Marketing Policy Dec 1, 2007

Healthy Choic­es

Do peo­ple pre­fer the car­rot or the stick?

Based on the research of

Angela Y. Lee

Jennifer L. Aaker

Which tac­tic would moti­vate you to obey instruc­tions for tak­ing a pre­scribed med­i­cine: fear of harm­ful health con­se­quences of not tak­ing the drug or con­fi­dence in the even­tu­al health ben­e­fits bestowed by the drug?

Accord­ing to a study by Angela Lee, pro­fes­sor of mar­ket­ing at the Kel­logg School of Man­age­ment, and Jen­nifer Aak­er (the Uni­ver­si­ty of Cal­i­for­nia at Berke­ley), the per­sua­sive­ness of health­care-relat­ed adver­tise­ments depends on whether the ad’s word­ing — or fram­ing — induced fear or con­fi­dence. Fram­ing, espe­cial­ly in the health­care domain, has been stud­ied in terms of how effec­tive it is,” Lee said. How do we get peo­ple to get test­ed for cer­tain ill­ness­es or com­ply with cer­tain procedures?”

Con­flict­ing results among stud­ies using pos­i­tive and neg­a­tive mes­sages to moti­vate peo­ple to fol­low health­care rec­om­men­da­tions pro­voked Lee and Aak­er to inves­ti­gate when pos­i­tive frames or neg­a­tive frames may be dif­fer­en­tial­ly effec­tive. They pub­lished their find­ings in the Feb­ru­ary 2004 issue of the Jour­nal of Per­son­al­i­ty and Social Psychology.

Lee and Aak­er argued that the mixed results in whether pos­i­tive or neg­a­tive mes­sages encour­age com­pli­ance were due to dif­fer­ences in the desir­abil­i­ty of the out­come advo­cat­ed in the mes­sage. A pos­i­tive frame that pro­motes some­thing desir­able is more effec­tive than a neg­a­tive frame that laments the absence of some­thing desir­able. At the same time, a neg­a­tive frame that threat­ens the onset of some­thing unde­sir­able is more effec­tive than a pos­i­tive frame that promis­es the absence of some­thing unde­sir­able — a con­cept known as reg­u­la­to­ry fit” (Lee dis­cuss­es this aspect more ful­ly in the Q&A below). The researchers not­ed the most effec­tive ways to prompt healthy behav­iors: by tout­ing the ben­e­fits or empha­siz­ing the dan­gers. To sur­vive, we need to approach food and avoid being food,” Lee explained, and the sig­nal of food’ or dan­ger’ is much stronger than the sig­nal of no food’ or no danger.’”

To assess the effec­tive­ness of pos­i­tive and neg­a­tive fram­ing in a health pro­mo­tion sce­nario, Lee — who received the Kel­logg School’s Stan­ley Reit­er Best Paper Award in March 2007 for this work — manip­u­lat­ed the word­ing of mock Web sites and ads advo­cat­ing the health ben­e­fits of grape juice. Sub­jects read either a pos­i­tive­ly framed ad that tout­ed the ener­gy-boost­ing effects of grape juice (“Get ener­gized!”) or a neg­a­tive­ly framed ad that warned that not drink­ing the juice would keep them from being ener­gized (“Don’t Miss Out on Get­ting Ener­gized!”). The results showed that the sub­jects pre­ferred the pos­i­tive­ly framed ad, which pro­mot­ed a desir­able outcome.

How­ev­er, in a dis­ease pre­ven­tion sce­nario, in which ads attrib­uted heart dis­ease avoid­ance with drink­ing juice in either a pos­i­tive (“Pre­vent Clogged Arter­ies!”) or neg­a­tive (“Don’t Miss Out on Pre­vent­ing Clogged Arter­ies!”) frame, sub­jects were more moti­vat­ed by the neg­a­tive­ly word­ed ad.

The dif­fer­ence between the two sce­nar­ios is how peo­ple think about some­thing desir­able ver­sus some­thing unde­sir­able,” Lee said. A pos­i­tive frame fits with a desir­able out­come and a neg­a­tive frame fits with an unde­sir­able out­come.” Miss­ing out on some­thing desir­able is per­ceived as more detri­men­tal in the case of the more severe con­se­quence of heart dis­ease as opposed to the health-pro­mot­ing con­se­quence of increased energy.

The researchers found the same pat­tern of pos­i­tive and neg­a­tive fram­ing when ads for a sun­screen prod­uct and for a mononu­cle­o­sis drug were used.

Lee and Aak­er, who are con­sumer psy­chol­o­gists, won­dered why their sub­jects were more per­suad­ed by pos­i­tive­ly framed health pro­mo­tion mes­sages and neg­a­tive­ly framed dis­ease pre­ven­tion mes­sages. Lin­guis­ti­cal­ly, it would make sense that whichev­er ad is sim­plest would be most per­sua­sive,” Lee said. Typ­i­cal­ly sub­jects are more swayed by short, crisply word­ed ads. What, then, explains the advan­tage of the length­i­er ad in the unde­sir­able dis­ease pre­ven­tion scenarios?

