The Effect of Message Credibility on Attitude Change as Measured by Argumentation
Style: In an Introductory Nutrition Class
A dissertation presented to
the faculty of
The Patton College of Education of Ohio University
In partial fulfillment
of the requirements for the degree
Doctor of Philosophy
Abednego K. Bansah
May 2016
© 2016 Abednego K. Bansah. All Rights Reserved.
2
This dissertation titled
The Effect of Message Credibility on Attitude Change as Measured by Argumentation
Style: In an Introductory Nutrition Class
by
ABEDNEGO K. BANSAH
has been approved for
the Department of Educational Studies
and The Patton College of Education by
David R. Moore
Professor of Educational Studies
Renée A. Middleton
Dean, The Patton College of Education
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Abstract
BANSAH ABEDNEGO K, Ph.D., May 2016, Curriculum and Instruction,
Instructional Technology
The Effect of Message Credibility on Attutude Change as Measured by Argumentation
Style: In an Introductory Nutrition Class
Director of Dissertation: David R. Moore
Numerous methods have been employed to propagate persuasive messages for
attitude change. The art of developing persuasive messages for attitude change has
featured prominently with regards to health related issues over the years, especially in
diet and nutrition. The approach of delivering these messages include the source of the
information (message credibility) and how the information is framed is vital in attitude
change due to the content of messages by persuasion through argumentation. All these
factors may determine whether the message results in attitude change. With the recent
call for proper diet and nutrition as a result of the effects of poor diet and nutrition on an
individual’s overall health, the credibility and content of a message containing diet and
nutrition information is vital in promoting good eating habit. Most notably among health
conditions that results from poor dietary habits are overweight and obesity. Obesity
which cuts across all ages, racial and ethnic groups, and gender have been the cause of
400,000 (an estimated 1,096 deaths per day) deaths each year in the United States,
making obesity the second leading cause of death after smoking. The main purpose of
this study is to investigate the effect of message credibility and content of messages (in
terms of argumentation style) on nutritional attitude change among undergraduate
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students. Data were collected through a large Midwestern university’s Qualtrics website
situated in the University’s Learning Management System. Participants of the study were
enrolled in an online Introduction to Nutrition class developed by the Midwestern
University. Details of the results indicated that participants rated on the messages
presented on the average as very good and this resulted in a significant nutritional
attitudinal change among participants, t(191) = 6.64, p = .001, d = .5. While there was
not a significant difference in nutritional attitudinal change between emotive and logic
messages, t(61) = 1.55, p = .127, the best model developed from this study indicates that
for an effective nutritional attitudinal change, in addition to credibility, the messages
should be composed of both emotion and logic. This study further reiterates not only the
importance of message credibility and content but the role digital technology plays in
nutrition intervention and counseling.
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Dedication
To my daughters, Allyson Elorm Maadjoa Bansah, Ailynn Dela Akonua Bansah, and
Arianne Elikem Adow Bansah for being the reason for all the right choices I have made
and my best friend Priscilla Baaba Bansah. I have made it this far not because of my
abilities but you have always directed my choices. Thanks for being my wife.
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Acknowledgments
All praise and thanks to God almighty for how far He has brought me and for the
knowledge and wisdom He has endowed me with. My profoundest gratitude goes to Dr.
David Moore, my advisor and director of this dissertation for his continuous support,
guidance, and encouragement. You have always been there for me from the day I walked
into your office. I wouldn’t have gotten this far with my doctoral studies without you.
Thank you. I wish to express appreciation to my committee members Dr. Teresa Franklin
whose words of encouragement laid the foundation for me to pursue this program, Dr.
Krisanna Machtmes whose office was always open to me for guidance especially with
this research work. My heartfelt appreciation goes to Dr. David Holben for his
mentorship, making his class available for this research purposes and for being a strong
pillar of support for me throughout my studies at OU. To Dr. Tania Basta words cannot
express my gratitude for responding to my call at the hour of need. To Drs. Moore,
Franklin, Machtmes, Holben and Basta I say “In as much as your advises are dear to
mean, I'll cherish and follow your examples more”.
My gratitude also go to the following persons: Daniel and Josephine Bansah;
Prof. George Oduro; Prof. John Nelson Buah; Dr. Sir Sam Jonah; Nana Brew Butler;
Brigitte and John Amissah; Edem and Akpene Ameko; Dr. Ann Paulins; Dr. Beth
Vanderveer; Kobina Obu Hayford. May the good Lord continue to bless you.
I certainly cannot forget the Holben family (David, Lisa, Ezra and Ethan) for
opening their doors to my family and I. Lisa, Allyson braids hair extremely well now,
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thanks for allowing her to use your hair for practice during soccer games . She misses
you.
I wish to express my deep gratitude to the Ohio University’s Patton College of
Education’s Department of Human and Consumer Sciences for granting me the
opportunity to pursue my future goal. To Rev. Prof. Emmanuel Adow Obeng, President
of Presbyterian University – Ghana and Mrs. Rosilta Adow Obeng; may the good Lord
bless you for all your continuous support. Pops, we made it!
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Table of Contents
Page
Abstract ............................................................................................................................... 3
Dedication ........................................................................................................................... 5
Acknowledgments............................................................................................................... 6
List of Tables .................................................................................................................... 12
List of Figures ................................................................................................................... 14
Chapter 1: Introduction ..................................................................................................... 15
Statement of the Problem .............................................................................................. 17
Purpose of the Study ..................................................................................................... 20
Theoretical Framework ................................................................................................. 22
Research Questions ....................................................................................................... 25
Significance of the Study .............................................................................................. 26
Delimitations and Limitations of the Study. ................................................................. 28
Delimitations. ............................................................................................................ 28
Limitations. ............................................................................................................... 28
Definitions of Terms ..................................................................................................... 29
The Organizational Plan of the Study ........................................................................... 33
Chapter 2: Review of Literature ....................................................................................... 35
Persuasion, Designing Persuasive Messages and Argumentation as an Instructional
Variable ......................................................................................................................... 36
Elaboration likelihood model (ELM) of persuasion. ................................................ 37
Methods of persuasion (tools of persuasion). ........................................................... 44
Ethos (Argument by character). ............................................................................ 46
Pathos (Argument by emotion). ............................................................................ 49
Designing persuasive messages. ............................................................................... 55
The source. ............................................................................................................ 55
Messages. .............................................................................................................. 58
Health and Culture ........................................................................................................ 65
Uncertainty reduction. ............................................................................................... 67
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High-context versus low-context cultures. ............................................................... 68
Overweight, Obesity and their Contributors ................................................................. 74
Prevalence of obesity. ............................................................................................... 76
Causes of obesity. ..................................................................................................... 77
Outcomes of obesity. ................................................................................................ 79
Combating obesity. ................................................................................................... 80
Technology and Nutrition Intervention and Counseling .............................................. 81
Attitude ......................................................................................................................... 90
Definition and conceptualization of attitude. ............................................................ 90
Measurement of attitudes. ......................................................................................... 95
Attitude change. ........................................................................................................ 97
Instructional design principles for attitude change. ................................................ 100
Attitude as a latent variable................................................................................. 100
Attitudes have objects. ........................................................................................ 100
Attitudes have a behavioral component. ............................................................. 101
Attitudes have a cognitive component. ............................................................... 101
Attitudes have an affective component. .............................................................. 102
Attitudes are relatively stable and enduring. ....................................................... 103
Instructional Design .................................................................................................... 104
Merrill’s first principles of instruction and levels of instructional strategy. ........... 105
First principles of instruction. ............................................................................. 105
Levels of instructional strategy. .......................................................................... 107
Online Education ........................................................................................................ 110
Summary ..................................................................................................................... 113
Chapter 3: Methodology ................................................................................................. 116
The Research Questions.............................................................................................. 116
The Research Design .................................................................................................. 118
Operational definitions of variables. ....................................................................... 122
Independent variables. ........................................................................................ 122
Dependent variable. ............................................................................................ 122
The setting. .............................................................................................................. 122
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Population of the Study. .......................................................................................... 123
Sampling and research sample. ........................................................................... 124
Sample size selection. ......................................................................................... 125
The Online Introduction to Nutrition Program ........................................................... 125
Researcher’s abilities and experience. .................................................................... 125
Education. ........................................................................................................... 126
Researcher as a facilitator. .................................................................................. 127
Research Instrument and Procedure ........................................................................... 129
Data Analysis .............................................................................................................. 132
Result of Pilot Study ................................................................................................... 132
Validity and reliability of the data. ......................................................................... 138
Validity issues. .................................................................................................... 138
Reliability issues. ................................................................................................ 140
Summary ..................................................................................................................... 142
Chapter 4: Results ........................................................................................................... 143
Introduction ................................................................................................................. 143
Instrumentation ........................................................................................................... 143
Reliability of the instrument. .................................................................................. 144
Validity of the instrument. ...................................................................................... 148
Data Collection and Cleaning ..................................................................................... 150
Descriptive of the Sample with Descriptive Data ....................................................... 155
Demographics information of the sample. .............................................................. 155
Academic level information of participation. ......................................................... 155
Participant employment information. ..................................................................... 156
Groups’ Rating of Message Credibility ...................................................................... 159
Objectives and Statistical Analysis ............................................................................. 163
Supplemental Analysis ............................................................................................... 172
Summary ..................................................................................................................... 183
Chapter 5: Discussions, Recommendations and Conclusions ........................................ 184
The Purpose and Design of the Study ......................................................................... 184
Discussions for the Findings ....................................................................................... 185
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Research question 1. ............................................................................................... 185
Research question 2. ............................................................................................... 189
Research question 3. ............................................................................................... 192
Research question 4. ............................................................................................... 193
Findings from the Supplementary Analysis................................................................ 195
Recommendations ....................................................................................................... 200
Conclusion .................................................................................................................. 202
Researcher’s Reflection .............................................................................................. 206
Limitations .................................................................................................................. 207
Summary ..................................................................................................................... 208
References ....................................................................................................................... 209
Appendix A: Recruiting Tool ......................................................................................... 246
Appendix B: Messages and Scale Rating ....................................................................... 248
Appendix C: Attitudinal Change Questionnaire ............................................................. 288
Appendix D: Ohio University Online Consent Form ..................................................... 296
Appendix E: Institutional Review Board Approval Letter ............................................. 299
Appendix F: Tables ......................................................................................................... 300
Appendix G: Figures ....................................................................................................... 343
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List of Tables
Page
Table 1 The Research Questions of the Study with Rationale and Citations................... 25
Table 2 Major Aspect of High-versus Low Context Concept .......................................... 70
Table 3 Attitude Definitions Ordered According to Their Conceptualization of Attitudes
as Stable Entities versus Temporary Constructions ......................................................... 94
Table 4 Content Information and Portrayal Elements ................................................... 110
Table 5 Research Objectives of the Study and Research Instruments Used for Data
Collection ........................................................................................................................ 133
Table 6 Research Objectives and Statistical Analyses .................................................. 136
Table 7 Group One Results Obtained for Analyzing the Reliability of their Message
Instrument ....................................................................................................................... 145
Table 8 Group Two Results Obtained for Analyzing the Reliability of their Message
Instrument ....................................................................................................................... 146
Table 9 Group Three Results Obtained for Analyzing the Reliability of their Message
Instrument ....................................................................................................................... 147
Table 10 All Three Groups Result Obtained for Analyzing the Reliability of the Message
Instrument ....................................................................................................................... 148
Table 11 Factor Analysis: The Correlation Results Obtained for Analyzing the Six
Credibility Items Presented to Participants for Rating of the Messages ........................ 149
Table 12 Factor Loading, Eigenvalues, and Variance for the Six Credibility Items
Presented to Participants for Rating of the Messages .................................................... 150
Table 13 Distribution of Participants Who Registered for the Class and the Groups into
Which the Participants Were Assigned ........................................................................... 152
Table 14 Distribution of Participants Who Successfully Completed All the Required
Research Activities .......................................................................................................... 154
Table 15 Demographical Distribution of the Participants Who Successfully Completed
All the Requirements of the Research Activities ............................................................. 157
Table 16 Distribution of Academic Level of Participants Who Successfully Completed
the Required Research Activities. ................................................................................... 158
Table 17 Distribution of the Participant Who Successfully Completed All Required
Research Activities Employment Status .......................................................................... 158
Table 18 Group One Distribution of the Averagely Rated Messages Using the Six
Credibility Items.............................................................................................................. 160
Table 19 Group Two Distribution of the Averagely Rated Messages Using the Six
Credibility Items.............................................................................................................. 161
Table 20 G Group Three Distribution of the Averagely Rated Messages Using the Six
Credibility Items.............................................................................................................. 162
Table 21 Overall Group Distribution for the Three Groups Averagely Rated Messages
Using the Six Credibility Items ....................................................................................... 163
Table 22 Paired Sample Test Analysis to Determine the Extent That Message Credibility
Has on Participants as Measured by the Attitudinal Change Questionnaire ................. 165
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Table 23 Paired Sample Statistics Analysis to Determine Whether a Two Sided Argument
Would Result in a More Attitudinal Change Than a One Sided Argument .................... 166
Table 24 Paired Sample t-Test to Determine Whether a Two Sided Argument Would
Result in a More Attitudinal Change Than a One Sided Argument ................................ 167
Table 25 Paired Sample Statistics to Determine Which Method of Persuasion Has the
Most Effect on Attitudinal Change among the Participants ........................................... 168
Table 26 Paired Sample Test to Determine Which Method of Persuasion has the Most
Effect on Attitudinal Change among the Participants .................................................... 169
Table 27 Significance of the Regression Equation Employing Four Independent Variable
in Predicting Overall Attitudinal Change among the Participants ................................ 171
Table 28 Coefficient Values, Standard Errors, Standardized Coefficient Values, T
Values, and Significance Levels for Independent Variable Retained in the Regression
Equation Predicting Overall Attitudinal Change ........................................................... 171
Table 29 Group One Participants’ Comments derived from the supplementary Analysis
and the Corresponding Themes Developed by the Researcher ...................................... 173
Table 30 Group Two Participants’ Comments derived from the supplementary Analysis
and the Corresponding Themes Developed by the Researcher ...................................... 177
Table 31 Group Three Participants’ Comments derived from the supplementary Analysis
and the Corresponding Themes Developed by the Researcher ...................................... 180
Table 32 Distribution of Group Gain as Measured by Attitude Change Questionnaire in
the Pilot Study ................................................................................................................. 300
Table 33 Distribution of the Individual Gain as Measured by Attitude Change
Questionnaire in the Pilot Study ..................................................................................... 301
Table 34 Distribution of the Responses on Overall Eating Habit for the Pilot ............. 302
Table 35 Reliability Analysis of the Message Instrument for the pilot Study ................ 302
Table 36 Pilot Study Respondent Credibility Themes ................................................... 303
Table 37 Group One Distribution for the Descriptive for Message Credibility Rating 304
Table 38 Group Two Distribution of the Descriptive for Message Credibility Rating . 306
Table 39 Group Three Distribution of the Descriptive for Message Credibility Rating 308
Table 40 Comments Made by Participants in Group One with their Corresponding
Credibility Item ............................................................................................................... 310
Table 41 Comments Made by Participants in Group 2 with their Corresponding
Credibility Item ............................................................................................................... 319
Table 42 Comments Made by Participants in Group Three with their Corresponding
Credibility Item ............................................................................................................... 327
Table 43 .......................................................................................................................... 339
Table 44 Correlation Matrix to Determine if a Model Exists Which Would Explain a
Significant Portion of the Variance of Attitudinal Change as Measured by the Method of
Persuasion and the Demographic Characteristics Indicators (gender, age, and race). 340
Table 45 Excluded Variables, Standardized Coefficients, T Values, Significance Levels,
and Partial Correlations for the Regression Equation Predicting Overall Attitudinal
Change ............................................................................................................................ 341
Table 46 Descriptive for Reporting and Interpreting Cohen’s d ................................... 342
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List of Figures
Page
Figure 1: Dual Memory: Past attitudes are still past. “Attitude and attitude change” by G.
Bohner & N. Dickel, 2011, Annual Review of Psychology, 62, p. 397. ........................... 99
Figure 2: The multicomponent Model of Attitude. “The psychology of attitude”. A. H.
Eagly & S. Chaiken, 1993, Fort Worth, TX: Harcourt. .................................................. 103
Figure 3: First Principle of Instruction. “First Principle of Instruction”. M. D. Merrill,
2013. Identifying and designing effective, efficient, and engaging instruction. San
Francisco, CA: Pfeiffer, p. 22. ........................................................................................ 106
Figure 4: Procedure for delivering the messages to participants .................................... 121
Figure 5: Box plot to Determine Outliers for Message Ratings for Groups1 ................. 343
Figure 6: Box plot to Determine Outliers for the Differences between Post and Pre-test
for Group 1 ...................................................................................................................... 343
Figure 7: Boxplot to Determine Outliers for Message Ratings for Group 2 .................. 344
Figure 8: Box plot to Determine Outliers for the Differences between Post and Pre-test
for Group 2 ...................................................................................................................... 344
Figure 9: Boxplot to Determine Outliers for Message Ratings for Group 2 .................. 345
Figure 10: Box plot to Determine Outliers for the Differences between Post and Pre-test
for Group 3 ...................................................................................................................... 345
Figure 11: Scatterplot of ZPRED and ZRESID .............................................................. 346
Figure 12: Histogram Showing the Distribution of Normality ....................................... 346
Figure 13: Normality Plot for the Dependent Variable .................................................. 347
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Chapter 1: Introduction
Various methods have been employed to propagate persuasive messages for
attitude change. The art of developing persuasive messages for attitude change has
featured prominently with regards to health related issues over the years, especially in
diet and nutrition (Carbone, Campbell, & Honess-Morreale, 2002). The approach of
delivering these messages include the source of the information (message credibility) and
how the information is framed (Kiousis, 2006). These are vital in eliciting attitude change
(Simonson & Maushak, 1996). According to McGuire (1989), “four basic components
that are vital in persuasion are the 1) source, 2) the message, 3) the channel and 4) the
receiver” (p. 46-47). “A distinctive features associated with source-related persuasion are
reported be similarity, liking, attraction, trustworthiness, and expertise of the source”
(McGuire, 1989, p. 46). All these factors may determine whether the message results in
attitude change. With the recent call for proper diet and nutrition as a result of the effects
of poor diet and nutrition on an individual’s overall health, the credibility of a message
containing diet and nutrition information is vital in promoting good eating habits. Most
notably among health conditions that results from poor dietary habits are overweight and
obesity (Schwimmer, Burwinkle, & Varni, 2003; Harrison & Marske, 2005). It is
reported that more than a third of U.S. adults are obese and 147 billion dollars was spent
in 2008 in the U.S. on obesity-related diseases (CDC, 2014, para. 1).
Many websites have been developed over the years to encourage healthy eating
habits (Eastin, 2001). Apart from it being the primary factor in the perception of website
credibility (Walther, Wang, & Loh, 2004), source expertise plays a vital role on users’
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insight of the credibility of health website (Eastin, 2001). A number of studies have
reported that a highly credible message source is more effective in eliciting positive
attitude change and behavioral intentions (Gottlieb & Sarel, 1991; Ward & McGinnies,
1974). Yoon, Kim and Kim (1998) pointed out that expertise and trustworthiness
represent the most noteworthy and long-term factors of credibility. In a study to compare
1) two different computer-tailored bulletins (expert oriented bulletin [EXP] and spiritual
and pastor-oriented bulletin [SPIR]) to promote fruit and vegetable consumption among
members of a rural African-American church and 2) tried to find the effect of message
source on message recall and perceived credibility, it was reported “in this randomized
study that, both bulletin groups increased fruit and vegetable consumption significantly
compared to the control group” (Campbell, et al., 1999, p.165). This research also
reported that “the EXP group had higher trust of health and nutrition information coming
from scientific research, and the SPIR group indicated higher trust of information coming
from the pastor” (Campbell, et al., 1999, p.164). In a study that employed an
experimental approach to test the influence of message framing and credibility on
participants’ attitude and intention toward following the guidelines for healthy eating and
preventing cancer, it was reported that the influence of credibility had an effect on
attitude as well as intention (Arora & Arora, 2004). Results from these studies indicate
how vital a credible source can be to contributing to attitude change. These studies
further buttress earlier studies that reported that a high credible source often is more
persuasive than a low-credible one (Kelman & Hovland, 1953; Lirtzman & Avichai,
1986).
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The diverse nutritional choices that people make depend on how the nutrition
message is framed (Tversky & Kahneman, 1981). Message-framing has been employed
as a strategy for promoting health related issues by highlighting the gains or losses
associated with certain behaviors (Leshner & Cheng, 2009). There are reports of printed
letter tailored messages in randomized trials that have been used to promote a number of
social health issues including healthy eating habits (Brug, Steenhuis, Van Assessa, & De
Vries, 1996; Brug, Glanz, Van Assesma, Kok, & van Breukelen, 1998), encourage
women to go through mammography screening (Skinner, Strecher & Hospers, 1994), and
dissemination of HIV/AIDS prevention information (Mayor & Coleman, 2012). In as
much as attitudes are complex phenomena and motivation is related to attitude change
(Simonson & Maushak, 1996), these studies show how important source credibility
(Campbell, et al., 1999; Arora & Arora, 2004) and content of messages (Brug, et al.,
1998; Skinner, et al., 1994; Mayor & Coleman, 2012) are to attitude change.
Statement of the Problem
A report from the World Health Organization (WHO) indicated that “in 2014,
over 1.9 billion adults aged 18 and above were overweight and of whom 600 million
were obese globally” (WHO, 2015, para. 1). This figure is a concern for all especially
when it is reported that the mean body mass index (BMI) of the world’s population has
gone up significantly between 1980 and 2014 (WHO, 2015). “Formerly considered a
problem for only high-income countries, overweight and obesity are now dramatically
rising all over the world, especially in the urban settings of low and middle-income
18
countries” (WHO, 2014, para. 2). This is not different from the U.S., with a third of its
population reported to be obese (Ogden, Carroll, Kit, & Fregal, 2014).
Obesity, which cuts across all ages, racial and ethnic groups, and genders has
been the cause of 400,000 (an estimated 1,096 deaths per day) deaths each year in the
United States, making obesity the second leading cause of death after smoking (United
States Department of Health and Human Services [HHS], 2012). In 1999, the percentage
of obese children in the United States aged 6 to 11 and adolescents aged 12 to 19 were
13% and 14% respectively (HHS, 2012, para. 1). These figures nearly tripled from 2000
to 2008 (Center for Disease Control and Prevention [CDC], 2012a). Recent data
indicates that 17% of youth are obese (Ogden et al., 2014). The report indicates that the
medical cost of obesity was estimated to be as high as 147 billion dollars annually in the
United States (Finkelstein, Trogdon, Cohen, & Dietz, 2009). This report further indicated
that the amount of all yearly health costs, that is, payment by Medicare, Medicaid, Private
insurers, including prescription drugs that were due to obesity increased from 6.5% in
1998 to 9.1% in 2006 (Finkelstein et al, 2009, p. 828). To compound issues, obese
children are more likely to become obese adults (Biro & Wien, 2010; Whitaker, Wright,
Pepe, Seidel, & Dietz, 1997). This concern was further reinforced by the call from the
Office of the Surgeon General who lamented about the high obesity rate in the country
(HHS, 2010).
To help minimize the obesity epidemic, especially among children, various
interventions have been sought to increase the physical activity levels during physical
education (PE) lessons (Kelder, Mitchell, McKenzie, Derby, Strikmiller, Leupker, &
19
Stone, 2003; McKenzie, Sallis, Prochaska, Conway, Marshall, & Rosengard, 2004) and
through national school breakfast and lunch programs such as, Fight BAC©, Eat Smart©,
Play Hard©, Nibbles for Health©, and Power of Choice©, just to mention a few (United
States Department of Agriculture, Food and Nutrition Service, 2012). Despite the call
from the Office of the Surgeon General and the various interventions through these
programs, these figures seem to be at a standstill, if not worse, as it has been reported
that:
only about 25% of U.S. adults consume the recommended five or more servings
of fruits and vegetables each day, below 25% of adolescents eat the recommended
five or more servings of fruits and vegetables each day, above 50% of American
adults do not get the suggested amount of physical activity to provide health
benefits and more than a third of young people in grades 9–12 do not regularly
engage in vigorous physical activity (CDC, 2013, para. 3).
Recently it has been reported that two-third of adults (Flegal, Carroll, Ogden, &
Curtin, 2010) and nearly one in three children are overweight or obese (Ogden, Carroll,
Curtin, Lamb, & Flegal, 2010). Concern for outcomes of the high prevalence of
overweight and Obesity in the U.S. has been shared by the U.S. Department of Health
and Human Services (HHS, 2001), yet, more than a decade after, the current Surgeon
General of U.S. continues to lament over the high overweight and obesity in the U.S. by
indicating that, “today’s epidemic of overweight and obesity threatens the historic
progress we have made in increasing American’s quality and years of healthy life” (HHS,
2010, para. 1). With this statement of rising overweight and obesity rate and its outcomes,
20
coupled with all the interventional programs (e.g., Fight BAC, Eat Smart, Play Hard,
Nibbles for Health, Power of Choice, School Breakfast and Lunch Programs) in the U.S.,
obesity remains an issue and the country remains plagued with overweight and obesity,
and its associated chronic diseases like diabetes, cardiovascular diseases and cancer
(CDC, 2012c; Schwartz & Puhl, 2003; Davison & Birch, 2001). With all these measures
in place with minimal outcomes, question may be raised about the credibility of diet and
nutrition information sources, how messages are framed in terms of content, structure and
the channels in which these diet and nutrition information are delivered for better lifestyle
interventions and counseling. This might be the reason why the debate on media
credibility for nutrition intervention continues to grab attention (Sundar & Nass, 2001).
Sternthal, Dholakia, & Leavitt (1978) report that highly trustworthy and expert
individuals induce a positive attitude toward the situation they advocate than do
individuals with less credibility. Dutta-Bergman (2004) emphasizes the importance of
message accuracy in informative messages when evaluating the credibility of online
health information. The medium in which the information or message is delivered plays a
role in attitude change (Velicer, et al., 1993) even though attitude change as a result of
the medium is not the purpose of discussion or study.
