A brief measure of reactance to health warnings
- 798 Downloads
Reactance to persuasive messages involves perceived threat to freedom, anger, and counterarguing that may undermine the impact of health warnings. To understand reactance’s effects, reliable and valid assessment is critical. We sought to develop and validate a brief Reactance to Health Warnings Scale (RHWS). Two independent samples of US adults completed the brief RHWS in studies that presented warnings on cigarette packs that smokers carried with them for 4 weeks (Study 1; n = 2149) or as digital images of cigarette packs that participants viewed briefly (Study 2; n = 1413). The three-item Brief RHWS had good internal consistency and test–retest reliability. The scale correlated with higher trait reactance and exposure to pictorial warnings, supporting its convergent validity. With respect to predictive validity, the Brief RHWS predicted perceived message effectiveness, quit intentions, avoidance of the warnings, and number of cigarettes smoked per day. The Brief RHWS can serve as an efficient adjunct to the development of persuasive messages.
KeywordsReactance Defensive processing Health warnings Tobacco control Pictorial warnings Health communication
Research reported in this publication was supported by The National Cancer Institute and FDA Center for Tobacco Products (CTP) under Award Number P30CA016086-38S2. F31CA196037 from the National Cancer Institute of the National Institutes of Health supported MGH’s time writing the paper. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or the Food and Drug Administration.
Compliance with ethical standards
Conflict of interest
Marissa G. Hall, Paschal Sheeran, Seth M. Noar, Kurt M. Ribisl, Marcella H. Boynton and Noel T. Brewer declare that they have no conflict of interest.
Human and animal rights and Informed consent
Study procedures were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments. Researchers obtained informed consent from study participants.
- Bollen, K. A. (1998). Structural equation models. New York: Wiley.Google Scholar
- Brehm, K. A. (1966). A theory of psychological reactance. New York, NY: Academic Press.Google Scholar
- Brehm, S. S., & Brehm, J. W. (1981). Psychological reactance: A theory of freedom and control. New York, NY: Academic Press.Google Scholar
- Brennan, E., Durkin, S. J., Cotter, T., Harper, T., & Wakefield, M. A. (2011). Mass media campaigns designed to support new pictorial health warnings on cigarette packets: Evidence of a complementary relationship. Tobacco Control, 20, 412–418. doi: 10.1136/tc.2010.039321 CrossRefPubMedGoogle Scholar
- Brewer, N. T., Hall, M. G., Noar, S. M., Parada, H., Stein-Seroussi, A., Bach, L. E., et al. (2016). Effect of pictorial cigarette pack warnings on changes in smoking behavior: A randomized clinical trial. JAMA Internal Medicine, 176, 905–912. doi: 10.1001/jamainternmed.2016.2621 CrossRefPubMedGoogle Scholar
- Cho, Y. J., Thrasher, J. F., Swayampakala, K., Yong, H. H., McKeever, R., Hammond, D., et al. (2016). Does reactance against cigarette warning labels matter? Warning label responses and downstream smoking cessation amongst adult smokers in Australia, Canada, Mexico and the United States. PLoS ONE, 11, e0159245. doi: 10.1371/journal.pone.0159245 CrossRefPubMedPubMedCentralGoogle Scholar
- Davis, K. C., Nonnemaker, J., Duke, J., & Farrelly, M. C. (2013). Perceived effectiveness of cessation advertisements: The importance of audience reactions and practical implications for media campaign planning. Health Communication, 28, 461–472. doi: 10.1080/10410236.2012.696535 CrossRefPubMedGoogle Scholar
- De Ayala, R. J. (2013). Theory and practice of item response theory. New York, NY: Guilford Publications.Google Scholar
- Diepeveen, S., Ling, T., Suhrcke, M., Roland, M., & Marteau, T. M. (2013). Public acceptability of government intervention to change health-related behaviours: A systematic review and narrative synthesis. BMC Public Health, 13, 756. doi: 10.1186/1471-2458-13-756 CrossRefPubMedPubMedCentralGoogle Scholar
- Embretson, S. E., & Reise, S. P. (2013). Item response theory. Mahwah, NJ: Psychology Press.Google Scholar
- Li, L., Borland, R., Fong, G. T., Jiang, Y., Yang, Y., Wang, L., et al. (2014). Smoking-related thoughts and microbehaviours, and their predictive power for quitting: Findings from the International Tobacco Control (ITC) China Survey. Tobacco Control. doi: 10.1136/tobaccocontrol-2013-051384 Google Scholar
- Noar, S. M., Francis, D. B., Bridges, C., Sontag, J. M., Ribisl, K. M., & Brewer, N. T. (2016a). The impact of strengthening cigarette pack warnings: Systematic review of longitudinal observational studies. Social Science and Medicine, 164, 118–129. doi: 10.1016/j.socscimed.2016.06.011 CrossRefPubMedGoogle Scholar
- Population Assessment of Tobacco and Health Study. (2014). PATH: Population assessment of tobacco and health. Retrieved April 3, 2014, from http://www.pathstudyinfo.nih.gov/UI/HomeMobile.aspx
- Rains, S. A., & Turner, M. M. (2007). Psychological reactance and persuasive health communication: A test and extension of the intertwined model. Human Communication Research, 33, 241–269.Google Scholar
- Yong, H. H., Fong, G. T., Driezen, P., Borland, R., Quah, A. C., Sirirassamee, B., et al. (2013). Adult smokers’ reactions to pictorial health warning labels on cigarette packs in Thailand and moderating effects of type of cigarette smoked: Findings from the international tobacco control southeast Asia survey. Nicotine and Tobacco Research, 15, 1339–1347. doi: 10.1093/ntr/nts241 CrossRefPubMedPubMedCentralGoogle Scholar