Framing of Memorable Messages
Running Head: EFFECTS OF FRAMING MEMORABLE BREAST CANCER MESSAGES
The Effects of Framing of Memorable Breast Cancer Messages
on Engagement in Detection or Prevention Behaviors
This research was supported by the Breast Cancer and the Environment Research Centers grant
number U01 ES012800 from the National Institute of Environmental Health Sciences (NIEHS),
and the National Cancer Institute (NCI), NIH, DHHS. Its contents are solely the responsibility
of the authors and do not necessarily represent the official views of the NIEHS, NCI, or NIH.
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Framing of Memorable Messages
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Abstract
Memorable messages can to be guides to actions such as practicing health behaviors.
Message framing suggests that gain framed messages are well suited to promote disease
prevention behaviors, whereas loss-framed messages are better for promoting detection
behaviors. A set of self-reported memorable messages about breast cancer was examined. About
one-fourth of the reported messages were framed, and most of them were gain-framed. Gainframed messages were found to be significantly associated with prevention behaviors.
Framing of Memorable Messages
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The Effects of Framing of Memorable Breast Cancer Messages
on Engagement in Detection or Prevention Behaviors
Cancer is a health issue that cannot be ignored. It affects the lives of millions of people;
the American Cancer Society (2008b) predicted that in 2008 alone, 1,437,180 new cancer cases
would be diagnosed in the United States. Breast cancer is one of the most prevalent types, as it is
the second leading cancer diagnosed in women, aside from skin cancer (American Cancer
Society, Inc., 2008b). Due to the salience of breast cancer in our society, messages containing
information about the disease are continuously being distributed through various media,
interpersonal, and medical sources. The messages can be used to improve healthy behaviors and
even save lives, because they contain information about breast cancer awareness, detection,
prevention, and treatment (Pribble, et al., 2006).
However, in order for these messages to have any effect, they must be both encountered
and remembered by women. Thus, research has been conducted to study “memorable
messages,” which are interpersonal messages that are “remembered for extremely long periods
of time and which people perceive as a major influence on the course of their lives” (Knapp,
Stohl, & Reardon, 1981, p. 27). Another important feature of messages is the way in which they
are framed. Research on message framing, which refers to emphasizing either the benefits (gainframed) or the costs (loss-framed) of a behavior, has studied people’s interpretations of, and
reactions to, different kinds of framing (for a discussion, see Rothman, Bartels, Wlaschin, &
Salovey, 2006).
This research effort collected reports of women’s memorable messages about breast
cancer and asked them to report whether or not they had engaged in breast cancer detection or
prevention behaviors. The reported messages were examined to see if framing was present, and
Framing of Memorable Messages
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the data were analyzed to determine if certain types of framing were associated with selfreported prevention and detection behaviors. The remainder of this paper will discuss breast
cancer, review the research on memorable messages and message framing, provide the
hypotheses and research questions, explain the method, review the results, and discuss the
implications of the findings.
Breast Cancer
As previously stated, breast cancer is the second-most common cancer in women besides
skin cancer. It is estimated that every woman has a 1 in 8 chance of developing breast cancer at
some point in their lifetime (American Cancer Society, Inc., 2007). The National Cancer Institute
(2008) estimates that 182,460 women will be diagnosed with and 40,480 women will die of
breast cancer in 2008. For women, it is the second leading cause of cancer death, after lung
cancer (American Cancer Society, Inc., 2007). The median age for breast cancer diagnosis is 61,
but cases have been found in women as young as 20 years old (National Cancer Institute, 2008).
It is important to distinguish between breast cancer prevention and breast cancer
detection behaviors, which are both discussed throughout this paper. The definition used here
for prevention behaviors is anything that reduces a woman's risk of getting breast cancer. The
American Cancer Society (2008a) lists the following as behaviors that may reduce breast cancer
risk: limiting alcohol use, exercising regularly, maintaining a healthy body weight, choosing to
breast feed for at least several months, avoiding post-menopausal hormone therapy, and avoiding
chemicals with estrogen-like properties. This study focuses specifically on exercise and healthy
diet as forms of breast cancer prevention. Conversely, breast cancer detection behaviors are any
acts which help to find existing cancer within the breasts. The following are listed by the
American Cancer Society (2007) as methods to detect breast cancer: mammograms, clinical
Framing of Memorable Messages
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breast exams, breast self-exams, and magnetic resonance imaging (MRI). Mammograms and
breast self-exams are the focus in this study in terms of detection behaviors.
