Abstract: The Role of Message Framing and Efficacy in Prescription Drug Misuse Prevention Messages

◆ Parul Jain, Ohio University
◆ Vinayak Shukla, OhioHealth

The misuse of prescription drugs (PD; consuming PD in a manner different than that prescribed by a physician) is responsible for more than 130 deaths each day in the US (NIDA, 2019). Opioids, one of the most commonly misused PD, costs $75 billion annually (Florence et al., 2016). This has led to desperate calls to fight the epidemic and one solution would be to create effective prevention messages. Message design research emphasizes that message content has a strong influence on effectiveness (Cohen et al., 2015). Specifically, research found the impact of framing (Kasting et al., 2019) and efficacy (Roberto et al., 2008) on intentions and behavior. Therefore, this research examines the impact of these message design features in the context of PD misuse.
We conducted 2(framing) X 2(efficacy) experiment with random assignment to view one of the 4 messages that differed in their use of “medicine” or “drug” to describe the story of an individual misusing PD and presence or absence of efficacy information. Outcome variables of interest were intentions to misuse and expectations regarding engaging in other unhealthy behaviors (such as the likelihood of binge drinking). Relevant control variables (e.g., past use; sensation seeking) were included.
The PROCESS model 1 (Hayes, 2013) was used for analyses. Overall, the model, R2 = .36, F(8, 202) = 14.07, p < .001, revealed that neither efficacy, B = -0.14, SE = .15, t(202) = -.93, p = .35 nor framing, B = 0.01, SE = .15, t(202) = .09, p = .93 had an effect on intentions. A significant interaction B = 0.64, SE = .30, t(202) = 2.10, p = .04 revealed that those participants who received medicine-framed message without any efficacy information expressed higher intentions to engage in misuse (M = 2.10) than those who received message with efficacy information (M = 1.66).
Furthermore, there was no main effect of R2 = .16, F(8, 201) = 4.67, p < .001 efficacy, B = -.40, SE = .23, t(201) = -1.72, p = .09 and framing, B = -0.29, SE = .23, t(201) = - 1.25, p = .21 on expectations regarding practicing other unhealthy behaviors. A significant interaction , B = 0.91, SE = .47, t(201) = 1.94, p = .05 revealed that when efficacy information was excluded, those in medicine-framing (M = 4.83) perceived the expectations to engage in other unhealthy behaviors to be much higher than those in drug-framing (M = 4.04) as a consequence of PD misuse.
The findings suggest the importance of including efficacy information in the PD misuse context. In medicine-framing, when efficacy information was included, people were least likely to express intentions to misuse but when it was excluded people associated high likelihood of practicing other unhealthy behaviors as a consequence of misuse. In conclusion, findings suggest that using “medicine” rather than “drug” framing and including efficacy information in campaigns might be an effective message design strategy in PD misuse context.