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The Effect of Perspective Type and Target on the Effectiveness of Health Campaigns

Abstract

This study looks at the effectiveness of narrative campaigns with regards to emotional engagement and the
viewers relationship with the subject in the campaign. The first hypothesis for this study is that the effectiveness
of narrative campaigns is lessened when emotional perspective-taking is used. The second hypothesis is that the
negative effect of taking an emotional perspective can be reduced or reversed if the participant takes the
perspective of an in-group member. This study looks at the interaction between these two factors. The findings
support the predictions and show that the effects of emotional perspective-taking significantly depend on whose
perspective the participants took. An emotional perspective would result in a significantly less positive attitude
toward getting tested for a Sexually Transmitted Infection compared to a non-emotional perspective. However this
effect disappears when the participants can relate to the target in the narrative campaign. The two independent
variables for this study are whether participants were emotionally engaged in the narrative campaign and whether
or not they could relate to the target in the campaign. The two dependent variables are how distressed the
participants were by the campaign and their attitudes towards getting tested for Sexually Transmitted Diseases.
The participants in this study were 172 Social Psychology students from the University of Exeter, ranging in age
from 17 to 47.

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Research has shown that people can have an unrealistically optimistic view when it comes to their own
susceptibility to health risks (Weinstein 1984), people seem to have an It wont happen to me mentality. Studies
have also found that people tend to reject information that suggests that their health may be at risk (Lieberman &
Chaiken 1992) and are more likely to recall information suggesting they are in good health (Kiviniemi & Rothman
2006). This may be why it requires a realisation of great personal risk for people to change their behaviour
(Schwarzer 2001). Evidence in health campaigns can fall into two categories, it can either be statistical or it can
be anecdotal and narrative (Perloff 2003). Narrative campaigns are becoming more and more common and tend
to be more influential than advertisements which rely on statistics to inform people (deWit et al 2008). This may
be due to the fact that narratives are easier to remember and more relatable than statistics (Tversky & Kahneman
1973). However, little is known about how narrative campaigns work and how people process campaign
narratives, which tend to involve taking the perspective of the actors in the advertisement and engaging
emotionally with them. Perspective-taking in health advertisements has not been greatly studied, however
research by Tarrant, Calitri and Weston (2012) indicates that taking the perspective of somebody similar is more
effective than taking the perspective of a stranger. Cameron and Chan (2008) have shown that emotional
evolvement with health issues can cause people to become defensive, which can be problematic if they feel like
they dont want to report honestly about their health or they may not have any desire to find out more about it and
protect themselves against it. This study asks whether emotional involvement in an narrative campaign about
gonorrhoea combined with perspective taking is effective in influencing the participants attitudes about Sexually
transmitted Diseases and whether it makes a difference whose perspective is taken. The first hypothesis for this

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study is that when the participants use emotional perspective-taking narrative campaign is less effective. The
second hypothesis is that whatever negative effect emotional perspective taking has can be reduced or reversed
if the participant takes the perspective of somebody similar to them. The rates of Sexually Transmitted
Diseases/Infections in young people are rising despite attempts to increase health awareness and the prevalence
of education. Therefore it is worthwhile to study what the most effective way of encouraging behaviour change is
for young adults.

Method

The participants used in the study were students from the Introduction to Social Psychology class in the
University of Exeter. The sample size was 172, 138 of which were male and 34 were female, ranging in age from
17-47. The mean age was 19.01, with a standard deviation of 2.85. None of the participants were excluded. The
participants were assigned to the different conditions based on whether the first letter of their surname was in the
first or second half of the alphabet and also based on convenience with regard to their classes. The participants
were spread out across 6 different sessions, each lasting an hour long. The study has an experimental between
subjects design, with 2 independent variables and 2 dependant variables. One of the independent variables in
this study was whether the perspective taking was emotional or not. This was manipulated by asking the
participants to either imagine how Sam, the character in the campaign narrative, would feel or what he would do
having found out that he has gonorrhoea. The other independent variable was whether or not the participants
would relate to the subject in the advertisement. This was manipulated by showing half the participants products
with the University of Exeter brand, they were then asked to name what made them similar to other University of
Exeter students. The narrative campaign for the participants in this condition was presented with Sam being an
Exeter student. The participants in the other condition were shown products with messages on them about being
unique, they were then asked what they thought made them unique. They were shown a narrative campaign were
Sam was not an Exeter student. The cover story that was told to the participants was that the researchers were
looking at different techniques for consumer and health marketing. The first part was actually to get the
participants to engage in either their unique identity or their University of Exeter focused identity. The picture in

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the campaign showed a man and a woman and depending on the gender of the participant a speech bubble
would be coming out of either the man or the womans head, this would allow the participant to take the subjects
perspective without being influenced by gender. The unisex name Sam was also chosen for this reason. One of
the dependant variables in this study was how distressed the participants were by the narrative campaign. This
was measured by asking the participants, in a questionnaire, to what extent did they feel distressed, upset,
disgusted, worried, disturbed, troubled, grieved, perturbed and alarmed on a 7 point scale, with 1 being Not at all
and 7 being Very Much. The other dependant variable for this study was the participants attitudes towards
taking action to protect themselves against Sexually Transmitted Diseases. The participants were asked whether
they agreed that getting tested for STIs is beneficial, useful, important, sensible and worthwhile on another 7 point
scale, with 1 being Totally Disagree and 7 being Totally Agree. They were also asked whether they agreed that
getting tested for STIs is awkward, embarrassing and unpleasant, these scores were reversed on the scale.

