April 22-24, 2021
Promoting Equity in Health Communication Research
Promoting Equity in Health Communication Research
Abstract: Influence of Presumed Media Influence Hypothesis for Health Promotion About PrEP for HIV Prevention For Cisgender Women
From the third-person effect theory to influence of presumed influence hypothesis (IPI hypothesis), communication scholars have been interested in phenomena regarding people’s biased perceptions of media influence on others and how they react to that perception.
The IPI hypothesis explains that people tend to presume greater media influence on others and they change their behavior based on such perception. While early studies have found the influence of presumed media influence on promoting harmful health behaviors such as smoking and unhealthy dieting (Chia, 2006; Gunther, Bolt, Borzekowski, Liebhart, & Dillard, 2006), recent studies have showed that presumed media influence increases healthy behaviors like condom use and regular exercise (Ho, Lee, Ng, Leong, & Tham, 2016; Hong & Kim, 2019).
This study aims to expand the IPI hypothesis as a framework for health communication and health promotion. The goal of this study is to establish a theoretical explanation about the underlying mechanisms of presumed influence on health behaviors by integrating theories of normative influence. In response to calls for research that clarify causal mechanisms of the IPI hypothesis (Tal-Or, Tsfati, & Gunther, 2009), an experiment was conducted.
The study examined presumed influence of media messages promoting PrEP (pre-exposure prophylaxis - a daily pill protecting people from HIV infection). PrEP is beneficial for women at risk of HIV infection (i.e., low income women of color), because women can protect themselves from HIV infection without risking harm or disadvantage as a result of requesting partners’ cooperation for safer sex. However, PrEP has been significantly underutilized by cisgender women due to social barriers such as lack of promotion targeting women, low awareness, and stigmatization (Patel et al., 2019). Thus, this study examines willingness for information seeking and community health advocacy about PrEP as behavioral outcomes of presumed influence.
A total 675 Black and White cisgender women with low to mid-income were recruited from two cities with the highest HIV infection rates: metropolitan Atlanta, Georgia, (n = 338, 50.1 %) and the greater Washington, D.C. area (n = 337, 49.9%). Black women with low income were oversampled because they have high risk of HIV infection.
According to the IPI hypothesis, perception of others’ exposure to PrEP messages was manipulated by media reach (local vs. nationwide conditions). The results supported the expectations. Perceived exposure shapes perceived influence of the message on others, which in turn affects one’s own intentions for further information seeking about PrEP (e.g., consulting with healthcare provider) and public discussion and engagement (e.g., volunteering for community PrEP campaign). As hypothesized, descriptive norms and injunctive norms interact with presumed influence differently, affecting behavioral intentions.
In conclusion, this study found that subjective inferences of others’ media exposure and media influence enhance their own behavioral intention through normative perceptions. This study specified different roles of descriptive norms and injunctive norms in the process and provided evidence for the causal relationships. As a theory of indirect media effect, the IPI hypothesis occupies a unique position in media effect theories and is a useful theoretical framework for health communication.
The IPI hypothesis explains that people tend to presume greater media influence on others and they change their behavior based on such perception. While early studies have found the influence of presumed media influence on promoting harmful health behaviors such as smoking and unhealthy dieting (Chia, 2006; Gunther, Bolt, Borzekowski, Liebhart, & Dillard, 2006), recent studies have showed that presumed media influence increases healthy behaviors like condom use and regular exercise (Ho, Lee, Ng, Leong, & Tham, 2016; Hong & Kim, 2019).
This study aims to expand the IPI hypothesis as a framework for health communication and health promotion. The goal of this study is to establish a theoretical explanation about the underlying mechanisms of presumed influence on health behaviors by integrating theories of normative influence. In response to calls for research that clarify causal mechanisms of the IPI hypothesis (Tal-Or, Tsfati, & Gunther, 2009), an experiment was conducted.
The study examined presumed influence of media messages promoting PrEP (pre-exposure prophylaxis - a daily pill protecting people from HIV infection). PrEP is beneficial for women at risk of HIV infection (i.e., low income women of color), because women can protect themselves from HIV infection without risking harm or disadvantage as a result of requesting partners’ cooperation for safer sex. However, PrEP has been significantly underutilized by cisgender women due to social barriers such as lack of promotion targeting women, low awareness, and stigmatization (Patel et al., 2019). Thus, this study examines willingness for information seeking and community health advocacy about PrEP as behavioral outcomes of presumed influence.
A total 675 Black and White cisgender women with low to mid-income were recruited from two cities with the highest HIV infection rates: metropolitan Atlanta, Georgia, (n = 338, 50.1 %) and the greater Washington, D.C. area (n = 337, 49.9%). Black women with low income were oversampled because they have high risk of HIV infection.
According to the IPI hypothesis, perception of others’ exposure to PrEP messages was manipulated by media reach (local vs. nationwide conditions). The results supported the expectations. Perceived exposure shapes perceived influence of the message on others, which in turn affects one’s own intentions for further information seeking about PrEP (e.g., consulting with healthcare provider) and public discussion and engagement (e.g., volunteering for community PrEP campaign). As hypothesized, descriptive norms and injunctive norms interact with presumed influence differently, affecting behavioral intentions.
In conclusion, this study found that subjective inferences of others’ media exposure and media influence enhance their own behavioral intention through normative perceptions. This study specified different roles of descriptive norms and injunctive norms in the process and provided evidence for the causal relationships. As a theory of indirect media effect, the IPI hypothesis occupies a unique position in media effect theories and is a useful theoretical framework for health communication.