Investigating the Effects of Threatening Language, Message Framing, and Reactance in Opt-Out Organ Donation Campaigns

• Published in: Annals of behavioral medicine Vol. 56; no. 1; pp. 50 - 63
• Main Authors: Miller, Jordan, McGregor, Lesley, Currie, Sinéad, O’Carroll, Ronan E
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 01-01-2022
• Subjects: England; Humans; Intention; Language; Regular; Tissue and Organ Procurement; Tissue Donors - psychology; England; Reactance; Opt-out consent; Message framing; Organ donation; Threat to freedom
• ISSN: 0883-6612; 1532-4796
• DOI: 10.1093/abm/kaab017

Abstract
Background
Under opt-out organ donation policies, individuals are automatically considered to have agreed to donate their organs in the absence of a recorded opt-out decision. Growing evidence suggests that the language used within organ donation campaigns influences donor intentions and decision-making.
Purpose
As awareness campaigns to promote opt-out consent in the UK are ongoing, the objectives of this study were to investigate the effect of language and message framing used in opt-out organ donation campaigns on donor intentions and psychological reactance.
Methods
Individuals from Scotland and England (N = 1,350) completed this online experiment. Participants were randomized to view one of four messages, designed in the format of a newspaper article, which described the upcoming opt-out system. This followed a 2 × 2 design whereby the degree of threatening language (high threat vs. low threat) and message framing (loss vs. gain) of the newspaper article was experimentally manipulated. Measures of intention (pre-exposure and postexposure) and postmessage reactance (threat to freedom and anger and counter-arguing) were obtained.
Results
A mixed analysis of variance revealed a significant Group × Time interaction on donor intentions; post hoc analysis revealed that intentions significantly decreased for individuals exposed to the High threat × Loss frame article but significantly increased for those exposed to the High threat × Gain frame article.
Conclusions
In campaigns to promote opt-out legislation, high-threat language combined with loss-frame messages should be avoided. If high-threat language is used, gain-frame messaging that highlights the benefits of organ donation should also be incorporated.
Within opt-out campaigns, high-threat language and loss-frame messaging decreased donor intentions. Emphasizing the benefits of donation using gain-frame messaging, within campaigns that contain high threat language, increased intentions.