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      Identifying the Most Autonomy-Supportive Message Frame in Digital Health Communication: A 2x2 Between-Subjects Experiment

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          Abstract

          Background

          The effectiveness of digital health communication may be increased by enhancing autonomy supportiveness.

          Objective

          This study aimed to identify the most autonomy-supportive message frame within an intervention for increasing vegetable intake by testing the effect of the following 2 strategies: (1) using autonomy-supportive language and (2) providing choice.

          Methods

          A Web-based 2 (autonomy-supportive vs controlling language)×2 (choice vs no choice) experiment was conducted among 526 participants, recruited via a research panel. The main outcome measures were perceived autonomy support (measured using the Virtual Care Climate Questionnaire, answered with scores 1 to 5), perceived relevance (measured with one question, answered with scores 1 to 5), and overall evaluation of the intervention (measured with 1 open-ended question, answered with scores 1 to 10).

          Results

          Choice had a significant positive effect on the overall evaluation of the intervention ( b=.12; P=.003), whereas for participants with a high need for autonomy, there was a significant positive effect on perceived relevance ( b=.13; P=.02). The positive effect of choice on perceived autonomy support approached significance ( b=.07; P=.07). No significant effects on any of the three outcomes were observed for language.

          Conclusions

          Results suggest that provision of choice rather than the use of autonomy-supportive language can be an easy-to-implement strategy to increase the effectiveness of digital forms of health communication, especially for people with a high need for autonomy.

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          Most cited references20

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          Facilitating Internalization: The Self-Determination Theory Perspective

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            Advancing Tailored Health Communication: A Persuasion and Message Effects Perspective

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              The European Smoking Prevention Framework Approach (EFSA): an example of integral prevention.

              A smoking prevention project in six European countries (European Smoking prevention Framework Approach) was developed, featuring activities for adolescents, schools and parents, including out-of-school activities. Consensus meetings resulted in agreement between the countries on goals, objectives and theoretical methods. Countries' specific objectives were also included. National diversities required country-specific methods to realize the goals and objectives. The community intervention trial was used as the research design. Since interventions took place at the community level, communities or regions were allocated at random to the experimental or control conditions. Complete randomization was achieved in four countries. At baseline, smoking prevalence among 23 125 adolescents at the start of the project was 5.6% for regular smoking and 4.0% for daily smoking. Smoking prevalence rates were higher among girls than boys in all countries as far as weekly smoking was concerned. Process evaluations revealed that the project's ambitions were high, but were limited by various constraints including time and delays in receiving funds. Future smoking prevention projects should aim to identify the effective components within the social influence approach as well as within broader approaches and on reaching sustained effects.
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                Author and article information

                Contributors
                Journal
                J Med Internet Res
                J. Med. Internet Res
                JMIR
                Journal of Medical Internet Research
                JMIR Publications (Toronto, Canada )
                1439-4456
                1438-8871
                October 2019
                30 October 2019
                : 21
                : 10
                : e14074
                Affiliations
                [1 ] Department of Communication Science Amsterdam School of Communication Research University of Amsterdam Amsterdam Netherlands
                [2 ] School of Public Health University of Michigan Ann Arbor, MI United States
                [3 ] Department of Health Promotion Care and Public Health Research Institute Maastricht University Maastricht Netherlands
                Author notes
                Corresponding Author: Eline Suzanne Suzanne Smit E.S.Smit@ 123456uva.nl
                Author information
                https://orcid.org/0000-0001-8588-6194
                https://orcid.org/0000-0002-5386-9127
                https://orcid.org/0000-0003-1416-9627
                https://orcid.org/0000-0002-3640-2517
                Article
                v21i10e14074
                10.2196/14074
                6914245
                31670693
                f82e2052-9f75-4956-bb1d-51927cab0f31
                ©Eline Suzanne Suzanne Smit, Chamoetal Zeidler, Ken Resnicow, Hein de Vries. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 30.10.2019.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.

                History
                : 20 March 2019
                : 14 June 2019
                : 20 August 2019
                : 20 August 2019
                Categories
                Original Paper
                Original Paper

                Medicine
                health communication,health behavior,personal autonomy,internet,health promotion,healthy diet,self-determination theory

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