Memorable Messages
Research has discovered that memorable messages are widespread and concern many
topics. They have been studied within the contexts of final conversations about religious faith
(Keeley, 2004), gendered socialization (Dallimore, 2003), aging (Holladay, 2002), and
newcomer socialization in organizations (Stohl, 1986), among other topics. Memorable messages
are seen as meaningful to the receiver, and they can affect behavior and guide sense-making
processes (Holladay, 2002). According to Knapp et al. (1981) the reasons these messages are
seen as memorable involve the nature of the message receiver, the sender, and the message itself.
Usually, memorable messages are brief and provide rules for problem solving.
Studies similar to this one have specifically examined memorable messages about breast
cancer. Smith, Atkin, Skubisz, Munday, and Stohl (in press) found that women who are the most
likely to recall memorable breast cancer messages have had personal experience and close
friends or relatives who have had experience with breast cancer. Other research by Smith et al.
(in press) has found that memorable breast cancer messages topics include early detection,
awareness, treatment, and prevention of breast cancer, and the most common sources of these
messages are the media, friends, family, and medical professionals. They also examined the
impact of different sources of messages on prevention or detection behaviors, and found that
medical professionals were substantially more likely to influence breast cancer detection than
breast cancer prevention behaviors. However, research has yet to study the impact framing has
on the behavioral effects of memorable messages.
Message Framing
Framing of Memorable Messages
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Message framing refers to emphasizing either the benefits (gain-framed) or the costs
(loss-framed) of a behavior. Various researchers (Dillard & Marshall, 2003; Rothman &
Salovey, 1997; Wilson, Purdon, & Wallston, 1988) have concluded that each kind of framed
message can take two forms—the outcome of the behavior can be described as desirable or
undesirable, and the outcome can be described as being either attained (acquired, achieved, made
more likely) or avoided (averted, not realized, made less likely)—leading to four possible
framing scenarios. In their meta-analysis of framing studies, O'Keefe and Jensen (2006)
supplemented this disambiguation by also considering the kernel states of framed messages. In
their words, "The kernel state is the basic, root state mentioned in the message's description of
the consequence" (p. 7). For example, in the message "If you take your hypertension medication,
you will reduce your risk of heart disease," the kernel state is "heart disease," which is clearly
undesirable. All of these methods of conceptualizing framed messages can placed into a 2 x 2
array, shown in Figure one, which expresses the four different scenarios in terms of the kernel
states in messages.
-- Insert Figure 1 here -Message framing was first discussed as a part of prospect theory, which was postulated
by Tversky and Kahneman as a result of an experiment (1981). Their findings revealed that
participants were much more likely to prefer a behavior perceived as "risky" if it was lossframed. These results have been applied to the area of health communication, with scholars
hypothesizing that disease detection behaviors, which are considered risky due to the possibility
of finding a disease, will be more likely to be influenced by loss-framed messages; in turn,
disease prevention behaviors, which are less risky, will be more likely to be influenced by gain-
Framing of Memorable Messages
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framed messages (For a discussion, see Rothman, Bartels, Wlaschin, & Salovey, 2006; Salovey,
Schneider, Apanovitch, 2002).
Numerous studies have tested this hypothesis, leading to inconclusive results. One line of
research has supported it: studies have found that loss-framed messages were more effective than
gain-framed messages for encouraging mammography use (Banks et al., 1995; Schneider et al.,
2001), breast self-exams (Meyerowitz & Chaiken, 1987), PAP test utilization (Rivers, Salovey,
Pizarro, Pizarro, & Schneider, 2005) and HIV screening (Kalichman & Coley, 1995). Other
research has found that gain-framed messages were more effective at encouraging prevention
behaviors like using sunscreen (Detweiler et al., 1999;), using infant car seats (Christophersen &
Gyulay, 1981), exercising (McCall & Ginis, 2007) and using condoms (Linville, Fischer, &
Fischhoff, 1993).
Nevertheless, two large meta-analyses yielded results that were not completely
supportive of the detection/prevention hypothesis (O'Keefe & Jensen, 2006; O'Keefe & Jensen,
2007). Both meta-analyses found that gain-framed messages were significantly more likely to be
more persuasive in terms of prevention behaviors. However, the 2007 analysis attributed this
almost completely to dental-hygiene behaviors, and did not find any differences in
persuasiveness for the preventive behaviors of safer-sex behaviors, skin cancer prevention
behaviors, or diet and nutrition behaviors. Only the 2006 analysis tested messages in relation to
detection behaviors and did not find any difference in the persuasiveness of gain- and lossframed messages.
