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Accepted for/Published in: Journal of Medical Internet Research

Date Submitted: Apr 15, 2021
Date Accepted: Sep 12, 2021
Date Submitted to PubMed: Nov 23, 2021

The final, peer-reviewed published version of this preprint can be found here:

Reactance to Social Authority in a Sugar Reduction Informational Video: Web-Based Randomized Controlled Trial of 4013 Participants

Hachaturyan V, Adam M, Favaretti C, Greuel M, Gates J, Bärnighausen T, Vandormael A

Reactance to Social Authority in a Sugar Reduction Informational Video: Web-Based Randomized Controlled Trial of 4013 Participants

J Med Internet Res 2021;23(11):e29664

DOI: 10.2196/29664

PMID: 34813490

PMCID: 8663693

Reactance to social authority in a sugar reduction informational video: an online randomized controlled trial of 4,013 participants

  • Violetta Hachaturyan; 
  • Maya Adam; 
  • Caterina Favaretti; 
  • Merlin Greuel; 
  • Jennifer Gates; 
  • Till Bärnighausen; 
  • Alain Vandormael

ABSTRACT

Background:

Short and animated story-based (SAS) videos can be an effective strategy to promote health messages. However, health promotion strategies often arouse a motivation to reject the health message, a phenomenon known as reactance. In this study, we examine if the child narrator of a SAS video (perceived as non-threatening, with low social authority) minimizes reactance to a health message about the consumption of added sugars.

Objective:

1) To determine if our SAS intervention video attenuates reactance to the sugar message when compared with a content placebo video (a health message about sunscreen) and a placebo video (a non-health message about earthquakes). 2) To determine if the child narrator is more effective at reducing reactance to the sugar message when compared with the mother narrator (equivalent social authority to target audience) or family physician narrator (high social authority) of the same SAS video.

Methods:

This is an online randomized controlled trial comparing an intervention video about sugar reduction narrated by (i) a child (low social authority), (ii) the child’s mother (equivalent social authority), or (iii) the family doctor (high social authority) against (iv) a content placebo video about sunscreen use (no sugar content), and (v) a placebo video about earthquakes (no health content). The primary endpoints are differences in the antecedents to reactance (proneness to reactance, threat level of the message), its components (anger and negative cognition), and outcomes (source appraisal and attitude). We performed an Analysis of Variance (ANOVA) on data collected from 4,013 participants aged 18 to 59 years who speak English and reside in the United Kingdom.

Results:

Between 09 December 2020 and 11 December 2020, we recruited 1550 (38.6%) men, 2442 (60.9%) women, and 21 (0.5%) others for our study. We found a strong causal relationship between the persuasiveness of the content promoted by the videos and the components of reactance. Compared with the placebo (M = 1.56, SD = 0.63) and content placebo (M = 1.76, SD = 0.69) videos, the intervention videos (M = 1.99, SD = 0.83) aroused higher levels of reactance to the message content (P < .001). We found no evidence that the child narrator (M = 1.99, SD = 0.87) attenuated reactance to the sugar reduction message, when compared with the doctor (M = 1.95, SD = 0.79, P = .772) and mother (M = 2.03, SD = 0.83, P = .926). In addition, the doctor was perceived as more qualified, reliable, and having more expertise than the child (P < .001) and mother (P < .001) narrators.

Conclusions:

Although children may be perceived as neutral or non-threatening messengers, we found no evidence that a child narrator attenuated reactance to a SAS video about sugar consumption when compared with a doctor, who has high social authority and expertise. Further, our intervention videos, with well-intended goals toward audience health awareness, aroused higher levels of reactance when compared with a placebo video about earthquakes and a content placebo video about sunscreen use. Our results speak to the challenges in developing effective interventions to promote persuasive health messages. Clinical Trial: This study was registered at the German Clinical Trials Register (www.drks.de) on July 24th, 2020: DRKS00022340.


 Citation

Please cite as:

Hachaturyan V, Adam M, Favaretti C, Greuel M, Gates J, Bärnighausen T, Vandormael A

Reactance to Social Authority in a Sugar Reduction Informational Video: Web-Based Randomized Controlled Trial of 4013 Participants

J Med Internet Res 2021;23(11):e29664

DOI: 10.2196/29664

PMID: 34813490

PMCID: 8663693

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