Improving Communication During a Pandemic Flu Outbreak

NCT03431012 | Completed Results

• 1 other identifier: LRS-15/16-2297
• Study Type: interventional
• Target: 349
• Locations: 0 countries
• Sites: N/A

Brief Summary

During the last pandemic influenza antivirals were prescribed both as prophylaxis and treatment. However, adherence rates were suboptimal. This study assessed the effect of theory-based and evidence-based health messages, which promoted the use of antivirals as prophylaxis for pandemic influenza, on intentions to use antivirals. Using hypothetical scenarios, the investigators tested whether written health communications about pandemic flu and recommended preventative medication (i.e. a prophylactic treatment with antivirals) had an effect on study participants' beliefs about the pandemic flu and the advice received, and their intention to adhere to the recommendation. In particular, the investigators assessed the behavioural impact of health messages presented in four different linguistic formats, defined by a 2×2 (agency assignment × attribute framing) factorial design. The originality of this study relies on the attempt to maximise the behavioural impact of written health messages by combining the agency assignment and attribute framings, which have never been tested together, and by systematically targeting specific predictors of adherence intentions through these messages. The findings of this study may be used to improve the behavioural impact of health communications to the general public in case of a pandemic flu outbreak in the UK.

Conditions

Healthy

Keywords

Adherence, medication; Pandemic Influenza

Outcome Measures

Primary Outcomes (1)

• Change in Intentions to Take Antivirals for Pandemic Flu

  Mean adherence intentions post- exposure to the health information in the 4 groups. Intentions were measured by self-report items: participants were asked to agree with three statements about their intentions to take antivirals as recommended in the hypothetical scenario (on 9-point scale, where 1=strongly disagree to 9=strongly agree). The scores reported below represent a composite variable 'change in intentions', which reflects the average of the three items that compose it.

  Straight after exposure to the health messages

Secondary Outcomes (6)

• Worry of the Pandemic Flu Threat

  At 20 minutes (i.e. straight after exposure to the health messages)

• Perceived Susceptibility to the Pandemic Flu

  At 20 minutes (i.e. straight after exposure to the health messages)

• Perceived Severity of the Pandemic

  At 20 minutes (i.e. straight after exposure to the health messages)

• Perceived Self-efficacy

  At 20 minutes (i.e. straight after exposure to the health messages)

• Perceived Efficacy of the Antivirals

  At 20 minutes (i.e. straight after exposure to the health messages)

Study Arms (4)

Virus Agency/Negative Attribute Framing

EXPERIMENTAL

Participants in this condition, after reading a hypothetical scenario, received health messages describing the pandemic flu and the efficacy of the antivirals using linguistic expressions that assigned transmission to the pandemic flu virus itself (Virus Agency Assignment framing), whilst describing the side effects of the antivirals in terms of chances of experiencing side effects after using them (Negative Framing).

Other: Agency Assignment framing; Other: Attribute framing

Human Agency/Negative Attribute Framing

EXPERIMENTAL

Participants in this arm, after reading a hypothetical scenario, received a health message describing the pandemic flu and the efficacy of the antivirals using linguistic expressions that assigned transmission to humans (Human Agency Assignment framing), whilst describing the side effects of the antivirals in terms of chances of experiencing side effects after using them (Negative Framing health messages).

Other: Agency Assignment framing; Other: Attribute framing

Human Agency /Positive Attribute Framing

EXPERIMENTAL

Participants in this arm, after reading a hypothetical scenario, received a health message describing the pandemic flu and the efficacy of the antivirals using linguistic expressions that assigned transmission to humans (Human Agency Assignment framing), whilst describing the side effects of the antivirals in terms of chances of not experiencing side effects after using them (Positive Framing).

Other: Agency Assignment framing; Other: Attribute framing

Virus Agency /Positive Attribute Framing

EXPERIMENTAL

Participants in this arm, after reading a hypothetical scenario, received a health message describing the pandemic flu and the efficacy of the antivirals using linguistic expressions that assigned transmission to the pandemic flu virus itself (Virus Agency Assignment framing), whilst describing the side effects of the antivirals in terms of chances of not experiencing side effects after using them (Positive Framing).