The researchers decid­ed to explore how easy it was for peo­ple to process the per­sua­sive mes­sages. If some­thing is easy to under­stand, they think it is more believ­able and true,” Lee said. To eval­u­ate this pos­si­bil­i­ty, Lee and Aak­er sur­veyed their sub­jects’ abil­i­ty to com­pre­hend each mes­sage and their inter­est in the ad. Peo­ple thought the more per­sua­sive mes­sages were eas­i­er to under­stand, which sup­ports the the­o­ry of pro­cess­ing fluency.

Pro­cess­ing flu­en­cy was also mea­sured by flash­ing words from ads on a com­put­er screen and ask­ing sub­jects if they could iden­ti­fy the words. Sub­jects rec­og­nized the words more quick­ly when the words came from the more per­sua­sive ad. These find­ings present fur­ther evi­dence that an ad that is eas­i­er to process is more persuasive.

The results have impor­tant social impli­ca­tions,” said Lee, cit­ing can­cer pre­ven­tion, smok­ing, exer­cise, and weight loss among exam­ples of health con­cerns in which fram­ing could be used to encour­age a par­tic­u­lar behavior.

Fac­ul­ty Q&A: Pro­fes­sor Angela Lee talks about the ori­gins of her research on frame theory 

Near­ly ten years ago, Pro­fes­sor Angela Lee hap­pened upon a research sub­ject that has result­ed in her work on reg­u­la­to­ry focus the­o­ry gain­ing tremen­dous recog­ni­tion, most recent­ly in the form of the Stan­ley Reit­er Best Paper Award, giv­en annu­al­ly to a mem­ber of the Kel­logg School fac­ul­ty. While attend­ing a lec­ture by her col­league and coau­thor Wen­di Gard­ner, a social psy­chol­o­gist at North­west­ern, Lee became fas­ci­nat­ed by Gardner’s dis­cus­sion of turn­ing Amer­i­cans into Chi­nese.” In par­tic­u­lar, Gard­ner had designed an exper­i­ment in which a group of Amer­i­cans, who are more like­ly to think of them­selves indi­vid­u­al­ly because they are part of an indi­vid­u­al­is­tic nation, adopt­ed a col­lec­tivis­tic mind­set more com­mon to Asian culture.

Lee was intrigued by how the find­ings moved beyond the cul­tur­al literature’s tra­di­tion­al bound­aries, in which researchers were stat­ing that cul­ture A is dif­fer­ent from cul­ture B, but with­out an under­ly­ing rea­son­ing as to why this was the case,” she says. Wen­di was say­ing that these dif­fer­ences are the prod­uct of the dif­fer­ent ways in which peo­ple can look at them­selves — as either an inde­pen­dent per­son or as part of a larg­er group.”

Bridg­ing the focus between the cul­tur­al lit­er­a­ture and how peo­ple process infor­ma­tion, Lee, Gard­ner, and anoth­er researcher named Jen­nifer Aak­er extend­ed the self-view’ con­cept. They exam­ined the impli­ca­tions of Japan­ese and Kore­ans tend­ing toward self-crit­i­cism and Amer­i­cans focus­ing on self-enhance­ment. Says Lee: When these two groups try to attribute mean­ing to out­comes, Asians are more like­ly to attribute fail­ures to the self where­as Amer­i­cans are much more like­ly to attribute suc­cess­es to the self.” This raised the ques­tion of whether the two groups process neg­a­tive and pos­i­tive infor­ma­tion dif­fer­ent­ly. To help deter­mine the answer, Lee col­lect­ed five stud­ies to address that ques­tion. With Gard­ner and Aak­er she dis­cov­ered that reg­u­la­to­ry focus the­o­ry had great explana­to­ry pow­er in terms of how peo­ple from dif­fer­ing cul­tures think and what moti­vates them.

Q: Talk more about reg­u­la­to­ry focus the­o­ry. What is the idea of moti­va­tion that’s involved?

Pro­fes­sor Lee: This frame­work is called self-reg­u­la­to­ry focus the­o­ry because it basi­cal­ly says there are two moti­va­tion­al dri­vers in human nature. One is the need to be nur­tured: when dri­ven by this need, we strive toward growth and accom­plish­ment. On the oth­er hand, we also have a fun­da­men­tal need to feel secure. These both have evo­lu­tion­ary roots —we want to have food so we can grow and mul­ti­ply, but we also want to avoid being food so we can sur­vive. It turns out this dual­i­ty dic­tates how we reg­u­late our behav­iors and atti­tudes in all sorts of con­texts, since we are con­stant­ly seek­ing to ser­vice these needs.

Q: So is there always a con­stant bal­ance between these two moti­va­tors? Or does one win out over the oth­er based on the type of per­son you are?

Pro­fes­sor Lee: Even though we all have both needs, because we have lim­it­ed resources we tend to focus on one over the oth­er. How you allot your ener­gy or resources has impli­ca­tions for your behav­ior. So what reg­u­la­to­ry the­o­ry focus does is to iden­ti­fy the two needs ini­tial­ly and then break them down fur­ther into why peo­ple act a cer­tain way in accor­dance with these needs.