Research Questions and Hypotheses
Though the research is mixed, the possibility that gain or loss framed messages can affect
detection and prevention behaviors differentially is worth examining. Memorable messages,
Framing of Memorable Messages
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because they have been shown to affect behavior and guide sense-making processes, are a
valuable topic of research in the realm of breast cancer prevention and detection. Research,
however, has yet to investigate the intersection of framing and memorable messages and the
effects it may have on the responses elicited. Additionally, to the best of the knowledge of the
authors, this is the first study to examine a set of naturally occurring messages and determine
their frames, as opposed to performing the usual practice of manipulating the messages
experimentally.
To examine the framing of breast cancer memorable messages reported by women, this study
used the same classification of message framing as used by O'Keefe and Jensen in their metaanalyses (2006; 2007). Thus, our research questions address the frequencies of framed messages
in general and each of the four framing possibilities:
RQ1. What percentage of messages are either gain or loss framed?
RQ2. What percentage of messages are gain-framed due to an undesirable kernel state that
is avoided?
RQ3. What percentage of messages are gain-framed due to a desirable kernel state that is
attained?
RQ4. What percentage of messages are loss-framed due to an undesirable kernel state that
is attained?
RQ5. What percentage of messages are loss-framed due to a desirable kernel state that is
avoided?
This study also sought to test the previously discussed prevention/detection hypothesis to
examine whether memorable messages framed as gain or loss were associated with prevention or
detection behaviors. This is reflected by the following hypotheses:
Framing of Memorable Messages
H1:
Gain-framed messages will be significantly associated with prevention behaviors.
H2:
Loss-framed messages will be significantly associated with detection behaviors.
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Method
Participants
Participants were recruited from breast cancer awareness organizations, advocacy groups,
a large Midwestern university, and a medium-sized Western university in the United States. In
sum, 359 female respondents completed the survey. Participants ranged from 18 to 85 years old.
Caucasians composed the majority of the sample, 85%. African Americans (4%), Latinos (3%),
Asian Americans (2%), Native Americans (2%), Pacific Islanders (3%), and those choosing not
to respond (1%) composed the remainder of the sample. When participants were asked about
their highest level of education, 11% reported a high school degree or less, 35% participants
completed some college, technical school, or earned an associates degree, 32% earned a
bachelor’s degree, and 22% had graduate schooling.
Instrumentation and Procedure
Participants completed a web-based survey questionnaire. The beginning of the survey
gave the definition of a memorable message and asked participants if they could recall a
memorable message about breast cancer. If the participant did have a memorable message (n =
207, 60%), they were asked to report it. Then, a series of open-ended questions were asked about
their personal experience with breast cancer, as well as the characteristics of and responses to
their memorable message.
Framing of Messages
Each of the reported memorable messages was first coded in terms of whether it had a
desirable or undesirable kernel state. If the message included a kernel state (some did not), it was
Framing of Memorable Messages 10
then listed and coded in terms of whether it was avoided or attained. The messages were coded
reliably by two coders with 81% agreement for coding both the gain/loss framing of a message
and the kernel states of the messages. Responses that were coded differently were discussed by
the two coders and reconciled. Examples of the kernel states that were coded include "detect
breast cancer," "death," "enjoy my grandchildren" and "life," among others.
Relationship between Memorable Messages and Behaviors
In order to assess the relationship between memorable messages and behaviors,
respondents indicated whether they had engaged in breast cancer detection behaviors and/or
breast cancer prevention behaviors. Responses to the questions, “Did you engage in breast self
exams?” and “Did you engage in mammograms?” had a Pearson correlation of .52 (n = 214, p <
.05) and were summed to form a measure of detection behaviors that ranged from zero to two.
Responses to the questions, “Did you engage in eating healthy food?” and “Did you engage in
exercise?” had a Pearson correlation of .71 (n = 210, p < .05). Summing responses to these two
questions formed a measure of prevention behaviors that ranged from zero to two. Although the
data are categorical, this procedure is meaningful because the categories differ in magnitude
rather than quality. Consequently, the Pearson correlation coefficient as employed here can be
interpreted in the usual manner.
