Funded PhD Opportunity: Understanding persuasive effects of message framing for vaccination uptake in university students

Photo by Gustavo Fring on Pexels.com
Author(s): Angela Rodrigues and Nicki O’Brien

The field of health communication tends to centre on analysing the effectiveness of specific information contexts and less on relationships between message framing, intentions and behaviour (Nabi & Green, 2015; Joyce & Harwood, 2014). People’s health-related decision-making is not completely rational (Witteman, van den Bercken, Claes & Godoy, 2009). Framing effect theory suggests that different presentations of health-related information can affect individuals’ decision-making preferences (Tversky & Kahneman, 1981). Research suggests that messages presenting gains are more persuasive in encouraging prevention behaviours (Noar, Harrington & Aldrich, 2009); Rothman, Bartels, Wlaschin & Salovey, 2006). Gain framing messaging may be more effective in promoting vaccination – a type of health preventive behaviour (Park, 2012).

Persuading young adults to get vaccinated is critical for the national vaccination programme as a whole and is also arguably the key to achieving herd immunity. Within the national vaccination programme for young adults, the following vaccinations are available: Human papillomavirus (HPV), meningitis, seasonal influenza, and COVID-19.

According to the latest figures, HPV vaccine coverage for the first dose in 2019/20 was 59.2% in Year 8 (aged 12-13) females (compared with 88.0% in 2018/19) and 54.4% in Year 8 males (Public Health England, 2020). From September 2019 the national HPV vaccination programme became universal with 12- to 13-year-old males becoming eligible alongside females (Public Health England, 2020). For females that missed or chose not to get the HPV vaccine offered in school, they can get the vaccine up until their 25th birthday; males can take up the vaccine until they are 45 years old (NHS, 2021).

Influenza is a vaccine-preventable disease, and annual influenza vaccination is the most effective method for prevention (WHO, 2012). Despite not part of the national vaccination programme, some universities are implementing a flu vaccine for their student communities (https://www.ucl.ac.uk/students/support-and-wellbeing/health-care/vaccinations/get-flu-vaccination).

Research has found low seasonal flu vaccine uptake and low vaccine knowledge among university-aged students (Ryan, Filipp, Gurka, Zirulnik, & Thompson, 2019). In the US – where influenza vaccination is recommended for everyone aged ≥6 months – data show that vaccination rates range from 9-30% in university students (Ryan, Filipp, Gurka, Zirulnik, & Thompson, 2019). Recent evidence suggests that making the flu vaccine part of the national vaccination programme for young adults (<20 years old) might be cost-effective (Hill et al., 2020). 

Amid the COVID-19 pandemic, the urgency to vaccinate young adults and promote COVID-19 vaccination uptake in this population is particularly pronounced (Lucia, Kelekar & Afonso, 2021). Recent NHS England figures show that approximately 75% of 18-24 years olds have had one COVID-19 vaccination; but only approximately 60% have had two vaccinations (NHS England COVID-19 Dashboard 21 Oct. , 2021). Together, these figures highlight that a proportion of young adults is left unvaccinated. Vaccination of young adults can potentially provide direct protection for the recipients and indirect (herd) protection for the community (Pebody et al., 2018).

In the transition period of attending university, for many away from home, there might be an opportunity to promote a range of vaccinations to young adults, and shape these emerging adults’ vaccination habits for other vaccines, such as the COVID-19 vaccines. As settings within which students become independent, universities have both a responsibility and the potential to enable healthy development (Tsouros, Dowding, Thompson & Dooris, 1998). Accordingly, ‘health-promoting universities’ are being called upon to embed health into all aspects of campus culture and of providing health-promoting activities for students (Bachert et al., 2021).

Understanding underlying mechanisms that drive young adults’ preferences for and engagement with vaccination campaigns could inform the design of effective messaging to influence their decision-making processes when communicating during a public health crisis.

What is the aim of this PhD project?

This PhD project will develop and test, evidence-based vaccination messages targeted at young adults, using framing theory as theoretical approach.

Objectives

  1. Appraise existing vaccination campaigns directed at young adults by exploring effective behaviour change strategies and mechanisms of change associated with vaccination uptake;
  2. With young adults, co-design and develop a suite of health messages aimed at promoting vaccination uptake (such as influenza, COVID-19, HPV, meningitis);
  3. Conduct experimental and longitudinal studies to explore young adults’ preferences for and impact of the co-produced vaccination messages.

What skills and knowledge does the PhD candidate need?

We would love to work with someone who feels passionate about health-related behaviour change, and is keen to further our understanding.

