'A post-test experimental study on the effects of message framing and the use of a patient testimonial on intentions of osteoarthritis patients to adhere to treatment advice'.

Abstract

Background: Recent findings show that intentions to adhere to conservative treatment of osteoarthritis are negatively influenced by certain beliefs and rely strongly on testimonies of others. Message framing, i.e., focusing on either gains or losses, and the use of a patient testimonial in educational material are commonly used techniques to influence beliefs, and ultimately, health behaviors.

Objectives: To study the effects of 1) message framing and 2) patient testimonials on osteoarthritis patients' beliefs about and intentions to be physically active and to use pain medication.

Methods: Members of a research panel (n=639) with a self-reported diagnosis of knee OA were, after informed consent, randomly allocated to watching one out of four video messages combining a framing condition (gain or loss-frame) with the use of a testimonial (yes/no). After watching this video, participants completed a questionnaire on attitudes, behavioral beliefs, attitudes towards physical activity and pain medication (1=completely disagree, 7=completely agree), and intentions towards physical activity and pain medication (1=I do not do this now and am not planning on doing this, 7=I am doing this already for more than 6 months). ANOVA was used to assess the main and interaction effects.

Results: A total of 154 respondents completed the questionnaire. Message framing and the use of a testimonial did not impact attitudes, beliefs, or intentions on physical activity. However, loss framing resulted in more positive attitudes towards pain medication (mean (SD) 5.5 (1.6)) than gain framing (mean (SD) 4.9 (1.9), mean difference=0.6, 95% CI [0.0, 1.1]). Furthermore, the patient testimonial induced more positive pain medication attitudes (mean (SD) 6.0 (1.1)) than the informative control message (mean (SD) 5.0 (1.7), mean difference=0.9, 95% CI [0.1, 1.6]) when the message used a loss, rather than a gain-frame.

Conclusion: This study suggests that describing the disadvantages of nonadherence to pain medication resulted in more positive beliefs about pain medication than stating the advantages of adherence. The use of a patient testimonial within this loss-frame strengthened the effect. Our findings indicate that the use of framing and testimonials in OA care can matter and that healthcare providers should be aware of the potential effects of emphasising either gains or losses in communicating with their patients.