Results
Framing of Messages
Of reported messages, 23.08% (n=48) were framed. Twelve and a half percent of the
messages were framed as having an undesirable kernel state that was avoided, and 68.75% had a
desirable state that was attained; summed together, both of those percentages show that 81.25%
of all framed messages were gain-framed. One example of an undesirable/avoided message is "I
Framing of Memorable Messages 11
do not recall the exact wording, but there was a TV ad about a woman who was saying that
women should be tested so that no one will lose a sister like she did." Here, the undesirable
outcome of losing a sister is avoided by getting tested. An example of a desirable/attained
message is "Early detection saves lives," where "life" is the desirable kernel state that is attained
by early detection.
Twelve and a half percent of the messages had an undesirable kernel state that was
attained, and 6.25% had a desirable kernel state that was avoided; thus, 18.75% of all the framed
messages were loss-framed. An example of a undesirable/attained message is "Smoking
increases the chances of breast cancer," with "breast cancer" being the undesirable state that is
attained/made more likely by smoking. A desirable/avoided message is "If I do not have the
mass taken care of now, I may not be able to enjoy my grandchildren," where "enjoy my
grandchildren" is the desirable state that is avoided/made less likely by not having a mass taken
care of.
Behavioral Outcomes
Of women who reported a memorable message, 72.46% (n = 150) reported engaging in
breast self-exams and 68.12% (n = 141) said that they had a mammogram. 60.89% (n = 126) of
women reporting messages said that they engaged in breast self-exams and had a mammogram,
whereas 78.26% (n = 162) of women reported engaging in at least one of the detection behaviors.
In terms of prevention behaviors, 64.73% (n = 134) of women who reported a message said that
they ate more healthy food and 63.29% (n = 131) said that they exercised. 57.01% (n = 118) of
women reporting messages said that they engaged in both eating healthy food and exercise, and
69.57% (n =144) engaged in at least one of the prevention behaviors.
Relationship between Message Framing and Behaviors
Framing of Memorable Messages 12
Hypothesis one. Overall, data were consistent with hypothesis one, which predicted that gainframed messages would be significantly associated with prevention behaviors. Specifically,
people who were exposed to messages with an undesirable kernel state that was avoided were
more likely to engage in prevention behaviors than people not exposed to those messages (r =
.31, p = .03, n = 48). This correlation came mainly from the interaction between
undesirable/avoid gain-framed messages and engaging in exercise, as people exposed to those
messages were more likely to exercise than those not exposed to it (r = .29, p = .04, n = 48).
However, those participants who recalled a memorable message with a desirable kernel state that
was attained were less likely to engage in prevention behaviors (r = -.50, p = .0003, n = 48) than
those not exposed to such messages.
Hypothesis two. Data were not consistent with hypothesis two, which said that loss-framed
messages would be significantly associated with detection behaviors. People exposed to
messages that contained an undesirable kernel state that was attained were no more likely to
engage in detection behaviors than participants who were not (r = -.15, p = .32, n = 46).
Similarly, people who reported messages with a desirable kernel state that was avoided were no
more likely to engage in detection behaviors (r = .08, p = .62, n = 46).
Discussion
This research was innovative in comparison to the rest of the message framing literature,
as to our knowledge no other studies have taken reported messages and examined them in terms
of framing. Usually, studies experimentally create either gain- or loss-framed messages, present
them to participants, and then analyze the results. This research brings forth the possibility that
individuals can remember the specific framing of messages they hear, even after a long period of
time, and that the framing can have differential effects on their behavior. It would be interesting
Framing of Memorable Messages 13
for future research to more thoroughly test the long-term effects of framed messages (either
experimentally created or reported by participants) to see if they affect behaviors in different
ways. This potential for long-term influence is important in the realm of disease prevention and
detection, because most behaviors advocated in these messages are behaviors that should be
continued for a long period of time.
The results of this study support the findings of the O'Keefe and Jensen meta-analyses
(2006; 2007), which also found that gain-framed messages were more effective than loss-framed
messages at persuading individuals to engage in disease prevention behaviors. This has
important implications in the field of health communication, as disease prevention is increasingly
an important goal for health educators. It is difficult to persuade people to engage in disease
prevention behaviors because they often require a lot of personal effort (e.g. exercise, eating
healthy, etc.), so it is valuable for researchers to know what ways of presenting the information
are more persuasive than others. More research is needed in this area, however, as O'Keefe and
Jensen found only a small effect for gain-framed messages (2006), and in one meta-analysis said
that it was almost solely due to dental hygiene behaviors (2007).