By learning more about what constitutes source credibility, we should be able to
improve instructional materials designed for changing attitudes and behaviors.
Purpose of the Study
The main purpose of this study is to investigate the effect of perceived message
credibility and content of messages (in terms of argumentation style) on nutritional
21
attitude change among undergraduate students. Bednar and Levie (1993) identified two
characteristics of source credibility culminating from numerous studies as expertise and
trustworthiness. According to Bednar and Levie (1993), while trustworthiness may
contribute to high source credibility, expertise is commonly the most significant
component of high source credibility. Bednar and Levie (1993) further indicated that
while it is important to enhance communicator attractiveness and establishing belief
congruence with the receiver by arguing in favor of the position of the receiver,
informing the receiver of the expertise of the communicator is crucial. In this study,
messages on a set of nutritional topics will be designed to promote healthy eating habits
among undergraduate students. These messages will be designed in multiple versions that
will attempt to manipulate source credibility. Students will be asked to respond to
instruments that will establish perceived credibility and attitude.
The study will be undertaken among students enrolled in an online Introduction to
Nutrition class developed by a large Midwestern University. The class, which takes five
weeks to complete, is made available for enrollment in Fall and Spring semesters, and
summer sessions (1 and 2). The study was conducted among students who were be
enrolled in the first summer session. Students with diverse majors enroll for this online
class.
The result of this study divulged the role credibility of a message and message
content (in terms of argumentation style) play in attitude change especially in curricula
development and instruction. Conducting this study in this online context promoted cost
effectiveness form of recruitment, data collection, and analysis (Tate, Finkelstein,
22
Khavjou, & Gustafson, 2009) and was flexible (Oenema, Tan, & Brug, 2005). Research
has shown positive results in online nutrition interventions (Evers, Prochaska, Prochaska,
Driskell, Cummins, & Velicer, 2003; Beauchamp & Eng, 2006).
Theoretical Framework
The conceptual frame was guided by the works of Bednar and Levie (1993), and
Bandura (1986, cited in Grusec, 1992). The conceptual delineations of attitude differ
across a number of dimensions (Bednar & Levie, 1993). The following characteristics of
the concept of attitude which are more agreeable upon are: 1) attitude is a latent variable;
2) attitude has an affective component; 3) attitude has a behavioral component; 4) attitude
has a cognitive component; and 5) attitude is relatively stable and enduring (Bednar &
Levie, 1993). For the purposes of this study, one of the framework upon which this study
was based on is Bednar and Levie’s (1993) principles of attitude change. These principles
was guided by the elaboration likelihood model of persuasion and the rhetorical tools:
ethos, pathos, and logos. The principles was limited to the credibility of the source of the
persuasive message and the content of the persuasive message. According to Bednar and
Levie (1993), “Whether designing a persuasive message or developing a lesson based on
modeling, the likelihood that a receiver will accept the conclusions advocated in a given
lesson is in part a function of the receiver’s perception of the source’s or model’s
credibility” (p. 286). The source principle was limited to the following:
1. High credibility sources exert more persuasive influence than low-credibility
sources
23
2. The content of the persuasive massage principle will be limited to the
following;
1. Arguments are more effective if they are relevant to the receiver’s needs.
2. Generally two-sided arguments are slightly more effective than one-sided
messages (Bednar & Levie, 1993, p. 287, 291-292 ).
The elaboration likelihood model (ELM) according to Petty, Cacioppo, and
Schumann (1983) is part of the persuasion approach, which elucidates how people
process messages in a media situation. According to Cacioppo, Petty, and Crites (1994),
the numerous approaches to attitude change can be conceptualized within a general
outline for organizing, classifying and understanding the basic processes underlying
attitude change. Two routes have been proposed by Petty and Cacioppo (1986) to
involve the ELM process: central and the peripheral routes. According to Jung (2011),
while the receiver in central route directs more thoughtfulness to the argument that
appears in the message and tends to fathom the message more, peripheral routes relies on
simple implication about the argument without complex cognitive processing. Jung
(2011) is of the view that “The ELM offers an effective perspective for explaining how
message and source cues work in information processing” (p. 11). From this point of
view, some preceding works on source cues have been associated to peripheral route,
while message cues being indicative of the central route (Dutta-Bergman, 2004;
Cacioppo et al., 1994).
According to Heinrich (2013), the goals of persuasion in an argument are to
change the mood or mind of an audience. The most powerful tools of persuasion
24
according to Heinrich (2013) are agreement by character (Ethos), agreement by logic
(Logos), and agreement by emotion (Pathos). These three form the core of persuasion
(Heinrich, 2013). According to Heinrich (2013), another tool of persuasion vital in
argumentation is Kairos (opportune moment), which entails the timing and medium of
the presentation of the argument.
Reciprocal determinism was the second theoretical framework employed in this
study. Bandura (1986 cited in Grusec, 1992) is of the view that the interaction between a
person’s behavior, the environment and cognition coupled with other personal factors
leads to a bidirectional influence on each other. In other words;
Expectancies, self-perceptions, goals, and physical structures direct behaviors,
with the results of that behavior of that behavior having an impact on those
cognitions and biological properties. The environment events in the form of
modeling, instruction, and social persuasion affect the person, and the person in
turns evokes different reactions from the environment depending on his or her
personality and physical features. Finally, behavior determines aspects of the
environment which the individual is exposed, and behavior is, modified by that
environment. (Grusec, 1992, p 782-783).
This framework was guided by Bandura argument that people contribute to their
own life course by selecting, influencing, and constructing their own circumstances
(Grusec, 1992, p. 783).
25
Research Questions
The research questions are listed as follow (Table 1):
Table 1
The Research Questions of the Study with Rationale and Citations
Research Questions
Rational
Citations
1. Does knowledge of a
communicator’s
expertise correlate with
learner’s attitude
change?
Attitudes are acquired and can
be changed fairly predictably
(Zimbardo & Leippe, 1991)
and as such it is vital to add to
the existing literature the
importance expertise play not
only in the field of psychology
but also nutrition. This will
enable experts to consider the
dynamism of individuals’
attitude they intend to change
especially in the field of
curriculum and instruction.
Bednar & Levie, 1993;
Bohner & Dickel,
2011; Reigeluth, 1992;
Zimbardo & Leippe,
1991.
2. Does fairness, as
defined by a two-sided
argument versus a one
sided argument,
correlate with attitude
change?
Disseminating information on
good nutrition should involve
both side of the spectrum in
that it is vital to have intended
recipient of the nutrition
information know the pro and
cons related to that attitude
change. Dwelling on one-side
of the nutrition information
might not be that motivating
for attitude change especially
in curricula development and
instruction.
Bednar & Levie, 1991;
Heinrichs, 2013; Petty,
et al., 1983.
26
Table 1 Cont.
Research Questions
Rational
Citations
3. Which message of
persuasion has the most
impact on attitude
change?
Employing persuasion in
attitude change cannot be
overemphasized especially in
nutrition. For a noticeable
attitude change to take place,
nutrition information should
be based on reputation,
character and credibility of
the source, evidence, reasons
and appeal to the emotion of
the listener. Knowing which
one of the above has the most
gain on attitude change could
be vital in curricula
development and instruction.
Heinrichs, 2013;
Jung, 2011;
McCroskey, & Teven,
1999; McCroskey, &
Young, 1981;
Tomala, Briňol, &
Petty, 2006.
4. What combination of
factors best explains a
significant portion of the
attitudinal change as
measured by the
predictors (tools of
persuasion and the
demographic
characteristics such as
gender, age, etc.). ?
Per the rationale given in
research question 3, knowing
which combination of the
above stated qualities as well
as the demographics of the
intended population receiving
the information can be useful
on gain attitude change
especially in the field of
curricula development and
instruction.
Heinrichs, 2013;
Jung, 2011;
McCroskey, & Teven,
1999; McCroskey, &
Young, 1981;
Petty, & Cacioppo,
1984; Tomala, et al.,
2006.
Significance of the Study
This study will offer health educators, instructional designers, and policy makers
the opportunity not to only consider source credibility, emotion and logic when
delivering nutritional messages for attitudinal change but also consider the timing of
delivering the message as well as message content. Research indicates that a number of
individuals are not motivated to change their unhealthful eating habits due to fact that
27
they are unaware of their personal dietary behavior (Brug, Hospers, & Kok, 1997; Glanz,
Brug, & Van Assema, 1997). Lack of awareness has been reported to be a major obstacle
in encouraging people to change to healthful diets (Oenema, Brug, & Lechner, 2001). As
a result, it is vital to make people aware of their dietary intake as an initial step to
behavioral change (Oenema, et al., 2001). The significance of raising awareness is
further highlighted in Weinstein’s Precaution Adoption model (Weinsteins, 1988, cited in
Oenema et al., 2001). This model stipulates that, “awareness of risk behavior occurs in
three stages and if people are to become fully aware of a risk behavior and are to become
motivated to change this behavior, they have to proceed through all three stages”
(Weinstein, 1988, cited in Oenema et al., 2001, p. 648). According to this model, stage 1
is attained when an individual come to an understanding that they have heard of the
health risk related with a particular behavior. Stage 2 is reached when an individual know
that the risk behavior is widespread and finally Stage 3 is attained when an individual
admits that they are engaging in the risk behaviors themselves (Weinstein, 1988, cited in
Oenema et al., 2001). The findings from this study will demonstrate what type of
relationship is most likely to exert attitude among participants and also point out which
stage of the model did the participants attain before and after the intervention. By testing
the interaction between source credibility and argumentation styles (in terms of message
content), this research will expand our knowledge and ability to create effective health
messages that could be helpful in minimizing obesity and in general its related illness.
28
Delimitations and Limitations of the Study
Delimitations of a study are “factors that limit generalization” to people, times,
and places; limitations are “restrictions created by your methodology” (Bryant, 2004, p.
57-58).
Delimitations.
Participants were registered students for an online Introduction to Nutrition class
offered by a large Midwestern University main campus, thus limiting the study to one
college within the large Midwestern University making generalization rather difficult.
Participants may have some knowledge about good nutrition as most of the students
registered for the class are registered nurses seeking a Bachelors of Science degree in
nursing.
Limitations.
Respondents’ honesty and their variances in the interpretation/understanding of
the questions played a vital role this study. The questionnaire elicited responses that
represent perceptions of participants. This may have been swayed by other variables not
mentioned in this study. The sample size could not be chosen from the pilot study as the
sample for this study was dependent on the number of students who enrolled for the
Introduction to Nutrition class that is, sample size could not controlled. Participants may
have prior knowledge with the subject matter which may have swayed their responses.
Participants chose to be part of the study and this may reflect a personal interest in the
subject matter. Even though the researcher (a facilitator in the class) did not make himself
known to the students as the one conducting the research, results from this study might
29
have been influenced since the researcher was the one sending the research links to them
for participation.
Definitions of Terms
Attitude – Attitude is a “mental and neural state of readiness, organized through
experience, exerting a directive or dynamic influence upon the individual’s response to
all objects and situations, which it is related” (Thomas & Znanieecki, 1918, cited in
Simonson & Maushak, 1996, p. 985).
Attitude – Mental position with regard to a fact or state (Merriam-Webster Online
Dictionary, 2014).
Change – Making either an essential difference often amounting to a loss of original
identity or substitution of one thing for another (Merriam-Webster Online Dictionary,
2014).
Attitude Object - Any targets of judgment, including people, places, and things, that have
an attitude or opinion associated with it (Psychology Dictionary, retrieved from
http://psychologydictionary.org/attitude-object/).
Attitude Change – “…whenever people process information with the result of forming an
evaluation of an object of thought” (cf., Crano & Prislin, 2006, Walther & Langer, 2008
cited in Bohner & Dickel, 2011, p. 397).
Implicit Attitude – Attitude measured by implicit procedures, e.g., the implicit association
test (Bohner & Dickel, 2011).
Explicit Attitude – Attitude measured by self-report instrument, e.g., questionnaires
(Bohner & Dickel, 2011).
30
Attitude Strength – “the extent to which attitudes manifest the qualities of durability and
impactfulness” (Krosnick & Petty, 1995 cited in Bohner & Dickel, 2011, p. 394).
Persuasion – The act of causing people to do or believe something (Merriam-Webster
Online Dictionary, 2014).
Argumentation – The act or process of forming reasons and of drawing conclusions and
applying them to a case in discussion (Merriam-Webster Online Dictionary, 2014).
Message – An important idea that someone is trying to express in a book, movie, speech,
etc. (Merriam-Webster Online Dictionary, 2014).
Credibility - The quality of being believed or accepted as true, real, or honest ((MerriamWebster Online Dictionary, 2015).
Message Credibility – “Is contingent on discourse that manifests specific empirical
referents and that concomitantly conveys to the receiver the perception that these
references can be verified” (Rosenthal, 1971, p. 400)
Source credibility – Source credibility is “an attribution that is conferred upon the source
by the receiver” (Bednar & Levie, 1993, p. 286). Central route - Entails a careful and
thoughtful evaluation of messages (Petty & Cacioppo, 1986)
Peripheral route - Reactions based on evaluation of the cognitive, affective, or behavioral
cues in the messages (Petty & Cacioppo, 1986).
Tailoring – Designed messages that are more personally pertinent hence eliciting higher
attention and involvement leading to greater impact (Skinner, Siegfried, Kegler, &
Strecher, 1993).
31
Gain-framed messages - Emphasize the advantages of certain behaviors that an
individual would achieve something by adopting these behaviors (Mayer & Coleman,
2012).
Loss-framed messages - Emphasize the disadvantages linked with not adopting a certain
behavior are derived from the prospect theory (Mayor & Colemen, 2012).
Involvement – “There is considerable agreement that high involvement messages have
greater personal relevance and consequences or elicit more personal connections than low
involvement messages” (Sherif & Hovland 1961, cited in Petty et al., 1983, p. 136).
Involvement – “Other social (Rhine and Severance 1970) and consumer (Lastovicka &
Gardner 1979) researchers have defined involvement in terms of the specific issue or
product under consideration. This procedure, of course, confounds involvement with
aspects of the issue or product that may be irrelevant to its personal importance” (Petty et
al., p. 136).
Involvement – “A preferred procedure for studying involvement would be to hold
recipient, message, and medium characteristics constant and randomly assign participants
to high and low involvement groups” (Petty et al., 1983, p. 137).
Pathos – Presenting argument by emotion (Heinrichs, 2013).
Ethos – Presenting argument by character (Heinrich, 2013).
Logos – Presenting argument by logic (Heinrich, 2013).
Kairos – Timing of the presentation of the argument. Is it right or not (Heinrich, 2013).
Adapt – To change (something) so that it functions better or is better suited for a purpose
(Merriam-Webster Online Dictionary, 2015).
32
Obesity – According to the World Health Organization (2014) “Overweight and obesity
are defined as abnormal or excessive fat accumulation that presents a risk to health. A
crude population measure of obesity is the body mass index (BMI), a person’s weight (in
kilograms) divided by the square of his or her height (in meters). A person with a BMI of
30 or more is generally considered obese. A person with a BMI equal to or more than 25
is considered overweight” (WHO, 2014, para. 1).
Undergraduate Students – Students enrolled in an Introduction to Nutrition class.
Culture - The quality in a person or society that arises from a concern for what is regarded
as excellent in arts, letters, manners, scholarly pursuits, etc. (Merriam-Webster Online
Dictionary, 2015)
High-context culture - A high-context (HC) culture is one in which people are deeply
involved with each other (Kim, Pan & Park, 1998, p. 509).
Low-context culture - A low-context (LC) culture is one in which people are highly
individualized, somewhat alienated, and fragmented, and there is relatively little
involvement with others (Hall, 1976, cited in Kim, Pan & Park, 1998, p. 509).
Synchronized e-learning - commonly supported by media such as videoconferencing and
chat, has the potential to support e-learners in development of learning communities.
(Hrastinski, 2008, p. 52).
Asynchronized e-learning - Commonly facilitated by media such as e-mails and
discussion board, supports work relations among learners and with teachers, even when
participants cannot be online at the same time. Asynchronous e-learning makes it
33
possible for learners to log on an e-learning environment at any time and download
documents or send messages to teachers or peers. (Hrastinski, 2008, p. 51-52).
Online Education - Online education involves taking courses presented over the Internet,
which can be taken synchronously (in real-time) through webcams and chat rooms or
asynchronously through e-mail and discussion boards. Many high schools, colleges and
universities offer online courses and degree programs to distance learning students and
working professionals. (Learn.org, para. 2).
Supplemental Nutrition Assistance Program (SNAP) - SNAP offers nutrition assistance to
millions of eligible, low-income individuals and families and provides economic benefits
to communities. SNAP is the largest program in the domestic hunger safety net. The
Food and Nutrition Service works with State agencies, nutrition educators, and
neighborhood and faith-based organizations to ensure that those eligible for nutrition
assistance can make informed decisions about applying for the program and can access
benefits. FNS also works with State partners and the retail community to improve
program administration and ensure program integrity” (United States Department of
Agriculture, 2015, para. 1).
Refer to the following links below for further information of SNAP:
http://www.fns.usda.gov/snap/supplemental-nutrition-assistance-program-snap
http://www.fns.usda.gov/snap/eligibility
The Organizational Plan of the Study
This study will be divided into five chapters. Chapter 1 will address the purpose
of the study, statement of the problem, theoretical framework, research questions,
34
hypothesis, significance of the study, delimitations and limitations of the study, and
definitions of terms. Chapter 2 will review the literature. Chapter 3 will describe the
research methodology. Chapter 4 will be the analysis of collected data. The finally
chapter which will be chapter 5 will comprise of summary of findings, discussion, and
recommendations for future study.
35
Chapter 2: Review of Literature
This chapter reviewed the literature of this study. There were six main themes
associated with this chapter:
1. Persuasion, designing persuasive messages and argumentation as an
instructional variable.
2. Health and culture.
3. Contributors of obesity.
4. Technology and nutrition intervention and counseling.
5. Attitude.
6. Instructional Design
7. Online education
The theme on persuasion, designing persuasive messages and argumentation as an
instructional variable focused on the elaboration likelihood model of persuasion, methods
of persuasion (tools of persuasion), message source, and message content. Health and
culture provided literature on the role culture plays in societal decision-making.
The obesity section discussed some of the leading causes of obesity, the high rate
of obesity in the United States, and health implications of obesity and overweight. The
technology and nutrition intervention and counseling section provided literature on the
current trends and successes in using technology (computers and internet) for nutrition
intervention and counseling in relation to on-site interventions and counseling. The
attitudes section addressed the definition and conceptualization of attitude, measurement
of attitude and attitude change and instructional design principles for attitude change. The
36
instructional design section discussed Merrill’s First Principles of Instruction and Levels
of Instructional Strategy. Finally, online education discussed the advent of online
education and its impact on society.
The main reason for these seven sections is to provide literature that provided
guidance and understanding to this study that seeks to address the effect of source
credibility as measured by argumentation style on attitude change. This research was
conducted among participants in a large Midwestern University Introduction to Nutrition
class taught online. Furthermore, this study discussed persuasive and argument
instructional messages and message credibility delivered through an online environment,
thus, placing emphasis on attitude change as a result of message content, argumentation
style and message credibility and not the medium through which the message is
delivered. While the debate (Clark, 1994; Kozma, 1994) on the effectiveness of medium
on cognitive relevance continues amongst scholars, the researcher has not delved into
these debates to take a stand hence the omission of the medium in this study. The type of
source credibility, coupled with the persuasive nature (or design) of a message, has been
reported to influence attitude change (Arora & Arora, 2004; Bednar & Levie, 1993;
Campbell, et al., 1999; Simonson & Maushak, 1996).
Persuasion, Designing Persuasive Messages and Argumentation as an Instructional
Variable
According to Bohner and Dickel, (2011) “persuasion may be defined as the
formation or change of attributes through information processing in response to a
message about the attitude object” (p. 403). Two models that have been instrumental in
37
persuasion research is the elaboration likelihood model (ELM) and heuristic systematic
model (HSM) (Bohner & Dickel, 2011; Petty & Wegener, 1998). ELM and HSM are
termed the dual-process models and debate still lingers as to whether ELM and HSM
together or individually (unimodel) better explains persuasion (Bohner & Dickel, 2001).
Bohner and Dickel points out:
Although proponents of the dual-processing approach have pointed out that a
given variable can play multiple roles in persuasion, including that of a peripheral
cue and that of a content argument (e.g., Petty & Wegener 1998), the unimodel
more radically proposes that there is no theoretically relevant difference between
such information types at all (Bohner & Dickel, 2011, p. 403).
For the purposes of this study, the literature will elaborate on ELM. According to Petty
and Wegener (1998) “today the models have more similarities than differences and can
generally accommodate the same empirical results, though the explanatory language and
sometimes the assumed mediating processes vary” (p. 326).
Elaboration likelihood model (ELM) of persuasion.
Petty and Cacioppo (1986) note, “in the ELM, arguments are viewed as bits of
information contained in a communication that are relevant to a person's subjective
determination of the true merits of an advocated position” (p. 133). Persuasion which
sometimes results to attitude change entails exposure to information from others (Olson
& Zanna, 1993). According to Olson and Zanna (1993) the exposure normally occurs
through a written or spoken messages delivered by a source to a receiver. ELM of
persuasion involves the formations and changes in attitude (Petty & Briñol, 2011; Petty,
38
Cacioppo, & Schumann, 1983; Petty & Wegener, 1999). Cacioppo and Petty (1984)
suggest that to accomplish elaboration likelihood the following are likely about people:
a) attend to the appeal; b) endeavor to access relevant relations, images, and
experiences from memory; c) inspect and elaborate upon the externally delivered
message arguments in light of the relations accessible from memory: d) come to
conclusions about the virtues of the arguments for a commendation relaying on
their analyses of the data gotten from the appeal and accessed from memory; and
e) subsequently develop an overall appraisal of, or attitude to, the commendation
(Cacioppo & Petty, 1984, p. 673).
These conditions nurture individual's motivation and ability to involve in issue-relevant
thinking (Cacioppo & Petty, 1984). A main construct in the elaboration likelihood model
is the elaboration likelihood continuum (Petty & Wegener, 1998; Petty, Wheeler, &
Tormala, in press). Elaboration likelihood continuum is explained by how motivated and
able individuals are to evaluate the central merits of an issue or a position (Petty &
Wegener, 1988; Petty, et al., in press). According to Petty et al. (in press) “the more
motivated and able people are to assess the central merits of an issue or position, the
more likely they are to effortful scrutinize all available issue relevant information” (p. 9).
Petty and Cacioppo (1986) made mention of two routes to persuasion. They are
the central (being persuaded in an argument or content in a message) and peripheral
(being persuade in way that is not based on the argument or content in a message) routes.
Petty and Cacioppo (1996) assert that while new attitudes attained as a result of
employing the central routes are relatively enduring, attitudes attained as a result of
39
peripheral routes due to numerous persuasion cues are likely to be existent only as long
as the cues continue to be salient. Researches measuring persistence as indicated by Petty
and Cacioppo (1996) have supported the above assertion that active cognitive
involvement like role-playing studies in a persuasion circumstances was central for
eliciting enduring attitude change. Where issue-relevant cognitive activity were probable
to be weak in such situation like experiments using topics of little personal relevance, the
first attitude changes produced were comparatively short-lived. According to Petty and
Cacioppo (1996) “enduring attitude change, then, appears to depend on the likelihood
that an issue or argument will be elaborated upon (though about)” (p. 263).
For a receiver of a message to be persuaded, motivation and ability of the receiver
are vital in determining whether or not an individual will put thoughts into a persuasive
message (Petty & Cacioppo, 1996). While there are many variables that can affect an
individual’s motivation to elaborate upon the content of the message, motivation alone is
not adequate enough for message elaboration; but the individual must have the ability to
process the message (Petty & Cacioppo, 1996). Other variables such as message
repetition and written messages are important for the ability of a person to look into a
message (Petty & Cacioppo, 1996) but distractions and incomprehensible messages may
affect a person’s ability (Petty & Cacioppo, 1996). In the presence of both motivation and
ability, message elaboration will take place (Petty & Cacioppo, 1996).
In situations where the individual sees the message to consist of strong and
compelling arguments, the individual puts thinking into the argument, a phenomenon
Petty and Cacioppo (1996) refer to as “… argument will cause favorable thoughts to be
40
rehearsed” (p. 265), thus leading to enduring persuasion. On the other hand if the person
sees the argument in the message to be weak, counterarguments will be rehearsed.
According to Petty and Cacioppo (1996) in such situations, the individual may look away
from what is advocated in the message in a “boomerang” effect that is, making it possible
for the person to move in a direction away from that advocated in the message. The
central route is employed in the above situations (Petty & Cacioppo, 1996), thus
satisfying the central route model which indicates that if an individual is motivated and
able to ponder over an argument in a message, subsequent sequences of event (attention,
comprehension, elaboration, integration, then enduring attitude change) will take place
(Petty & Cacioppo, 1996).
In situations where an individual is unmotivated or do not understand the
argument or there is no argument, then elaboration of the arguments cannot take place
(Petty & Cacioppo, 1996). According to Petty and Cacioppo (1996) “attention and
comprehension of the arguments are perquisites for argument elaboration” (p. 265).
Nevertheless, Petty and Cacioppo (1996), state that in this situation, a person might still
think about the issue at hand but the individual will be directed by his/her previous
attitude on the issue. When this happens the individual is probable to produce and
rehearse favorable thoughts and espouse an even more positive attitude if the individual’s
attitude is positive with additional thoughts. On the other hand, if the individual’s attitude
is negative with additional thoughts, the individual is probable to produce and rehearse
unfavorable thoughts and espouse an even more negative attitude (Tesser, 1978).
Clarification of the nature of the advocacy is expatiated on:
41
…when a person is either not motivated or able to think about the arguments in a
message but is motivated and able to think about the issue, the nature of a
person’s thoughts will be guided more by a preexisting attitude than by the nature
of the arguments presented in the message. According to the elaborationlikelihood model, thoughts, the attitude changes that result from issue elaboration
will be just as enduring as those that results from message-argument elaboration
(Petty & Cacioppo, 1996, p. 266).
