With the FDA approval of the Pfizer-BioNTech vaccine and the continued rise of the delta variant, governments around the world have renewed their efforts to increase the number of people vaccinated by persuading the recalcitrant.
By S. Shyam Sundar, State of pennsylvania
On September 9, 2021, President Joe Biden announced broad vaccination mandates, expressing his frustration with refractory vaccines: âWe have been patient, but our patience is running out. And your refusal has cost us all.
As a communications scientist who has studied the effects of media and health campaigns over the past 30 years, I fear that feverish rhetoric in vaccine messages will make refractories even more resilient. The straightforward, straightforward messages to get vaccinated that worked for three-quarters of Americans may not work for the remaining quarter. If anything, they might turn against them.
Research has shown that some health communication techniques work more effectively than others depending on the audience. This is a lesson that not only policy makers can apply, but also members of the media, industry and even parents and relatives.
When it comes to adopting new ideas and practices, research has identified five categories of people: innovators, early adopters, early majority, late majority, and laggards. With the COVID-19 vaccination, it boils down to the last two, and they are the most resistant to change.
This group of unvaccinated people is large in numbers – there are nearly 80 million people in the United States who are eligible for the vaccine but remain unvaccinated – and they are the ones who could help the United States achieve herd immunity. . But, research suggests that they are also the ones who will take offense at strong urges to get vaccinated.
A strong message can backfire
Public health messages can and often do influence people, but not always in the desired direction. In 1999, I testified before the United States Congress on how powerful anti-drug messages can make teens take drugs rather than shy away from them. Likewise, the strong language of current vaccine messages may evoke resistance rather than compliance.
Consider this headline from a recent New York Times editorial: âGet Masked. To get vaccinated. This is the only way out. It follows 18 months of public health messages urging people to stay home, wash their hands and maintain social distancing.
They may be well-intentioned, but health communication research shows that such directive messages can be perceived as a “high threat,” meaning that they threaten the free will of the recipient of the message by dictating what they want. must do. They are likely to trigger what psychologists call “reactance”. In other words, when individuals feel their freedom of action is threatened, they are motivated to restore that freedom, often by trying to do the very thing that is prohibited or by refusing to adhere to recommended behavior.
Recent research by my communications colleagues at Penn State shows that even ads that include directive slogans such as “No Mask, No Ride” – from Uber – and “Socialize Responsibly to Keep Bars Open” – a message from Heineken – can irritate consumers and make them less likely to adopt responsible behavior.
The reaction to the COVID-19 messages is evident in the form of widespread protests around the world. Many have taken to the streets and on social media, with slogans such as “my body, my choice”, “let me do my own thing” and “coercion is not consent”.
These responses demonstrate not only reluctance to be vaccinated, but rather active resistance to vaccine messages, reflecting an effort to protect free will by asserting freedom of action.
Flip the script
Freedom is a central concept in anti-vaccination rhetoric. âFreedom, not strengthâ is the protesters’ battle cry. âIf we lose medical freedom, we lose all freedom,â one poster read. “Choose freedom,” urged Senator Rand Paul in a recent editorial expressing resistance to masking mandates and blockages. âWe will make our own health choices. We will not show you a passport, we will not wear a mask, we will not be required to do random screening and testing. “
One way to counter such reactance is to change the communication strategy. Health communication researchers have found that simple changes in the wording of messages can make a big difference. In a study by my colleagues at Penn State who study health persuasion, researchers tested participants’ responses to sensitive health behaviors such as flossing: “If you already floss, don’t floss. not even stop for a day. And, if you haven’t flossed, now is the time to start. â¦ Flossing: It’s easy. Do it because you have to! Study participants responded to such messages by expressing their disagreement with anger and challenging the recommended behavior.
But then the researchers rephrased the same plea to be less threatening, for example, “If you already floss, keep up the good work.” And if you haven’t flossed, now might be a good time to start. And “Flossing: it’s easy. Why not give it a try? âThey found that participants’ reactance was significantly lower and their acceptance of the message higher.
Likewise, sweetening the message and using less dogmatic language might be the key to persuading some of the unvaccinated. This is because suggestive, rather than directive, messages allow people to exercise their agency. Health communication studies also suggest several other strategies for reducing reactance, ranging from offering choice to evoking empathy.
Perhaps most important – given people’s reliance on smartphones and social media – is to make better use of the technological features of interactive media, which include websites, social media, mobile apps, and games. Smart use of digital media can help deliver strong health messages without triggering reactance.
Research conducted in our lab shows that people’s responses to media messages can be influenced by the approval of other anonymous people on the internet, in the same way that consumers rely on the opinions and ratings of others to make decisions. online shopping. In a recent study, we found that freedom-threatening health messages can be made more acceptable if they are accompanied by a large number of likes on other people’s social media. When many others were seen as supporting the advocacy message, the forceful language seemed no more threatening to their freedom than the milder version.
In other words, we have found that the number of likes has a strong “ripple effect” in reducing reactance. We have also found that providing an option to comment on the health message imbues a higher sense of personal agency and greater acceptance of the message.
In another recent experiment, we found that personalization, or the ability to tailor one’s phone or online site to one’s tastes, can also facilitate health communication. Whether it’s a phone app, dating site, or social media feed, personalizing a digital space allows people to reflect their personalities. Seeing a health promotion message in such a personalized space is not such a big threat in such places because people feel secure in their identities. We have found that personalization helps reduce negative reactions to health messages by increasing a sense of identity.
A communication strategy sensitive to psychological reactance could allow holdouts to be vaccinated voluntarily instead of reluctantly complying with a warrant.
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S. Shyam Sundar, James P. Jimirro Professor of Media Effects and Co-Director, Media Effects Research Laboratory, State of pennsylvania
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