PsychologicalReports, 1990, 66, 1057-1058. @ Psychological Reports 1990
HEALTH EDUCATION AND HEALTH PSYCHOLOGY A COMPARISON THROUGH CONTENT ANALYSIS OF REPRESENTATIVE JOURNALS DAVID F. DUNCAN '
Illinois Primary Health Care Association Summary.-A comparison of the content of four journals representing health in education and in health psychology over 2 years shows some interesting similarities and differences.
The fields of health education and health psychology are both concerned with the connections between behavior and health and with changing behavior in ways which wlll prevent or ameliorate illness. Just how these fields actually differ is not clear from the formal definitions that have developed. According to Winslow (1923) health education originated in the antituberculosis campaigns of the nineteenth and early twentieth centuries. Health education has been defined as, a process with intellectual, psychological, and social dimensions relating to activities which increase the ability of people to make informed decisions affecting their personal, family, and community well-being (Green, 1973, p. 63).
When Schofield (1969) conducted a content analysis of Psychological Abstracts in 1966 and 1967, he found very few health-related articles, but the years which followed his seminal paper brought major developments in what was to become known as health psychology. Included among these was establishment of a Division of Health Psychology in the American Psychological Association in 1978. Matarazzo (1980) defined this new field as, the aggregate of the specific educational, scientific, and professional contributions of the discipline of psychology to the promotion and maintenance of health, the prevention and treatment of illness, and the identification of etiologic and diagnostic correlates of health, illness, and related dysfunction (p. 815).
To examine the differences between the two fields a content analysis was conducted of the articles published during 1988 and 1989 in two major journals in each field. The four journals examined were Health Psychology (66 papers), Psychology and Health (34 papers), Health Education (127 papers), and Health Values (49 papers). The content of each article was classified according to a list of 100 descriptors. No instances for 14 descriptors were found. The relative frequencies of the remaining 86 descriptors was 'Reprints may be requested from the author at 517 North Michaels, Carbondale, IL 62901-1352.
D. F. DUNCAN
examined for each journal and for the psychology journals versus the health education journals. A full table of frequencies is on file with Microfiche Publications. The five most frequent topics in the two health psychology journals and the percentage of health psychology and health education articles in which they appeared were patients (17%; I%), stress (15%; 4%), blood pressure/hvpertension (12%; 2%), tobacco (12%;1%), and social support ( I 1 % ;1%). Those most frequently addressed in the health education journals and the percentage of health education and health psychology articles in which they appeared were the process of health education (19%; 3%), health promotion/wellness (13%;1%), adolescent health (8%;5%), AIDS (7%; 6%), and worksite interventions (7%;1%). The five diseases most frequently dealt with were coronary heart disease (10% of health psychology articles and 5 % of health education articles), AIDS (6%; 7%), cancer (4%; 4%), diabetes (8%; 2%), and hypertention (12% and 2%). As indicated by the relative frequencies of topics in these representative journals, the fields of health education and health psychology both focus to a large extent on the same chronic diseases. Health psychology shows a greater focus on clinical settings and applications, while health education articles more often focus on school and occupational settings. Health education articles more often fell in the area of primary prevention while health psychology articles were more often in the area of secondary prevention. REFERENCES GREEN, L. W. (1973) New definitions: report of the 1972-1973 Joint Committee on Health Education Terminology. Health Education Monographs, 2(33), 63-70. MATARAZZO, J. D. (1980) Behavioral health and behavioral medicine: frontiers for a new health psychology. American Psychologist, 35, 807-817. SCHOFIELD,W. (1969) The role of psychology in the delivery of health services. American Psychologist, 24, 565-584. Wnis~ow,C. E. A. (1923) The evolution and significance of the modern public health campaign. New Haven, C T Yale Univer. Press.
Accepted May 15, 1990.