The role motivation and ability play in processing arguments in messages cannot
be overstated. Reflection on the central route of the elaboration-likelihood model further
throws more light on the difficulty it is to employ it to achieve attitude change. As
indicated by Petty and Cacioppo (1996), it is fairly easy to manipulate information in
experimental work on the basic persuasion process however, in the real world the
difficulty in developing a highly persuasive message is much more enormous task to
achieve. This is their statement to buttress the above statement:
If the arguments you construct turn out not to be compelling, people may counter
argue your message; or if the arguments are compelling- but too complex to be
understood fully- people’s thoughts will be guided by their preexisting attitudes
(which may be antagonistic) rather than your arguments. In many cases, however,
the problem is even more basic- just motivating people to attend to and think
about what you have to say (Petty & Cacioppo, 1996, pp. 266-7).
The central route is elicited when elaboration likelihood is high (involves cautious
and considerate valuation of arguments) and the peripheral route when elaboration
42
likelihood is low (involves reactions based on valuation of the cognitive, affective or
behavioral hints in the messages) (Cacioppo & Petty, 1984). Receivers who process
through the central route are more attentive to the arguments that are delivered in
messages while peripheral route outcome simple involves argument without complex
cognitive processing (Jung, 2011). While peripheral route mainly focuses on such factors
as the attractiveness of the source, source credibility, and the number of sources
certifying a position (Dutta-Bergman, 2004), design topographies like layout or colors
(Flanagin & Metzger, 2007), affect like mood or fear (Petty, Gleicher, & Baker, 1991),
central route processing depend on the quality of the message (Miniard, Bhatla, Lord,
Dickson & Unnava, 1991). According to Cacioppo and et al. (1994), “attitudes formed
through the central route, therefore, are relatively persistent, resistant to counter
persuasion, and predictive of behavior” (p. 266). The relationship between the likelihood
continuum and the routes of persuasion is further buttressed by Petty et al. 2003:
…, when the elaboration likelihood is high, people will assess issue-relevant
information in relation to knowledge that they already possess, and arrive at a
reasoned (though not necessarily unbiased) attitude that is well articulated and
bolstered by supporting information (central route). When the elaboration
likelihood is low, however, then information scrutiny is reduced and attitude
change can result from a number of less resource demanding processes that do not
require as much effortful evaluation of the issue-relevant information (peripheral
route) (Petty et al. 2003, pp. 9-10).
43
The difficulty associated with the central route has resulted in the frequent use of
peripheral route (Petty & Cacioppo, 1996). The central route explains attitude change as
culminating from a diligent thoughtfulness of issue relevant arguments (Petty, Cacioppo,
& Goldman 1981). The theoretical methods that fall beneath the central route have
accentuated such factors as the comprehension, learning, and retention of message
arguments, the self-generation of arguments, and the combination and integration of
issue-relevant arguments into an overall evaluative (Petty et al. 1981; Petty et al., 1983).
On the other hand, the peripheral route explains attitude change as a result of the attitude
object being linked with either positive or negative ‘cues’ (Petty et al., 1981; Petty et al.,
1983). The methods that fall within the peripheral route have accentuated linking the
advocated position with such basic cues as food and pain or more secondary cues such as
credible, attractive, and powerful sources (Petty et al. 1981). Petty et al. (1981) reported
that “these cues may shape attitudes or allow a person to decide what attitudinal position
to adopt without the need for engaging in any extensive issue-relevant thinking” (p. 847).
In a study to further expatiate on the roles that the two routes to persuasion play in
an argument presentation, it was reported that:
Interactions of the personal relevance manipulation with the argument quality
and expertise manipulations revealed that under high relevance, attitudes were
influenced mainly by the quality of the arguments in the message, while under
low relevance, attitudes were influenced mainly by the expertise of the source
(Petty, et al., 1981, pp. 851-852).
44
In this study, participants expressed their attitudes on an issue after exposure to a counterattitudinal advocacy containing either strong or weak arguments that emanated from a
source of either high or low expertise. For some participants, the communication was
high in personal relevance, whereas for others it was low (Petty et al., 1981). Petty et al.,
(1981) concluded that “study suggests that although the message content may be the most
important determinant of persuasion under some circumstances, in other circumstances
such noncontent manipulations as source credibility, attractiveness, and so forth, may be
even more important” (p. 852).
In another study in which participants were asked to express their attitudes about
a product after being exposed to a magazine ad under conditions of either high or low
product involvement, the authors indicated that “the manipulation of argument quality
had a greater impact on attitudes under high than low involvement, but the manipulation
of product endorser had a greater impact under low than high involvement” (Petty et al.,
1983, p. 140-142). In this study the ad contained either strong or weak arguments for the
product and featured either prominent sports celebrities or average citizens as endorsers
(Petty et al., 1983, p. 140-142). The authors thus concluded that results were consistent
with the view that there are two relatively distinct routes to persuasion.
Methods of persuasion (tools of persuasion).
“Persuasion is achieved by the speaker’s personal character when the speech is so
spoken as to make us think him credible.... his character may almost be called the most
effective means of persuasion he possesses” (Roberts, 1954, cited in Deìrdöğen, 2010, p.
191). Rhetoric forms the basis of argument (Heinrichs, 2013). According to Heinrich
45
(2013), “rhetoric is the art of influence, friendship, and eloquence, of ready wit and
irrefutable logic. And it harnesses the most powerful of social forces, argument” (p. 4).
Argument does not only talk an individual into a decision, change attitudes and play on
people’s emotion, but it is responsible for political labeling, advertising, jargons, voices,
gestures, and guilt trips (Heinrichs, 2013). Heinrichs (2013) labels it as the real-life
matrix, the supreme software that drives our social lives. Simply put, rhetoric deciphers
an argument (Heinrichs, 2013).
Heinrichs (2013) reports that the success of an argument lies in persuasion of an
audience (Heinrichs, 2013). Heinrichs (2013) further indicates that in presenting an
argument, it is vital to question yourself what you want at the end of the argument. Is it to
change your listener’s mind, mood or their willingness to get them to do something or
prevent them from doing something. As indicated, “to win a deliberative argument, do
not try to outscore your opponent. Instead try to get your way” (Heinrichs, 2013, p. 19),
that is, acknowledge your opponent’s thoughts in order to gain what you want (Heinrich,
2013). Having accessed yourself, Heinrichs (2013) quoted Aristotle as saying, it is
important to put thought into the issue at hand, as issues hinges on blame, values and
choice. For argumentation purposes how sentences are constructed are vital in eliciting
thoughts on issues that is, blame deals with the past, values deals with the present and
choice deals with future tenses (Heinrichs, 2013). According to Heinrichs (2013), of the
three tenses, Aristotle recommended the usage of future tenses.
Citing Aristotle, Heinrich (2013) reports that while past and present tenses deal
with issues of justice and, praise and condemnation (sorting the good from the bad,
46
differentiating groups from other groups and individuals from each other) respectively,
the future tense deals with the advantages available. According to Heinrich (2013),
Aristotle called the future tense as ‘deliberative’ since it entails arguing about choices and
helps individuals decide how to meet their mutual goals. As reported by Heinrichs
(2013), “instead of helping to find some elusive truth, deliberative argument deliberates,
weighing one choice against the other, considering the circumstances” (p. 33). The
strength of deliberative argument lies in what Heinrichs (2013) reported as Aristotle’s
three most powerful tools of persuasion: argument by character, argument by logic and
argument by emotion. According to Heinrichs (2013), Aristotle called the argument by
character, argument by logic, and argument by emotion ethos, logos and pathos
respectively. Heinrichs describes the relationship between the ethos, pathos and logos as
follow:
Together they form the three basic tools of rhetoric…Logos, ethos, and pathos
appeal to the brain, gut, and heart of the audience. While our brain tries to sort the
facts, our guts tells us whether we can trust the other person, and our heart makes
us want to do something about it (Heinrichs, 2013, pp. 39-40).
Ethos (Argument by character).
Ethos could be considered as the charisma and credibility of the orator
(Deìrdöğen, 2010). Ethos is considered the most important appeal among the three
(Heinrich, 2013; McCroskey & Young, 1981). According to Heinrichs (2013), ethos
entails the persuader’s personality, reputation, and ability to look trustworthy. Heinrichs
(2013) quoted Aristotle as say “a person’s life persuades better than his word” (p. 40).
47
The strength in employing ethos is an individual’s ability to fit in and be true to his
audience (Heinrichs, 2013). Fitting in and remaining true to your audience elicits love
from them which is paramount in persuasion. According to Heinrichs (2013), three
essential qualities of a persuasive ethos lie in virtue, craft, and disinterest. Virtues
encompasses the audience believing that the presenter share their values, craft entails the
presenter appearing to know the right decision to make every instance and disinterest
representing impartiality and paying attention to the audience interest instead of your own
(Heinrichs, 2013). Bragging, getting a witness to brag for you, revealing tactical flaws,
and switching sides when the powers that be do are among ways to pump up a rhetorical
virtue (Heinrichs, 2013). Showing off your experience, bending the rules (if the rules
don’t apply, don’t apply them), and appearing to take the middle course are tools for
enhancing craft (Heinrichs, 2013). Furthermore, seeming to deal reluctantly with
something you are really eager to prove, acting as if the choice you advocate hurts you
personally and making it seem you have no tricks are strong tools of disinterest
(Heinrichs, 2013).
According to Aristotle, “persuasion is accomplished by character whenever the
speech is held in such a way as to render the speaker worthy of credence. The speaker
must exhibit the following to seen as credible: (i) practical intelligence (phronêsis), (ii) a
virtuous character, and (iii) good will (Rhet. II.1, 1378a6ff, cited in Stanford
Encyclopedia of Philosophy, 2014, para. 15). Furthermore:
If a speaker displays none of them, the audience would doubt that he is able to
give good advice. Again, if he displayed (i) without (ii) and (iii), the audience
48
could doubt whether the aims of the speaker are good. Finally, if he displayed (i)
and (ii) without (iii), the audience could still doubt whether the speaker gives the
best suggestion, though he knows what it is. But if he displays all of them,
Aristotle concludes, it cannot rationally be doubted that his suggestions are
credible. Attentions should be paid to the fact that the speaker must accomplish
these effects by what he says; it is not necessary that he is actually virtuous: on
the contrary, a preexisting good character cannot be part of the technical means of
persuasion (Stanford Encyclopedia of Philosophy, 2014, para. 15)
In a study to determine the nature of the ethos construct and its measurement, five
dimension to ethos were discovered: sociability, competence, extroversion, composure,
and character (McCroskey & Young, 1981). In this study, a sample of 726 college
students enrolled in basic communication classes were asked to provide adjectives to
describe 1) "the person you would be most likely to believe" and "the person you would
be least likely to believe;" 2) the theoretical literature concerning ethos and source
credibility was surveyed to find adjectives most frequently employed to describe credible
and non-credible sources; and 3) previous research concerning the measurement of
source credibility and ethos was reviewed to determine the adjectives most commonly
found to appear in the various studies. Each subject responded on the 41 scales with
regard to a particular source (McCroskey & Young, 1981). This study concluded that
amongst the five constructs, competence and character defines ethos the most
(McCroskey & Young, 1981). While competence encompasses qualification, expertness,
intelligence, and authoritativeness; character, sagacity, safety, and honesty are derivatives
49
of trustworthiness (McCroskey & Teven, 1999). In another study that sought to examine
the comparative importance of the ethos dimension, the researchers reported goodwill as
a component of ethos construct and a meaningful predictor of believability and likeability
(McCroskey & Teven, 1999).
Pathos (Argument by emotion).
Pathos is propelled from psychological appeals. Pathos is elicited through the
receiver’s emotions. Before employing the psychological appeals, persuaders have to
assess the emotional state of their audience (Deìrdöğen, 2010; Heinrichs, 2013). The
tools of pathos that play an integral part of persuasion are sympathy, generosity,
gentleness, courage and sharing your audience mood. The appearance of struggling for
self-control plays an integral part of pathos as it affects an audience judgment (Heinrichs,
2013). Heinrichs (2013) quoted Cicero as saying “a genuine emotion persuades more
than a fake one” (p. 41). Emotions are derived from experience and expectation, in that
what an audience believes has taken place or can take place in the future can arouse a
sensation of an experience and a greater emotion can be aroused from the audience
(Heinrichs, 2013). Apart from employing pathos through what the audience has
experience and expert to elicit belief, Heinrichs (2013) suggested the following tools of
pathos:
1. Storytelling – it should be centered on the audiences past experience and it
should be told in the first person. This help give the audience a virtual
experience.
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2. Volume control – beginning a speech in a subtle manner and turning it up to
portray an apparent difficulty in controlling an emotional struggle.
3. Simple speech – avoid fancy words when faced with emotion. These are
reserved for logos and ethos.
4. Anger – directing an audience fury to a situation of lack of commitment to
their problems or concerns.
5. Patriotism – attaches a choice or action to the audience’s sense of group
identity. You can stir it by comparing the audience with a successful rival.
6. Emulation – responding emotionally to a role model.
7. Passive voice – directing unwanted attention from others, implying that the
action happened on its own.
8. Comfort – creating an easy, docile and instinct state environment. These
attributes do not only help persuasion go down more easily but helps counter
or prevent anger. It is achieved through keeping things simple, empowering
the audience and trying to get them to smile.
9. Humor – if used properly it is a wonderful calming technique (Heinrichs,
2013, p. 95).
Basing an argument on the audience believes, or desire, coupled with pointing out
what is in their best interest creates what Heinrichs (2013) term as a “commonplace” (pp.
107-110, 114). According to Heinrichs (2013), commonplace sets the foundation for
presenting an argument. Argument by logic (logos) in this situation makes the audience
51
think there in not much of a difference in opinion of the presenter from their
commonplace. Heinrichs (2013) outlined the following cues of commonplace:
1. Babbling – the repetition of the same thing by an audience over and over.
2. The rejection – listening to the language used by audience when they are in
disagreement with the presenter. Odds are, you will hear a commonplace.
3. The commonplace label – application of a commonplace to idea such that
anyone who opposes it stands the risk of being deemed an outsider (Heinrichs,
2013, p. 114).
Once this commonplace is ascertained, deliberative argument can be presented.
Taking a stance during an argument presentation should be supported by
employing favorable words and connotation to people and concepts by defining
the issues at hand . The position a presenter takes should be based on facts or
definition or quality or relevance with each of these employed if the other fails to
persuade an audience. Indicating that, if facts fail, definition should be employed
(Heinrichs, 2013, pp. 115-116).
In a study to manipulating discrete negative emotional states and message frames, the
authors indicated that persuasion was more successful when messages were framed with
emotional overtones matching the emotional state of the receiver (DeSteno, Petty,
Rucker, Wegener, & Braverman, 2004). According to the authors these changes were
mediated by emotion-induced biases involving expectancies attached to arguments
contained in the messages, indicating that specific emotions can alter the persuasive
impact of messages as a function of the emotional framing of persuasive appeals
52
(DeSteno et al., 2004). Recently, Griskevicius, Shiota and Neufeld (2010) investigated
the influence of positive emotions on the processing of persuasive messages by using
different methods to induce emotions and assess processing. The authors ascertained that
the positive emotions of anticipatory enthusiasm, amusement, and attachment love tended
to facilitate greater acceptance of weak persuasive messages, whereas, the positive
emotions of awe and nurturant love reduced persuasion by weak message.
Logos (Argument by logic).
Gagarin (2001) quoted Gorgias portraying of logos (Argument by logic) “as using
array of tools to persuade others to do its bidding…” (p. 276). This assertion is further
supported by the following statement:
Logos is the argument the speaker is advancing; that meant appeals to the intellect
or to reason. It is dependent on the audience’s ability to process information in
logical ways; in order to appeal to the rational side of the audience, the persuader
has to assess their information-processing patterns (Deìrdöğen, 2010, p. 192).
According to Heinrichs (2013) logos is not just not centered on following rules of
logic but a set of techniques that use what the audience is thinking. As useful as facts are
in presenting an argument, Heinrichs (2013) is of the view that logos permits an
individual to do away with facts when needed while directing attention on rational
strategy, definition and other subtle tactics. For the purposes of this study, logic is
discussed rhetorically (Rhetorical logic) not philosophically (Philosophical logic). The
belief held by or the decisions made by the presenter or receiver of an argument is
paramount in rhetorical logic as compared to philosophical logic which is based on
53
conclusions (or “the truth”) (Heinrichs, 2013). As indicated by Heinrichs (2013)
“assumption or beliefs–commonplace–work just as well as facts” (p. 132). Heinrichs
(2013) outlined two forms of logic; deductive and inductive logic. While the deductive
logic begins with the general and works to the specific (The premise proves the
examples), inductive begins with the specific and works to the general (The examples
proves the premise) (Heinrichs, 2013). Every logical argument is based on a proof and a
conclusion, in that the premise presented is the proof and the choices outlined for the
audience to make as a result of the deliberative argument represents the conclusion
(Heinrichs, 2013). According to Heinrichs (2013), the presenter bears the sole
responsibility in presenting the proof while backing up the choices he/she want her
audiences to make through examples (inductive logic) or premise (deductive logic). It is
reported that employing commonplace to reach a conclusion by construing the situations
through a lens of beliefs and values makes for a better presentation of deductive logic
(Heinrichs, 2013). Using the circumstances to form a belief through fact, comparison and
story makes for a better presentation of inductive logic (Heinrichs, 2013). According to
Heinrichs (2013), logos is a strong determinant of a presenter’s ethos. Once the logos are
in doubt by the audience, the presenter’s ethos suffers.
According to Heinrichs (2013) the following questions need to be addressed by a
presenter before the commencement of argumentation:
1. Proof holding up.
2. The right number of choices being presented.
3. Proof lead to the conclusion.
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4. Addressing audience concern (Heinrichs, 2013, p. 146).
Heinrichs (2013) outlined following good practices associated with employing logos
during argumentation:
1. Avoid false comparison – the examples should hold up. It should be slotted
into the right category.
2. Avoid bad examples – there should not be a disconnection between the
examples and the choice. In some instance, while the example might be true
and relevant, they do not actually support the choice.
3. Avoid ignorance as proof – there should not a disconnection between the
proof and the choice. Never conclude what cannot be proven, cannot exist.
4. Avoid tautology – making the proof the choice. The proof does not support
the choice because the proof is the choice.
5. Avoid false choices – there should not be a break down between the proof and
the conclusion as a result of either the proof itself does not hold up, or because
it fails to lead to the conclusion. There may be nothing wrong with the proof,
and the proof may lead to a choice, but the problem is that the audiences are
given the wrong number of choices.
6. Avoid red herring – irrelevant issues should be avoided. The problem may
not be with the proof or the conclusion at all. The problem is that the wrong
argument is presented to create a diversion from the real one.
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7. Avoid wrong ending – pay attention to your conclusion and refrain from bad
conclusion. The proof may be okay, but it leads to the wrong conclusion
(Heinrichs, 2013, pp. 147-163).
The importance of pathos, ethos and logos in argumentation cannot be overstated.
For an effective persuasion to be realized, the persona (ethos or credibility) of the
persuader coupled with the content of message (pathos and logos) is vital. An assertion
supported by various studies (Chaiken, 1979; Deaux, Dane & Wrightsman, 1993; Eagly
& Carli, 1981; Hovland, Mandell, Campbell, Brock, Luchins, Cohen, McGuire, Janis,
Feirerabend & Anderson, 1957; Hovland & Weiss, 1951; Jung, 2011; O’Keefe, 2002).
Designing persuasive messages.
According to Bednar and Levie (1993), “persuasive messages can be viewed as an
example of a basic communication in which a source presents a message through a
channel and a receiver… any step might be differentially affected by the any variation in
the source, message, channel or receiver” (p. 286). A complexity bemoaned by Bednar
and Levie (1993).
The source.
Bednar and Levie (1993) reported that receiver’s perception of a source is vital in
the receiver’s accepting the conclusions advocated by the source. In other words, they
proposed that “ whether designing a persuasive message or developing a lesson based on
modeling, the likelihood that a receiver will accept the conclusions advocated in a given
lesson is in part a function of the receiver’s perception of the source’s or models
56
credibility” (p. 286). They further asserted that source credibility is not a fixed attribute
of the source but somewhat an attribution that is lord upon the source by the receiver.
Research has reported vocal pleasantness and facial expressions to be linked with
persuasiveness (Burgoon, Birk, & Pfau, 1990). While Walther and colleagues (2004)
admit that the concepts of credibility overlay, and are multidimensional, the importance
of the source credibility for a diet and nutrition attitude change in an online environment
cannot be overstated (Campbell, et al. 1999; Eastin, 2001). This is further supported by
the work of Walther et al. (2004) and Treise, Walsh-Childers, Weigold and Friedman
(2003) who emphasized the importance of source expertise as a vital component of
website credibility. Bednar and Levie (1993) outlined the following features of the source
of the persuasive message: a) High-credibility sources exert more persuasive influence
than a low-credibility source; b) Source perceived by the receiver as attractive are more
influential; and c) The quality and structure of the arguments in a persuasive message are
more critical for credible sources than for attractive sources (Bednar & Levie, 1993).
Bednar and Levie (1993) made mention of two characteristics associated with a
high-credibility source as source expertise and source trustworthiness. Expertise
encompasses the credentials of the communicator and it is content-specific (Bednar &
Levie, 1993). Inferring that while a person might have expertise in a particular content
he/she might not be in another content. Bednar and Levie (1993) ascertain that if a source
is observed as being subjective or dishonest, effort at attitude change may be ineffective
thus, affecting trustworthiness. Olson and Zanna (1993) referenced the work of
Brownlow and Zebrowitz (1990) in which they reported that individuals with babyish
57
facial appearance are observed as extra trustworthy. The following relationship between
source expertise and source trustworthiness was provided:
The trustworthiness of the source appears to be a less important matter than the
source’s expertise particularly when the basis for persuasion is the legitimacy of
the factual contant in a persuasive message. Even so, it is generally to the source’s
advantage to be rated high in trustworthiness” (Bednar & Levie, 1993, p. 287).
According to Bednar and Levie (1993), “sources perceived by the receiver as attractive
are more influential” (p. 288). The main process in influence is not change in attitude
toward an object but rather the designation and significance of the object (Asch, 1940,
cited in Wood, 2000). When significance alters, attitudes change consequently too
(Wood, 2000).
Bednar and Levie (1993) are of the view that source attractiveness is vital in
accomplishing this. Similarity, familiarity and appearance are some factors that
contribute to attractiveness and these factors overlay and are jointly reinforcing (Bednar
& Levie, 1993). In quoting Rogers and Shoemaker (1971), Bednar and Levie (1993)
indicated that when source and receiver “share common meanings, a mutual subculture
language, and are alike in personal and social characteristics, the communication of ideas
is likely to have greater effects in terms of knowledge gain, attitude formation and
change, and overt behavior change” (p. 288). Physical appearance plays a vital role in
that it shapes the assessments of attractiveness and sincerity (Bednar & Levie, 1993).
According to Bednar and Levie (1993), a receiver’s perception of the ideal image
and expected physical appearance of source plays an important role in influencing the
58
receivers (Bednar & Levie, 1993). This emotional level is further reinforced by the
following statement made by Benar and Levie (1993) “The effectiveness of source
credibility lies in the receiver’s belief that the source has the ability to know the proper
stand on an issue and the objectivity to communicate that stand truthfully” (p. 288).
Bednar and Levie (1993) informed that “the quality and structure of the arguments in a
persuasive message are more critical for credible sources than for attractive source” (p.
289). Indicating that it is more important to employ an expert source when the message
argument is complex and use an attractive source in cases were the message argument is
less complex. It is reported that attractiveness alone was not instrumental in changing
attitudes on complex and controversial issues but rather expertise was effective only
when combined with attractiveness (Stone & Hoyt, 174, cited in Bednar & Levie, 1993).
Implying that the most effective way is to have a source vested both in credibility and
attractiveness (Bednar & Levie, 1993). Kelman (1961) is also cited by Bednar and Levie
(1993) to indicate that the “relative effectiveness of credibility and attractiveness may
also be related to the nature of the source-receiver relationship and the context of the
behavior related to the attitude” (pp. 289-290).
Messages.
Message is the second main constituent of a persuasive communication (Bednar
& Levie, 1993). While the communicate is caught between the dilemmas of what
information to present, which argument will be more or less convincing, Bednar and
Levie (1993) are of the view that “one means of determining the most effective messages
is to pretest alternative messages” (p. 290). Message content about the information of the
59
source is vital as a potential effect on an argument and this is often overlooked in
education (Bednar & Levie, 1993). They pointed out that “if attitude change is an
objective, and if the source is not well known by the learners but possesses characteristics
that may facilitate attitude change, then the information should be made part of the
messages” (p. 290).). This further reinforce Olson and Zanna (1993) assertion that “when
recipients could not easily comprehend a message, they used source credibility to infer
level of agreement with the recommendation’ (p. 137
Bednar and Levie (1993) outlined the following to constitute a persuasive
message for attitude change: a) be sure the receiver is informed of the expertise of a high
credibility communicator; b) to enhance communicator attractiveness, establish belief
congruence with the receiver by arguing in favor of positions the receivers is known to
hold; c) arguments are more effective if they are relevant to the receiver’s needs; d)
generally two-sided arguments are slightly more effective than one-sided messages; e) it
is almost always advisable to state the conclusion explicitly rather than to allow receivers
to draw their own conclusions and f) repetition helps, but only one or two repetitions are
likely to have additional effects.
Bednar and Levie (1993) cited two studies that supported reason why sources that
are observed as experts on a subject are more persuasive and what makes up expertise for
a particular receiver may not be observable. In the first study in which they cited the
work of Cantor, Alfonso, and Zillman (1976), they informed that a tape-recording
message endorsing the use of an intrauterine device was more effective when accredited
to source that had used intrauterine device before than a source that had not (Bednar &
60
Levie, 1993). In the second study, referencing the work of Shrigley (1976), in which
third-year elementary education students were asked to indicate the characteristics of the
teachers for elementary science methods courses that relate to teaching credibility, it was
informed that while participation in research and authoring science textbooks was ranked
low, practical teaching knowledge was ranked high (Bednar & Levie, 1993). Thus,
reiterating the notion that credibility and other factors linked to expertise are perception
of the receivers and not properties of the source. Bednar and Levie (1993) asserted that
“since the source’s attractiveness can also enhance the message’s effectiveness, one
technique is to increase the perceived similarity of the source by establishing belief
congruence between the source and receiver as part of the message” (p. 291). The
strength of arguments that promote attitude change are those that enriches the receiver’s
perception that the object can enhance need satisfaction and increases the significance of
the needs (Bednar & Levie, 1993).
