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Communication Cues and Engagement Behavior: Identifying Advertisement Strategies to Attract Middle-Aged Adults to a Study of the Chronic Disease Self-Management Program

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A box labeled advertisement cues on the left has one-way arrows, labeled “a” and “b,” pointing to the right and connecting to 2 boxes, one labeled cognitive engagement and one labeled behavioral engagement. The cognitive engagement box has 3 constructs listed under its title: cue processing, appraisal, and motivation to enroll. The behavioral engagement box has 2 constructs listed under its title: enrollment and program participation. A one-way arrow labeled “c” runs between these two boxes. A fourth box labeled demographic characteristics lies between the advertisement cues box and the two boxes on the right (cognitive engagement and behavioral engagement). That box is connected by one-way arrows labeled m1, m2, and m3 to all aforementioned arrows.


Figure 1.

Advertisement engagement framework combines constructs from the Elaboration Likelihood Model and Protection Motivation Theory (12,13) to outline potential relationships among advertisement cues, cognitive engagement with study advertisements, and behavioral engagement outcomes, including potential moderating effects of demographic variables on the relationship between advertisement cues and cognitive engagement (m1) and behavioral engagement (m2), and the relationship between cognitive and behavioral engagement constructs (m3).

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Two images make up the figure. In the first image, a box displays the words “self management” inside the image of a medicine pill. Four results of disease self-management words are listed across the top of the box: less stress, better health, work stability, financial security. Text below that reads, “The real magic pill. Looking for a better way to take control of your health and financial future? Let us help.” The website and telephone number follow: smartlife.web.unc.edu, 919-962-9865. Beneath that information is the phrase, “payment for participation is provided.” The same image appears next to the first image with various parts of the advertisement highlighted to indicate fields that were overlaid on the advertisement and remained invisible to participants until clicked. These fields were used to quantitatively capture participant’s cue preferences.

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Figure 2.

The most widely distributed SMART Life Study advertisement with a second version overlaid to indicate fields, defined a priori by study staff, for cue preference data collection. Beneath the image elements of the table that are cues are listed is a table describing responses to the cues contained in the advertisement.

The most widely distributed SMART Life Study advertisement with a second version overlaid to indicate fields, defined a priori by study staff, for cue preference data collection. Beneath the image elements of the table that are cues are listed is a table describing responses to the cues contained in the advertisement.
Cue Cue Title Selected, No. (%)
Financial security Financial security 228 (56.0)
Less stress Better health 215 (52.8)
Better health Less stress 204 (50.1)
Self-management Self-management pill 81 (19.9)
Work stability Work stability 60 (14.7)
Looking for a better way to take control of your health and financial future? Take control 41 (10.0)

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