OVERCOMING RESISTANCE TO PERSUASION
ment message which gave the "correct response" that should have been made to the persuasive attack. The reinforcement message was a very brief 91-word message informing the students that the correct response was to change attitudes to conform to the position advocated in the attack message (elimination of students' parking on campus). The message simply stated that previous studies showed an overwhelming majority of students had favorable opinions of restrictive parking proposals, that such evaluations had been supported by feasibility studies showing such restrictions had desirable effects on parking problems, and ended by claiming that the proposal was the most practical, beneficial solution to a serious problem. The second persuasive message was placed in one-half of the packets. After reading the experimental packets, subjects then completed the attitude measure tapping their views on eliminating students' parking on campus. These procedures created a three-way analysis of variance design, with two levels of inoculation (presentlabsent), reinforcement (presentlabsent) and second persuasive attack (presentlabsent). The .05 level of confidence was used in all analyses.
Experimental and Control Group Comparisons To evaluate whether the experimental manipulations affected attitudes, a simple analysis of variance was computed for the experimental and control groups. There was a significant difference among the means (F,,,,,= 6.03, p< .05). To assess the specific experimental conditions that differed significantly from the pretest-posttest only control, Dunnett's procedure was used to compare each experimental group with the control group. Only in the two experimental groups in which inoculated subjects did not receive two persuasive attack messages were there no significant differences with the control group. All other experimental groups had significantly more positive attitudes than did the control conhtion.
Test of the Hypotheses A three-way, fixed-effect factorial analysis of variance was computed as the primary test of the hypotheses. First, tests of homogeneity of variance indicated no significant differences. In fact, the range of the eight standard deviations was quite small (low = 1.08; high = 1.73). Three significant main effects obtained for inoculation (F,,,,, = 8.56, p < .05), reinforcement (F,,,,, = 3.44, p < .05), and repetition of message (F,,,,,= 9.61, p < . 0 5 ) All main effects were tested with a priori one-tailed tests. There were no significant interactions. Means and standard deviations are presented in Table 1. The data clearly support the first three hypotheses. The significant main effects for reinforcement, inoculation, and second attack, plus the direction of the mean differences, were exactly as posited. Hypotheses 4 and 5 were
M. BURGOON & M. D. MILLER
TABLE 1 D SCORES E AND STANDARD DEVIATIONS FOREXPERIMENTAL GROUPS
Inoculation ReinforceNo Reinment inforcernent M a
Inoculation M No Inoculation M Reinforcement M No Reinforcement M Message Repetition M No Message Repetition M Grand M
3.76 1.63 2.02 1.70 2.53 3.44 3.30 2.72 3.51 2.49 3.00
2.96 1.50 1.63 1.73
No Inoculation ReinforceNo Reinment forcement 4.01 1.08 3.40 1.51
3.33 1.47 3.06 1.49
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also supported. Means for main effects presented in Table 1 indicate that in addition to statisticdy significant differences being present, there were relatively large effect sizes due to inoculation, reinforcement, and repetition of message. With each manipulated variable, there was approximately one scale-unit difference in the means for main effect for each predictor variable. An inspection of the means of each condition plus the three significant effects leads to important information. As predicted, the No Inoculation/Reinforcement/Second Attack Condition had the most positive attitude toward elimination of students' parking on campus. Also, as hypothesized, the Inoculation/ No Reinforcement/No Second Attack Condition had the least positive attitude. I n fact, this condition did not differ significantly from the control condition, lending further statistical support to Hypothesis 5 . By inspection, since the three main effects computed from the grand means were significant, the predicted high and low means also differed significantly. The pattern of the eight cell means conformed exactly to the hypothesized relationships.
DISCUSSION The data from both the pilot study and the actual experiment indicated that the messages were effective in inhibiting and producing change. The carefully constructed inoculation-pretreatment message was effective in both experiments in inducing resistance to persuasion. The first persuasive attack was successful in producing significant attitude change in both experiments. The second attack message was also effective as evidenced by the main effect for message repetition. I t was especially successful when subjects had received prior inoculation manipulations, since inoculated subjects who only received one attack message did not differ significantly from the control