Health Communication

ISSN: 1041-0236 (Print) 1532-7027 (Online) Journal homepage: http://www.tandfonline.com/loi/hhth20

Let’s Blog About Health! Exploring the Persuasiveness of a Personal HIV Blog Compared to an Institutional HIV Website German Neubaum & Nicole C. Krämer To cite this article: German Neubaum & Nicole C. Krämer (2015) Let’s Blog About Health! Exploring the Persuasiveness of a Personal HIV Blog Compared to an Institutional HIV Website, Health Communication, 30:9, 872-883, DOI: 10.1080/10410236.2013.856742 To link to this article: http://dx.doi.org/10.1080/10410236.2013.856742

Published online: 02 Jun 2014.

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Date: 05 November 2015, At: 14:32

Health Communication, 30: 872–883, 2015 Copyright © Taylor & Francis Group, LLC ISSN: 1041-0236 print / 1532-7027 online DOI: 10.1080/10410236.2013.856742

Let’s Blog About Health! Exploring the Persuasiveness of a Personal HIV Blog Compared to an Institutional HIV Website

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German Neubaum and Nicole C. Krämer Department of Social Psychology: Media and Communication University of Duisburg–Essen

On HIV blogs, people living with HIV share their intimate thoughts and experiences with the world in the form of personal online diaries. While previous research investigated the reasons why patients engage in blogging activities, the effects of such diaries on nondiseased recipients are largely unexplored. Following an experimental design, this study (n = 261) tested whether a one-time exposure to a personal HIV blog has greater persuasive effects on its readers than an institutional HIV website providing the same content. Results showed that although source credibility was perceived as higher when reading the HIV website from an official institution, blog readers had more positive attitudes and a higher self-efficacy toward condom use than website readers. Implications for health message design are discussed.

I’ve decided to share my story because I feel it’s important that people who have unprotected sex know what they might be getting themselves into. People have asked me why I am doing this, why have I put my personal business out like this. I tell them it is to help educate people, to make them aware and to make them think twice about having unprotected sex. This is my personal journey that needs to be told to help the community. HIV is neither glamorous or a rite of passage. Watch the Journal and think twice. (www.justinshivjournal. blogspot.com, 2013)

Today, anybody has the opportunity to publish their personal story on the World Wide Web. The advent of user-generated content within Web 2.0 in recent years has enabled every Internet user to be not only a consumer but also a creator of digital data. In this regard, blogging in terms of regularly publishing entries on a personal homepage (weblog or blog) has become a widespread activity (e.g., State of the Blogosphere, 2011), including in the area of health communication. Accordingly, health-related blogs are kept not only by professionals like doctors or nurses, but also by individuals affected by a serious disease (cf. Miller & Pole, 2010). These bloggers report on their experiences, therapies, and the attendant physical and psychological ups and downs. One Correspondence should be addressed to German Neubaum, MSc, Department of Social Psychology: Media and Communication, University of Duisburg–Essen, Forsthausweg 2, 47057 Duisburg, Germany. E-mail: [email protected]

specific form of online health diaries consists of blogs written by people infected with HIV. For instance, on the blog Justin’s HIV Journal (www.justinshivjournal.blogspot.com, 2013) an HIV-positive man provides information about how he became infected with the virus and how other people can prevent an infection. While previous research has largely focused on the motivations of bloggers and health bloggers to host such a personal online diary (Chung & Kim, 2008; Hollenbaugh, 2011; Nardi, Schiano, Gumbrecht, & Swartz, 2004), little is known about the recipients and how they are affected by reading such personal blogs. It is possible that reading personal accounts by HIV patients who disclose their lives with the disease might influence the health beliefs and persuade nondiseased readers to change their health behavior to prevent such an infection. In terms of theoretical concepts that may address this persuasion process, the present study suggests two different approaches: First, source credibility has been shown to be a critical determinant for persuasion (e.g., Hovland & Weiss, 1951). With respect to online health communication, the question arises of whether readers rely on professionals rather than on people with lay knowledge such as patients (Eastin, 2001; Hu & Sundar, 2010). Second, the message content is likewise presumed to be essential for persuading an audience (Hovland, Janis, & Kelley, 1953). Considering that patients divulge their individual experiences in their blog entries, this content might have a personal and emotional tone and health bloggers might serve as exemplars (cf.

