Prospect theory in message framing

Daniel Kahneman and Amos Tversky’s Prospect theory has helped improve our quality of life in a variety of ways. I have written about it in another blog post.

According to the Prospect theory, we overvalue even a small loss much more than its comparable gain. More clearly, we do not take any risk when we are given two options; one with a small sure gain and a larger unsure gain. We go for the sure gain. However, when we are given two options with a sure loss and a gamble for a loss or a win, we will take the gambling option. You read more about it in the previous post.

This post relates the application of the Prospect theory in message framing.

Prospect theory in message framing: gain-framing versus loss-framing

Tversky and Kahneman’s scenario of a public health intervention

This is the most popular example of message framing in the public health sector.

Tversky and Kahneman presented the following hypothetical scenario to a group of students.

They requested students to think of an impending epidemic that would be expected to cost 600 lives. They also presented two public health interventions to save lives. However, they frame the two interventions in two frames: The survival frame and the mortality frame. What they were not told was that irrespective of the type of intervention, the outcome was the same.

Survival frame (gain frame):

Program Amay save 200 people.
Program Bmay save one-third of all people.

Mortality frame (loss frame):

Program Amay die 400 people.
Program Bmay die two-thirds of all people.

 Kahneman and Tversky found that the students chose program A when the programs were presented in a survival frame (gain-frame). but, the same group chose program B when the programs were presented in a mortality frame (loss-frame). 

Which frame doctors should choose? Survival frame or mortality frame?

Consider the following scenario;

A patient is consulting a doctor for a cancer treatment, which carries a 70 per cent death rate and a 30 per cent survival rate in 5 years. If the doctor uses the survival frame, they can say the patient is having a 30 per cent chance of living with the treatment. On the other hand, if they use the mortality frame, they would say that the patients would have a 70 per cent chance of not surviving with the treatment. Gerd Gigerenzer is director, Harding Centre for Risk Literacy and Centre for Adaptive Behaviour and Cognition, Max Planck Institute for Human Development, Berlin suggests that doctors provide the full information because then the framing effect disappears.

Gain-framing versus loss-framing in public health

As in the above scenario, we can frame our health messages under two frames of reference: Gain-framed and loss-framed. Following are several examples of gain-framed and loss-framed messages;

Gain-framed messages versus loss-framed messages examples

Following are several examples of gain-framed messages;

Gain-framed messagesLoss-framed messages
If you exercise regularly, you will lose weight. If you do not exercise regularly, you will gain weight.
If you do mammograms regularly, you are doing your best to detect breast cancer at the earliest stage1. (Gain-framed message highlighting a favourable outcome for doing it.)If you are not doing mammograms regularly, you will miss the chance of detecting breast cancer at its earliest stage1. (Loss-framed message highlighting the failure to achieve a favourable outcome for not doing it.)
If you do mammograms regularly, you are doing your best to avoid detecting breast cancer at its late stages1. (Gain-framed message that highlights avoiding an unfavourable outcome for doing it.)If you do not do mammograms regularly, you will end up detecting breast cancer at late stages1. (Loss-framed message highlighting an unfavourable outcome for not doing it.)
If you eat high in fruits and vegetables, you will have more energy and are more likely to maintain a healthy weight2. (Short-term gain-framed message).If you do not eat high in fruits and vegetables, you will have less energy and be more likely to be overweight2. (Short-term loss-framed message)
If you eat high in fruits and vegetables, you will have a lower risk of cancer over your lifetime2. (Long-term gain-framed message). If you do not eat high in fruits and vegetables, you are more likely to develop cancer over your lifetime2. (Long-term loss-framed message).

References:

  1. Gallagher KM, Updegraff JA, Rothman AJ, Sims L. Perceived susceptibility to breast cancer moderates the effect of gain- and loss-framed messages on use of screening mammography. Health Psychol. 2011 Mar;30(2):145-52. doi: 10.1037/a0022264. PMID: 21401248; PMCID: PMC4679369.
  2. Satia JA et al., 2010. A Qualitative study to explore Prospect theory and message framing and diet and cancer prevention-related issues among African American adolescents, Cancer Nurs. 33(2): 102-109

A few more examples can be found in detail in the following two posts;

How to decide which message type is more effective?

Gain-framed messages to promote healthy behaviours

We cannot use all message types in one go. Ideally, we need a pre-test with the above message types. However, researchers have meta-analyzed 94 studies published until 2012 and found the following;

Gain-framed messages appear to be more effective than loss-framed ones in promoting healthy behaviors;

Kristel M. Gallagher, M.A., John A. Updegraff, Ph.D., Health Message Framing Effects on Attitudes, Intentions, and Behavior: A Meta-analytic Review, Annals of Behavioral Medicine, Volume 43, Issue 1, February 2012, Pages 101–116, https://doi.org/10.1007/s12160-011-9308-7

Loss-framed messages to promote screening for disease promotion

In 1997, Alexander Rothman & Peter Salovey suggested that Alexander Rothman and Peter Salvoy suggested that loss-framed messages would promote disease detection (screening) behaviours. However, more recently, in 2016 another group of researchers argued this narrative is problematic.

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Author: Prasantha De Silva

A specialist in Community Medicine board-certified in Sri Lanka and a research analyst in Canada

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