An interesting finding of this study was that participants reporting gain-framed
memorable messages that were undesirable/avoided were more likely to engage in prevention
behaviors than people who had not been exposed to them, but those who reported a
desirable/attained gain-framed memorable message were less likely to engage in prevention
behaviors. The research using the "kernel states" conceptualization is sparse, as it was first
introduced by O'Keefe and Jensen in their 2006 meta-analysis. In both of their studies, they
found that the phrasing of kernel states (whether they were desirable/undesirable or
avoided/attained) did not have a significant effect on how persuasive the messages were (2006;
Framing of Memorable Messages 14
2007). It would be useful for future research to further test this conceptualization to see if there
are indeed differential effects in terms of the way the framed message is presented.
Generalizations from these results must be made with caution due to the small sample
size. The analysis of the data in this study was limited, due to the fact that few of the memorable
messages reported had any framing (48/208). Most of these messages were gain-framed, which
left very few loss-framed messages to analyze (n=9). However, they do raise interesting
questions about the variant effects of gain- and loss-framed messages, the consequences of using
different constructions to create the framed messages, and the long-term effects of being exposed
to framed messages. Though it was critical to examine the framing of self-reported messages, it
did limit the sample size. Thus, future research in this area should control framing in
experimental messages and then test for its effects.
Conclusion
Although this study had a small sample size to work with, the results show that the
intersection of framing and memorable messages is worthy of examination. If researchers can
discern that framing a message in a certain way makes it more likely to be remembered, then that
would be valuable information, as memorable messages have been shown to guide behaviors.
Additionally, this study represents a significant step in the message framing literature and
presents many possibilities for future research, which could address how memorable the framing
of a message is over time, the long-term effects of message framing on behaviors, and the natural
occurrence of framing in interpersonal communication, among other topics.
Especially significant is the fact that this study lends support to the idea that gain-framed
messages are more likely to result in disease prevention behaviors, and adds another level of
specificity by showing that messages which discuss methods to avoid an undesirable kernel state
Framing of Memorable Messages 15
are more likely to be associated with prevention behaviors. This also provides opportunities for
future research, as additional study using the kernel states conceptualization could illuminate
more information about effectively using framing in messages. This, in turn, could aid campaign
creators, medical professionals, the media, and interpersonal sources in presenting breast cancer
prevention and detection messages to others in the most persuasive way possible.
Framing of Memorable Messages 16
References
American Cancer Society, Inc. (2007). Breast cancer facts & figures 2007-2008. Retrieved
November 30, 2008 from http://www.cancer.org/downloads/STT/BCFF-Final.pdf
American Cancer Society, Inc. (2008a). Can breast cancer be prevented? Retrieved November
30, 2008 from
http://www.cancer.org/docroot/CRI/content/CRI_2_4_2X_Can_breast_cancer_be_preven
ted_5.asp?sitearea=
American Cancer Society, Inc. (2008b). Cancer Facts & Figures 2008. Retrieved November 30,
2008 from http://www.cancer.org/downloads/STT/2008CAFFfinalsecured.pdf
Banks, S. M., Salovey, P., Greener, S., Rothman, A. J., Moyer, A., Beauvais, J., et al. (1995).
The effects of message framing on mammography utilization. Health Psychology, 14,
178-184.
Christophersen, E. R., & Gyulay, J. E. (1981). Parental compliance with car seat usage: A
positive approach with long-term follow-up. Journal of Pediatric Psychology, 6, 301312.
Dallimore, E.J. (2003). Memorable messages as discursive formations: The gendered
socialization of new university faculty. Women’s Studies in Communication, 26, 214-265.
Detweiler, J. B., Bedell, B. T., Salovey, P., Pronin, E., & Rothman, A. J. (1999). Message
framing and sunscreen use: Gain-framed messages motivate beach-goers. Health
Psychology, 18, 189-196.
Dillard, J. P. & Marshall, L. J. (2003). Persuasion as a social skill. In J. O. Greene & B. R.
Burleson (Eds.), Handbook of communication and social interaction skills (pp. 479-513).
Mahwah, NJ: Lawrence Erlbaum Associates.
Framing of Memorable Messages 17
Holladay, S.J. (2002). “Have fun while you can,” “You’re only as old as you feel,” and “Don’t
ever get old!” An examination of memorable messages about aging. Journal of
Communication, 52, 681-697.
Kalichman, S. C., & Coley, B. (1995). Context framing to enhance HIV-antibody-testing
messages targeted to African American women. Health Psychology, 14, 247-254.