You should possess a sound grounding in quantitative and qualitative research methods but have ambition to extend your skills into other research design methods

Applicants will normally have a track record of academic achievement in psychology or a related discipline, demonstrated by a first class or upper second undergraduate honours degree and/or a master’s degree (or equivalent)

About the supervisors

Angela is a Senior Lecturer in the psychology department and has experience in the area of developing and evaluating complex interventions for behaviour change, with a specific focus on theory- and evidence-based interventions. Angela co-Leads the Behaviour Change Research Programme of Fuse (the Centre for Translational Research in Public Health).

Nicki is a Health Psychologist and an Associate Professor in the Psychology department. She has expertise in health behaviour and behaviour change interventions, and a particular interest in the application of co-design techniques for intervention development with stakeholders.

The supervisory team works alongside other behaviour change experts in the north east of England and the North East North Cumbria NHIR ARC

More information and how to apply

If you’d like to discuss the opportunity, please contact the principal supervisor, Angela Rodrigues (angela.rodrigues@northumbria.ac.uk). Details on how to submit an application are below. We’ve added some useful reading for prospective candidates at the end of the post

Details on how to submit an application are below. We’ve added some useful reading for prospective candidates at the end of the post

The advert for the post can be found here, this includes full eligibility requirements. As part of the application process you will need to submit a 1000 word proposal of how you would approach the project by 18th February 2022

Full details of the application process can be found here

Further Reading

Ruddy, E., Moor, J., Idowu, O., Araujo Soares, V., Rodrigues, A., & Birch-Machin, M. The Impact of COVID-19 lockdown on health behaviours of the UK population: a cross-sectional study. European Journal of Cancer Prevention. [Manuscript in preparation].

O’Brien N, Vijaykumar S, Craig M, Land E, Aguilar S, Bedoya X, De la Cruz R, Najera E, Nicolau L (Under Review). A before-after cross-sectional survey of the effect of exposure to GIFs communicating Covid-19 preventive behaviours on behavioural cognitions of Guatemalan adults. Annals of Behavioral Medicine.

O’Brien N, Land E, Vijaykumar S, et al. (2021) Languageless animated gifs to communicate COVID-19 preventive behaviours to adults in Guatemala: Development and evaluation of efficacy. International Journal of Behavioral Medicine. 28:S11-S12.

Araújo-Soares, V., Hankonen, N., Presseau, J., Rodrigues, A., & Sniehotta, F. F. (2019). Developing behavior change interventions for self-management in chronic illness. European Psychologist, 24(1), 7-25.

Rodrigues, A., Sniehotta, F. F., Birch-Machin, M. A., Olivier, P., & Araújo-Soares, V. (2017). Systematic and iterative development of a smartphone app to promote sun-protection among holidaymakers: design of a prototype and results of usability and acceptability testing. JMIR Research Protocols6(6), e112.

O’Brien N, Heaven B, Teal G, Evans E, Cleland C, Moffatt S, Sniehotta FF, White M, Mathers J, Moynihan P (2016). Integrating evidence from systematic reviews, qualitative research, and expert knowledge using co-design techniques to develop a web-based intervention for people in the retirement transition. Journal of Medical Internet Research,18(8):e210; doi: 10.2196/jmir.5790

Funded PhD Opportunity: Languageless visual messages to prevent Covid-19 transmission

Authors: Dr Nicki O’Brien, Dr Santosh Vijaykumar and Dr Michael Craig

Background to the project

Effective public health communications are critical to prevent the spread of Covid-19. Internationally, government guidance and legislation have advocated and coerced evidence-based transmission preventive behaviours, such as physical distancing, good hygiene practices such as handwashing, and mask-wearing. Encouraging individual adherence to these behaviours is challenging, requiring input and evidence from psychology and behavioural science.

Research on the individual determinants of transmission preventive behaviours provides evidence of potentially modifiable targets for behaviour change interventions to help during the Covid-19 pandemic. Intention, self-efficacy and outcome expectancies have been shown to predict preventive behaviours of physical, handwashing and mask-wearing.

Information is better retained when health communications include visuals rather than text alone. Visual communications do not rely on language but use images and animations to tell the message narrative. In countries with multiple official languages, visual languageless communications can disseminate messages to the entire population.

The languageless visual messages (GIFs) that have been developed

The proposed project will extend previous work of a collaboration between the supervisory team at Northumbria University and the Human Rights Office of the Archbishop of Guatemala, Guatemala (http://www.odhag.org.gt/). The collaboration developed evidence-based, languageless, animated messages, in the form of GIFs, which have been disseminated via social media across Guatemala and on the national catholic TV channel. The GIFs can be seen here. Guatemala is an exemplar multilingual country with 25 official languages spoken (24 indigenous and Spanish).

