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The role of message framing in health behavior promotion among older adults

Adherence rates to public health recommendations are low, and seem to be falling. DiMatteo (2004) found that on average, at least one quarter of patients and recipients of lifestyle advice do not follow the recommendations given; other studies estimate this rate as high as 90% (Burke & Dunbar-Jacob, 1995). One possible reason why people are not following these recommendations may be that they are not communicated in a way that motivates people, especially not older adults. Older adults attend relatively more to positive than negative information (e.g., Carstensen, 2006) as a result of age-related socioemotional changes (Carstensen, Isaacowitz, & Charles, 1999). A number of studies found that this is relevant in the health context; for example, older adults prefer positively-framed over negatively-framed health brochures (Shamaskin, Mikels, & Reed, 2010) and they tend to follow recommendations to walk more when they are informed about the benefits of walking, rather than the negative consequences of inactivity (Notthoff & Carstensen, in revision).

The researchers are examining the applicability of this type of message framing intervention to promoting walking in older adults who face barriers to activity in their social and physical environments. Additionally, the researchers are examining a potential mechanism through which these messages might operate. They formally tested the hypothesis that the positivity effect operates through subcortical and frontal circuits to account for the greater effectiveness of positively compared to negatively framed health messages among older adults by acquiring data on brain activation using functional magnetic resonance imaging (fMRI) while both younger and older adults listened to and were later asked to remember positively- and negatively- framed information about walking. The researchers examined whether participants’ neural activations during initial exposure to the statements and memory for the information predict how much participants walk (measured using pedometers) in the subsequent week and whether and how much they increase their walking compared to baseline.