Study On Tabacco Control Health Education Based On Framing Effect

Objective:In order to improve the effect of health education on smoking control in China,this research analyzed the effectiveness of the health education message on smoking control with the framing effect theory.The framing effect means people react to a particular choice in different ways depending on how it is presented.The framework is refers to the decision-maker's perception of the options,results and the possibility of the results for specific problems.Recently,the framing effect theory has been a hot application in the field of international tobacco control research while the related research has not been started in China.Through the field randomized trial and randomized controlled trial,this study tested the effect of the tobacco control health education message framework on participants'message choice preference,proved that the implementation of tobacco control health education under a particular framework has higher cognitive functions,and provided some suggestions for improving the effectiveness of China's tobacco control health education.This study is a new try for the theory research on smoking control health education,which is expected to provide a new perspective for our research in the field of tobacco control,to provide a new method of education implementation and to offer a theoretical basis to the new health education strategy formulation.Methods:In order to verify the framing effect of tobacco control health education messages,this study suggested a hypothesis firstly,through literature review,that the different presentations of messages make the choice preference of anti-smoking health education messages.Secondly,after designing health versus financial framing messages of smoking cessation according to the framing effect theory and making corresponding brochures,we conducted a‘message framing'field study among financial,health and neutral type of settings in high,medium and low income areas respectively in order to prove that message choice preference exists in tobacco control health education through counting how many brochures of different frameworks were picked-up and to verify the influence factors to the framing effects of anti-smoking health education message through questionnaire survey?Thirdly,we constructed loss versus gain framed messages,health versus finance framed messages and oneself versus family framed messages in the field of smoking control health education,and conducted a randomized controlled trial to the pregnant women and their spouses who had the health education courses in the three hospitals.The pregnantwomen were randomly divided into experimental and control group with their husband.Theexperimental groups were given different message to read,while the control groups were not,before they answer the questionnaires.Then,our study tested the effectiveness of loss-gain framework,health-financial framework and self-family framework on improving smoking cognition by comparing the women and their husband's scores of smoking cognition scale.The test data were entry to database using Epidata3.1,and were made reliability and validity analysis,descriptive analysis,X~2 test and t test analysis using software SPSS19.0.Results:.The analysis of 4650 questionnaire surveys recovered from economic,health and neutral location sites in Jing'an District,Chang ning District and suburbs of Pu dong of Shanghai showed that subjects in different areas have different choice preference for health education messages on smoking control,in different types of location have different choice preference for health education messages on smoking control,economic and health place preference for health education on smoking control information differences,but no difference in health location and neutral place preference(P>0.05).Moreover,different career and family income of the subjects made the difference of choice preferences.The test results of the loss-gain framing intervention trials to 399 pregnant women and 239 pregnant women's spouses showed that:the subjects'average scores of smoking cognition scale had significant differences and compared with the ensemble average,the pregnant women intervened by gain framed message had a higher score than those by loss framed message.The test results of the health-financial framing intervention trials to 413 pregnant women and 325 those women's spouses showed that:the subjects'average scores of smoking cognition scale had significant differences and compared with the ensemble average,the pregnant women intervened by health framed message had a higher score than those by finance framed message.On the contrary,the spouses intervened by finance framed message had higher score than health.The smoking cognition scale average score of the pregnant women affected by personal framed message and family framed message had significant differences.In addition the women and their husband influenced by family framework had higher average score than oneself framework.Conclusions:The results of field randomized trial confirmed that the anti-smoking health education message has health-financial framing effect,which was influenced by areas,the types of sittings to make the reverse of choice preference.In high income regions,people represent health framework preference,and financial framework preference in low income regions;In healthy and neutral places,people tend to choose health message of the anti-smoking health education,and in economy places people prefer financial message;in low income areas,regional factors outweigh the location type factors for the influence of framing effect,in the high-income region,location type factors outweigh the regional factors for the influence of framing effect.With the combination effect of the two factors above,people has different choice preference of anti-smoking health education message.The smoking-control health education intervention experiment to pregnant women and their spouses proved that the smoking-control health education messages constructed in this study based on benefit-loss framework,health-financial framework,and personal-family framework could improve the subjects'right cognition of smoking with framing effect.And to the pregnant women and their husband,a certain framework of the smoking-control health education could improve the result of smoking cognition scale.Among them,smoking-control health education messages framed by"not smoking gain benefit"has better cognition effect of pregnant women on tobacco;‘no smoking will gain health'is better for the pregnant women who care about health.‘No smoking will gain wealth'is better for the pregnant women who care about finance.Health education with the objective of"family"would have better cognitive effect of smoking of the women and their husband.