When a receiver has the following characteristics; familiarity of the issue, initially
opposes the source’s position, is highly intellectual, the receiver may look out for
contrasting view points, and is likely to hear contrasting perspective later. To be
facilitative, the source should introduce and refute opposing argument (Bednar & Levie,
1993). Cacioppo and Petty (1984) asserted that:
As factors in the persuasion setting reduce the recipients' motivation or ability to
think about an issue… when recipients by their nature tend to avoid effortful
thinking…, view the appeal as being personally inconsequential…, are engaged in
a distracting task during their exposure to the appeal…, or possess little prior
61
knowledge on the issue…there is a reduction in the likelihood that the recipients
will relate the incoming information to their prior knowledge about and
experiences with the attitude object in an effort to evaluate the merits of the
arguments for the recommendation (Cacioppo & Petty, 1984, p. 673).
Opposing arguments should be avoided if the receiver has opposite
characteristics. Bednar and Levie (1993) are of the view point that “to reinforce existing
attitudes it is a good idea to expose receivers to weak forms of opposing arguments so
that they have to defend and thereby strengthen their view” (p. 292). Upon deciding on a
two-way or one-way, decision will have to made as to whether to extant the ‘pro’ or
‘cons’ first (Bednar & Levie, 1993). It is suggested that receivers who are unaccustomed
with the issue should be introduced with the “pro” arguments first, while making sure
that the receiver is clearly vested in the “pro” argument before presenting and refuting
“con” arguments. In a study were participants were asked to evaluate the sound quality of
an audiotape prepared by a faculty committee for possible broadcast in the university
community, it was reported that participants experiencing auditory messages three times
had an increased effectiveness of appeals based on strong arguments than participants
exposed to one. (Cacioppo & Petty, 1989).
For the purposes of this study, persuasive messages will be designed based on the
following constituent: a) arguments are more effective if they are relevant to the
receiver’s needs and b) generally two-sided arguments are slightly more effective than
one-sided messages.
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Bednar and Levie (1993) makes mention of the importance the channel in which
the persuasive message is delivered and the receiver based on their heterogeneity. The
following principles are presented about the channel and receiver respectively: a) No one
media has been explicitly shown to have greater persuasive effectiveness than any other
media type. Face-to face communication is a) more effective in promoting acceptance
than mediated communication, particularly in difficult cases and b) it is very difficult to
change the attitudes of receivers who are highly committed to their positions on an issue;
however channel and receiver are not the point for discussion in this study even though
the research will be conducted online.
In an experiment conducted to determine the view if the number of arguments in a
message could affect agreement with a communication by serving as a simple
acceptance cue when personal involvement was low but could affect agreement
by enhancing issue-relevant thinking when personal involvement was high, it was
reported in both studies (pilot and experiment) that increasing the number of
arguments in a message could affect persuasion when or not the actual content of
the argument was scrutinized . In this study, result from the pilot study reported
that when the issue was of low relevance, participants showed more agreement in
response to a message containing six arguments (3 strong and 3 weak) than
messages containing either three strong or three weak arguments . This study also
revealed that the number of arguments in a message serves as a peripheral cue
under low involvement (Petty & Cacioppo, 1984, pp. 74-76, 78).
63
Petty and Cacioppo (1984) indicated that even though past researches on
peripheral cues have been centered on attributes of messages sources like expertize and
attractiveness can elicit persuasion without issues-relevant thinking even in situation
where people are either rather unmotivated or incapable to think about issue-relevant
argument. Suggesting that features of persuasive messages may also function as
peripheral cue (Petty & Cacioppo, 1984). The number of arguments, message factors
such as length of the arguments and the complexity of the language used in the message
might also inform as simple cues as the validity of the message (Petty & Cacioppo,
1984). In addition to source and message factors, peripheral cues may be linked with
audience (e.g., the existence of hecklers), the message recipient (e.g., existence of
hastened heart rate) and the overall persuasion context (e. g., existence of pleasurable
surroundings) (Petty & Cacioppo, 1984). Petty and Cacioppo (1984) made these remarks:
According to the central/peripheral framework when motivation or ability to
expend cognitive effect are low, cues residing in any of the places may lead
people to infer that they like or do not like the advocacy or that it is or is not
worth supporting (p. 78).
The importance of message framing as a strategy for health messages by
emphasizing the gains or losses connected with certain behaviors cannot be overstated
(Leshner & Cheng, 2009; Tversky & Kahneman, 1981). In a meta-analysis conducted by
Gallagher & Updegraff (2012), they reported that not only do gain-framed messages
exhibit significant effect on making proper behavioral choices than loss-framed messages
but also promotes the prevention of illnesses such as skin cancer prevention, smoking
64
cessation, and physical activity behavior in particular (Gallagher, & Updegraff, 2012).
Results from this study is supported by other studies using the same message delivery
methods (Leshner & Cheng, 2009; Brug, et al., 1996; Brug, et al., 1998 Skinner, et al.,
1994; Mayor & Coleman, 2012); however:
In a study that examined the effect of message framing on mother’s intentions to
obtain human paillomavirus (HPV) vaccination for their teenage daughters and
investigated predictors of HPV vaccination intentions it was reported that there
was no effect of message frame on vaccination intentions (Fahy & Desmond,
2010). Rather attitudes toward HPV vaccination and the influence of both peers
and medical professionals may have played an important role in HPV vaccine
acceptability (Fahy & Desmond, 2010, pp.429-430).
In a research that involved two experiments which explored the prediction from the
self-validation framework the authors reported that when people generate primarily
positive thoughts in response to a message as result of the message containing strong
arguments and then learn of the source, high source credibility leads to more favorable
attitudes than does low source credibility (Tomala, et al., 2006). They further indicated that
when people have primarily negative thoughts in response to a message due to weak
arguments, this effect is reversed. High source credibility leads to less favorable attitudes
than does low source credibility (Tomala, et al., 2006). This study was based on selfvalidation hypothesis of Briñol, Petty, and Tormala (2004) who asserted that source
credibility identified after message processing can influence the confidence people have
65
in their own thoughts generated in response to persuasive messages (cited in Tomala, et
al., 2006).
The above studies further iterate the importance that message framing and source
play in attitude change. The role of source credibility (ethos) coupled with the message
content (pathos and logos) in changing attitude cannot be overstated. Studies have shown
the importance of source credibility and design of messages message content in health care
(Brug et al., 1996; Brug et al., 1998: Campbell, et al., 1999; Arora & Arora, 2004; Mayor
& Coleman, 2012), marketing (Kelly &Rupert, 2009; Hamon & Coney, 1982; Eisend,
2006; Chu & Kamal, 2008) and even in politics (Sternthal, et al., 1978; Teven, 2008) and
it will be worth examining the effect of source credibility as measured by augmentation
style (pathos and logos) on attitude change.
Health and Culture
According to Carter (2013), the importance of culture and credibility in health
communication cannot be overstated and as such, it should be not be taken lightly in
information-seeking behavioral researches and should be not be ignored by health
communicators. The definition of Culture has its own complexity in that it may mean
different for diverse individuals (Duranti, 1997). Yet some researchers have tried to
provide some definitions for culture. According to Banks, Banks, and McGee (1989, cited
in Center for Advanced Research on Language Acquisition [CARLA], 2014), “the essence
of a culture is not its artifacts, tools, or other tangible cultural elements but how the
members of the group interpret, use, and perceive them. It is the values, symbols,
interpretations, and perspectives that distinguish one people from another…” (para. 2).
66
CARLA (2014) also defined culture as “the shared patterns of behaviors and interactions,
cognitive constructs, and affective understanding that are learned through a process of
socialization. These shared patterns identify the members of a culture group while also
distinguishing those of another group” (para. 1).
One challenging tool required by educators, especially those that are involved with
curriculum and instructions is, understanding the culture of the individuals receiving the
instructions. The instructor has to consider and understand the cultural values and
aspirations that recipient of the instructions bring from the larger society to school or
workplace if the instruction involves workplace training (Hogan, 2013). People come to
school or workplace with their own set of ideas or cultural values embedded in them and
in some cases these cultural values are in conflict with what is been taught or the
organization’s culture (Hogan, 2013). Simply put, diversity competence, cultural
competence, or cultural diversity competence on an instructor is vital during instructions
(Hogan, 2013). According to Hogan (2013), “these terms imply the underlying qualities of
awareness, understanding, and interpersonal skill (Koppelman, 2011; Sobo, 2009 cited in
Hogan, 2013 p. 1). Similarly, instructors need to understand these terms in order to design
appropriate instructional strategies to enhance positive result or performance (Merrill,
2013).
In the absence of cultural awareness and skills, instructional or operational hold up
can result to the detriment of an educational institution, workplace and community (Hogan,
2013). This situation has not only prompted individuals in education and health, but also
in human services, business and criminal justice to emphasis the importance of formal
67
training of employees in cultural diversity competence to promote culturally competent
organizations (Hogan, 2013).
Uncertainty reduction.
According to Carter (2013) “a popular topic in health communication research is
uncertainty reduction” (p. 5). Uncertain reduction has been vital in investigating
informational and support channels which a person employs to gain information and
support for themselves or others in order to enhance the understanding of a health topic
and in some cases make a health behavior choices (Carter, 2013).
The elaboration of the uncertainty reduction theory summaries three general
strategies for uncertainty reduction, passive which entails reactivity search, social
comparison, and disinhibition search; active which entails asking others about the target
and environmental structuring; and finally interactive which entails interrogation, selfdisclosure, and deception detection (Gudykunst, Yang, & Nishida, 1985). These three
strategies are argued by Snyder (1974) to be influenced by self-monitoring (cited in
Gudykunst, 1985). Compared to low self-monitors, high self-monitors are more able to
determine suitable behavior in new circumstances, exhibit higher control over emotional
reactions, and generate desired impressions (Snyder, 1974, cited in Gudykunst, 1985),
adapt to changes in social circumstances more (Snyder & Monson, 1975, cited in
Gudykunst, 1985), are more self-assured and show extreme quality or character
(Berscheid, Graziano, Monson & Dermer, 1976, cited in Gudykunst, 1985), are more
information seeking on individuals they anticipate to be interacting with (Elliot, 1979,
Gudykunst, 1985) and are more initiative and approachable in terms of conversations,
68
and conversational sequences (Ickes & Barnes, 1977, cited in Gudykunst, 1985).
“Uncertainty reduction, therefore, involves the creation of proactive predictions and
retroactive explanations about strangers’ behavior. The desire to reduce uncertainty
however, does not stop with initial encounters with strangers” (Gudykunst, 1985a, p. 7980). Numerous studies have been conducted on the interaction between attitude,
similarity and attraction (Gudykunst & Nishida, 1984). It is reported that the main reason
cited for the differences between diverse societal groups is the extent to which they
recognize similarity in between beliefs during communication between a recipient of the
message and the source (Rokeach, 1960, cited Gudykunst & Nishida, 1984). Attraction is
also a direct function of shared opinion as well as culturally (Byrne et al., 1971, cited in
Gudykunst & Nishida, 1984). These findings where supported in research conducted in
Lebanon (Yabtudi & Diab, 1978 cited in Gudykunst & Nishida, 1984) and ChineseAmerican college students (Ting-Toomey, 1981, cited in Gudykunst & Nishida, 1984). It
is reported that members of a high-context cultures asked more questions about a
stranger’s background than members of low-context cultures (Gudykunst, 1983, cited in
Gudykunst & Nishida, 1984).
High-context versus low-context cultures.
The usefulness of high versus low context has been employed in many fields,
most notably for cross-cultural communication studies (Gudykunst & Nishida, 1986 cited
in Kim, Pan, & Park, 1998), and conflict-resolution studies (Chua & Gudykunst, 1987,
cited in Kim, et al., 1998) According to Kim, et al., (1998), “the concept of high versus
low context which proposed by Hall (1976) is a way of understanding different cultural
69
orientations” (p. 508). Kim,et al., (1998) elucidate that “ it helps people to understand the
differences among cultures more easily and to study marketing and other managerial
implications of cultural differences” (p. 509). The major aspects of the high versus-versus
low context concept are summarized in Table 2.
In a cross-cultural study that employed survey comprising of 16 items to attempt to
show whether Hall's description of the characteristics of high- and low-context cultures can
indeed he empirically confirmed among participants from China, Korea, and the United
States, it was reported that the outcome showed that the three cultures differ in a way that
was consistent with Hall’s conceptualization (Kim et al., 1998). In this study, the following
questions were part of the 16 items: to determine a person’s tendency to engage in and
enjoy effortful cognitive endeavors;
1. Learning new ways to think does not excite me very much.
2. I have difficulty thinking in new and unfamiliar situations.
3. I try to anticipate and avoid situations where there is a likely chance I will have
to think in depth about something (Kim et al., 1998, p. 513).
Measures of the aspects of personality that deal with relationships to other people in
general, to social and political philosophy, and other aspects;
1. Insults to our honor are not always important to bother about.
2. It is all right for people to raise questions about even the most sacred matters
(Kim et al., 1998, p. 513).
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Table 2
Major Aspect of High-versus Low Context Concept
Concept
High Context Culture (HC)1
Low Context Culture (LC)1
Social Orientation
People are deeply involved with
one another. The bonds between
people start with one's family and
extend to one's friends, colleagues,
community, and society in general.
The bonds imply commitment,
expectation, and mutual goodwill.
High context cultures make greater
distinction between insiders and
outsiders than low-context cultures
do (Hall, 1976, cited in Kim et al.,
1998, p. 510)
The bonds that tie people
together are somewhat
fragile, so that people
move away or withdraw if
things are not going well.
On the other hand,
businesses in high-context
cultures depend more on
connections and
relationships (Hall, 1976,
cited in Kim et al., 1998, p.
510)
Commitment
Because of the high involvement
people have with each other and
the high cohesiveness, tend toward
high commitment to complete
action chains. A person's word is
his or her bond and a promise for
others to take, because in HC
cultures, one is expected to do as
one says. This, on the other hand,
suggests that people in HC cultures
tend to be extremely cautious and
even reluctant to begin something,
particularly in fields or
relationships that are not well
known. It is often said that a strong
introduction, especially by the
insider, is the most important step
in doing business in Asia. (Hall,
1976, Cited in Kim et al., 1998, p.
510).
Americans and other LC
people do not ordinarily
feel as bound to complete
actions regardless of
circumstances as some
other cultures do (Hall,
1976, Cited in Kim et al.,
1998, p. 510).
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Table 2 Cont.
Concept
High Context Culture1
Low Context Culture1
Responsibility
Related to social orientation and
commitment is the issue of responsibility.
In high-context systems, people in places
of authority are personally and truly (not
just in theory) responsible for the actions of
Subordinates, down to the lowest man. The
top-down decision-making process is more
commonplace and effective in
organizations in HC cultures (Hall, 1976,
cited in Kim et al., 1998, 510).
In low-context systems,
on the other hand,
responsibility is
diffused throughout the
system and difficult to
pin down. In the event
of errors, scapegoats are
often found from the
low level. Further, LC
context cultures seem to
resist self-examination
(Hall, 1976, cited in
Kim et al., 1998, p.
510).
Confrontation
In HC cultures people try to avoid
direct confrontation to maintain social
harmony and intimate bonds between
people, often through repressing self.
Amenities and cordialities are to be
maintained, no matter how one is feeling.
One reason that HC people sometimes
appear to express themselves in a
roundabout way, especially regarding
issues that might be disagreed upon, is to
reduce chances of open and direct
disagreement. Individuality, minor dissent,
and clashes of personality are handled by
pretending that they do not exist.
Therefore, people in HC cultures are more
likely to repress self-feelings and interests
to maintain harmony, and because the
bonds between people are so strong there is
a tendency to allow for considerable
bending of the system. In Asia, for
example, it is very seldom that one would
voluntarily correct you or explain things to
you, especially for things you are supposed
to know (Hall, 1976, cited in Kim et al.,
1998, p. 511).
In the eyes of people
from LC cultures, such
explosions take place
without warning and are
hard to predict. LC
culture people are less
likely to avoid direct
and open confrontation
at the expense of
expressing and
defending self and
criticism is more direct
and recorded formally.
LC are less capable of
integrating information.
(Hall, 1976, cited in
Kim et al., 1998, p.
511).
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Table 2 Cont.
Concept
High Context Culture1
Low Context Culture1
Communication In HC cultures the intimate human
relationships and the wellstructured social hierarchy and
norms serve as a broad context in
which human communication takes
place. In HC cultures, most
communication relies more on the
physical context or is internalized
in the person, and less information
is contained in the verbal part of
the message such as in words,
sentences, and grammar. In other
words, one needs to put the
messages in the appropriate
context in order to understand the
right meanings conveyed in the
messages. In general, HC
communication, is economical,
fast, efficient, and satisfying;
however, time must be devoted to
programming (to be high context)
(Hall, 1976, cited in Kim et al.,
1998, p.512).
In LC cultures, the mass of the
information is vested in the
explicit code, that is, in the
words, sentences, and grammar
(Hall, 1976, cited in Kim et al.,
1998, p. 512). Low-context
messages tend to be more
context-free, and deals are
made with much less
information about the character
and background and values of
the participants and much more
reliance upon the explicit
communications (Keegan,
1989, cited in Kim et al., 1998,
p. 512). What is important,
then, is what is said, not how it
is said and not the environment
within which it is said
(Onkvisit & Shaw, 1993, cited
in Kim et al., 1998, p. 512).
Dealing with
new Situations
People in the West who are
used to having to struggle with
the complexities of the LC
systems can, when they are
confronted with something
new, be quite creative about it
and not require an inordinate
amount of detailed
programming.
HC people can be creative within
their old system but have to move
to the bottom of the context scale
when dealing with anything new
(Kim et al., 1998, p. 512).
73
Table 2 Cont.
Low Context Culture1
On the other hand, although they can be
Dealing with New
creative and innovative when dealing
Situations
with the new, LC people have trouble
being anything but pedestrian when
working within the bounds of old
systems (Hall, 1976, cited in Kim et al.,
1998, p. 512).
1
Kim, Pan & Park (1998). High- versus low-context culture: A comparison of Chinese,
Korean, and American cultures. Psychology and Marketing. 15, (6): 507-521.
Concept
High Context Culture1
In this study, on confrontation, participants from the Chinese and Korean cultures
emphasized self-constraint and refrain from confrontation relative to their American
counterparts (Kim et al., 1998).
On communication, there was a slightly agreement with the Chinese respondents
than the American that an individual’s word is his or her bond and there is no need to
prove otherwise (Kim et al., 1998). When dealing with new situations in contrast to the
American participants, the Korean and Chinese respondents exhibited more e difficulty
putting thoughts together in an unexperienced circumstances, feel that the situations are
changing too fast and there is no fun associated with the new experiences and would
attempt to escape it when it involves detailed thinking (Kim et al., 1998). According to
Greenhalgh, Helman, and Chowdhury (1998), in cultures that strongly value family
interactions, lay sources of information have been reported to be the most widespread
method to seek health information, with persons reflecting on their personal experiences
and those of their family and friends. “Health education that concords with people's ‘lay
74
epidemiology’ and folk models is more likely to lead to changes in behavior than that
which seems to contradict such models” (Greenhalgh et al., 1998, p. 982).
It is reported that culture plays a vital role in health beliefs and informationseeking behaviors and these may permanently ingrain certain ideas or actions into
traditional culture (Carter, 2013). It is important to recognize the role culture plays to
help minimize difficulties encountered by professionals when trying to work with
individuals that are distanced from mainstream culture (Maher, 1999). This may not be
different with professional in education and training, especially when designing
curriculum and providing instruction.
Overweight, Obesity and their Contributors
The following statement was made by the Secretary, United States Department of
Health and Human Services in 2001:
The 20th century saw remarkable and unprecedented improvements in the lives of
the people of our country. We saw the infant mortality rate plummet and life
expectancy increase by 30 years. Deaths from infectious diseases dropped
tremendously, and improvements in medical care allowed many individuals with
chronic disease to lead longer, fuller lives. Yet despite these and other successes,
complex new health challenges continue to confront us. Overweight and obesity
are among the most important of these new health challenges. Our modern
environment has allowed these conditions to increase at alarming rates and
become highly pressing health problems for our Nation. At the same time, by
confronting these conditions, we have tremendous opportunities to prevent the
75
unnecessary disease and disability that they portend for our future. (Message from
The Secretary, U.S. Department of Health and Human Services, The Surgeon
General’s call to action to prevent and decrease overweight and obesity, 2001, p.
XI).
Almost a decade later, the current Surgeon General is of this view:
Our nation stands at a crossroads. Today’s epidemic of overweight and obesity
threatens the historic progress we have made in increasing American’s quality and
years of healthy life. Two-third of adults and nearly one in three children are
overweight or obese. In addition, many racial and ethnic groups and geographic
regions of the United States are disproportionately affected. The sobering impact
of these numbers is reflected in the nation’s concurrent epidemics of diabetes,
heart disease, and other chronic diseases. If we do not reverse these trends,
researchers warn that many of our children—our most precious resource—will be
seriously afflicted in early adulthood with medical conditions such as diabetes and
heart disease. This future is unacceptable. I ask you to join me in combating this
crisis (message from the Surgeon General, 2010, p. 1).
The above statement brings to light the concerns shared by the people of the
United States regarding overweight and obesity. Obesity as a result of an abnormal or
excessive fat accumulation that may have adverse impact on health is a concern for all
(World Health Organization [WHO], 2014). An individual is deemed as overweight or
obese by determining that individual’s body mass index (BMI). BMI is determined by
calculating a person's weight in kilograms divided by the square of his height in meters
76
(kg/m2) (WHO, 2014). According to WHO (2014), a BMI greater than or equal to 25 is
overweight and that greater than or equal to 30 is obesity (para. 1). This measurement
according to WHO (2015), delivers the most convenient population-level measure of
overweight and obesity as it is the identical for both sexes and for all ages of adults (para.
2). WHO (2015) reports that it should be regarded as a rough guide because it may not
match up to the same degree of fatness in different individuals.
Prevalence of obesity.
The World Health Organization report indicates that worldwide obesity has more
than doubled since 2008. (WHO, 2015). The report indicated that in 2014, about 39% of
adults aged 18 and above were overweight and of whom 14% were obese globally
(WHO, 2015). This report further indicated that in 2013, 42 million children under the
age of 5 were overweight or obese (WHO, 2015). It is reports that in developing
countries with emergent economies, the rate of increase of childhood overweight and
obesity is 30% higher than that of developed countries (WHO, 2015). Overweight and
obesity are connected to more demise worldwide than underweight (WHO, 2015).
Figures released by WHO indicates that 65% of the world's population live in countries
where overweight and obesity kill more people than underweight (WHO, 2015).
Furthermore, the mean body mass index (BMI) of the world’s population has gone up
significantly between 2008 and 2014 (WHO, 2015). These figures have dramatically
risen all over the world, especially in the urban settings of low and middle-income
countries (WHO, 2015). This is not different from a developed country like the U.S., with
the report indicating a third of her population to be obese (Ogden, et al., 2014).
77
According to the United States Department of Health and Human Services (HHS,
2012), obesity have been the cause of 400,000 deaths each year in the United States,
making obesity the second leading cause of death after smoking. The report indicated that
in 1999, the percentage of obese children in the United States aged 6 to 11 and
adolescents aged 12 to 19 were 13% and 14% respectively (HHS, 2012). These figures
nearly tripled from 2000 to 2008 (HHS, 2012; CDC, 2012a). Recent data indicates that
17% of youth are obese (Ogden et al., 2014) and this has reflected significantly in the
medical cost in United States (Finkelstein, et al., 2009). Figures presented indicate that
payment by Medicare, Medicaid, private insurer, including prescription drugs that were
due to obesity increased from 6.5 percent in 1998 to 9.1 percent in 2006 (Finkelstein et
al, 2009). To compound issues, obese children are more likely to become obese adults
(Biro & Wien, 2010; Whitaker, et al., 1997). This high prevalence has necessitated the
call by the Office of the Surgeon General for individuals in the United States to show
more interest in eating healthful (HHS, 2012).
Causes of obesity.
Food intake (energy intake) that exceeds energy expended (less exercise or less
physical activity) over prolonged period of time has been cited (Hardus, Van Vuuren,
Crawford, & Worsley. 2003; Wilding, 2001) as being the cause of overweight or obesity
which results from the accumulation of body fat. According to WHO (2014), alterations
in dietary and physical activity routines are often the result of environmental and societal
changes linked to development and absence of supportive policies in departments such as
health, agriculture, transport, urban planning, environment, food processing, distribution,
78
marketing and education. The expectation for a normal weight is that as food is
consumed on a daily basis, an individual needs to be physically active through exercising
on a daily basis as well.
A variety of reasons can be given for children being overweight or obese. The
most notable causes are genetic factors, absence of physical activities, hormonal growth,
unhealthful eating habits (behavioral or socioeconomic), cultural, or a combination of
these causes (DHHS, 2012). Genetics as a cause of obesity has been mentioned in some
studies (Bircan, 2009; Martı´nez-Herna´ndez, Enrı´quez, Moreno-Moreno, & Martı´,
2007). To help minimize the control obesity has over an individual’s weight, the
importance of diet and physical activities cannot be understated. It is reported that one
quarter of U.S. children spend 4 hours or more watching television daily and it has
reported that hours of TV (Eisenmann, Bartee, & Wang, 2012) and computer times
(Mendoza, Zimmerman, & Christakis, 2007; Vandelanotte, Sugiyama, Gardiner, &
Owen, 2009) are associated with increased obesity.