PERSUASIVENESS OF HIV BLOGS

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Zillmann & Brosius, 2000) for a community that is or could be affected by the same disease. In order to investigate how perceived source credibility and content characteristics of health blogs can affect readers’ health beliefs, the current study experimentally compares the persuasive effects of messages after receiving a personal HIV blog or an institutional HIV website providing the same content (but from a different narrative perspective). Based on health behavior models (e.g., Fishbein, 2000; Fishbein & Cappella, 2006), the persuasive effect is measured by means of variables like self-efficacy and attitudes that are assumed to predict the individual’s health behavior (e.g., condom use).

HEALTH BLOGS Blogs on the Internet have been defined as “frequently updated websites in which messages are posted in reverse chronological sequence, typically by a single author” (Herring, 2004, p. 31). On these diary-like websites, authors and readers are able to interact by commenting on or linking to each other’s entries. Health blogs, specifically, are used in various ways: On the one hand, there are physicians and caregivers blogging about medical knowledge and experience with patients (Lagu, Kaufman, Asch, & Armstrong, 2008; Thielst, 2007). On the other hand, there are patients with a serious disease who host a blog disclosing their daily life with their illness (Chung & Kim, 2008; Hillan, 2003). An American survey showed that 20% of Internet users living with a chronic disease have created health-related content online at least once (Fox & Purcell, 2010). For the specific area of HIV blogs, the Web platform POZ Blogs (http:// blogs.poz.com, 2013) lists numerous bloggers all around the world who chronicle their experiences with HIV/AIDS. In most HIV blogs, people living with HIV report how they were infected (e.g., unsafe sex), their daily life, their therapy, and they also comment on health campaigns related to their virus. Taking the perspective of the readers of this content, a current study revealed that 72% of Internet users look for health information online (Fox & Duggan, 2013). In this context, user-generated content, including descriptions of personal experiences by laypeople, has become a popular advisor in health-related issues (Fox, 2011). Given the pivotal role of the Internet for health information consumers, it should be asked how the readers of health blogs might be influenced by such messages in the sense of leading them to beliefs and behaviors that might prevent diseases such as HIV.

HEALTH BEHAVIOR MODELS AND PERSUASION IN THE CONTEXT OF HIV One way to protect against HIV (human immunodeficiency virus) is to use condoms during sexual intercourse (safe

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sex). To counteract the HIV/AIDS epidemic, preventive HIV communication has been designed with the aim of addressing the specific key factors that influence the individual’s condom use. Fishbein’s (2000) integrative model of behavioral prediction brings together a series of variables potentially affecting the individuals’ HIV protective behavior. This model draws on the assumption that the relative importance of the psychological factors and background influences might be a function of the behavior in the population of interest in the specific health context (cf. Fishbein & Cappella, 2006; Yzer, 2012). Given the body of variables proposed by this model, the present work focuses on the following psychological variables that are supposed to underlie the individual’s future condom use: One critical determinant of protective sexual behavior is assumed to be risk perception, subdivided into perceived vulnerability toward, and perceived severity of, a disease (Becker, 1974). Thus, when individuals believe that they are likely to become infected with an avoidable disease such as HIV, the most important precondition to prevent risk behavior (e.g., unsafe sex) is assumed to be fulfilled (Renner et al., 2008). Moreover, Bandura (1994) delineated the importance of self-efficacy in the context of protective sexual behavior: “Even though individuals acknowledge that safer sex practices reduce risk of infection, they do not adopt them if they believe they cannot exercise control in sexual relations” (p. 29). Hence, individuals have to believe in their own capabilities to enact a desirable behavior. Several studies supported the prediction of condom use with higher self-efficacy toward this behavior (e.g., NIMH Multisite HIV Prevention Trial Group, 1998; Siegel, Aten, & Enaharo, 2001). Attitudes have also been declared as key variables in HIV prevention (e.g., Albarracín et al., 2003). Defined as “a psychological tendency that is expressed by evaluating a particular entity with some degree of favor or disfavor” (Eagly & Chaiken, 1993, p. 1), individuals’ attitudes can also refer to (un)healthy behaviors and prevention measures: With regard to HIV prevention, attitudes toward condoms and their use are strong predictors of the subsequent condom use (e.g., Sacco, Levine, Reed, & Thompson, 1991). According to the integrative model (Fishbein & Cappella, 2006; Yzer, 2012), the already-mentioned variables might be able to predict future health behavior, in the case where the individual has the intention to perform this desirable behavior. Thus, the stronger the intention, the more likely it is that a person will act according to his or her internal beliefs. Considering these social cognitive predictors of protective sexual behavior, a meta-analysis by Noar, Pierce, and Black (2010) revealed that HIV-related computer-mediated interventions (CMIs), in terms of interactive multimedia learning content presented online or on CD-ROM, increase HIV knowledge, pro-condom attitudes, condom self-efficacy, and the intention to use condoms. However, there is lack of research exploring whether computer-mediated diaries such as HIV blogs can address the recipients’ beliefs determining