Keeley, M. (2004). Final conversations: Survivors’ memorable messages concerning
religious faith and spirituality. Health Communication, 16, 87-104.
Knapp, M. L., Stohl, C., & Reardon, K. K. (1981). “Memorable” messages. Journal of
Communication, 31, 27-41.
Linville, P. W., Fischer, G. W., & Fischhoff, B. (1993). AIDS risk perceptions and decision
biases. In J. B. Pryor & G. D. Reeder (Eds.), The social psychology of HIV infection (pp.
5-38). Hillsdale, NJ: Erlbaum.
McCall, L. A. & Ginis, K. A. M. (2004). The effects of message framing on exercise adherence
and health beliefs among patients in a cardiac rehabilitation program. Journal of Applied
Biobehavioral Research, 9, 122-135.
Meyerowitz, B. E., & Chaiken, S. (1987). The effect of message framing on breast selfexamination attitudes, intentions, and behavior. Journal of Personality and Social
Psychology, 52, 500-510.
National Cancer Institute (2008). SEER stat fact sheets: Cancer of the breast. Retrieved
November 30, 2008 from http://seer.cancer.gov/statfacts/html/breast.html
O’Keefe, D. J., & Jensen, J. D. (2006). The advantages of compliance or the disadvantages of
noncompliance? A meta-analytic review of the relative persuasive effectiveness of gainframed and loss-framed messages. Communication Yearbook, 30, 1-43.
Framing of Memorable Messages 18
O'Keefe, D. J. & Jensen, J. D. (2007) The relative persuasiveness of gain-framed and lossframed messages for encouraging disease prevention behaviors: A meta-analytic review.
Journal of Health Communication, 12, 623-644.
Pribble, J. M., Goldstien, K. M., Fowler, E. F., Greenberg, M. J., Noel, S. K., & Howell, J. D.
(2006). Medical news for the public to use? What’s on local TV news. American Journal
of Managed Care, 12, 170-176.
Rivers, S. E., Pizarro, D. A., Pizarro, J., Schneider, T. R., & Salovey, P. (2005). Message
framing and pap test utilization among women attending a community health clinic.
Journal of Health Psychology, 10, 67–79.
Rothman, A. J. & Salovey, P. (1997). Shaping perceptions to motivate healthy behavior: The role
of message framing. Psychological Bulletin, 121, 3-19.
Rothman, A. J., Bartels, R. D., Wlaschin, J., & Salovey, P. (2006). The strategic use of gain- and
loss-framed messages to promote healthy behavior: How theory can inform practice.
Journal of Communication, 56, S202-S221.
Salovey, P., Schneider, T. R., Apanovitch, A. M. (2002). Message framing in the prevention and
early detection of illness. In J. P. Dillard and M. Pfau (Eds.) Persuasion Handbook:
Developments in Theory and Practice (pp. 391-406). Thousand Oaks, CA: SAGE
Publications.
Schneider, T. R., Salovey, P., Apanovitch, A. M., Pizarro, J., McCarthy, D., Zullo, J., &
Rothman, A. J. (2001). The effects of message framing and ethnic targeting on
mammography use among low-income women. Health Psychology, 20, 256-266.
Framing of Memorable Messages 19
Smith, S. W., Atkin, C., Skubisz, C. M., Munday, S., & Stohl, C. (in press). The impact of
personal and/or close relationship experience on memorable messages about breast
cancer and the perceived speech acts of the sender. Journal of Cancer Education.
Smith, S. W. Munday, S., LaPlante, C., Kotowski, M. R., Atkin, C., Skubisz, C. M., & Stohl, C.
(in press). Topics and sources of memorable breast cancer messages and their impact on
prevention and detection behaviors. Journal of Health Communication.
Stohl, C. (1986). The role of memorable messages in the process of organizational socialization.
Communication Quarterly, 34, 231-249.
Tversky, A. & Kahneman, D. (1981). The framing of decisions and the psychology of choice.
Science, 211, 453-458.
Wilson, D. K., Purdon, S. E., & Wallston, K. A. (1988). Compliance to health recommendations:
A theoretical overview of message framing. Health Education Research: Theory and
Practice, 3, 161-171.
Framing of Memorable Messages 20
Undesirable kernel state
Desirable kernel state
Avoided kernel state
Gain-framed
Loss-framed
Attained kernel state
Loss-framed
Gain-framed
Figure One: 2 x 2 array describing kernel state types and framing