Many studies have linked obesity to low socioeconomic status (Bove, & Olson,
2006; Gordon-Larsen, Nelson, Page, & Popkin, 2006; Wang, Liang, Tussing,
Braunschweig, Caballero, & Flay, 2007). Food insecurity and lack of a safe place for
physical activities as a result of low socioeconomic status has been linked to obesity in
children (Alaimo, Olson, & Frongillo, 2001). With low socioeconomic status,
impoverished homes may be faced with challenges of eating healthful. To supplement the
little they have, a majority of impoverished homes in the United States participate in the
Supplementary Nutrition Assistance Program (SNAP, formerly known as Food Stamps).
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According to the Food Research and Action Center (FRAC), more than 46.6 million
Americans participated in SNAP in 2012 (FRAC, 2012). FRAC notes that even with
these high numbers, 3 out of 10 people eligible for SNAP go unattended. For
impoverished homes, means of eating are directed towards high sugar and fatty diets that
are cheaper to purchase and quickly satiate. Even though the idea of the SNAP program
is to enable low-income Americans to get enough to eat (Guthrie, Lin, Ver Ploeg, &
Frazao, 2007), choices surrounding food purchases have led to a number of questions. A
number of studies have reported links between participating in SNAP and obesity
(Guthrie et al., 2007; Leung, & Villamor, 2011; Ver Ploeg, & Ralston, 2008).
Outcomes of obesity.
Overweight and obesity does not only weigh down on the body (CDC, 2012a;
Schwimmer, et al., 2003), cardiovascular diseases (mainly heart disease and stroke),
diabetes, musculoskeletal disorders and some cancers (endometrial, breast, and colon)
(WHO, 2014), but affects academic outcomes (Schwartz & Puhl, 2003; Taras & PottsDatema, 2005) and mental health (Davison, & Birch, 2001). According to Viner and Cole
(2005), obesity is linked to deprived employment and relationship outcomes. In a
nationally representative sample of 10, 039 randomly selected young people aged
between 16 to 24 years to determine the relation between overweight and subsequent
educational attainment, marital status, household income, and self-esteem, it was reported
that US women who were obese in late adolescence in 1981 were unlikely to be married
and had lesser incomes seven years later than women who had not been overweight,
80
while men who had been overweight were unlikely to be married too (Gortmaker, Must,
Perrin, Sobol, & Dietz, 1993).
Studies indicate that apart from childhood obesity being linked cross-sectionally
with numerous risk factors for coronary heart disease (CHD) (Must & Strauss, 1999),
there are numerous documentation of longitudinal association of overweight children and
adolescents having an upsurge risk of adult obesity (Guo, & Chumlea, 1999), a number
of CHD risk factors in adulthood (Freedman, Khan, Dietz, Srinivasan, & Berenson,
2001), and diverse adult comorbidities (Eriksson, Forsen, Tuomilehto, Winter, Osmond,
& Barker, 1999). In a study to estimate the prevalence of obesity and diabetes among US
adults in 2001, it was reported that compared with adults with normal weight, overweight
and obesity adults were significantly linked to diabetes, high blood pressure, high
cholesterol, asthma, arthritis, and poor health status (Mokdad, Ford, Bowman, Dietz,
Vinicor, Bales, & Marks, 2003).
Combating obesity.
To help minimize the obesity epidemic among children, various interventions
have sought to increase the physical activity levels during Physical Education (PE)
lessons (Kelder, et al., 2003; McKenzie, et al., 2004) and through National school lunch
and breakfast programs, Fight BAC, Eat Smart, Play Hard, Nibbles for Health, and Power
of Choice, just to mention a few (United States Department of Agriculture [USDA],
2012). Yet, with all these programs, the rate of obesity continues to rise as indicated in
the research conducted by Ogden et al. (2014).
81
Studies show that a number of individuals are not motivated to change their
unhealthful eating habits due to the fact that they are unaware of their personal dietary
behavior (Brug, et al., 1997; Glanz, et al., 1997) and participants will have the
opportunity to access their eating patterns and if participants admit that they are engaging
in the risk behaviors themselves they will be able to make informed decisions as a result
of change in attitude.
Technology and Nutrition Intervention and Counseling
One notable means other than the face-to-face or on-site method is employing
digital technology or computer-based method in reducing overweight or obesity to
promote better lifestyle habits. This method has gained popularity over the past decade
(Eastin, 2001; Kreuter, Farrel, Olevitch, & Brennan, 2000) with some huge successes in
changing relevant health-related behaviors (Brug, Campbell, & Van Assema, 1999; Brug,
et al., 1997). Even though the debates on the efficacy of digital technology on
interventions and counselling to promote better lifestyle continues (Miles, Petrie, & Steel,
2000; Tate, Wing, & Winett, 2001), digital technology has its own competitive edge over
the on-site interventions. Based on the following reasons digital media applications or
communications can influence human behavior.
First, digital technology has the advantage of reaching a larger population
(Oenema, et al., 2001). Current research report indicates that 87% of United States adults
use the internet, 90% own a cell phone and 58% own a smartphone (Pew Research
Internet Project, 2014, p. 5). Of the 87% of the internet user, 59% indicated using the
internet for information about a variety of health topics within the past year while 35%
82
reported going online specifically in an attempt to research on what medical illness
themselves or someone else might have (Pew Research Internet Project, 2014a). It is
further reported that one in three cellphone owners used their cell phone to research on or
look for health related information while half of smart phone users did the same (Pew
Research Internet Project, 2014a).
Of the smart phone users, 19% downloaded health app (Pew Research Internet
Project, 2014a). This number continues to rise as similar results were reported in a search
for information about physical activity (Saperstein, Atkinson, & Gold, 2007). In a random,
population-based sample of 431 women aged 18 to74 who completed a survey module on
Internet use and access, of the 79% who reported having access to the internet, 71% used
the internet for health information (Bowen, Meischke, Bush, Wooldridge, Robbins,
Ludwig, & Escamilla, 2003). They further indicated that the online information they read
was vital in their decisions making on health care, correspondence with the health care
providers and how they managed their health (Bowen et al., 2003). In a study to
investigate, among 300 primary care patients, the interest in and experience with using
the internet for a variety of health-related activities it was reported that 191 accessed the
internet and regardless of usage, patients were most interested in using the internet for
searching information about diseases, medications and other health related information
(Sciamanna, Clark, Houston, & Diaz, 2002). It was reported that among the internet
users, the opportunity between interest and experience was in the fact that they could use
the internet to investigate the quality of their care as in whether their health care
providers were giving them all of the tests and treatments that were due them and using it
83
as an administrative function like scheduling an appointment with health providers
(Sciamanna et al., 2002).
Secondly, employing digital technology for nutrition intervention and counseling
is also considered to be cost effective than the on-site interventions. Reviewing the
economic evaluation of internet interventions of peer-reviewed journals published in
PubMed from 1995 to 2008, the authors bemoan that only eight studies made mention of
specific economic indicators associated with internet intervention (Tate, Finkelstein,
Khavjou, & Gustafson, 2009). The authors indicated that the lack of coast data published
at the time of review was a likely reflection of the early stage of research into the webbased intervention (Tate, et al., 2009). Despite Tate and colleagues’ (2009) worry, recent
data has shown considerable data into cost related issues during web-based lifestyle
interventions. In a randomized trial study that provided insight in the cost-effectiveness
and cost-utility of different versions of a tailored physical activity intervention (Active
Plus) among adults aged over fifty, the researchers indicated that the web-based
intervention resulted in higher effects on physical activity and lower societal costs than
the control group (Golsteijn, et al., 2014).
In this study, the intervention conditions included print-delivered basic, printdelivered environmental, web-based basic, web-based environmental and a
waiting-list control group and the whole the Active Plus intervention was found to
be cost-effective. According to the authors, the tailored Active Plus intervention
delivered through printed material and with additional environmental information
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turned out to be the most cost-effective intervention condition (Golsteijn et al.,
2014, pp. 7-13).
In another study:
That had two-group parallel randomized controlled trial to determine whether a
behavioral internet treatment program for weight management is a viable, costeffective option compared with usual care in a diverse sample of overweight,
healthy adults serving in the US Air Force, it was reported that even though it cost
more initially, the program was a cost-effective choice for weight management
and it resulted in long-term cost savings (Rasu, Hunter, Peterson, Maruska, &
Foreyt, 2010). The authors of this study concluded that such cost-effective,
internet-based behavioral interventions for weight management is vital in
providing a valuable tool for preventive care designed at improving an individual
and societal health as a whole (Raus et al., 2010, pp. 100-103).
Furthermore:
In a 2-year randomized controlled trial including three (3) study groups to
determine the cost-effectiveness and cost-utility of a sequential and a
simultaneous web-based computer-tailored lifestyle intervention for adults
compared to a control group, it was reported both the sequential and the
simultaneous lifestyle interventions were likely to be cost-effective when it
concerned the lifestyle factor, whereas, the control condition was when it
concerned quality of life. According to this study all groups received personalized
health risk appraisals based on the guidelines for physical activity, fruit intake,
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vegetable intake, alcohol consumption, and smoking Furthermore, respondents in
the sequential condition received personal advice about one lifestyle behavior in
the first year and a second behavior in the second year; respondents in the
simultaneous condition received personal advice about all unhealthy behaviors in
both years (Schulz, Smit, Stanczyk, Kremers, de Vries, & Evers, 2014, para. 2432).
Finally, the flexible nature of digital media applications or communications can
also influence human behavior. Recommendation for lifestyle intervention and
counseling gold standard for an on-site therapy is 6 month (Jensen & Ryan, 2014). For an
adult who has other things like work and family to attend to will have difficulties under
going through an intervention for that long. This will be the same for adolescents who
have to attend to school activities as well. The flexibility of a web-based intervention
enables individuals to undertake intervention sessions to fit their schedules. This could
promote completion of an intervention and counseling session earlier than an on-site
intervention. In a study of randomly assigned 782 respondents to a tailored intervention
group to determine the short-term efficacy and respondents’ evaluations of a web-based
computer-tailored nutrition intervention, targeting to decrease saturated fat intake and
increase fruit and vegetable intake, it was reported that computer-tailored intervention
showed significant effects for the determinants of fat, fruit, and vegetable intake and for
vegetable and fruit intake (Oenema, Tan, & Brug, 2005). The authors concluded that
web-based, computer-tailored nutrition information can have a short-term effect on the
determinants of fat, fruit, and vegetable intake (Oenema et al, 2005).
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In this hard economic era where individuals are faced with economic challenges
coupled with taking care of family issues, people seeking intervention and counseling for
better lifestyle, may want a convenient, easily accessible, flexible, cost effective and a
medium that can maintain anonymity/privacy for improving a better lifestyle which a
web-based intervention and counseling provides
Literature support on the effectiveness of on-site intervention cannot be ignored
(Jensen & Ryan, 2014); yet, the contribution of digital technology to the success of
intervention in this technologically driven era cannot be overstated.
An effect size comparisons in a meta-analysis on a web-based interventions
compared to non-Web-based interventions indicated an improvement in outcomes
for participants using web-based interventions to achieve the specified knowledge
and/or behavior change for the studied outcome variables. The outcomes included
increased exercise time, increased knowledge of nutritional status, increased
knowledge of asthma treatment, increased participation in healthcare, slower
health decline, improved body shape perception, and 18-month weight loss
maintenance (Wantland, Portillo, Holzemer, Slaughter, & McGhee , 2004, para.
15-19).
In another review:
That provided a descriptive discussion of web-based behavioral interventions for
the management of type 2 diabetes mellitus, it was reported that goal-setting,
personalized coaching, interactive feedback and online peer support groups were
some of the successful approaches which were applied in e-interventions to
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manage type 2 diabetes mellitus. The authors further indicated that web-based
interventions could have promoted an even more level of favorable outcomes,
provided they are further enhanced with proper e-research strategies (Ramadasa,
Queka, Chana, & Oldenburgb, 2011, pp. 400-402).
Another review that investigated the impact of the internet as a medium to deliver
weight loss programs in terms of the public’s interest, the availability and the known
efficacy of internet based weight loss programs reported that general public is turning to
the internet for diet and fitness information and the information they found online has
impacted their behavior (Saperstein et al., 2007). A structured approach such as
modifying energy balance, the use of cognitive-behavioral strategies such as selfmonitoring, and individualized feedback and, support accounted for the success
(Saperstein, et al., 2007). The short-term impact of web-based computer-tailored nutrition
education on behavior has been reported in other studies too (Oenema et al., 2001; Tate,
Jackvony, & Wing, 2006).
Finally, in a study that determined the efficacy of an Internet-based program for
weight-loss and weight-gain prevention with a two-group, prospective, randomized
controlled trial among 446 overweight individuals, after 6 months, the researchers
indicated that individual who received behavioral internet treatment lost 1.3 kilograms as
compared to 0.6 kilograms weight gained by the usual care group (Hunter et al., 2008).
The behavioral internet group had significant changes in body mass index, percent body
fat and waist circumference (Hunter al., 2008). Other studies have shown success by
employing digital technology in promoting better lifestyle (Beauchamp & Eng, 2006;
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Rothert, et al., 2006; Sciamanna et al., 2002; Tate, Jackvony, & Wing, 2003; Tate, Wing,
& Winett, 2001).
The above studies throws more light on how effective digital technology can be
employed to promote better lifestyle. When properly designed, the results produced by
digital technology can be at par with on-site interventions, not to mention digital
technology’s advantage of convenience, easy accessibility, flexibility, cost effectiveness
and anonymity/privacy. Most effective website designs provide information that is in
concurrence to an individual’s personal characteristics. This includes a person’s health
behaviors, motivations, attitude and perceived barriers, making the information
personally relevant (Oenema, et al., 2001). While the debate on the effectiveness of
digital technology in intervention and counseling to improve lifestyle will linger on, the
above studies point to the fact that when designed properly, digital technology can
produce results as effective as on-site intervention and counseling.
Most designs of digital technology in terms of software and hardware have been
one of the reasons cited for their effectiveness in intervention and counseling for better
lifestyle (Evers, Prochaska, Prochaska, Driskell, Cummins, & Velicer, 2003). Most of the
digital technologies try to mimic an on-site intervention method for an effective result
and digital technologies software and hardware makes this possible (Oenema et al.,
2001). Users in an online environment do not only draw on aesthetic factors to judge
usability and credibility (David & Glore, 2010) but online content (Hu & Sundar, 2010).
Investigations into the credibility of websites providing behavior change and weight loss
content for consumers have stimulated diverse responses. In a full review of 37 public
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websites on health behaviors change for disease prevention and management, it was
reported that all had at least four of the five of the 5A’s (advise, assess, assist,
anticipatory guidance and arranged follow-up), assumed to be the minimum criteria for a
program to promote behavior change (Evers, et al., 2003). This review further indicated
that the strength of these sites were in providing rationale for assessment, privacy and
confidentiality protections, provided some form of feedback and interactivity (Evers, et
al., 2003). Evers et al. (2003) study determined that these websites fell short of
individualized tailoring and plans for evaluation.
In another investigation into weight loss websites as part of the developmental
research for an online program, the investigators indicated that although the online sites
contained much of the content of traditional behavioral weight loss programs, they fell
short in programmatic nature, structure and professional contact that were a vital part of
in-person programs (Tate et al., 2001).
According to Saperstein et al., (2007), Consumer Reports WebWatch and the
Health Improvement Institute recently evaluated the 20 most trafficked diet
websites for quality by basing their rating on composite scores of site credibility,
information quality and reliability, and ease of use and eight sites with diet selfhelp components were assessed on the characteristics of the diet plans. The diet
self-help component was rated as ‘very good’ on only WebMD, ‘good’ on five
sites including eDiets and Weight Watchers, ‘fair’ on Light ‘n Fit, and ‘poor’ on
TrimLife (p. 461).
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For the purposes of this study, participants were students enrolled in an online
class and this will have the advantage of reaching a larger population as students who
enroll in this class come from all over the United States. Secondly, the online class
provided some form of flexibility for participants as they can work within their own
schedule even though there will be time specified for responses to be turned in. Finally,
the course site was designed for educational instructional purposes and the instructor of
record is a registered and licensed dietician (RDN, LD), and a Professor of Nutrition. The
facilitators for the class have masters in food and nutrition, thus confirming the credibility
of the course and those associated in teaching the class.
Attitude
As core topics of contemporary social psychology (Bohner & Dickel, 2011), the
debate on the best conceptualization (definition and measurement) of attitudes (Fabrigar,
MacDonald & Wegener, 2005) and the theorization about the relationships among
attitude structure and the processes of attitude change (Gawronski & Bo denhausen,
2006, cited in Bohner & Dickel, 2011; Petty & Wegener, 1998) have lingered; however,
in recent years there have been advances in more stable multi-process frameworks to
account for the numerous, apparently contradictory, findings (Petty & Wegener, 1998).
Definition and conceptualization of attitude.
Building on the work of Crano and Prislins (2006), Bohner & Dickel (2011)
reviewed literature that was published between 2005 and 2009 to further provide themes
that underpin the dynamic association between attitude representation and change.
According to Bohner and Dickel (2011), while most researchers agree that an attitude
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object is comprised, “of anything a person may hold in mind, ranging from the mundane
to the abstract, including things, people, group and ideas” (p. 392), their review further
revealed that “researchers also adopt the view that either attitudes are stable entities
stored in memory versus temporary judgments constructed (constructionist view) on the
spot from the information at hand” (p. 392). Some models clearly ratify either a stableentity or constructionist view, while others take a more in-between position (Bohner &
Dickel, 2011). The stable-entity side of the continuum comprises MODE (motivation and
opportunity as determinants) model and the meta-cognitive (MCM) model (Bohner &
Dickel, 2011). MODE and MCM treat attitudes as long-term memory structures (Bohner
& Dickel, 2011). While the MODE model representation of the object is evaluated with
associative link with that object, MCM follow a similar pattern but the associative
linkage may be more than one with varying associative strength (Bohner & Dickel,
2011). On the constructionist side of the continuum, Bohner and Dickel (2011), asserted
that, the constructionist “see attitude not enduring personal dispositions but rather as
evaluative judgments that are constructed in the situation based on currently accessible
information” (p. 393). This concept is firmly supported by the works of Schwarz and
Bohner (2001), and, Wilson and Hodges (1992) who are of the view that attitudes are
developed based on salient beliefs, emotions and behaviors rather than being stored in the
memory for retrieval; however, there are those whose definition encompasses both
MODE and MCM models and those who find their definitions between MODE and
MCM models (Table 3).
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Bearing in mind research evidences of context-sensitivity versus stability of
attitudes, each view is not without its strengths and limitations (Bohner and Dickel, 2011)
especially when there are studies linking genetics to attitudes (Olson, Vermon, Harris &
Jang, 2001; Tesser, 1993). Therefore making a concise and definitive judgment on
context-sensitivity versus stability of attitudes debatable. “Whereas abundant evidence
for the context-sensitivity of evaluative judgments supports a constructionist view, there
is also evidence for high stability of many attitudes even in the face of changing
situations” (Bohner and Dickel, 2011, p. 393).
Petty, et al., (in press) made mention of a couple of reasons why a strict
constructivist view of attitude appears improbable. First Petty et al. (in press) made
mention of research indicating that not only are persons motivated to protect their
attitudes even in spite of counter-attitudinal appeals but they also tend to dissuade when
they are in conflict with their current attitude. Secondly, research has revealed structural
properties (behavioral, affective and cognitive components) of attitudes that can impact
their perseverance across diverse context (Petty et al., in press). Third as Petty et al. (in
press) pointed out “attitudes can be automatically activated under response conditions
that would make spontaneous construction seem unlikely, though people can also have
automatic evaluative reactions to specific objects (e.g., abstract paintings) they have
never seen” (p. 3). According to Petty et al., (in press), in the latter instances, people
could be retrieving reactions to salient features of the object (e.g., colors, shapes). Bohner
and Dickel (2011) reiterated “the assumption is that strong attitudes are more stable
across situations and over time and can consistently be recalled from memory, whereas
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weak attitudes are less accessible and thus more susceptible to context influences”
(Bohner & Dickel, 2011, p. 394).
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Table 3
Attitude Definitions Ordered According to Their Conceptualization of Attitudes as Stable
Entities versus Temporary Constructions
Definition
Conceptualization
Authors
“psychological tendency
expressed by evaluating a
particular entity with some
degree of favor of disfavor”
Umbrella definition
Eagly & Chaiken, (2007).
“array of summary
evaluations stored in
memory”
Stored in memory
Visser & Mirabile (2004).
“object-evaluation
associations in memory”
Stored in memory
Fazio (2007).
“attitude objects linked in
memory to global evaluative
associations”
Stored in memory
Petty, Brinol & DeMarree
(2007).
“current evaluations are
constructed from relatively
stable representations”
Between definitions
Cunningham et al. (2007).
“evaluative judgments,
formed when needed, rather
than enduring personal
dispositions”
Constructed on the spot
Schwarz (2007).
“time-dependent states of the
system rather than static
‘things’ that are ‘stored’ in
memory”
Constructed on the spot
Conrey & Smith (2007).
“attitudes construction has
different Meanings for
associative and prepositional
processes”
Constructed on the spot
Gawronski &
Bodenhausen (2007).
“Attitude and attitude change” by G. Bohner & N. Dickel, 2011, Annual Review of
Psychology, 62, p. 393.
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Measurement of attitudes.
According to Petty et al., (in press) “measurement of attitudes is important for
determining what people’s current attitudes are and whether or not they have changed”
(p. 6). The advent of attitude measurement in research has been based on explicit or
direct attitudes (Bohner & Dickel, 2011; Petty et al., in press). Measuring explicit or
direct attitudes entail employing self-reported scales, where responses are elicited from
respondents to assess an attitude object by choosing a numeric response on single or
multiple items (Bohner & Dickel, 2011; Petty et al., in press). Devices employed in
assessing explicit attitudes include the semantic differential, the one-item rating scale, the
Likert scale and the Thurstone scale (Petty at al., in press). Most recently among the
technique of measuring attitude is the implicit or indirect attitude measurement (Bohner
& Dickel, 2011; Petty et al., in press). According to Petty et al. (in press) “…, implicit
attitudes are said to come to mind automatically upon the mere presentation of the
attitude objects” (p. 5). Indirect or implicit attitudes are gathered from a person’s
judgments, reactions or behaviors and not from self-reporting (Bohner & Dickel, 2011;
Petty et al. in press). Methods employed in implicit attitude measurements also includes
the thematic apperception test, the information test, the implicit association test, the
automatic evaluation task, electroencephalogram (physiological measures) and physical
behaviors like eye contact or gestures (Petty et al., in press).
Referencing the work of Dovidio, Kawakami and Beach (2000), Petty et al. (in
press) indicate that explicit and implicit measurement methods typically exhibits modest
positive correlations even though there are reports of wide variations in some studies
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(Hofmann, Gawronski, Gschwendner, Le, & Schmitt, 2005; Rydell, McConnell, Strain,
Claypool, & Hugenberg, 2007). While explicit measures permit for some period for the
production of an attitude report, some implicit measures intend to assess more
spontaneous evaluations (Petty et al., in press). Simply put “implicit measures are said to
assess implicit (automatic) attitudes, whereas explicit measures said to assess explicit
(deliberative) attitudes” (Petty et al., in press, p. 7). Implicit measures has the advantage
of reducing motivated responses biases, examine facets of attitudes that are not open to
introspection (Bohner & Dickel, 2011) and it does not make its assessment obvious like
the explicit measures (Petty et al., in press).
Petty et al. (in press) are of the view that the MODE model suggests that implicit
measures assess stored and underlying automatic evaluation relationship, while explicit
measures assess the same relationship in addition to downstream processes that can alter
the look of that attitude. However, with the MCM model, implicit measures assess the
associations between the attitude object without deference to the validity tags while
explicit measures takes into consideration the perceived validity of the evaluative links
including any contextual factors operating (Petty, 2006; Petty et al., in press). In their
review of studies published from 2005 and 2009, Bohner and Dickel (2011) are of this
view:
[T]there is no process-pure measurement paradigm and hence no one-to-one
correspondence between the type of measure and the type of representation or
process being assessed…To explain why correlations between implicit and
explicit attitude measures widely vary across studies …, researchers have
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emphasized the role of elaboration. The more the participants elaborated their
self-report answers, the less these answers corresponded to implicit
measures…Studies of attitude change that have used both explicit and implicit
measures produced mixed results… Some studies demonstrated parallel change
on both measures, whereas others showed implicit but not explicit attitude
change, or vice versa. This reflects on the questions of which processes underlie
changes on implicit and explicit attitude measures and of whether they are the
same or different (Bohner & Dickel, 2011, p. 396).
Greenwald, Poehlman, Uhlman and Banaji (2009) reported that, often the
outcome of using explicit or implicit measures have resulted in the same result about an
individual’s attitude, hence, the same behavioral results (cited in Petty et al., in press).
Explicit measures tend to predict deliberative more (thinking through an issue) and
implicit measures are better at predicting spontaneous behavior when both explicit and
implicit measures produce different attitudes (Dovidio et al., 2000, cited in Petty et al., in
press). “Generally, implicit and explicit measures each serve as independent predictors of
behavior above and beyond the other, suggesting that they both provide input into most
actions” (Greenwald, et al., 2009, cited in Petty et al., in press, p. 8).
Attitude change.
From a strictly constructionist point of view, attitude change must be
conceptualized as the variations between recurring instances of attitude formation while
the strictly memory based model will suggest that attitude change occurs when old
attitudes are replaced by new in the memories (Behner & Dickel, 2011). Considering
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these two views, Bohner and Dickel (2011) are of the view that “… attitude change
involves both retrieval of stored evaluations and the consideration of new evaluative
information to varying extent” (p. 397). There is a possible presence of dual attitude in
the memory-based conceptualization in that old memory might be stored while new ones
are created (Wilson, Hodges, & Lafleur, 1995). As noted by Bohner and Dickel (2011),
“context dependent variations in evaluative judgments may then depend on which of the
stored evaluations is more accessible in a given situation and on the individual’s
motivation and ability to reflect on his or her attitude” (p. 397). Wilson, Lindsey, and
Schooler (2000) assertion on dual memory was further elaborated by the work of Petty,
Tormala, Brinol and Jarvis (2006) who were of the view that old attitudes that a person
does not think of as suitable any more are ‘deemed’ in the memory as false, a model Petty
el al. (2006) refer to as “past attitudes are still past” (PAST) (cited in Bohner & Dickel,
2011). Petty et al., (2006), provided the case where after the delivery of a persuasive
message about the health complications associated with smoking, an individual may form
a negative attitude but the positive former attitude will still linger in the memory as
invalid (cited in Bohner & Dickel, 2011) (Figure 1).