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condom use. Therefore, it is crucial to discuss the persuasiveness of HIV blogs by accounting for blog-specific characteristics. PERSUASION FACTORS OF BLOGS

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In order to depict how personal HIV blogs may differ from other HIV-related computer-mediated interventions and how these differences may influence the persuasion of the recipient, two crucial factors should be addressed (cf. Hovland et al., 1953): the perceived credibility of the source and the message content. Perceived Credibility of the Source Perceived credibility refers to “the judgments made by a perceiver (e.g., a message recipient) concerning the believability of a communicator” (O’Keefe, 2002, p. 181), comprising the recipient’s evaluation of the communicator’s expertise, bias, trustworthiness, depth or completeness of message (Eastin, 2001; Hovland et al., 1953). In the context of sources on the Internet, these judgments should be even more complex: As today, anyone can publish anything on the Internet and online content is not controlled by any regulatory institution, Internet users are challenged to decide whether or not a source of health information is credible. In this case, there might be two different types of sources on the World Wide Web: professionals and laypeople (Hu & Sundar, 2010). At first glance, one might assume that online content authored by professionals (e.g., doctors or health institutions) may be perceived as more credible than contributions made by laypeople, due to the professional’s obvious superiority in terms of expertise (cf. Eastin, 2001). However, online content generated by laypeople (e.g., HIV blogs written by HIV-positive bloggers) is assumed to provide firsthand expertise and lay knowledge, which includes authentic “everyday experience of living with it [the illness]” (Hu & Sundar, 2010, p. 112). Thus, Internet users might also evaluate patients as credible sources—perhaps due to the fact that they perceive laypeople as more similar to themselves than professionals (Wang, Walther, Pingree, & Hawkins, 2008). In an online experiment that presented professionals and laypeople writing about sunscreen or milk consumption, Hu and Sundar (2010) showed that although there was no difference between health professionals and laypeople with regard to credibility, recipients relied more on content from a health website than from a health blog. However, the perception of source credibility in the specific context of blogs authored by people living with HIV in comparison with institutional HIV websites has not yet been studied. Message Content Content analyses of personal blogs (Nardi et al., 2004; Papacharissi, 2007; Trammell & Keshelashvili, 2005) and research on other person-centered media may make a

contribution to identifying special content characteristics of personal blogs. Person-centered media content has already been examined in the context of affect TV (Bente & Feist, 2000) and news research (Semetko & Valkenburg, 2000). These research realms have detected personalization and emotionality as main characteristics of such media formats. These factors and their persuasive potential are discussed next. Personalization. When a problem or an issue is explained by a human case story, media research speaks of personalized or exemplified content (Bente & Feist, 2000; Zillmann & Brosius, 2000). Media producers intentionally use this technique to capture the attention and affection of the recipients (Bennett, 2006). This kind of message presentation can also be found in personal blogs, but there is a difference here to the traditional personalization concept: Within user-generated content, the individual anecdote is mostly not told by journalists to intentionally evoke the interest of the audience, but rather illustrated by the person concerned, who uses the public medium as a diary (Nardi et al., 2004). In the context of blogs, Trammell and Keshelashvili (2005) state: “The intimacy and personalized tone that create the impression of an uncontrolled, spontaneous flow of feelings and thoughts allow readers to look far beyond the stage into a person’s ‘back stage’” (p. 978). In this case, patients as health bloggers might serve as concrete exemplars of an abstract community affected by the same disease. Following this line, the question arises of what kind of effects personalized or exemplified content might have on its recipients. In their exemplification theory, Zillmann and Brosius (2000) claimed that an issue that is represented by an exemplar is mentally easier to process for recipients than non-person-centered content. The vivid images that are created by personal testimonials and stories in the recipients’ minds demand distinctive attention and lead to a greater recall of the content over time (Green, 2006; Kazoleas, 1993; Wakefield et al., 2003). However, these advantages of person-centered narrative media do not guarantee their persuasiveness: Indeed, there is debate concerning whether narrative or statistical (abstract data and facts) communication has greater persuasive effects on recipients. Several studies compared the two presentation types and achieved inconsistent results, identifying either personal narratives (e.g., Brosius & Bathelt, 1994; De Wit, Das, & Vet, 2008; Taylor & Thompson, 1982), or statistical, dataoriented messages (e.g., Baesler & Burgoon, 1994; Greene & Brinn, 2003) as more persuasive, or both as equally persuasive (e.g., Iyengar & Kinder, 1987). However, Zillmann (2006) advises researchers to consider the potentials of exemplars in health communication: “Exemplars can be used to draw attention to pressing safety and health issues, to alter beliefs concerning risks, and to create a greater readiness for protective and corrective action” (p. 232). With that said, it is worthwhile to explore whether health blogs can function as such exemplars influencing the readers’ attention and beliefs toward health behaviors.

