Visual aids can make written materials easier to understand. For example, an
experiment conducted by Kools et al. (2006) showed that participants who read text
describing asthma care extracted from a health promotion leaflet had poorer
comprehension of the text than participants who read the same text modified by the
addition of graphic organizers (including the one in Figure 8.1). Pre-testing of such
materials is important to ensure that they are appropriate for the target audience.
The way in which risk information is presented can also determine its impact on
motivation and action. As we shall see in Chapter 11, risk information can be more
or less persuasive depending on whether it is framed in terms of gains or losses (even
when the same information is included).
Information knowledge and motivation
Unfortunately, information is often not enough to change behaviour because even
those who understand and have a good knowledge of the consequences of their actions
fail to follow advice. Why? Can you think of a health-related behaviour that you know
you should change?
Using meta-analysis (see Research methods 8.1), Sheeran, Abraham and Orbell
(1999) examined psychosocial factors associated with heterosexual condom use in 121
empirical studies. Effect sizes for 44 separate factors correlated with condom use could
be calculated. These analyses revealed an average weighted correlation of 0.06 (a small
effect size) for the relationship between knowledge and reported condom use. Thus
increasing knowledge by itself is unlikely to be enough to promote condom use. By
contrast, the average weighted correlations for attitude towards condom use (0.32),
others’ approval of use (0.37) and intention to use (0.43) were equivalent to medium
effect sizes. These findings indicate that changing perceived approval and attitudes
towards condoms is much more likely to impact on heterosexual condom use than is
changing knowledge. Sheeran et al. (1999: 126) concluded that these results ‘provide
empirical support for conceptualizing condom use in terms of... an extended theory
of reasoned action’ and argued that these correlates specify important targets for safer
sex promotion. A similar meta-analysis of studies applying the theories of reasoned
action (Fishbein and Ajzen, 1975) and planned behaviour (TPB, Ajzen, 1991) to
condom use confirmed the utility of these theories as models of cognitive antecedents
of condom use (Albarracín et al., 2001). Thus for many behaviours changing cognitive
elements of motivation is critical to behaviour change. This may not be achieved by
simply providing good information.
PERSUADING OTHERS
We have seen that providing information can sometimes be persuasive in itself but
that, more often, even when people understand information and have good knowledge
of health risks, this may not be enough to motivate change. So how can we overcome
resistance to change? How can health professionals move beyond providing information
to persuading target audiences to change? Persuasion is social influence (one person
or group influencing another) and there is a considerable body of research on how
social influence works. For example, Pratkanis (2007) lists 107 potentially effective
CHANGING MOTIVATION 169