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Before attitude change
SMOKING
GOOD
After attitude change
GOOD
NO
SMOKING
BAD
Figure 1: Dual Memory: Past attitudes are still past. “Attitude and attitude change” by G.
Bohner & N. Dickel, 2011, Annual Review of Psychology, 62, p. 397.
Therefore, in reference to the PAST model, attitude change could be characterized
as attitude formation in addition to labeling stored attitudes as valid or invalid (Bohner
and Dickel, 2011). According to Petty and Wegener (1998) a definite distinction
between attitude formations versus attitude change is not employed as a result of accrued
research proposes, that, it is beneficial to look at attitudes that are changed as falling
along a continuum extending from non-attitudes to strong attitudes. The following
statement further elaborates on attitude:
…, the factors involved in moving an individual with no attitude to adopt
a position favorable toward an advocacy are more similar to the factors
involved in making a person with a weak but existent attitude become
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more favorable toward the advocacy than to the factors involved in
making the same change in an individual with a strong initial attitude
(Petty & Wegener, 1998, p. 2).
Instructional design principles for attitude change.
The most suitable conceptual and definition for attitude remains a debate amongst
social psychologist (Bednar & Levie, 1993) however Bednar and Levie (1993) report that
a few of the more usually settled on the following characteristic associated with attitude:
a) attitude is a latent variable; b) attitudes have objects; c) attitude have a behavioral
component; d) attitude have a cognitive component, e) attitudes have affective
component, and f) attitude are relatively stable and enduring (Bednar & Levie, 1993).
Attitude as a latent variable.
According to Bednar and Levie (1993), “Attitudes, like many other constructs in
psychology, are not directly observable but are inferred from behavior” (p. 285). These
behaviors according to Bednar and Levie (1993) are manifested by a person’s verbal
statements or their observable actions. In other words, one’s readiness to respond in a
particular manner to a psychological object elicits attitude (Bednar & Levie, 1993).
Attitudes have objects.
Bednar and Levie (1993) indicate that “people have attitudes towards specific
referent as in art works and towards events or behaviors being arrested or painting with
oils” (p. 285).
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Attitudes have a behavioral component.
Bednar and Levie (1993) point out that “attitudes imply a predisposition to
behavior in an evaluative way. Maio and Haddock (2009) are of the view that the
behavioral component entails past behaviors with respect to an attitude object. Maio and
Haddaock (2009) referencing the work of Bem’s (1972) self-perception theory reported
that individuals do not always have access to their opinions about diverse objects, and
sometimes deduce their attitudes by thinking about how they behaved in relation to the
attitude objects in the past. Bednar and Levie further made these emphasizes on behavior
and attitude:
Both researchers and practitioners have found frequently that people’s attitudes
towards some class of objects fail to predict their behavior towards a member of
that class in a particular situation… any particular act is the product of a blend of
several personal predisposition and of the demands the particular situation places
upon the performer” (Bednar & Levie, 1993, p. 285).
Making reference to the work of Eagly and Chaiken (1993), Simonson and Maushak
(1996) made mention of a composite attitude-behavior in which they indicated that
“behavior is likely to be partially determined by attitudes, but that the relation between
attitudes and behavior is best understood by placing attitude in the context of other
factors that also help to determine behavior” (p. 994).
Attitudes have a cognitive component.
Maio and Haddock (2009) report that cognitive component encompasses beliefs,
thoughts and attributes that are linked with an object. They further indicated that “in
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many cases, a person’s attitude might be based primarily upon positive and negative
attributes they associate with an object” (p. 25). This statement is further buttressed by
Bednar and Levie (1993) who reported that “… attitudes are learned and people are born
with a set of attitude structure. However, it has often been observed that information
alone may not be sufficient to change attitude” (p. 285). This is supported by various
studies’ inability to find a correlation between people’s recall of the information in a
persuasive message and their agreement with the conclusions of the message (Bednar &
Levie, 1993). A reason cited by Bednar and Levie (1993) in which they referenced Insko,
Lind and LaTour (1976) is that “people’s retention from a persuasive message is not of
the information per se, but of their cognitive reactions that were aroused by the message”
(p. 285).
Attitudes have an affective component.
The affective component entails the feelings or emotion connected to an attitude
object. According to Bednar and Levie (1993), “an individual’s affective evaluation of an
object can vary in direction, either positive or negative; in degree… and in intensity, the
amount of commitment or involvement with which a particular position (direction and
degree) is held” (p. 285). This statement is further buttressed by Maio and Maddock
(2009) who are of the view that “affective responses influence attitudes in a number of
ways. A primary way in which feelings shape attitudes is through feelings that are
aroused in response to an attitude object” (p. 25).
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Attitudes are relatively stable and enduring.
Attitudes linger for a considerable period of time and are comparatively resilient
to change. According to Bednar and Levie (1993), “while, again, definitions vary widely,
it is on the dimension of durability that attitudes may be differentiated from opinion.
Opinions are more transitory and subject to change” (p. 285).
Cacioppo and Petty (1984) asserted that “resultant attitude is expected to be
relatively enduring since the thoughts and associations upon which it is derived are
central to the attitude object and, as a result of the issue-relevant thinking, the attitude is
an integrated part of the schema for the attitude object” (p. 673). The affective, cognitive
and behavior components are termed the multicomponent models of attitudes (Figure 2).
Behavioral Component
Cognitive Component
Attitude
Affective Component
Figure 2: The multicomponent Model of Attitude. “The psychology of attitude”. A. H.
Eagly & S. Chaiken, 1993, Fort Worth, TX: Harcourt.
Maio and Haddock (2009) provided this assertion on these three components,
“these components have a “synergistic relation”. When an individual possesses positive
beliefs about an attitude object, they typically have positive affections and behavioral
association with the object. Despite this synergism, the cognitive, affective and
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behavioral components are quantitatively and qualitatively distinct. Furthermore people
differ in the degree to which their attitudes are based on each of the cognitive, affective
and behavioral components” (p. 33).
Attitudes are not only made of, are closely related to, our opinions and beliefs and
experiences but they have the tendency to respond positively or negatively towards a
certain thing (idea, object, person, or situation) (Culatta, 2015, para. 1). As far as
instruction is concerned, a great deal of learning comprises acquiring or changing
attitudes (Culatta, 2015, para. 1). According to the Hovland, Janis, & Kelly (1953),
changes in opinions can lead to attitude change depending upon whether there are
rewards or not (cited in Culatta, 2015, para.2).
The learning of new attitudes is no different in nature than any other verbal or
motor skill, except that opinions relate to a single proposition whereas other skills
involve a series of propositions. The reception of a new opinion (and hence
attitude formation) is dependent upon the incentives that are offered in the
communication (Hovland et al., 1953, cited in Culatta, 2015, para. 2).
Instructional Design
According to Reiser and Dempsey (2002), “instructional design is a systematic
process that is employed to develop education and training programs a consistent and
reliable fashion. It is also a complex process that is creative, active, and iterative” (p. 11).
There are numerous models and theories of instruction like Gagne’s nine events of
instruction (Gagne, 1985), Keller’s ARC model (Keller, 1987) and Reigeluth’s
Elaboration Theory of Instruction (Reigeluth, 1992) just to mentions a few for designing
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or redesigning a course or training. Yet the imaginative process used by Instructional
Designers, is centered on improving learning and usually at all times comprises the
following:
1. Assessing overall curriculum needs
2. Analyzing learners background knowledge and instructional needs
3. Determining course goals
4. Determining course objectives and the sequence in which to address them
5. Developing and implementing instructional content, teaching strategies, and
assessments
6. Conducting formative and summative course evaluations (Reiser & Dempsey,
2007, p. 13).
Merrill’s first principles of instruction and levels of instructional strategy.
Merrill’s work is based on a set of principles on which a number of design
theories and models are in essential agreement (Merrill, 2013). Merrill (2013) laments on
the fact that whiles these principles are not new, seldom are they implemented.
First principles of instruction.
According to Merrill (2013), several present instructional theories and models
propose that the most effective learning environments are one’s that are problem-centered
and include learners in four discrete phases of learning namely:
1. Problem-centered principle – learning is promoted when learners acquire
skills in the context of real-world problems.
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2. Activation principle – learning is promoted when learners activate or recall
existing knowledge and skill as a foundation for new skills.
3. Demonstration principle – learning is promoted when learners observe a
demonstration of the skill to be learned.
4. Application principle – learning is promoted when learners apply their newly
acquired skill to solve problems.
5. Integration principle – learning is promoted when learners reflect on, discuss,
and defend their newly acquired skill (Merrill, 2013, p. 44).
While instructional designs emphasizes problem-centered and employs some or all of the
principles, too much instructional practice concentrates primarily on demonstration phase
and ignores the other phases in this cycle of learning (Merrill, 2013). Summary of the
interrelationship between problem-centered and the principles are provided in Figure 3.
INTGREATION
ACTIVATION
PROBLEMCENTERED
APPLICATION
DEMONSTRATION
Figure 3: First Principle of Instruction. “First Principle of Instruction”. M. D. Merrill,
2013. Identifying and designing effective, efficient, and engaging instruction. San
Francisco, CA: Pfeiffer, p. 22.
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The successful application of these First Principles of Instruction defines
increasingly effective levels of instructional strategy. Application of the
demonstration principle represents the first level of effectiveness, including
application principle defines the second level, and including the problem-centered
principles defines the third level. Adding the activation principle and the
integration principle adds additional effectiveness enhancements to the instruction
(Merrill, 2013, p. 22).
Levels of instructional strategy.
Merrill (2013) mention of three strategies that work in hand for an effective
design.
Information Level (Level 0)
According to Merrill (2013), this level may include PowerPoint, music, audio,
graphics or animation. While the assumption is that this strategy may result to
understanding information and remember more information, and use this information
solve complex problem, it is not fed with too many information always the case as
learners are dump with information which is subjected to forgetting and are ineffective in
performance on complex problems (Merrill, 2013). For the purpose of this training, care
will be taken not give bulk promoting information.
Demonstration (Level 1)
This uses both information and demonstration strategies in that, learners are
taught what to do to be able to apply the information (Merrill, 2013). According to
Merrill (2013), extra learning can only take place when the demonstration is consistent
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with the type of skill being taught. For an effective demonstration to be consistent with
the kind of problem, there should be information with respect to the whole for parts (partof), give examples of the various categories of the concepts (Kind-of), showing the
execution of the steps together with the consequences for a procedure (how-to) and
illustrating a specific process by showing the portrayal of the conditions and
consequences (what-happens (Merrill, 2013). For a learner to be able to associate the
relationship between the information and demonstration, that learner requires guidance to
be able to relate to certain instances (Merrill, 2013). According Merrill (2013),
multimedia should not be used merely to promote interest but rather use it to implements
prescribed instructional events and functions.
Application (Level 2)
This level incorporates application, information and demonstration strategies
together (Merrill, 2013). The application process involves the use acquired skills and
knowledge to complete a specific problems in that consistent application for kind-of
problems is to sort examples into appropriate categories, for a how-to problems, it is to
execute a series of steps and for a what-happens problems, it is to predict a consequence
given a set of conditions or find faulted conditions given an unexpected consequence
(Merrill, 2013). This level is made effective if the acquired knowledge and skill are
consistent with the type of content being taught, learners receiving intrinsic or corrective
feedback, and are coached while the coaching is gradually withdrawn for each
subsequent problem (Merrill, 2013).
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Problem-centered (Level 3)
The level 3 instructional strategy involves the addition of the problem-centered to
demonstration and application (Merrill, 2013). The essence of this level is to have
learners acquire knowledge and skill in the context of real-world problems (Merrill,
2013). This level is made effective when component skills are taught in the context of a
simple-complex progression of the whole real-world problems, a mental activation of
learners prior knowledge and skill as a formation for new skill through recall to structure
the new knowledge through guidance during demonstration, coaching during application,
and reflection during integration, by discussion and defending their newly acquired
knowledge and skill through peer-collaboration and peer-critique (Merrill, 2013).
According to Merrill (2013), different kinds of skills are vital to solve a problem
and each kind of component skill requires a different content element. The five primary
types of component skill are provided in table 4.
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Table 4
Content Information and Portrayal Elements
Information
Portrayal
Information about (verbal
information)
Facts, association
NA
Part-of (verbal
information)
Name, description
Location of the parts with
regard to specific whole
Kind-of (concept)
Definition – list of property Instances – specific
values
examples and nonexamples that illustrate
property values
How-to (procedure)
Steps and sequences
Portrayal of a specific
example of the procedure
What-happens (process)
Conditions and
Portrayal of specific
consequence
example of the process
“First Principle of Instruction”. M. D. Merrill, 2013. Identifying and designing effective,
efficient, and engaging instruction, p. 49. San Francisco, CA: Pfeiffer
Online Education
The contribution of online education (a form of modern distance education) to
society cannot be overstated. Since its inception in the early 70s (Lau, 2000 cited in
Desai, Hart & Richards, 2008) and despite the limitations (Guernsey, 2001 cited in Desai,
Hart & Richards, 2008) online education has come a long way by encompassing
collaborative learning approaches (conferencing, chats and assessment tools) in achieving
the current successes (Desai, Hart & Richards, 2008). Advances in technologies and the
prominence of the internet has resulted in the expansion and successes of online
education (Leran.org, 2015). Compared with the traditional learning method that employs
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only synchronous communication during learning, online education employs both
synchronous and asynchronous communication (Desai, Hart & Richards, 2008).
According to Hrastinski, (2008) synchronous is a key feature for flexible online learning
and as such may people take online class as a result of its asynchronous environment
which suits combining learning with work, family and other obligations.
While e-learning have many benefits (independent of time and open environment)
it is not without limitations and challenges (dedication, discipline, communication
breakdowns and technical difficulties) (Desai et al., 2008). Desai and colleagues (2008)
are of the view that with advances in technologies these limitations could disappear
resulting e-learning have a competitive edge over the traditional learning. The absence of
guidance and interaction can result in failures in e-learning (Desai, et al., 2008).
According to Desai et al., (2008), in the absence of a physical setting in an e-learning
environment, guidance and interaction are vital in creating a sense of community for a
learner. Two types of interaction (interaction with content and interpersonal interaction)
are critical in e-leaning (Berge, 1995). According to Berge (1995), a successful online
tutoring requires the following conditions: pedagogical, social, managerial and technical.
While these four roles are vital to the success of e-learning, rarely are they undertaken by
one person (Berge, 1995).
Michinov, Brunot, Le Bohec, Juhel, and Delaval, (2011) are of the view that due
to the capability of delivering instruction remotely, online learning is a means of
providing education to the people who could not access it otherwise due to problems
associated with time and space. Allen and Seaman (2013) reports that the number of
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students enrolled for at least one online course increased from 29.2% in fall 2010 to
32.0% in fall 2011 however this growth rate was .1 percent lesser than the previous year.
Online learning overcomes the geographic borders and individuals across can benefit
from them, this can also mean an increased number of students for programs that are not
doing well in the face to face format (Appana, 2008). Appana (2008) reported that online
learning provides additional opportunities to individuals who cannot take time off from
their or other relevant responsibilities to attend regular school. There have been a number
of studies on the effectiveness of online learning as compared to traditional learning
(Schwartz, 2012; Summers, Waigandt & Whittaker, 2005; Neuhauser). Schwartz (2012)
in his study in an accounting course found that the students in the online class did not
perform as well as the traditional students. Summers, et al., (2005) found no significant
difference in students’ performance of the online and traditional format and Neuhauser
(2010) while studying the difference in students’ performance in online and traditional
format (same course, but two sections) did not find any significant difference in the
students’ grades in the two sections. However there have been studies which report that
though there is not significant difference between online and face to face learning, still
learning in an online environment is comparatively better than the face to face to face
environment (Barbour, McLaren, & Zhang , 2012; Guri-Rosenblit, 2009). Barbour et al.,
(2012) study with secondary school students about online learning found that though the
students faced some problems with technology, their overall view of the online
experience was positive.
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While continue to make progress on the role and effect on online education,
results from this study will only not add to the literature on current trends on online
education but also throw more light the application of online education on nutritional
attitude change.
Summary
The role that a messages’ credulity and content play in attitude change cannot be
overstated. This has been evident in the field health promotion (Mayor & Coleman,
2012), marketing (Kelly &Rupert, 2009) and even politics (Teven, 2008). Other than a
face-to-face or on-site method to help minimize overweight or obesity to promote better
lifestyle habits, employing digital technology or computer-based method in minimizing
overweight or obesity to promote better lifestyle habits has gained face over the years
(Eastin, 2001) with some huge successes in changing relevant health-related behaviors
(Brug, Campbell, & Van Assema, 1999; Brug, Hospers, & Kok,(1997). Digital
technology has its own competitive edge over the on-site interventions despite debates on
its efficacy on interventions and counselling to promote better lifestyle continues (Miles,
Petrie, & Steel, 2000; Tate, Wing, & Winett, 2001). Message framing includes the
persuasive element of probability or risk of attaining or not attaining results linked with
the advocated behavior (Aldridge, 2006, p. 2). A message’s frame may impact the
listener’s perceptions and choices in a way that its affective appeal cannot since framing
brings into play how people assess risk to make decisions (Aldridge, 2006, p. 2). While
very little evidence exists in nutrition education research to support framing effects on
perceptions, attitudes, intentions, or behavior (Aldridge, 2006, p. 8), findings from this
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study will not only provided insight into instructional design and curricula development
in nutrition education but will be vital in addressing the above limitation. Pertaining this
study, the attitude change was determined explicitly as the study was conducted online
and as measures cannot be taken for participants to respond spontaneously to study
material. Also the researcher wanted the participants of this study to elaborate on the
materials presented for this study before they respond to the study questionnaire. It will
be interesting to find out how central and peripheral routes are employed by participants
in this study to achieve attitude change as some studies (McCroskey & Young, 1981;
McCrosskey & Teven, 1999) have used human credibility to achieve attitude change as
compared to this study employing message credibility. Finally, knowing what
combination of factors such one-sided argument (only emotive or logic message) versus
two-sided argument (Combination of emotive and logic messages) can have a positive
attitude change will add to nutrition education’s curricula and instruction literature.
This chapter presented a review of the literature for the research. The chapter
began with an overview of the following: a) Persuasion, designing persuasive messages
and argumentation as an instructional variable; b) Health and Culture; c) Contributors of
Obesity; d) Technology and Nutrition Intervention and Counseling; e) Attitudes; f)
Instructional Design and; Online education. Persuasion, designing persuasive messages
and argumentation as an instructional variable addressed the elaboration likelihood model
of persuasion, tools of persuasion, message source, and message content. Health and
culture provided literature on the role culture plays in societal decision making.
Contributors to obesity discussed some of the leading causes of obesity, the high rate of
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obesity in the United States, and health implications of obesity and overweight.
Technology and nutrition intervention and counseling provided further elaboration on the
current trends and successes in using technology (computers and internet) for nutrition
intervention and counseling in relation to on-site interventions and counseling. Attitudes
addressed the definition and conceptualization of attitude, measurement of attitude and
attitude change. instructional design principles for attitude change will addressed attitude
as a latent variable, objects, affective component, behavioral component, cognitive
component and, relatively stable and enduring. The instructional design section discussed
Merrill’s First Principles of Instruction and Levels of Instructional Strategy as these
principles and strategy were employed during the five weeks class among the research
participants and finally there were some discussion on online education.
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Chapter 3: Methodology
This chapter discussed the research questions and what was done to attain it. The
research design was presented and well as the program in which the participants were
enrolled was discussed. The research instrument and procedures was also discussed.
Details of the pilot study was addressed as well.
The Research Questions
The research questions of this study are:
1. Does knowledge of a communicator’s expertise correlate with learner’s
attitude change?
Developed messages (to determine credibility) and attitude change questionnaire
will be used to answer this research questions. Both the credibility items (Appendix B,
chosen from Eisend, 2006, p.10) and questionnaire (Appendix C) data sources were
delivered and obtained online. Messages developed were assigned to three randomly
assigned groups. Groups were randomly assigned to treatments that is, messages made up
of emotions were assigned to group 1, those made up of logic were assigned to group 2
and finally messages comprising a combination of emotion and logic were assigned to
group 3. Two messages (2 emotion messages, 2 logic messages and 2 combination of
emotion and logic messages) were made available per week to their respective tab group
for students’ response. All the messages were based on the curriculum developed and
taught in the Introduction to Nutrition class. The 7 items to be rated on the 1 to 10 scale
were chosen because they best fit nutrition related issues. The 1 to 10 scale was chosen in
order to increase the net variability and the likelihood of detecting an effect (Light,
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Singer & Willett, 1990). After reading each message the participant was required to
respond to 8 items. Of the 8 items 7 was based on a rating a particular message on a scale
of 1 to 10. The eighth item is an open-ended question to elicit participants’ personal
responses to see if participants made mention of message based on the work Eisend
(2006) credibility items. The second data source were obtained from a questionnaire
which was based on retrospective pre-test design. Participants were asked to initially
report their ability due to the outcome of the program (post-test) and then at the same
time to recollect the commencement of the program and compare it with where they are
now (then-test). Both instruments’ reliability and validation were conducted through a
pilot study. (Details in the later part of this chapter) All groups will respond to the same
questionnaire. With the questionnaire participants will be asked to initially report their
ability due to the outcome of the program (post-test) and then immediately after which
they responded to the same questions only this time, they recollect how their thoughts
before the commencement of the program and compare it with where they are now (thentest). All groups responded to the same questionnaire. Table 5 summarizes the research
questions with their respective instrumentations
2. Does fairness, as defined by a two-sided argument versus a one sided
argument, correlate with attitude change?
To answer the above research question the same method was employed as in the case of
research question 1. A regressions analysis from all the three groups were correlated with
the gained in attitudinal change from the retrospective pre-test to determine this research
questions.
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3. Which message of persuasion has the most impact on attitude change?
To answer the above research question the same method was employed as in the case of
research question 1. Analysis from all the three groups were compared to the gained in
attitudinal change from the retrospective pre-test to determine this research questions.
4. What combination of factors best explains a significant portion of the
attitudinal change as measured by the predictors (tools of persuasion and the
demographic characteristics such as gender, age, etc.).
This research question was answered using the method as stated in research question 1.
The characteristics of a source (that’s the expertise, trustworthiness, or credibility
of an individual providing a message) coupled with the ability to use words or messages
to convince whoever is receiving the information is vital if the aim of the source is to
change the attitude of the receiver of the information (McGuire, 1990). Persuasive
communication is reported to have been found by researchers in the laboratory to yield
attitude and/or behavior change (Burn & Oskamp, 2006). Issue involvement has been
reported to increase an individual’s motivation to process a persuasive message (Petty &
Cacioppo, 1981). Hence, reiterating the importance of issue involvement, characteristics
of the source providing the message and a well-developed persuasive message during
persuasion.
The Research Design
The characteristics of message credibility was based on expertise and
trustworthiness. Trustworthiness may contribute to high source credibility and expertise
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is commonly the most significant component of high source credibility (Bednar & Levie,
1993).
Participants for this study were recruited from an online class which is developed
by a Midwestern University. The online course was an Introduction to Nutrition. The
course site was located in the Blackboard Learning Management System of the large
Midwestern University. Participants were recruited (Appendix A) through the Instructor
of Record for Introduction to Nutrition course. For the purposes of this study activities to
be performed by participants for data collection was offered as an extra credit activity. It
was offered as an extra credit to promote students’ participation. Students were prompted
to send an email to the Instructor of Record if they wish not to have their class responses
used as data for the research purposes or participate in the exercise. This was to enable
the Instructor of Record to provide a different exercise for extra credit. The course is
offered during fall and winter semesters, and summer (summer 1 and 2). For the purposes
of this study the research was conducted during the summer 1 session. The course was a
five weeks program which entailed two exams, two assignments and ten discussion board
posting. Students responded to two discussion messages per week.
Two research instruments were used for data collection. The first instrument was
for participants to read nutrition messages and rate the messages based on 7 items on a
scale of 1 to 10 and an open-ended question, and the second was a survey instrument
(made up of three parts) which employed the retrospective pre-test method which was
based on Likert scale (four scale).
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Participants were randomly assigned to three groups after enrolling for the class.
For the purposes of this study, three tabs will be created in the Introduction to Nutrition
course site as an extra credit exercise. The three tabs were named as group 1, 2 and 3.
Thirty messages (Appendix B) were created in total for the purposes of this study. Ten of
these messages comprised of emotion, 10 made up of logic and the final 10 made up of a
combination of emotion and logic messages. All 10 messages per group were derived
from the course module, government websites and articles. The researcher determined
which message was deemed emotional or logic. This study was based on 10 messages per
group because the Introduction to Nutrition course was developed on 10 modules.
Secondly, the researcher was of the view that these 10 developed modules addresses
virtually all issues related with nutrition and good health. Figure 3 illustrates the
procedure.
The open-ended question was analyzed to look for credibility themes such as
informing the researcher that the messages would have been more credible if references
were provided after each message. The themes coded were based on the participants
using the six items chosen from the work of Eisend (2006) which were indicative of
credibility in the researcher’s view.
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3 group tabs
10 emotive
messages
10 logical
messages
10 emotive +
logical
messages
2 links per
Week
2 links per
week
2 links per
week
Questionnaire
on week 5
Questionnaire
on Week 5
Questionnaire
on week 5
Figure 4: Procedure for delivering the messages to participants
The messages with their respective response items will be situated at the large
Midwestern University Qualtrics websites (Version – 3092224). The messages were
made available for the participants by providing the link to each message to their
respective tab group for participation. After the completion of the 10th and final message
rating, participants were required to complete a questionnaire (Appendix C). The link to
the questionnaire was situated at the large Midwestern University Qualtrics websites
(Version – 3092224). The questionnaire was the same for all 3 group participants but the
links to the questionnaire were different for each group to maintain data independence.