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Emotionality. As soon as a person narrates his or her experiences, thoughts, and feelings, the message is characterized by an emotional setting. Emotionality in news coverage and affect TV is assumed to provoke emotional responses from the audience (Bente & Feist, 2000). Personal blogs are marked by an emotional tone, since bloggers use this medium like a private diary to release emotional tension (Nardi et al., 2004) and to share intimate thoughts as well as affective events in their lives with others (Trammell & Keshelashvili, 2005). Through this emotionally involving information, processes like transportation might be facilitated that also enable recipients to establish an affective connection to the presented person (Green & Brock, 2000). The perceived connection with a media character can be like identification and state empathy with the presented character: Empirical evidence shows that individuals assuming the identity of a media character or vicariously experiencing his or her feelings are prone to adopt the attitudes and behavior of this person (Basil, 1996; Shen, 2010; see also Slater & Rouner, 2002 for a theoretical argument). The persuasive potential of these mediated socioemotional responses can be depicted using the social-cognitive theory of mass communication (Bandura, 2009), suggesting that recipients can change their self-related cognitions like self-efficacy or attitudes and even their behavior by observing engaging media characters (Klimmt, Hartmann, & Schramm, 2006). Nevertheless, it remains unexplored whether such persuasive media effects occur when users read person-centered online diaries of noncelebrity bloggers. Emotionalized media content still might provide further advantages with regard to persuasion: When affectively based attitudes should be changed, prior studies showed that affective messages (e.g., with affect-laden language) are more influential than rather rational, cognitive-oriented messages (e.g., Edwards, 1990; Fabrigar & Petty, 1999). In addition, another advantage of emotionalized messages might also lie in their absorbing impact, which reduces cognitively based reactance against persuasion attempts. Thus, Green (2006) defines this kind of communication as a “subtle form of persuasion” (p. 168), which has been empirically found to mitigate resistance (e.g., Shen, 2010; Slater & Rouner, 1996). In light of this theoretical and empirical background, the purposes of this study are to investigate the reception of personal HIV blogs and to explore whether the perceived credibility as well as the personalized and emotionalized content of these applications might exert persuasive potential on uninfected recipients.

THE PRESENT STUDY Considering the persuasiveness of person-centered and affectively based narratives, it seems likely that personcentered HIV blogs might be superior in terms of promoting

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preventive health behavior to non-person-centered institutional HIV websites confronting uninfected recipients with negative consequences of unsafe sex. Given that protective sexual behavior is predicted to be a function of social cognitive variables (see Fishbein, 2000; Yzer, 2012), the present research draws on these variables to formulate assumptions on the persuasive effects of user-generated in comparison to non-user-generated content on the Internet: Focusing on risk perception as a crucial determinant of health behavior (Renner et al., 2008), De Wit et al. (2008) showed that the perception of a personal infection risk can be increased more by narrative (private account by a diseased peer-group member) than by statistical evidence (facts and infection rate). Given the narrative nature of personal blogs (e.g., Trammell & Keshelashvili, 2005), HIV blogs should make the risk toward this virus more salient than a non-person-centered HIV website: H1: The reading of a person-centered HIV blog evokes a higher risk perception toward the disease than the reading of a non-person-centered institutional HIV website. While prior research revealed that exemplified media content can have stronger effects on recipients’ attitudes than a more abstract presentation of information (cf. Brosius & Bathelt, 1994; Taylor & Thompson, 1982), Zillmann (2006) and Green (2006) in addition attest to the idea that exemplars in health communication serve as appropriate instruments to positively modify recipients’ beliefs on how to maintain health and to take preventive measures. Building on this, it is also predicted that HIV bloggers will function as exemplars affecting readers’ attitudes toward condoms: H2: Recipients of a person-centered HIV blog have more positive attitudes toward condoms and their use than recipients of a non-person-centered institutional HIV website. According to Bandura (2009), self-efficacy toward a certain behavior can be strengthened by vicarious experience, being guided by (positive or deterrent) experiences of others, such as media characters. In the context of HIV blogs, one might predict that observing the effects of an unhealthy behavior on a living example might encourage recipients to pursue healthy behavior: H3: Recipients of a person-centered HIV blog have a higher self-efficacy toward condom use than recipients of a non-person-centered institutional HIV website. Following the integrative model of behavioral prediction (Fishbein, 2000; Yzer, 2012), increased risk perceptions, enhanced self-efficacy, and more positive attitudes toward a health behavior can only turn into respective protective actions in case individuals also have the intention to do so. Given that person-centered interventions were shown to increase the recipient’s intention to enact a health behavior (De Wit et al., 2008), for readers of HIV blogs who are

