Discussion
cancer
CANCER
This study examined the effects of message framing on attitudes and intentions regarding social participation among older Japanese people living in rural areas. The private gain- and loss-framed messages tended to be more effective in increasing attitude and intention toward social participation than no messages, particularly among people without social participation activities. Although a statistically significant difference between the private gain- and loss-framed messages was not detected, we found that the private loss-framed message was possibly most effective at promoting social participation in older adults. Several studies have examined the effect of message framing on various health behaviors, including smoking, physical activity, dietary habits, and cancer screening, whereas no study has focused on social participation.We hypothesized that a gain-framed message would be the most effective in promoting attitudes and intentions toward social participation based on previous research [Another factor is “the level of involvement,” which refers to a person’s involvement, understanding, or interest in a particular issue (i.e., social participation activities in this case). Gain-framed messaging is effective for those with low involvement whereas loss-framed messaging is effective for those with high involvement in the issue [A meta-analysis conducted by Gallagher and Updegraff separately examined the impact of message framing on attitudes and intentions. Their findings concluded that there was no difference in the effect of gain- and loss-framed messages on attitudes and intentions for preventive behaviors, including smoking, physical activity, and diet [In contrast to the results observed among those who were not engaged in social participation activities, neither gain- nor loss-framed messages showed a significant association with attitude or intention outcomes among individuals with social participation experiences. Since many participants who participated in activities had already developed high attitudes and intentions toward social participation, the effect of the message might have been underestimated in the current sample. Furthermore, as strong attitudes and intentions are generally considered psychological antecedents to behavioral change, their attitudes and intentions toward social participation may have already been reinforced. Therefore, the framing message might prove ineffective among those who have already engaged in social participation activities.In this study, we prepared two types of gain-framed messages: private and public. However, the public gain-framed message was not associated with any outcome variable. This message was intended to appeal to people’s altruism because several studies have indicated that altruistic motivation may promote healthy behaviors [This study had several limitations. First, this was an observational study that used data from questionnaire surveys; therefore, it is necessary to verify the findings in interventional studies to ascertain whether framed messages on social participation can prompt behavioral change (i.e., whether participants actually begin engaging in social participation activities or increase their frequency and types of activities). A meta-analysis highlighted a significant gap between attitude, intention, and behavior [This study makes a significant contribution by uncovering the potential of framing messages to enhance social participation. While the importance of social participation for health promotion and frailty prevention in older people is widely recognized, an effective approach to encourage it has been lacking. As the cost of creating or modifying the messaging is low (sometimes zero), message framing may be cost-beneficial for promoting changes in people’s perceptions and behaviors. Furthermore, it is an easily implementable method. These constitute a significant advantage for the message-framing approach. Moreover, although the message-framing approach is not a panacea, our findings provide insight into developing effective approaches to facilitate older adults’ social participation. Our findings may instigate further interventions exploring the impact of message framing on social activity participation leading to valuable cumulative insights. Additionally, since the persuasive effect of message framing was particularly pronounced among those who were not engaged in any social participation activity, the intervention using framing messages may be highly effective for this specific group. Our results may be instrumental in identifying the target population for message-framing interventions.