Upon completion of the 10 messages with their corresponding rating scale of 7
items and open-ended question, and questionnaire, 10 points were awarded to participants
as an extra credit. However, commensurate points were also awarded if a participant
chooses to discontinue the exercise. For example, points were awarded depending on
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count of completed exercises that is, if 3 messages and their corresponding scale rating
items are completed and a participant chooses not to continue with the exercise, 3 points
were awarded.
Prior to the collection of data, Institutional Review Board (IRB) (Appendix E)
requirements was sent for approval.
Operational definitions of variables.
Based on this research purposes, the following independent and dependent
variables were identified:
Independent variables.
Total score of the messages and the six item rating scales: Types of messages: 1.
Emotion, 2. Logic, 3. Combination of emotion and logic, and Demographic information.
Dependent variable.
Total score of retrospective pre-test (questionnaire part II and III): Attitude change.
The setting.
The research was conducted through a course site located in the Blackboard
Learning Management System at a large Midwestern University. The university was
commissioned in 1804. Under the new 2010 Carnegie Foundation for the Advancement
of Teaching classifications, the University was nominated a Research University under
the Basic Classification category. In 2013 almost 22,660 students enrolled at the
University’s main campus, (about 28,790 including eLearning) and almost 10,075
students enrolled at the University’s regional campuses (5 Campuses) bringing the total
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enrollment for a large Midwestern University to over 28,000. Added to the above facts
the University has:
1. More than 33,000 undergraduate students
2. More than 6,000 eLearning students
3. More than 3,000 eLearning undergraduate
4. More than 280 majors
5. About 1,100 full-time faculty, almost a1,000 part-time faculty and 5, 000 total
employees
6. 20:1 student to faculty ratio at the main campus in Fall 2013
7. Almost 2, 000 students from other country (Office of Institutional Research,
2014).
The above information was provided to inform the nature of the large the Midwestern
University.
Participants for this study were recruited from an online class, which was
developed by the Midwestern University College. The online course was Introduction to
Nutrition.
Population of the Study.
The population of this study were undergraduate students in a Midwestern
University from which the accessible convenient group from which a sample will be
drawn. There were 7,856 undergraduate students in the College of large Midwestern
University from which the sample were drawn. The College offers undergraduate and
graduate as well.
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Sampling and research sample.
The importance of a sample lies in the fact that when researchers select a sample
from a clearly specified target population employing probability sampling methods, the
researchers can be reasonably certain, within the limits of sample variation, that what
they find can be generalized (Light, Singer & Willett, 1990). Employing this strategy has
been employed in nearly all social and behavioral science researches (Aron & Aron,
2002). Sample size that is, the number of individuals needed in a research in order to
minimize Type II error is termed statistical power. According to Light at al. (1990)
“statistical power is one minus the probability of a Type II error, and it is the probability
that you will detect an effect that is really there” (p. 191). By increasing power, you
minimize the chances of making a Type II error and increase the chances of finding a real
effect (Light et al., 1990). Although the debate still remains with respect to how much
power a researcher should adopt when planning a study, it is reported that researchers
should design their study to have at least moderate power between .70 and .90 (Light et
al., 1990).
Students enrolled in an online Introduction to Nutrition class, were surveyed. The
Introduction to Nutrition class is organized by a large Midwestern University. Majority
of the students enrolled in this class were students seeking the Bachelor of Science in
Nursing (BSN) degree or registered nurses seeking BSN degree, and other Bachelor
completing students (Other students from other departments and schools in the large
Midwestern University and other Universities who also enroll in this class).
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Sample size selection.
While pilot studies are instrumental in selection the number of participants
through the pilot study’s effect size, number of predictors, chosen a prior alpha and
statistical power, this was not the case with this study. The number of participants to be
employed for this study was dependent on the number of students enrolled in the
Introduction to Nutrition class and the willingness of students to consent to their extra
credit exercise been used for data source. In this case if the number of students was
computed and the research team did not get the computed number as a result of low
student’s enrollment, that puts a dent on the research. For this purposes of this research
the pilot study was conducted so as to validate the research instrument that is, to
determine if the instruments weree able to measure what it is intended to measure.
The Online Introduction to Nutrition Program
The online Introduction to Nutrition program was one of the courses developed
by a large Midwestern University. The course was a five weeks program which entailed
two exams, two assignments and ten discussion board responses. The total available point
for the course was 600. Both exams were 200 points each, one assignment was 100 points
and the second one 50 points, and the ten discussion board responses 50 points (5 points
for each response)
Researcher’s abilities and experience.
Researcher’s abilities and experience of the years are provided below in terms of
education and as facilitator over the years.
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Education.
The researcher has an undergraduate degree in Home Economics with a major in
Food and Nutrition and Minor in Psychology. During his undergraduate years, he
undertook a couple fund raising activities to help educate farming communities about
good health practices, in terms of good nutrition and family planning. The researcher
obtained his graduate degrees in Human Resource Management and, Food and Nutrition.
While pursuing the degree in Human Resource Management, the researcher was a branch
Manager for a Group of hotels as well as the Food and Beverages training Officer for the
group of Hotels. In this capacity, the researcher was only responsible for helping develop
healthy Hotels’ menu but also foresaw the recruitment of the Hotels’ Food and Beverages
(Including Kitchen) staff. The researcher’s graduate degree in Food and Nutrition placed
emphases on Community Nutrition where he conducted researches in Food security
(Food access) among HIV/AIDS individuals. The researcher has published articles to this
effect in relation to utility security and depression. The researcher is currently working on
another article in collaboration with other authors to determine the association between
food security and physical activities among HIV/AIDS individuals.
Due to the researcher’s interest in propagating healthy eating habits, he is
currently enrolled in a Doctoral program in Instructional Technology (Curriculum and
Instruction) so as to have knowledge and experience to design better curricula and
instruction to help improve better eating habits. The researcher has undertaken a number
of courses in instructional design, learning theories, and as well as diverse research
methods.
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As a graduate student during the researcher’s degree in Food and Nutrition, the
researcher was employed as an Instructor for a food science lab (2009-2011) as well as
for a food preparation lab (2012-2015) for a large Midwestern University.
Researcher as a facilitator.
The researcher has been a facilitator for the Introduction to Nutrition Class for the
past 6 year and has facilitated more 600 students over this period in the large Midwestern
University. Facilitators in the Introduction to Nutrition Class are considered part-time
teachers by the large Midwestern University. The part-time teachers see to the smooth
running of the class or assist the instructor of records for the Introduction to Nutrition
class. The facilitators are judged by the large Midwestern University’s Office of Online
Classes by going through a training module on the following criteria:
a) Facilitators in the online arena are generally considered to be ‘clinical’. That
is, they have a broad base of life experiences in addition to academic
credentials.
b) The personality of the facilitator should demonstrate the characteristics of
openness, concern, flexibility, and sincerity.
c) A successful online facilitator should feel comfortable communicating in
writing.
d) The person should be able to accept the value of facilitated learning as equal
to the traditional model.
e) The person should be able to subscribe to the value of introducing critical
thinking into the learning process.
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f) They should have the appropriate credentials to teach the subject matter.
g) They should be experienced and well trained in online learning experience.
Facilitators also have the following responsibility:
a) The students should expect that the facilitator would create a learning
environment that utilizes life, work, and educational experiences as key
elements in the learning process in order to make it meaningful.
b) The facilitator should be able to present the curriculum in a manner that
allows the student to easily translate theories into applications.
c) The students should be given the proper tools to transcribe theory into
practice.
d) Every student should be given every opportunity to improve until the learning
experience comes to an end.
e) Reasonable accommodations for the students' needs and desires should be
made.
f) The facilitator should solicit feedback from the students and listen throughout
the entire process.
g) The facilitator should be concerned about the students' success.
h) The facilitator should keep students aware of where they stand with respect to
the course evaluation process on a regular basis (i.e. weekly updates of what
has been turned in and what is missing).
i) The facilitator should give the student timely and quality feedback on student
contributions to discussion, homework, and quizzes.
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j) The student should expect little or no lecturing. Lecturing yields marginal
results in the online environment.
k) The student should not be subjected to tests requiring memorization. Case
analysis would be more appropriate.
l) The student should be treated politely and with respect.
m) The facilitator should be online everyday (at a minimum 5 of 7 days). (Office of
Online Classes, 2014).
Research Instrument and Procedure
Data was collected in two ways (Appendixes B & C). The retrospective pre-test
design was used for one part of data collection. It is reported that to control responseshift bias, it is appropriate to employ the retrospective pre-test method design when
conducting a self-report measure of change (Drennan & Hyde, 2008). The difference
between the retrospective pre-test and the traditional pre-test-post-test is that with the
retrospective pre-test, both post-test and pre-test insights of respondents are gathered at
the same time (Drennan & Hude, 2008; Howard, 1980). The retrospective pre-test has the
advantage over the traditional pre-test-post-test in that in takes care of the response-shift
bias, a mismatch between the traditional pre-test and post-test scores of a research study
(Drennan & Hyde, 2008). According to Drennan and Hyde (2008), “response-shift bias
calls into question the internal validity of measurements taken using traditional pre-testpost-test design” (p. 700).
The retrospective pre-test design requests the respondent to initially report his/her
ability due to an outcome of the program (post-test) and then at the same time to recollect
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the commencement of the program and compare it with where he/she is now (then-test)
(Drennan & Hyde, 2008; Howard, 1980). It is reported that “the collection of then-test
and post-test ratings at the same time leads to the reduction of response-shift bias due to
the fact that the respondent is making the ratings from the same internal frame of
reference” (Drennan & Hyde, 2008, p. 701) This method of data collection has been
employed in various studies (Goedhart & Hoogstraten, 1992; Rohs, 2002; Townsend &
Wilton, 2003; Umble, Upshaw, Orton, & Kelly, 2000), including public health education
programs (Farel, Umble & Polhamus, 2001; Umble et al., 2000).
In a study to measure students’ self-reports of change in their ability to both
understand and use research in their professional practice but also to test whether
a response shift had occurred in students’ concept of research ability following
exposure to a research module, it was reported that the retrospective pre-test
(then-test) design identified that the research module had more impact on research
ability than when evaluated using the traditional pre-test – post-test design only.
The authors concluded that the traditional pre-test–post-test method would have
led to an underestimation of the impact of the research module on student
outcomes and was found to be a lesser indicator of change (Drennan & Hyde,
2008, pp. 701, 703-704).
The instrument will be designed specifically for the Introduction to Nutrition class and
will be adapted from works of Howard (1980), and Drennan and Hyde (2008). The six
credibility items were chosen from Eisend (2006) list who analyzed the previously rather
vague structure of the concept of source credibility to generalize measurements of
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previous studies and examined whether a universal conceptualization of credibility for
diverse sources in marketing communication existed. Eisend (2006) developed a list of
64 items associated with credibility based on 36 studies that examined and in most cases
proved the persuasive impact of source credibility. The bulk of these studies created the
items through an appraisal of literature from marketing and beyond, culminating into a
rather broad domain of relevant items (Eisend 2006). The six items were chosen from the
list because they are more related to nutrition and this study. The items were adapted by
incorporating the items in a sentence to have participants rate the message based on these
six items. The sentences were validated through a pilot study (see pilot study) to see if
they will measure what they were intended to measure.
The messages made up of emotion were assigned to tab group 1, messages made
up of logic were assigned to tab group 2 and finally messages comprising of combination
of emotion and logic was assigned to tab group 3. All the messages were be based on the
topics or modules taught for the week, articles and government documents. The messages
presented for rating were reviewed by the Instructor of Record for the class for the
Introduction to Nutrition class to validate that message contents are in accordance with
the class modules. The second data collection was through questionnaire through the
retrospective pre-test design. With this design, participants will be first asked to respond
on how they perceive themselves at current (Post) (Appendix C, Part II). Instantly after
responding to each item on this manner, they were asked to provide answer to the same
item again, this time in allusion to how they perceive themselves before they started the
Introduction to Nutrition course (Then) (Appendix C, Part III). Subjects were informed to
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make the Then response in relation to the corresponding Post response to make sure that
both responses were reported based on the same perspective. Each set of ratings was
scored separately, thus yielding a Post score and a Then score. Response ratings was
based on Likert-like scale: ‘Strongly agree’, ‘Agree’, ‘Strongly disagree’, and ‘Disagree’.
In order to create a balanced keying that is, equal number of positive and negative
statement no neutral response was added to the Likert scale. Participants were prompted
to sign an online consent form (Appendix D) for their responses to be used as a data
source for the purposes of this study. Table 5 summarizes the research objectives with
their corresponding instrumentation.
Data Analysis
Questionnaire will be scored using the Statistical Program for the Social Sciences
(SPSS) version 18.0. SPSS will be used for analysis of the data. A p-value <.05 will be
utilized to identify statistical significance. Table 4 summarizes the analysis.
Result of Pilot Study
A pilot study was conducted among 14 students from the College of Education
and one student form the College of Business in order to check the survey items for
errors, confirm that the instrument was clearly understood by participants, and test the
researcher’s ability to reach participants. The importance of conducting a pilot study
cannot be overstated. This is reiterated by Light et al., (199) who asserted that “the time
spent creating good instruments and ensuring variability in true scores across people in
the sample has an exceptionally high payoff” (p. 171).
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Table 5
Research Objectives of the Study and Research Instruments Used for Data Collection
Research Instrument
Research Objectives
1. To determine if message credibility
 Research Instrument 1: Messages
as measured as by attitudinal change
Seven items scale
questionnaire is correlated with
 Research Instrument 2:
emotive messages, logic messages or a
Questionnaire
combination of the two messages
Part I: Academic and demographic
information.
Part II: Participants evaluation of how
they perceive themselves at the current
time.
Part III: Participants evaluation of how
they perceive themselves before the
commencement of class.
2. To determine if attitudinal change
questionnaire is correlated to a oneside message or two-sided message.
 Research Instrument 1: Messages
Seven item scale
 Research Instrument 2:
Questionnaire
Part II: Participants evaluation of how
they perceive themselves at the current
time.
Part III: Participants evaluation of how
they perceive themselves before the
commencement of class.
3. To determine which method of
persuasion (emotive messages, logic
messages and a combination of the
two) have the most gain effect on
participants as measured by attitudinal
change questionnaires.
 Research Instrument 1: Message
Seven item scale
 Research Instrument 2:
Questionnaire
Part II: Participants evaluation of how
they perceive themselves at the current
time.
Part III: Participants evaluation of how
they perceive themselves before the
commencement of class.
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Table 5 cont.
Research Objectives
Research Instrument
4. What combination of factors best
explains a significant portion of the
attitudinal change as measured by the
predictors (method of persuasion and
the demographic characteristics such
as gender, age, etc.).
 Research Instrument 1: Messages
Seven items scale
 Research Instrument 2:
Questionnaire
Part I: Academic and demographic
information.
Part II: Participants evaluation of how
they perceive themselves at the current
time
Part III: Participants evaluation of how
they perceive themselves before the
commencement of class
A sample for the pilot study was undergraduate students in Introduction to Food
Preparation: RHT 2990 course in spring 2015. The pilot study was conducted in a large
Midwestern University in spring 2015. A test course site was developed on the large
Midwestern University’s learning management system. All the developed instruments
were situated in the developed course site. The researcher was a Teaching Assistant in the
RHT 2990 class. Students in the class enrolled into the developed course site and an extra
credit (5 points) was awarded to participants. A total of 15 responses were received and
analyzed. The response rate of the pilot study was 100 percent. The researcher believes
the perfect response rate was a result of the researcher’s interacts with students in the
RHT 2990 class once a week.
The pilot questionnaire was distributed among three experts to judge if the items
were stated correctly, the language used is appropriate and the items relate to each
component. Recommendations from the experts were used to amend the instrument
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before piloting. The outcome of the pilot study provided very useful information that
influenced how the main study was conducted (Appendix F, Table 33 and 34). Tables 33
and 34 of Appendix F summarize the group and individual gain as measured by the
attitude change. Group 2 and 3 both had two cases that had negative gain which group 1
having one negative gain. Individually, there were 4 negative gains and 1 no gain.
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Table 6
Research Objectives and Statistical Analyses
Research Objectives
Statistical Analyses
1. To determine the extent that source
credibility has on participants as
measured by the attitudinal change
questionnaire.
A retrospective post then pretest will be
used to examine the change in attitudinal
score of the participants. At the
completion of the course they will fill out
the questionnaire. Individual means and
standard deviations will be calculated for
each individual question and for the
overall scale score for both the pre and
post. Change scores will be calculated
between the post then pre scores.
2. To determine whether a two-sided
argument versus a one sided argument
results in the largest change in attitude
among the participants.
Data gathered from the one sided versus
two-sided argument will be analyzed to
determine if the difference score between
the two arguments are statistically
significantly different. A paired t-test will
be used to analyze the data.
3. To determine which tools of
persuasion have the most effect on
attitudinal change among the
participants
This objective will be accomplished
through the analysis of a paired t-test.
The tools of persuasion are the
independent variables and the attitudinal
change is the dependent variable
4. To determine if a model exists which
would explain a significant portion of
the variance of attitudinal change as
measured by the tool of persuasion
and the demographic characteristics
such as gender, age, etc.
This objective will be accomplished
through a multiple regression analysis.
Demographic variables will be entered
stepwise into the equation owing to the
exploratory nature of the study along with
the tools of persuasion.
However there were some positive changes among 10 individuals. On the overall
eating habits as a result of the course based on the Likert scale, whiles 8 and 5
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participants agree and strongly agree respectively, 2 participants disagree with that notion
(See Appendix F, Table 35).
While the overall gain as measured by the attitude change questionnaire was not
significant (p = 0.116), there was a noticeable change between the post-test (Mean =
2.29) and pre-test (Mean = 2.69). The piloting was conducted for only a week and
participants might have been overloaded with the piloting exercise and their individual
classwork. This might have led to rush through the piloting exercise without putting
much thought into the messages. This might have a counted for the non-significance of
the gain as measured by the attitude change questionnaire. The intended population for
the main study was undergraduate students in the large Midwestern University and 93
percent of the piloted population were students from the University’s College of
Education. This difference resulted in an interesting main study. The open-ended
questions revealed some insight into the thoughts of the participants (Appendix F, Table
37). Even though only 40 percent of the participants responded to this question some of
the words indicative of credibility were stated by the participants, thus indicating the
importance of message credibility in attitude change.
As important as the role of pilot study plays in influencing the selection of sample
size, for the main study, the researcher is making reference to the fact that the purpose of
the pilot study was to validate the research instruments as in whether they measured what
they were intended to measure. From the researcher’s point of view, despite the gain not
being significant, the research instruments measured what they were intended to measure.
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Validity and reliability of the data.
Validity issues.
Validity is an integrated evaluative judgment of the degree to which theoretical
rationales and empirical evidence support the adequacy and appropriateness of
interpretations and actions based on test scores or other methods of assessment (Messick,
1989 cited in Rourke & Anderson, 2004, p. 6). Creswell (2014) is of the view that the
main forms of validity to look for when conducting research are, do the items measure
the content they were intended to measure, do scores predict a criterion measure, do
results correlate with other results and do items measure hypothetical construct or
concepts. According to Warner (2013), “a measure is valid if the scores provide
information about the underlying construct or theoretical variable that it is intended to
measure” (p. 902). Validity informs the researcher how sound a measure accurately
assesses what the researcher wants it to (Light, Singer, & Willett, 1990). Simply put
validity is a comparative concept that defines how suitable or sound a measure is for the
aim of which it is meant. It is reported that measures are not commonly valid in that the
acceptance of a researcher establishing the validity of a measure does not mean that the
measure is valid for other purpose (Light et al., 1990). According to Light et al., (1990), a
measure is content valid if its distinct items as a collection cover all the diverse domains
the researcher wants to measure.
While internal validity affects observers’ foregone conclusion that the outcomes
of a research can be acknowledged, based on the design of the research undertaken,
external validity affects observers’ capability to credit the outcome of the research with
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generalization based on the procedures employed (Tuckman, 1999). There are several
threats to validity that will raise questions about a researcher’s ability to come to the
conclusion that the outcome of the intervention was a result of the intervention and not
some other factor (Creswell, 2014). Two types of threats to validity are known and it is
vital to identify the threats so as to have the measures design in such a way that the
threats are not likely to arise or minimized. The two known threats to validity are internal
threats and external threats (Creswell, 2014). While internal validity entails the
procedures, treatments or experiences of the participants (e.g., testing, mortality,
selections, regression, maturation, instrumentation to mention a few) that threatens the
researcher’s ability to draw correct inferences from the data about the population in the
study, external threat to validity deals with researchers drawing incorrect inferences from
a sample data to other persons, others settings, and past or future situations (e.g.,
interaction of selection and treatment, interaction of setting and treatment, and interaction
of history and treatment) (Creswell, 2014).
Tuckman (1999) reported that rather than placing an individual in each situation,
a test would propose a shortcut to establish their conducts and acts in the whole set of
research circumstances. To safeguard and to ensure content validity in the study the
researcher disseminated the instruments among three experts in the fields of nutrition and
research methods to review if the items are presented and worded appropriately, and the
items relate to each component. Recommendations from the three experts were employed
to amend the instrument to safeguard and ensure content validity.
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Reliability issues.
It is reported that every time data is collected, measurement errors may happen
(Light et al., 1990). As a result these errors, an instrument would not produce the
fundamental accurate result which the researcher is interested in. “Rather than thinking
about measurement errors directly, researchers often evaluate their measurement in terms
of its reliability. Reliability describes the extent to which two sets of measurement of the
same characteristics on the same people duplicate each other” (Light et al., 1990, p. 165).
Reliability is associated with the consistency in a test. Simply put under the same
circumstances, an administered test should yield the same result if given to same person
again and again.
According to Tuckman (1999) a number of factors contribute to unreliability in a
test. These factors comprise:
1. Familiarity with the particular test form (such as multiple-choice questions)
2. Subject fatigue
3. Emotional strain
4. Physical conditions of the room in which the test is given
5. Subject health
6. Fluctuations of human memory
7. Subjects practice or experience in the specific skill being measured
8. Specific knowledge gained outside the experience evaluated by the test.
(Tuckman, 1999, p. 198)
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Six strategies for improving measurement quality has been mentioned by Light et al.,
(1990).
1. Selecting and revising items
2. Increasing the number of items
3. Lengthening item scales
4. Administering the instrument systematically
5. The timing of data collection
6. Use multiple raters or scorers (Light et al., 1900, p. 171-183)
A statistical calculation called Cronbach’s Alpha (α) which is an index of internal
consistency reliability that measures the extent to which responses are consistent across a
set of several measures of the same construct- usually self-reported items is usually
employed to inform one’s general consistency in the test (Tuckman, 1999; Warner,
2013). Cronbach’s Alpha is deemed the most popular form of reliability assessment for
multiple-items scales (Warner, 2013). Generally most measure are expected to have a
Cronbach’s Alpha of at least 0.6 or 0.7 and if possible closer to 0.9 to be well thought out
to be useful in informing one a proof of how reliable the test is (Tuckman, 1999). The
importance of testing for reliability of a test instrument before concluding a researcher
study cannot be overstated. This is evident in commercially available standardized test to
check for reliability (Tuckman, 1999). This is further reiterated by Tuckman (1999) who
indicated that “when using a self-made instrument, a researcher should assess its
reliability either before or during the study” (p. 198). Some commercially available
standardized tests have been checked for reliability (Tuckman, 1999). The researcher
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used Cronbach (α) reliability for item analysis. The analysis indicates to the researcher
how reliable the items within each component and reliability for the whole scale are.
From the pilot studies the Cronbach (α) reliability for the six credibility items was .89.
Cronbach (α) of the .85 for the usefulness of the message, .89 for the message is openminded, .86 for the message’s ability to help change eating habits for the better, .87 for
the accuracy of the message, .86 for the messages convincingness, .87 for the message
founded on research (Appendix F, Table 36). Only ‘the message is open-minded’ (α =
.89) is greater than the Cronbach (α) for the total six credibility items (α = .89). There
was a positive correlation between all six credibility items.
Summary
Conducting research for nutritional purposes are not only important for better
eating lifestyle but also in curriculum and instruction. Conducting a good research does
not only demands good planning but making a good choice of research methodology to
address diverse questions (Light et al., 1990). This chapter provided a discussion of the
methodology that would be employed to examine the effect of source credibility on
attitude as measured by argumentation style: In an online Diet and Nutrition course. The
messages and questionnaire in Appendixes B and C will be used in the survey. Data
analysis will be quantitative using multiple regression analysis and ANOVA.
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Chapter 4: Results
Introduction
The main purpose of this study was to investigate the effect of perceived message
credibility and content of messages (in terms of argumentation style) on nutritional
attitude change among undergraduate students. The researcher was motivated by the
belief that through this study, individuals involving in designing nutritional programs
(either as a curricula or an instruction for attitude change, or nutrition intervention or
nutrition counseling) for healthier eating habits would be vested in the knowledge of how
best to develop nutritional messages for better outcomes if they intend to help improve
healthier eating habits or change nutritional attitudes. Secondly, the researcher was
motivated by the belief that the positive outcomes of digital technology on nutritional
interventions and counseling for the promotion better lifestyle (Golsteijn, Peels, Evers,
Bolman, Mudde, de Vries, & Lechner, 2014; Oenema, Brug & Lechner, 2001; Rasu,
Hunter, Peterson, Maruska, & Foreyt, 2010) can go a long way to complement activities
of on-site interventions.
This chapter begins with instrumentation, reliability analysis, data collection and
cleaning, descriptive of the sample with descriptive data, and, objectives and statistical
analysis are presented.
Instrumentation
The instrumentation were in two parts. One part of the research instrument was
made up of messages with their corresponding credibility items that were used by the
participants to rate the credibility of all the messages and the second part of the
144
instrument was the survey. The survey were made up of three parts. Part I of the survey
was made of academic and demographic information. Part II of the survey asked the
participants to respond on how they perceive themselves at current (Post, that is, how
they perceive themselves after the class) and instantly after responding to each item on
this manner, they were asked to provide answer to the same item again, this time in
allusion to how they perceive themselves before they started the Introduction to Nutrition
course (Then)(Part III). The rating of credibility for the messages contained items from 1
to 10 with 1 to 2 interpreted as “Poor”, 3 to 4 interpreted as “Fair”, 5 to 6 interpreted as
“Good”, 7 to 8 interpreted as “Very Good” and 9 to 10 interpreted as “Excellent”
(Appendix B). Part II and Part III of the survey contained items on a 4-points Likert
scale: 1 = Strongly Disagree, 2 = Disagree, 3 = Agree and 4 = Strongly Agree (Appendix
C).