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confronted with an exemplification of this virus, it is also expected that: H4: The reading of a person-centered HIV blog evokes a higher intention to use condoms in the future than the reading of a non-person-centered institutional HIV website.

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With regard to the results of Hu and Sundar (2010), who ascertained no credibility differences in the perception of health professionals and laypersons on a health website versus a health blog, the following research question is posed: RQ1: How is source credibility of a person-centered HIV blog perceived in comparison to a non-personcentered institutional HIV website? Exemplars are supposed to affect recipients’ perceptions and beliefs due to their vividness and due to the ease with which recipients can mentally process these stimuli (Zillmann, 2006; Zillmann & Brosius, 2000). Empirically, personalized media formats were shown to increase the attention and memorability of their content (Kazoleas, 1993; Wakefield et al., 2003). Considering that personal HIV blogs might imply person-centered vivid stories, it is further hypothesized that: H5: Readers of a person-centered HIV blog report being more attentive to the presented content than readers of a non-person-centered institutional HIV website. H6: Person-centered content of an HIV blog leads to better recall than non-person-centered content of a nonperson-centered institutional HIV website. With a focus on the psychological mechanisms that might foster the persuasiveness of person-centered in comparison with non-person-centered messages, it important to consider whether specific cognitive processes such as evaluations of credibility, devoted attention, and elaborated processing of the content might mediate the effect of the narrative perspective on recipients’ health cognitions:

RQ2: Do perceived credibility, recipients’ attention toward message content, and content recall mediate the influence of the narrative perspective (person- vs. nonperson-centered) on social cognitive variables?

METHOD To investigate these hypotheses and research questions, a between-subjects online experiment was conducted. The objective of this study was to compare the persuasive effects of an HIV blog versus an HIV website reading immediately after the reception of each. Study design, measures, procedure, and participants are described next. Independent Variable The respondents of the study were randomly assigned to one of the two conditions, which varied with regard to the narrative perspective of the message content (person-centered vs. non-person-centered). In the first experimental condition, a diary-like HIV blog was presented, which included personal, emotional, and intimate content from a subjective perspective (person-centered). In contrast, the second experimental condition featured an institutional website with the same content as the diary-like blog, but from an objective point of view (non-person-centered). These two perspectives were implemented in the stimulus material. Stimulus Material Screenshots of a fictitious HIV blog (first experimental stimulus) were created on the basis of the real HIV website (which served as a second experimental stimulus) of a governmental institution in Germany for health communication. Both stimuli included the same visual basis, the same number of articles with approximately the same number of words (see Figure 1), and the same content, describing the ways of HIV infection and recommending safe sex and condom use, respectively, as the best way to protect oneself from HIV. The main difference between blog and website was the narrative

FIGURE 1 Screenshots of the stimulus material, displaying (a) the person-centered HIV blog and (b) the non-person-centered governmental HIV website (texts of the governmental website were deliberately blurred for publication).