Other: Agency Assignment framing; Other: Attribute framing

Interventions

Agency Assignment framing OTHER

Linguistic framing used in written health messages. Each version of the messages described the pandemic flu and the efficacy of the antivirals using linguistic expressions that assigned transmission to either humans (HA: 'You can contract the virus when you touch…') or the pandemic flu virus itself (VA: 'It can infect you when you touch…')

Also known as: Framing effect on behavioural intentions

Human Agency /Positive Attribute Framing; Human Agency/Negative Attribute Framing; Virus Agency /Positive Attribute Framing; Virus Agency/Negative Attribute Framing

Attribute framing OTHER

Linguistic framing used in written health messages. Each message described the side effects of the antivirals in terms of chances of either experiencing (negative framing: 'Uncommon side effects (10% of people will be affected)') or not experiencing side effects (positive framing: 'Uncommon side effects (90% of people will not be affected)') after using them.

Also known as: Framing effect on behavioural intentions

Human Agency /Positive Attribute Framing; Human Agency/Negative Attribute Framing; Virus Agency /Positive Attribute Framing; Virus Agency/Negative Attribute Framing

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• To be eligible to participate, respondents had to be members of the UK general public in the adult age range (18-65 years), and be fluent in English.

You may not qualify if:

• non-UK residents
• younger than 18 or older than 65
• not fluent in English

Sponsors & Collaborators

• King's College London: lead
• National Institute for Health Research, United Kingdom: collaborator
• Public Health England: collaborator

Related Publications (3)

• McGlone MS, Bell RA, Zaitchik ST, McGlynn J 3rd. Don't let the flu catch you: agency assignment in printed educational materials about the H1N1 influenza virus. J Health Commun. 2013;18(6):740-56. doi: 10.1080/10810730.2012.727950. Epub 2012 Dec 5.

  PMID: 23216010 BACKGROUND

• Moxey A, O'Connell D, McGettigan P, Henry D. Describing treatment effects to patients. J Gen Intern Med. 2003 Nov;18(11):948-59. doi: 10.1046/j.1525-1497.2003.20928.x.

  PMID: 14687282 BACKGROUND

• Smith LE, D'Antoni D, Jain V, Pearce JM, Weinman J, Rubin GJ. A systematic review of factors affecting intended and actual adherence with antiviral medication as treatment or prophylaxis in seasonal and pandemic flu. Influenza Other Respir Viruses. 2016 Nov;10(6):462-478. doi: 10.1111/irv.12406. Epub 2016 Aug 8.

  PMID: 27397480 BACKGROUND

MeSH Terms

Conditions

Medication Adherence

Condition Hierarchy (Ancestors)

Patient Compliance; Patient Acceptance of Health Care; Treatment Adherence and Compliance; Health Behavior; Behavior

Results Point of Contact

• Title: Dr D D'Antoni
• Organization: KCL

donatella.d'antoni@kcl.ac.uk

Study Officials

• Donatella D'Antoni

  King's College London

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Masking Details: Participants were blinded to group assignment.
• Purpose: PREVENTION
• Intervention Model: FACTORIAL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: This study was a vignette-based randomised controlled trial, with a 2 (human vs virus agency assignment) x 2 (negative vs positive frame of antivirals side effects) between-participants factorial design. All participants were presented with a hypothetical pandemic flu scenario describing moderate health consequences (i.e. about 1 in 1000 infected people dying). The scenario: 1) in the initial scenario participants were told to imagine that their GP (although not confirming whether it was a pandemic case) had advised them to take antivirals as a precaution; 2) after measuring baseline intentions, participants were introduced to the second part of the scenario where they were asked to imagine being at their local pharmacy where a pharmacist provided them with some health messages and information about the antivirals. Participants were randomised to one of the four health messages described below. After reading the health messages their intentions to use antivirals were re-measured.

Study Record Dates

• First Submitted: January 17, 2018
• First Posted: February 13, 2018
• Study Start: May 26, 2016
• Primary Completion: June 8, 2016
• Study Completion: June 8, 2016
• Last Updated: December 16, 2019
• Results First Posted: December 16, 2019

Record last verified: 2018-01

Data Sharing

• IPD Sharing: Will not share