Abstract: Talking about Opioid Misuse: The Effect of Family Communication Patterns and Messages Advocating Direct and Indirect Conversation

◆ Deena Kemp, University of Texas at Austin
◆ Mike Mackert, University of Texas at Austin
◆ Siyan Li, University of Texas at Austin
◆ Billy Table, University of Texas at Austin
◆ Jiahua Yang, University of Texas at Austin
◆ Susan Kirtz, University of Texas at Austin
◆ Jessica Hughes Wagner, University of Texas at Austin

Families play an important role in addressing substance misuse and addiction. Extant literature suggests patterns of communication within families influence the ways in which they engage loved ones who may be misusing substances like prescription opioids. However, little is known regarding how strategic health messages about family communication influence individuals’ intentions to engage in conversations about substance misuse. This study examines whether messages advocating direct (versus indirect) communication approaches are more effective for individuals who describe their family as having a high (versus low) conversation orientation. We conducted a between-participants experiment varying exposure to messages advocating direct versus indirect dialogue with participants (N = 613) who described their family communication patterns as either low or high in conversation orientation. We recruited adults residing in Texas using quota sampling to approximate the state’s race and ethnicity demographics. The stimuli were developed to reflect theoretical differences between direct and indirect communication practices and pretested to confirm the manipulations were successful. We predicted interaction effects whereby the message suggesting a direct approach, such as addressing how a loved one behaves when using opioids, would have greater effects for participants with high-conversation orientation family dynamics. Conversely, we anticipated the message suggesting an indirect approach, such as talking about another individual struggling with misuse, would have greater effects with participants with low-conversation orientation family dynamics. Analysis of variance tests show that our hypotheses were supported for message attitudes, message elaboration, and perceived message effectiveness. There was also a significant interaction effect for intention “to start a discussion with a friend or loved one about their prescription opioid misuse or addiction.” However, there was only evidence of a matching effect for the message advocating indirect communication influencing intentions with low-conversation audiences. Both message types were equally effective at influencing intentions for high-conversation participants. These findings suggest message designers should consider the kinds of communication behaviors and actions advocated in appeals targeting family members. Messages may have greater effect if tailored to the conversation dynamics of particular audiences. In particular, for low-conversation audiences, messages advocating an indirect approach may be more effective at motivating intentions to engage a family member who is misusing opioids.