. Harris et al.

    Self-affirmation reduces smokers’ defensiveness to graphic on-pack cigarette warning labels

    Health Psychology

    (2007)
  • P.R. Harris et al.

    Self-affirmation and the biased processing of threatening health-risk information

    Personality and Social Psychology Bulletin

    (2005)
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      Though some efforts have been recently made to evaluate the moderator and mediator roles of variables, such as the message delivery channel, sociodemographic features, or the type of participant population (e.g., Updegraff, Sherman, Luyster, & Mann, 2007), there is an urgent need to more objectively understand the psychological mechanisms involved with eliciting a real-life health-behavior change by means of tailored nutritional communications. For example, while some studies point to attention and emotional arousal as the psychological mechanisms leading behavior change (Kessels, Ruiter, Brug, & Jansma, 2011; Lang et al., 2002), others emphasize the perceived relevance and salience, cognitive resource allocation (i.e., message processing), or deliberative processes as drivers of changes in healthy behavior (Rimer & Kreuter, 2006). Because of the inability of traditional techniques (such as surveys and questionnaires) to objectively assess these more implicit and introspective mechanisms present during (and not after) message exposure, we contend that neuroimaging methods (such as functional magnetic resonance imaging (fMRI)) could constitute a step forward in determining the neural processes triggered by tailored messages that may be associated with dietary changes.

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