Framing Health Care Messages: Why Interpersonal Context Matters

Susanna J. Smith
Marketing Health Services e-newsletter
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Interpersonal Context
Key Takeaways
  • Gain-framed messaging, such as when obese patients are shown images of the active, healthy lifestyles they could gain by losing weight, is rooted in the positive.

  •  Loss-framed messaging, however—such as showing patients images of individuals with diabetes—is a more negative, loss-based approach.

  • In addition to framing messages in a negative or positive light, researchers are finding that how a message is delivered is just as crucial.

When health care decisions are put to the test, marketers can find themselves at a crossroads. For example, when promoting an organization’s weight loss program, is it more helpful to show images of patients suffering from diabetes—a negative, loss-based tactic—or a more positive photo of people enjoying a healthy, active lifestyle (i.e., what they could gain)? The effectiveness of these dual approaches, referred to as loss-framed and gain-framed marketing, respectively, continues to be debated among health care marketers.

“The prevailing wisdom has been that messages should focus on the benefits,” says Alex Rothman, a psychology professor at the University of Minnesota who researches gain-framed and loss-framed messaging. “In fact, what we found in our work is that that there are benefits to focusing on the costs of not engaging in a behavior.”

But while many believe messaging should adhere to the positive, there’s growing support for messaging that’s rooted in a more negative approach. According to Dan Miers, chief strategy officer at La Grange, Ill.-based SPM Marketing & Communications, the growing effectiveness of negative messaging may be attributed, in part, to changing consumer expectations and involvement in health care.

“Across all of health care, we are seeing much more active and engaged consumers who may need a more in-depth education because they are often bearing more of the cost of their treatment,” Miers says. “Education sometimes requires learning about the negative things.”

He adds, "There is this unresolved issue around gain and loss framing, statistics and quality data as they influence the decisions that patients and consumers make. We’re constantly looking at how to talk about quality in ways that consumers find credible and useful. Sometimes that happens in conversations that are positive, like improved survival statistics, and sometimes its in conversations that are negative, such as the risks of hidden or undiagnosed conditions.”

Studies on the effects of different types of framing suggest that the relationship is more complex than thinking, for example, in terms of disease prevention versus disease detection. Most of the current research focuses on how messages are perceived when they are presented in print materials or video, says Rothman. But how those messages are delivered may be crucial.

“We have some preliminary evidence that suggests that when people are verbally communicating with friends, they are more comfortable communicating a loss-framed message,” he says. “If they are communicating with strangers, they tend to prefer talking in the gain-framed messages. Our intuition is that it has to do with managing the interpersonal context between people.”

Additional research suggests the importance of self-efficacy, or the patient’s perceived ability to carry out the desired action, in whether it is more effective to reach them with gain- or loss-framed messages. But experts say there’s no one-size-fits-all approach when it comes to communicating with people about health.

“We are moving into a world where we want to engage people more in their health care,” Rothman says. “One would imagine that greater engagement will come if the messages we have about their health care are a better fit for how they think about the world, including their dispositions and life experiences.”

According to Miers, this means health care marketers must create messages that speak directly and specifically to their audiences.

“We live in a unique time of hyper targeting, and we have the ability to thinly slice our audiences,” he says. “We have to be really smart about meeting patients where they are in their journey, and tailor the message as gain- or loss- framed based on what’s best in that particular moment. ” 

This was originally published in the July 2014 issue of Marketing Health Services e-newsletter​.

Author Bio:

Susanna J. Smith
Susanna J. Smith is a freelance writer and content strategist for digital health startup companies. You can find her at @susannajsmith and
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