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PERSUASIVENESS OF HIV BLOGS

perspective. In total, four articles were presented in each condition: The first article dealt with the aim of the website or blog, respectively. The second explained the terms HIV and AIDS, while the third article asserted how one might become infected with HIV. Finally, the fourth article dealt with the question of how to protect oneself or one’s partner against HIV. As shown in Table 1, the narrative type of the articles was adapted to each specific condition. In addition to the text-based differences, the personcentered stimulus was marked by typical characteristics of a diary-like blog such as the name and age of the blogger, tags, references to comments, and the date of the HIV diagnosis, which is common in health-related blogs. Moreover, the HIV blog contained a picture of the blogger, which showed a computer-based calculated human face with an average level of attractiveness (Braun, Gründl, Marberger, & Scherber, 2001). Dependent Measures To assess the fit of the measurement model to the data, a confirmatory factor analysis (CFA) was computed on all dependent measures (which consisted of more than one continuous item) in one model. After the analysis, items with low loadings on the respective factors were removed. The final model yielded a satisfactory fit: χ 2 (203) = 402.97, p < .001, TLI = .89, CFI = .90, RMSEA = .062. In the following, sample questions for all dependent variables are presented. Since the individual’s perceived risk of HIV encompasses the perceived personal vulnerability and the perceived severity toward this virus (cf. Becker, 1974), each aspect was

TABLE 1 Sample Sentences From the Four Articles in Each Condition (Blog vs. Website) Institutional HIV Website, Non-Person-Centered Content

Content of the Article

Personal HIV Blog, Person-Centered Content

Article 1: Aim of the blog versus website

“For me, it is important to “A sub-goal of this motivate people to use website is to increase condoms in risk the motivation of situations” condom use in risk situations” “My immune system is “HIV is a virus that attacked by this virus” attacks cells of the immune system” “I was infected with HIV “HIV infections often when I had unsafe sex occur in long-time with my long-time relationships” girlfriend” “Safe sex protects me and “Safe sex protects my current girlfriend against sexually against sexually transmitted diseases” transmitted diseases”

Article 2: Definition of HIV and AIDS Article 3: Transmission of HIV Article 4: HIV prevention

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measured by one item. Based on items developed by Renner, Hahn, and Schwarzer (1996), participants were asked for the personal vulnerability (“how do you estimate the probability of you contracting HIV through sexual intercourse?” ranging from 1 [not at all probable] to 5 [very probable]) and perceived severity of HIV (“What do you think, how severe is an infection with HIV?” ranging from 1 [not at all severe] to 5 [very severe]). Participants’ attitudes toward condoms and their use were assessed by 18 items of the UCLA Multidimensional Condom Attitude Scale (Helweg-Larsen & Collins, 1994). The original version of this scale was targeted at measuring attitudes toward condoms as a method of contraception. For the present study, selected items from this scale were adapted in order to assess attitudes toward condoms as protection against HIV. Thus, items such as “condoms are an effective method to not become infected with HIV” were rated on a 5-point scale. After the CFA, nine items were removed due to their low loadings on the latent variable. Thus, the final measure included nine items that had an internal consistency of Cronbach’s α = .61. To measure the respondents’ self-efficacy toward condom use in the sense of perceived ability to use condoms mechanically (skills to put on a condom) as well as socially (skills to discuss condom use with one’s partner), 17 items of the Condom Use Self-Efficacy Scale (Brafford & Beck, 1991) were used. Participants were asked whether they agreed or disagreed with items such as “I feel confident in my ability to suggest using condoms with a new parter” on a 5-point scale. Based on the CFA, the factor self-efficacy toward condom use was reduced to five items (Cronbach’s α = .77). Moreover, participants rated their intention to use condoms in the future by means of three items (based on Reinecke, Schmidt, & Ajzen, 1996), asking for agreement or disagreement with items such as “If I met a new partner and wanted to have sex with him/her, I would insist on using a condom” (5point scale). These items reached a reliability of Cronbach’s α = .88. Related to the participants’ exposure to the stimulus, perceived source credibility was measured by an eight-item semantic differential (5-point bipolar rating scales), including opposite adjectives such as trustworthy–untrustworthy or reputable–not reputable. Due to low factor loadings revealed by the CFA, three items were removed, resulting in a fiveitem scale with a reliability of Cronbach’s α = .87. The participants’ attention toward the media content was assessed on a 5-point scale by the item “how attentively did you read the articles?” ranging from 1 (not at all attentively) to 5 (very attentively). Recall of the blog versus website content was measured by means of five multiple-choice questions such as “what is the aim of the governmental institution with this campaign website?” (website condition) and “what is the aim of the blogger with this HIV blog?” (blog condition). For each question four answer options were given. Each condition

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contained five questions that were adapted to the specific narrative type. While recall questions reached a reliability of Cronbach’s α = .58 in the website condition, in the blog condition questions had a reliability of Cronbach’s α = .60.