The effect of exposure to the GIFs on behavioural beliefs about performing the preventive behaviours has been examined through an online experimental study of Guatemalan adults. The data demonstrated that exposure to the GIFs resulted in significant improvements in key determinants of preventive behaviours, namely intention, self-efficacy and outcome expectancies. These preliminary data suggest promise of the GIFs to have a positive impact on adherence to behaviours, however, this is yet to be determined.

The aim of this PhD project

To identify and explore how different features and potential mechanisms of action of languageless health messages (GIFs), promoting Covid-19 preventive behaviours, impact on their potential effectiveness. The project will include a consensus study to identify the behavioural science evidence base (including the behaviour change features) of the GIFs and a series of experimental studies to explore the effects of exposure to the existing GIFs and modified GIFs (i.e., with varying message features and mechanisms of action) on adherence to preventive behaviours in different Latin American and UK populations.     

The supervisory team

This PhD project will be supervised by Dr Nicki O’Brien, Dr Santosh Vijaykumar, Dr Michael Craig (Department of Psychology), and Ellie Land (Department of Arts). The supervisory team combines the complementary disciplinary, methodological and topic expertise required to fully support this research: Dr O’Brien is a Health Psychologist with expertise in health behaviour and behaviour change interventions. Dr Vijaykumar is a health and risk communication scientist with expertise in public health, behavioural science and new media technologies.  Dr Michael Craig is an experimental psychologist with expertise in the investigation of human cognition and the effects of behavioural interventions. Ellie Land is an award-winning factual animation maker, director, educator and researcher with expertise in animated short, feature-length and interactive films.  

The skills and experience a candidate needs

We are looking for someone who is keen to develop the science of behaviour change within the context of languageless visual health messages. Candidates would be expected to have a background in psychology, public health, health communication or a related discipline, demonstrated by a first class or upper second undergraduate honours degree and/or a master’s degree (or equivalent). An interest in design is desirable but not essential. Knowledge and experience of quantitative research methods are needed.  

More information and how to apply

If you’d like to discuss the opportunity, please contact the principal supervisor, Nicki O’Brien (nicki.obrien@northumbria.ac.uk).

The advert for the post can be found here, this includes full eligibility requirements. As part of the application process you will need to submit a 1000 word proposal of how you would approach the project by 18th February 2022

Full details of the application process can be found here

Northumbria researchers win Prolific Grant Competition

Richard Brown and Dr Gillian Pepper’s research proposal was crowned the overall winner of  Prolific’s Grant Competition. This will provide valuable funding for Richard’s next PhD study, supervised by Gillian, which aims to investigate perceptions of control over risk.

Photo by Nataliya Vaitkevich on Pexels.com

Over 2000 users of the recruitment platform Prolific voted to select the top 5 proposals out of more than 100 entries from universities and research institutions from around the word. Prolific’s internal review panel then selected the Northumbria Psychology Department’s research duo as the overall winner. The proposal requested £4,700 to pay for future research costs and the winners were awarded this amount in full.

Their winning proposal was entitled “Die young, live fast? Does the feeling that you’ll die young, no matter what you do, encourage unhealthy behaviour and worsen health inequalities?” The study will aim to investigate what causes of death are widely believed to be uncontrollable and what information people use to assess personal risk. This looks to build on previous research conducted by Dr Gillian Pepper and Professor Daniel Nettle at Newcastle University into the Uncontrollable Mortality Risk Hypothesis (1, 2).

The Uncontrollable Mortality Risk Hypothesis

This suggests that people who believe they are likely to die due to factors beyond their control take less care of their health because they are less likely to live to see the long-term benefits of a healthy lifestyle. This is of particular relevance to social class differences in health behaviours. Those from lower socioeconomic backgrounds are typically exposed to greater levels of uncontrollable risk. This may cause them to be less motivated to engage in preventative health behaviours, thus worsening existing health inequalities. To encapsulate the point, the proposal asks, “If you believed you were likely to be a victim of a stabbing before the age of 30, would eating your 5 a day seem very important?”

Little is known about what causes of death are thought to be beyond individual control, or why. By investigating perceptions of control over death, and identifying the informational sources of these perceptions, this study hopes to provide valuable insights for public health interventions. These insights may inform structural interventions aimed at reducing specific types of environmental risk, or help to produce targeted health messaging to influence perceived levels of control. Ultimately, the aim is to produce findings that help to understand health behaviours and how to reduce avoidable deaths.

Richard and Gillian are thrilled with the outcome of the competition and would like to thank everyone that helped and voted for their proposal. Time to get to work!

References

1.         Pepper GV, Nettle D. Out of control mortality matters: the effect of perceived uncontrollable mortality risk on a health-related decision. PeerJ. 2014;2:e459.

2.         Nettle D. Why are there social gradients in preventative health behavior? A perspective from behavioral ecology. PLoS One. 2010;5(10):e13371.

Want to learn more?

Head over to our Health and Wellbeing Blog