Results

Means and standard deviations for the two dependent measures, campaign distress and attitudes about
being tested, are presented in Table 1. Higher scores on each of these measures indicate more distress over the
campaign and more positive attitudes about being tested. Overall, participants did not find the campaign too
distressing (M = 2.88, SD = 1.20, on a 7-point scale) and held moderately positive attitudes about the target
behaviour of being tested (M = 5.03, SD = .57, on a 7-point scale).

Table 1.
Means and Standard Deviations for Campaign Distress and Attitudes about Testing as a function of perspectivetaking Target and Type.

Other Individual

Non-

Fellow Exeter Student

Emotional

emotional
Distress

Non-

Emotional

emotional

Mean

2.72

3.09

3.09

2.61

SD

1.20

1.14

1.24

1.19

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Attitudes

Mean

5.12

4.80

5.06

5.14

SD

.57

.46

.56

.64

39

42

45

46

To examine the hypothesis, a 2 (target: different individual, fellow Exeter student) x 2 (type: non-emotional,
emotional) analysis of variance was performed on each of the dependent measures. The analysis of campaign
distress revealed no significant main effects of either perspective target, F
F

(1, 168)

(1, 168)

= 11, p = .73, or perspective type,

= .11, p = .73. As predicted, however, there was a significant interaction between these factors, F

(1, 168)

= 5.35,

p = .02. As can be seen in Table 1, when participants were manipulated to think of themselves as an individual
and to take the perspective of a different individual, emotional perspective-taking increased distress relative to
non-emotional perspective-taking, although this difference was not significant, F

(1, 168)

= 1.85, p = .18. Conversely,

when participants were manipulated to think of themselves in terms of their Exeter student identity and to take the
perspective of a fellow Exeter student, emotional perspective-taking reduced distress relative to non-emotional
perspective-taking, F

(1, 168)

= 3.72, p = .055.

The same analysis performed on attitudes about testing also revealed no significant main effects of
perspective target, F (1, 168) = 2.58, p = .11, or type, F
significant, F

(1, 168)

(1, 168)

= 1.92, p = .17, but the predicted interaction was

= 5.52, p = .02. As can be seen in Table 1, when participants were manipulated to think of

themselves as an individual and to take the perspective of a different individual, emotional perspective-taking
reduced positive attitudes relative to non-emotional perspective-taking, F

(1, 168)

= 6.56, p = .01. Conversely, when

participants were manipulated to think of themselves in terms of their Exeter student identity and to take the
perspective of a fellow Exeter student, emotional perspective-taking slightly increased positive attitudes relative to
non-emotional perspective-taking, however this difference was not significant, F

(1, 168)

= .49, p = .48.

Discussion

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The results have shown that perspective type (emotional or non-emotional) and target (Exeter student or
not) does not significantly affect the distress that participants felt about Sams story. However the participants
attitudes towards getting tested for Sexually Transmitted Diseases was effected by perspective type, with
participants reporting less positively in the emotional condition, however this was only true for the participants in
the unique identity condition. This shows an interaction of the two factors. The results show that the perspective
taking type and target interact significantly. This supports the hypothesis that the effects of emotional perspective
taking depends on the target whose perspective is taken. The negative effects of emotional perspective taking
vanished when the participants could relate to the target in the narrative campaign. This supports Terrant, Calitri
and Westons research (2012) which demonstrated that when the target in the campaign whose perspective must
be taken is an in-group member, then the campaign is more effective. However, this would only hold true for
students who feel that the University of Exeter is a part of their identity. This may not be the case for everyone
and further research may be done into how much stronger the effect could be if the in-group was defined as
something more specific e.g. within a group of friends. Furthermore, this only seems to make the negative effect
of emotional engagement disappear, it does not seem to positively improve attitude or decrease distress
compared to the condition of unique identity. Perhaps if the bond with the target was stronger we would see
more of a positive effect. A further possible limitation of the study is, whether or not people engaged emotionally
with the target, those asked to do so may not have put much effort into it. A basic description of his emotion to
expand on may be helpful with encouraging people to connect emotionally with Sam. It is also possible that the
participants who described what Sam did could engage with him emotionally. To avoid the possibility of this
occurring maybe the participants need not describe Sams actions. Wit et als work found that narrative
campaigns are more effective than messages containing statistics (2008). This study shows that whilst this may
be true, under certain circumstances, health messages can backfire and deter people from engaging in behaviour
that would reduce health risks. This study supports the research of Cameron and Chan (2008) which suggested
that emotional engagement can create defensiveness. This is demonstrated here by a less positive self-reported
attitude towards getting tested for a Sexually Transmitted Disease but only when the target in the health campaign
is not an in-group member. It is understandable that participants may be defensive when talking about a matter as
private as Sexually Transmitted Disease, it may be worthwhile to see how students would respond to less

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personal matters (e.g. to get themselves checked for a cold going around campus) and whether the same
cognitive biases would be at work. It is important that more research is done into making health campaigns as
effective as possible to counteract peoples cognitive bias to reject information which suggests that their health
may be at risk (Lieberman & Chaiken 1992) and to more readily recall information suggesting they are in good
health (Kiviniemi & Rothman 2006). This study shows that emotional engagement can cause defensiveness,
unless you are engaging with someone you can relate to. It should therefore be the duty of health advertisement
designers to try and produce a range of narratives that people will be able to relate to so as to minimize as much
reactance as possible.

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References

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Schwarzer, R. (2001). Social-cognitive factors in changing health-related behavior. Current Directions in
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