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Personal Variables Besides the randomized assignment of participants to each condition, personal variables were measured in order to control that the samples in each condition did not differ. Therefore, participants’ personal relevance toward HIV/AIDS (“how important is the issue of HIV/AIDS in your life?” ranging from 1 [not important at all] to 5 [very important]), prior knowledge of HIV (five multiple-choice questions; e.g., “are women more vulnerable than men to sexually transmitted HIV infection?”), previous experience with blogs (one item: “how is your experience with blogs on the Internet?” ranging from 1 [far below average] to 5 [far above average]), demographics (sex, age, and education level) and relationship status were assessed. Participants and Procedure The experimental setting was created on a free online platform called SoSci Survey (www.soscisurvey.de, 2013), which enables the integration of stimulus material and scales for web-based psychological experiments. The link to the study was sent via various student e-mail distributions and posted in several online forums (e.g., forums called “planet love” or “lifestyle forum”). In total, 261 participants (161 women) completed the online experiment. The age of the sample varied from 18 to 58 years (M = 24.27, SD = 3.71), and the majority was highly educated: 96.2 % had at least a university entrance-level qualification. The majority of the participants (56.7%) stated that they were in a stable relationship, while 42.5% were not in a relationship (two participants did not want to specify their relationship status). Between the two experimental conditions, participants did not differ with regard to sex distribution (χ 2 (1) = .25, n.s.), age (t(259) = .71, n.s.), education level (χ 2 (4) =

4.89, n.s.), personal relevance (t(258.577) = –.46, n.s.), prior knowledge on HIV (t(259) = –.98, n.s.), previous experience with blogs (t(259) = .31, n.s.), and relationship status (χ 2 (2) = .01, n.s.). In the first part of the online experiment, personal variables were assessed. Subsequently, the participants were instructed to read the upcoming four webpages and blog posts, respectively, which were presented one after the other. To experimentally control cross-gender effects in the blog condition, males were presented with a male blogger and females with a female blogger. The website condition exclusively presented the non-person-centered Web articles of the German governmental institution. After the stimulus presentation, all dependent measures were assessed. RESULTS Effects of Person- Versus Non-Person-Centered Message Content As stated earlier, it was expected that HIV blogs would be more persuasive than institutional HIV websites. In this case, the persuasiveness was operationalized by the predictors of health behavior risk perception, self-efficacy and attitudes toward behavior, and behavioral intention. Between-group comparisons (t-tests for independent samples) were conducted to examine which stimulus had greater effects on recipients. Means of the dependent measures are shown in Table 2. H1 predicted the person-centered HIV blog to evoke a higher risk perception toward HIV than the non-personcentered HIV website. However, there was no significant difference with regard to the perception of vulnerability toward HIV between the two conditions: Recipients of the personcentered blog did not perceive a significantly higher vulnerability to HIV than recipients of the non-person-centered website. Nonetheless, the perception of HIV severity was significantly higher in the non-person-centered condition than in the person-centered one (t(225.75) = –2.40, p = .017, d = –0.31). H1 needs to be rejected.

TABLE 2 Means and Standard Deviations of Dependent Measures for Blog and Website Stimuli

Personal risk of infection: vulnerability Personal risk of infection: severity Attitudes toward condoms and their use Self-efficacy toward condom use Intention to use condoms Perceived source credibility Attention toward media Content recall

Person-Centered HIV Blog (n = 133)

Non-Person-Centered HIV Website (n = 128)

M (SD)

M (SD)

t

2.20 (.83) 4.78 (.50) 4.67 (.34) 4.31 (.62) 4.50 (.75) 3.87 (.63) 3.47 (1.15) 4.33 (1.04)

2.09 (.86) 4.91 (.32) 4.56 (.35) 4.09 (.68) 4.46 (.80) 4.28 (.62) 3.10 (.99) 3.85 (1.26)

1.05 −2.40 2.53 2.77 0.45 −5.24 2.76 3.36

df

p

259 .296 225.75 .017 259 .012 259 .006 259 .654 259

Let's Blog About Health! Exploring the Persuasiveness of a Personal HIV Blog Compared to an Institutional HIV Website.

On HIV blogs, people living with HIV share their intimate thoughts and experiences with the world in the form of personal online diaries. While previo...
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