It turns out that there are two dif­fer­ent foci: pro­mo­tion and pre­ven­tion. Peo­ple who are pro­mo­tion focused have stronger nur­tu­rance needs, which in turn means they are more tuned in to striv­ing toward growth and accom­plish­ment. They also have an avoid­ance sys­tem, which is anoth­er sto­ry alto­geth­er. Pro­mo­tion-focused indi­vid­u­als try to approach gains and avoid non-gains (or the absence of good things). For them, not hav­ing good things is real­ly bad, so that’s what they try to avoid. On the oth­er hand, peo­ple who are pre­ven­tion focused have dom­i­nant secu­ri­ty needs. They approach the absence of neg­a­tive things. They don’t real­ly care about good things, they are main­ly hap­py if bad things don’t hap­pen. So they avoid bad things.

Q: So is there always a con­stant bal­ance between these two moti­va­tors? Or does one win out over the oth­er based on the type of per­son you are?

Pro­fes­sor Lee: Instead of just sim­ple approach and avoid­ance behav­iors, indi­vid­u­als look at either approach­ing good things or approach­ing the absence of bad things. Or avoid­ing the absence of good things or avoid­ing bad things. That’s how the sys­tem works. To bring this back to the begin­ning, when I actu­al­ly looked at cul­tur­al dif­fer­ences I found that peo­ple with an inde­pen­dent self-view (like Amer­i­cans) are more pro­mo­tion focused. In con­trast, peo­ple with an inter­de­pen­dent self-view (South­east Asians) are pre­ven­tion focused.

Q: What is the con­nec­tion between per­sua­sive mes­sag­ing and reg­u­la­to­ry focus theory?

Pro­fes­sor Lee: Well, in the health­care field right now, for exam­ple, there is a dis­cus­sion about how to prompt peo­ple to fol­low the advo­ca­cy in the var­i­ous mes­sages. Giv­en that mes­sag­ing is very expen­sive — think of all the health-relat­ed fly­ers and brochures that exist — there is a lot of dis­cus­sion about the best way to get peo­ple to com­ply. A num­ber of experts think about this issue in terms of fram­ing: is it more effec­tive to use a gain frame that focus­es on the pos­i­tive or a loss frame that focus­es on the neg­a­tive effects? The find­ings have been very incon­sis­tent, as dif­fer­ent peo­ple come up with dif­fer­ent expla­na­tions as to why one frame is bet­ter than the oth­er, but much of this depends on the situation.

If we want peo­ple to come in and get test­ed for hepati­tis, it turns out there are at least two ways to frame a mes­sage in order to get them to com­ply. Typ­i­cal­ly we say do this and you will receive this ben­e­fit” which in this case would be iden­ti­fy­ing the dis­ease ear­li­er enough to start treat­ment. Or we try to scare them and say if you don’t do this you won’t get the ben­e­fit or you will suf­fer these con­se­quences,” which would mean it could poten­tial­ly be fatal.

Q: And this is where you began apply­ing your reg­u­la­to­ry focus theory?

Pro­fes­sor Lee: My co-author and I thought reg­u­la­to­ry focus the­o­ry, with our four main frames — gains, non-gains, loss­es, and non-loss­es — could have a much bet­ter han­dle on what con­sti­tutes per­sua­sive mes­sag­ing. We start­ed to apply reg­u­la­to­ry focus the­o­ry to sort out the messi­ness in the lit­er­a­ture. We argued that if the appeal is emo­tion­al, a gain frame works bet­ter than a non-gain. In pre­ven­tion appeals about safe­ty and secu­ri­ty, the loss frame works bet­ter. This is true in the case of health­care men­tioned ear­li­er. It sounds strange, but say­ing miss out on clogged arter­ies’ works bet­ter than sim­ply say­ing pre­vent clogged arteries.’

It is quite counter-intu­itive, but it works! Across all the stud­ies we pre­sent­ed, using the loss frame in con­nec­tion with the pre­ven­tion appeal actu­al­ly worked bet­ter and this is real­ly where reg­u­la­to­ry focus the­o­ry comes in and reveals that things can actu­al­ly be a lot clear­er if you apply this frame­work. It clear­ly maps out what moti­vates us and what we find per­sua­sive, giv­en the mes­sage at hand. We find it per­sua­sive because it res­onates with how we think about things in a more nat­ur­al way; there’s flu­en­cy between how we process par­tic­u­lar infor­ma­tion and how the mes­sage is delivered.

Featured Faculty

Angela Y. Lee

Mechthild Esser Nemmers Professor of Marketing, Chair of Marketing Department

About the Writer

Article written by Molly W. McElroy, a freelance writer based in Somerville, Massachusetts.

Interview by Chris van Nostrand, Assistant Director of Communications, Kellogg School of Management. Featured originally in the Dean’s Student Update newsletter, March/April 2007.

About the Research

Lee, Angela Y. and Jennifer L. Aaker (2004), “Bringing the Frame into Focus: The Influence of Regulatory Fit on Processing Fluency and Persuasion,” Journal of Personality and Social Psychology, 86(2): 205-218

This article received the Kellogg School’s "Stanley Reiter Best Paper Award" in 2006.

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