Reliability of the instrument.
Even though the same rating scale was used to rate the messages, the researcher
found necessary to determine the Cronbach (α) reliability for each group as each group
was composed of different messages. However, Cronbach (α) reliability for the three
groups put together was also determined. The Cronbach (α) reliability for item analysis
was used to determine how reliable the items with each group component and reliability
for the whole scale on the message credibility instrument. From the main study for group
1, the overall reliability with Cronbach (α) of .86 was determined. For the items on the
message credibility Cronbach (α) of .84 for the usefulness of the message, .85 for the
message is open-minded, .84 for the message’s ability to help change eating habits for the
145
better, .84 for the accuracy of the message, .82 for the messages convincingness, .84 for
the message founded on research (Table 7). There was a positive correlation between all
six credibility items.
Table 7
Group One Results Obtained for Analyzing the Reliability of their Message Instrument
Credibility Items
Reliability: Cronbach’s Alpha
N
The usefulness of the message
.835
64
The message being open-minded
.851
66
The message’s ability to help change
eating
habits for the better
.841
66
The accuracy of the message
.837
66
The message convincingness
.822
66
Message founded on research
.836
66
From the main study for group 2, the overall reliability with Cronbach (α) of .913
was found. For the items on the message credibility Cronbach (α) of .899 for the
usefulness of the message, .894 for the message is open-minded, .897 for the message’s
ability to help change eating habits for the better, .893 for the accuracy of the message,
.897 for the messages convincingness, .903 for the message founded on research (Table
8). There was a positive correlation between all six credibility items.
146
Table 8
Group Two Results Obtained for Analyzing the Reliability of their Message Instrument
Credibility Items
Reliability: Cronbach’s Alpha
N
The usefulness of the message
.899
64
The message being open-minded
.894
64
The message’s ability to help change
eating habits for the better
.897
64
The accuracy of the message
.893
64
The message convincingness
.897
64
Message founded on research
.905
64
From the main study for group 3, the overall reliability with Cronbach (α) of .914
was found. For the items on the message credibility Cronbach (α) of .884 for the
usefulness of the message, .895 for the message is open-minded, .912 for the message’s
ability to help change eating habits for the better, .904 for the accuracy of the message,
.896 for the messages convincingness, .898 for the message founded on research (Table
9). There was a positive correlation between all six credibility items
147
Table 9
Group Three Results Obtained for Analyzing the Reliability of their Message Instrument
Credibility Items
Reliability: Cronbach’s Alpha
N
The usefulness of the message
.884
64
The message being open-minded
.895
64
The message’s ability to help change
eating habits for the better
.912
64
The accuracy of the message
.904
64
The message convincingness
.896
64
Message founded on research
.898
64
Finally putting all three groups together for the main study, the overall reliability
with Cronbach (α) of .894 was found. For the items on the message credibility Cronbach
(α) of .869 for the usefulness of the message, .877 for the message is open-minded, .883
for the message’s ability to help change eating habits for the better, .875 for the accuracy
of the message, .871 for the messages convincingness, .878 for the message founded on
research (Table 10). There was a positive correlation between all six credibility items
with all the three groups combined.
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Table 10
All Three Groups Result Obtained for Analyzing the Reliability of the Message
Instrument
Credibility Items
Reliability: Cronbach’s Alpha
N
The usefulness of the message
.869
194
The message being open-minded
.877
194
The message’s ability to help change
eating habits for the better
.883
194
The accuracy of the message
.875
194
The message convincingness
.871
194
Message founded on research
.878
194
Validity of the instrument.
The instrument was given to three experts in the fields of nutrition and research
methods to review if the items are stated, presented and worded appropriately and the
items relate to the credibility component. Recommendations from the three experts were
employed to amend the instrument to safeguard and ensure content validity. An
exploratory factor analysis was conducted to support the construct validity. The result of
the factor analysis not only showed a correlation between the items on the message
credibility component (Table 11) but also loaded together with an explained variance of
67% (Table 12). This indicated that the items loaded well and appear to measure the true
construct for which it was intended. The outcome of the factor analysis support the
construct validity.
149
Table 11
Factor Analysis: The Correlation Results Obtained for Analyzing the Six Credibility
Items Presented to Participants for Rating of the Messages
1a
2b
3c
4d
1a
-
2b
.674
-
3c
.604
.547
-
4d
642
.607
.456
-
5e
.686
.548
.661
.618
5e
6f
-
6f
.596
.562
.552
.660
.576
a = Usefulness of the message
b = The message being open-minded
c = The message’s ability to help change eating habits for the better
d = The accuracy of the message
e = The convincingness of the message
f = Messages founded on research
-
The determinant readings from the Factor Analysis yielded .032 which is greater
than .001, indicating that the items in the message credibility component are related. The
Kaiser-Meyer-Olkin Measure of Sampling Adequacy yielded .875 which is deemed by
The University of Texas at Austin (UTA)(n.d.[a]) as meritorious. Bartlets test of
sphericity was significant (p = .001). This has lead the researcher to conclude that there
are correlations in the data set that were suitable for the factor analysis
150
Table 12
Factor Loading, Eigenvalues, and Variance for the Six Credibility Items Presented to
Participants for Rating of the Messages
Total Variance Explained
Extraction Sums of Square
Initial Eigenvalues
Component
Total
Loadings
% of
Variance
Cumulative
%
1
3.999
66.644
66.644
2
.588
9.803
76.446
3
.471
7.843
84.289
4
.407
6.781
91.070
5
.287
4.779
95.849
6
.249
4.15 1
100.000
Total
3.999
% of
Cumulative
Variance
%
66.644
66.544
Extracted Method: Principal Component Analysis
Data Collection and Cleaning
Data was collected through an online message rating and survey which were
hosted by a Midwestern University Qualtrics website. This enabled data to be collected
automatically for more analysis through the website. Links containing both messages for
rating and the survey were sent to participants through their email addresses. Participants
were randomly assigned to three groups with each group receiving different messages for
rating but the same survey for completion. Participants were students registered for an
151
online Introduction to Nutrition class at the Midwestern University. The researcher was a
facilitator in this class making the sample convenient to access. The exercise was offered
to participants as an extra credit exercise and as such not a compulsory exercise but a
voluntarily one.
The data was collected for the main study was over a 5 weeks period, starting
May 11, 2015 to June 13, 2015. With the permission of the class instructor, two messages
(links to the messages) were made available to students per week and the survey (link to
the survey) was included to the two messages on the final 5th week. Overall 257
registered for the class (Table 13). Of the 257, groups 1, 2 and 3 were assigned 87, 85 and
85 participants respectively. During the first week of the class, 12 students dropped from
the class. Of these 12 students, 3, 4 and 5 participants belonged or were part of groups 1,
2, and 3 respectively. Some participants completed all message ratings while others
dropped from the study as the weeks went by. Two hundred and seven participants
attempted to complete the survey with some completing the survey requirement and
others just completing the survey partially. This necessitated the examining and cleaning
the data before analysis.
The stated participation in the message ratings and survey completion above and
other possible errors that might have resulted from recording, coding, missing
information, influential cases and outliers necessitated the examining of the data. For
beginning the researcher took all partial responses for the message ratings and survey.
For the message ratings, participants that were taken out included those who did not
complete all 10 message ratings or, and partially completed a particular message ratings.
152
For the survey, participants that were excluded were individuals that partially completed
the survey.
Table 13
Distribution of Participants Who Registered for the Class and the Groups into Which the
Participants Were Assigned
T1
T2
T3
TR
D1
D2
D3
TD
GM
A1
A2
A3
TA
SA
87
85
85
257
3
4
5
12
1
66
62
67
195
207
2
64
61
65
190
3
71
66
70
207
4
69
64
69
202
5
70
67
69
206
6
71
66
67
204
7
74
66
65
205
8
76
63
64
203
9
72
73
70
215
10
71
72
67
210
T = Total number of participants assigned to group
TR = Total Registered for class
D = Drop out from the class
TD = Total drop out from class
GM = Group Message numbers
A = Number of participants who attempted the messages
TA = Total number of participants who attempted each group message
SA = Survey attempted
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These included participants that completed both Part I only or Part I and II only.
Partial completion of Part I and III was not recorded because participants had to complete
Part II before Part III was made available for completion. This means that to be included
in the analysis, participants had to complete all 10 message ratings as well as Parts I. II
and III of the survey.
A number of outliers were identified and investigated before analysis were made.
It is advised not to drop outliers automatically but to look into the data carefully before
making a decision to drop or not to drop (Stevens, 1999). These outliers may necessitate
future studies as the data are being investigated (Stevens, 1999). For the purposes of this
study, the researcher decided to drop outliers based on a standard score of ±3.
Investigating standard score for both group 1’s message ratings and difference
between the post and pre-test revealed no outliers (Appendix G, Figure 5 and Figure 6).
The standard score for message rating was skewed to the right with its corresponding
difference between the post and pre-test almost attained normality. There were some
outliers for group 2 message ratings (Appendix G, Figure 7). These outliers were
identified as ‘gg’, ‘69’ and ‘pp’ (Appendix G, Figure 7). A further investigation into
these cases revealed that ‘gg’. ‘69’ and ‘pp’ had standard scores of – 2.57369, - 2.57269
and 2.61392 respectively with each figure falling within the ±3 range used by the
researcher. As a result, the research kept these cases for analysis. The standard score for
the differences between the post and pre-test in group 2 also yielded some outliers. These
outliers were identified as ‘67’, ‘74’, ‘ff’, ‘pp’ and ‘dd’ (Appendix G, Figure 8). These
five cases had 4.08583, 3.04933, 2.39898, 2.01284 and 1.86477 respectively on the
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standard score. A further investigation into these cases indicated that cases ‘67’ and ‘74’
were not within the ±3 range set by the researcher and as such were taken out during
analysis. However, case ‘ff’, ‘pp’ and ‘dd’ were within the range and were retained for
analysis. While the message ratings was a little skewed to the left, the differences
between the post and pre-test showed some normality. An investigation into group 3
revealed no outliers for the message ratings with some skewness to the right (Appendix
G, Figure 9). One outlier was recorded for group 3 differences between the post and pretest. Case ‘kkk’ was recorded as the outlier (Appendix G, Figure 10) with a figure of
3.13266 and a little skewness to the right.
Table 14 provides a summary of the cleaned data that were analyzed for the
purpose of this study.
Table 14
Distribution of Participants Who Successfully Completed All the Required Research
Activities
Group 1
Group 2
Group 3
Total
Survey
66
62
64
192
192
From Table 13, of the 257 that registered for the class, 12 dropped from the class
leaving 245. Of the 245, 207 attempted participation representing 85.5 %. After data
cleaning as indicated by Table 14 and including the two outliers (2 cases) deleted from
the analysis, 194 participants successfully responded to the study resulting a response rate
of 79.2%. Totally excluding the two outliers and using only data from Table 14, a
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response rate of 78.4% would have recorded. The pilot study yielded a 100% response
rate.
Descriptive of the Sample with Descriptive Data
The descriptive of the sample coupled with supporting tables are provided below.
Demographics information of the sample.
Of the 192 participants that responded to questions regarding gender, 177 (92.8%)
were female while 15 (7.2%) were males. Responding to question on age, 13(6.7%)
participants were within the range of 18 to 25 years. Seventy-six (39.6%) participants
were between the ages of 26 to 35 years. Seventy-three (38.0%) respondents were
between the ages 36 to 45 years. Twenty-seven (14.1%) participants were between the
ages of 46 to 55 and finally, three (1.6) participants were 55 years or more. Furthermore,
of the respondents, one (0.5%) were American Indian/Alaska Native, 11 (5.7) were
African Americans/Black, 172 (89.6%) were Caucasian, two (1.1%) were African, four
(2.1%) were Asian, one (0.5%) were Hispanic/Latino. One respondent did not answer the
question concerning age (Table 15).
Academic level information of participation.
A total of 192 participants responded to question regarding academic level. Of
these, nine (4.7%) were freshman (1st year), 10 (5.2%) were sophomore (2md year), 52
(27.1%) were Junior (3rd year), 85 (44.3%) Senior (4th year) and 36 (18.7%) represented
others. The others included Registered Nurses seeking to obtain Bachelors in Nursing,
graduated Bachelor’s degree in others programs to mention a few (Table 16).
156
Participant employment information.
Of the 192 participants that provided information on their employment status, 117
(61%) were part time student full worker, 14 (7.3%) were part time student and part time
worker, 2 (1%) were full time student, and 59 (30.7) were full student and full time
worker (Table 17).
157
Table 15
Demographical Distribution of the Participants Who Successfully Completed All the
Requirements of the Research Activities
Variable
N
Gender
192
100
Female
177
92.8
Male
15
7.2
192
100
18 - 25
13
6.7
26 - 35
76
39.6
36 - 45
73
38.0
46 - 55
27
14.1
3
1.6
1
0.5
A. American/Black
11
5.7
Caucasian
172
89.6
African
2
1.1
Asian
4
2.1
Hispanic/Latino
1
0.5
No Response to Question
1
0.5
Age
55+
%
Race/Ethnicity
Am. Indian/Alaska Native
158
Table 16
Distribution of Academic Level of Participants Who Successfully Completed the Required
Research Activities.
Variable
N
%
192
100
Freshman – 1st year
9
4.7
Sophomore – 2nd year
10
5.2
Junior – 3rd year
52
27.1
Senior – 4th year
85
44.3
Others
36
18.7
Table 17
Distribution of the Participant Who Successfully Completed All Required Research
Activities Employment Status
Variable
N
%
192
100
Part time student and full
time worker
117
61.0
Part time student and part
time worker
14
7.3
Full time student
2
1.0
Full time student full time
worker
59
30.7
159
Groups’ Rating of Message Credibility
The rating and meaning of the ratings for the message credibility for the three
groups individually and as well as the three groups together are presented in tables 18,
19, 20, and 21 respectively. The frequency tables for each group are presented in
appendix F (Table 38, Table 39 and Tables 40 respectively)
The rating scales for all three groups as either ‘Poor’, ‘Fair’, ‘Good’, ‘Very good’,
or ‘Excellent’ can be located in Appendix F (Table 44). For group 1 the credibility of the
messages as measured or rated by the credibility item were as follow; usefulness of the
message was rated as very good, the message being open-minded was rated as good, the
message ability to change eating habits was rated as good, accuracy of the message was
rated as very good, the message convincingness was rated as good and, the message
founded on research was rated as good (Table 18). These ratings indicated that overall for
group 1, the credibility associated with the messages by the participants was acceptable
and rated high.
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Table 18
Group One Distribution of the Averagely Rated Messages Using the Six Credibility Items
Credibility Item
M
SD
Meaning on Rating Scale
Usefulness of the message
4.15
0.734
Very Good
Message being open-minded
3.69
1.074
Good
Message ability to change
eating habits
3.40
1.129
Good
Accuracy of the message
4.11
0.945
Very Good
Message convincingness
3.92
0.907
Good
Message founded on Research
3.71
1.366
Good
For group 2 the credibility of the messages as measured or rated by the credibility
item were as follow; usefulness of the message was rated as good, the message being
open-minded was rated as good, the message ability to change eating habits was rated as
good, accuracy of the message was rated as good, the message convincingness was rated
as good and, the message founded on research was rated as good (Table 19). These
ratings indicated that overall for group 2, the credibility associated with the messages by
the participants was acceptable and rated high.
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Table 19
Group Two Distribution of the Averagely Rated Messages Using the Six Credibility Items
Credibility Item
M
SD
Meaning on Rating Scale
Usefulness of the message
3.89
0.799
Good
Message being open-minded
3.72
0.951
Good
Message ability to change
eating habits
3.55
0.991
Good
Accuracy of the message
3.95
0.999
Good
Message convincingness
3.56
0.957
Good
Message founded on Research
3.67
1.027
Good
For group 3 the credibility of the messages as measured or rated by the credibility
item were as follow; usefulness of the message was rated as good, the message being
open-minded was rated as good, the message ability to change eating habits was rated as
good, accuracy of the message was rated as very good, the message convincingness was
rated as good and, the message founded on research was rated as good (Table 20). These
ratings indicated that overall for group 3, the credibility associated with the messages by
the participants was acceptable and rated high.
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Table 20
G Group Three Distribution of the Averagely Rated Messages Using the Six Credibility
Items
Credibility Item
M
SD
Meaning on Rating Scale
Usefulness of the message
3.97
0.908
Good
Message being open-minded
3.63
1.076
Good
Message ability to change
eating habits
3.28
1.161
Good
Accuracy of the message
4.05
0.906
Very Good
Message convincingness
3.94
0.852
Good
Message founded on Research
3.73
1.116
Good
Overall (Groups 1, 2 and 3 combined), the credibility of the messages as
measured or rated by the credibility item were as follow; usefulness of the message was
rated as very good, the message being open-minded was rated as good, the message
ability to change eating habits was rated as good, accuracy of the message was rated as
very good, the message convincingness was rated as good and, the message founded on
research was rated as good (Table 21). These ratings indicated that overall (Groups 1, 2
and 3 combined), the credibility associated with the messages by the participants as a
whole was acceptable and rated high.
163
Table 21
Overall Group Distribution for the Three Groups Averagely Rated Messages Using the
Six Credibility Items
Credibility Item
M
SD
Meaning on Rating Scale
Usefulness of the message
4.00
0.814
Very Good
Message being open-minded
3.68
1.034
Good
Message ability to change
eating habits
3.41
1.094
Good
Accuracy of the message
4.04
0.950
Very Good
Message convincingness
3.80
0.905
Good
Message founded on Research
3.70
1.170
Good
Objectives and Statistical Analysis
The primary objectives of this study was to investigate the effect of perceived
message credibility (content of message in terms of argumentation style) on nutritional
attitude change among undergraduate students.
Objectives 1
Objective one was to determine the extent that message credibility has on
participants as measured by the attitudinal change questionnaire. To achieve this
objective, a retrospective post then pretest was used to examine the change in attitudinal
score of the participants. At the completion of the course participants filled out the
questionnaire. Individual means and standard deviations was calculated for each
individual question and for the overall scale score for both the pre and post-test. Change
scores was calculated between the post then pre scores and paired-samples t-test was
164
conducted to determine the extent that message credibility has on participants as
measured by the attitudinal change questionnaire.
A paired samples t-test indicated that the message credibility as measured by
attitudinal change questionnaire (difference between post and pre-test for all groups) had
on average a significantly effect on participants nutritional attitudinal change, t(191) =
6.64, p = .001, d = .5 (Table 22). The effect, although statistically significant, was
medium using Cohen’s (1988) guidelines. According to Kotrlik, Williams and Jabor
(2011), “reporting effect size allows a researchers to judge the magnitude of the
difference between or among groups, which increases the researcher’s capability to
compare current research results to previous research and judge the practical significance
of the result derived” p. 134). Result from this study indicates that the magnitude of the
outcome due to the messages was medium. Interpretation of Cohen’s d is provided in
Appendix F (Table 47).
165
Table 22
Paired Sample Test Analysis to Determine the Extent That Message Credibility Has on
Participants as Measured by the Attitudinal Change Questionnaire
Paired Differences
95% CI of all the differences
M
Difference
between post
and pre-test
for all groups
- Grand mean
for all groups
SD
4.41 9.21
Std. EM
Lower
Upper
t
df
.66
3.10
5.72
6.64 191
Sig. (2
tailed)
.001
Objective 2
Objective two was to determine whether a two sided argument would result in a
more attitudinal change than a one sided argument
To achieve this objective, data gathered from the one sided versus two-sided
argument was analyzed to determine if the difference score between the two arguments
are statistically significantly different. A paired sample t-test was used to analyze the
difference between means for this objective. The mean (M = 10.25) for group 3
(combination of emotive and logic messages) was larger than the mean (M = 5.88) for
group 1 (Only emotive messages) (Table 23, paired 1). Also the mean (M = 4.63) for
group 2 (Logic messages) is lesser than the mean (M = 10.44) for group 3 (combination
of emotive and logic messages) (Table 23, paired 2).
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Table 23
Paired Sample Statistics Analysis to Determine Whether a Two Sided Argument Would
Result in a More Attitudinal Change Than a One Sided Argument
Paired 1
Paired 2
Group (G)
Mean
N
SD
Std. Error Mean
Difference between
post and pre-test G3
10.25
64
7.98
1.0
Difference between
post and pre-test G1
5.88
64
8.56
1.07
Difference between
post and pre-test G3
10.44
62
8.03
1.02
Difference between
post and pre-test G2
4.63
62
5.20
0.66
The paired sample t-test indicated that a combination of emotive and logic
messages had on average significantly more effect on participants attitude change than
only emotive messages, t(63) = 2.26, p = .027, d = .3 (Table 24. Paired 1). The
difference, although statistically significant, was medium using Cohen’s guidelines
(Warner, 2013; Kotrlik, Williams & Jabor, 2011). The differences in the means between
group 3 and group 1 could be as small as .51 or as large as 8.24 on a 2 to 10 point scale
(Table 24, Paired 1). Furthermore the paired sample t-test indicated that a combination of
emotive and logic messages had on average significantly more effect on participants
attitude change than only logic messages, t(61) = 3.71, p = .001, d = .5 (Table 24. Paired
2). The difference, although statistically significant, was medium using Cohen’s
guidelines (Warner, 2013; Kotrlik, Williams & Jabor, 2011). The magnitude of the
outcome as a result of the differences in the group messages in both cases was medium.
167
Table 24
Paired Sample t-Test to Determine Whether a Two Sided Argument Would Result in a
More Attitudinal Change Than a One Sided Argument
Paired Differences
Paired 1
Difference
between post
and pre-test
G1 Difference
between post
and pre-test
G3
95% CI of all the differences
M
SD
4.38
15.49
Paired 2
Lower
Upper
1.94
0.51
8.24
t
df
2.26 63
Sig. (2
tailed)
.027
95% CI of all the differences
M
Difference
between post
and pre-test
G2 –
Difference
between post
and pre-test
G3
Std. Error M
5.81
SD
Std. Error M
12.35
1.57
Lower
Upper
2.67
8.94
t
df
3.71 61
Sig. (2
tailed)
.001
The differences in the means between group 3 and group 2 could be as small as 2.67 or as
large as 8.94 on a 2 to 10 point scale (Table 24, Paired 2). Therefore results from
objective 2 analysis indicated that a two-sided argument had a stronger effect on
participants’ attitude than a one sided argument (Table 24’s Paired 1 and 2). Despite the
168
effect size was medium in both Table 24’s paired 1 and 2 analysis, the effect on
participants was statistically significant whether the two sided argument (combination of
emotive and logic messages) was paired with either one sided argument (Only emotive or
only logic messages).
Objective 3
Objective 3 was to determine which method of persuasion have the most effect on
attitudinal change among the participants. To accomplished this objective, a paired
samples t-test was run for the differences between the post and pre-test for both group 1
(emotive messages) and group 2 (logic messages). The mean (M = 5.31) for group 1
(Only emotive messages) was larger than the mean (M = 4.63) for group 2 (Only logic
messages) (Table 25).
Table 25
Paired Sample Statistics to Determine Which Method of Persuasion Has the Most Effect
on Attitudinal Change among the Participants
Paired 1
Group (G)
Mean
N
SD
Std. Error Mean
Difference between
post and pre-test G1
5.31
62
8.07
1.02
Difference between
post and pre-test G2
4.63
62
5.20
0.66
The paired sample t-test indicated that even though group 1 (emotive messages)
had a larger mean than group 2 (logic messages) (Table 25), on the average the difference
in effect on the participants was not statistically significant, t(61) = 1.55, p = .127, (Table
169
26). The differences in the means between group 1 and group 2 could be as small as -.20
or as large as 1.55 on a 2 to 10 point scale (Table 26).
Table 26
Paired Sample Test to Determine Which Method of Persuasion has the Most Effect on
Attitudinal Change among the Participants
Paired Differences
95% CI of all the differences
Difference
between post
and pre-test
for all groups
- Grand mean
for all groups
M
SD
Std. Error
0.68
3.44
.44
Lower
-.20
Upper
1.55
t
df
1.55 61
Sig. (2
tailed)
.127
Objectives 4
Objectives 4 was to determine if a model exists which would explain a significant
portion of the variance of attitudinal change as measured by the method of persuasion and
the demographic characteristics indicators (gender, age, and race). This objective was
accomplished through a stepwise multiple regression analysis. Demographic variables
were entered stepwise into the equation owing to the exploratory nature of the study
along with the method of persuasion.
A multiple regression analysis in a stepwise method was conducted to evaluate
how well the method of persuasion in combination with the demographic information
predict nutritional attitude change. The categorical independent variable was dummy
170
coded. The variable ‘age’ which initially had 6 levels was combined into two levels
namely ‘black’ and ‘non-black’ which were then dummy coded. The variable
‘race/ethnicity’ which originally had 5 levels was combined into four levels namely
‘AgeDummy’, AgeDummy1’, AgeDummy2’, and AgeDummy3’ which were then
dummy-coded.
These independent variables were entered stepwise into the regression analysis
with the difference between the post-test and pre-test entered as the dependent variable.
Diagnostic checks for collinearity were conducted (Hair, Anderson, Tatham, & Black,
1998). A check on the correlation matrix for independent variables did not disclose any
high correlations (Appendix F, Table 45). A look at the variance inflation factor (VIF)
and the tolerance values did not indicate presence of a collinearity problem (Appendix F,
Table 46).
Only one variable was retained in the equation and determined to explain
approximately 8% (R2 = .082) of the variance in the overall attitudinal change. The
regression equation with the one independent variable was found to be significant in
predicting the overall attitudinal change (F1, 61 = 5.450, p = <.023). The combination of
‘emotive and logic messages’ significantly contributed to the model (t = 2.335, p = .023).
Table 27 illustrates the ANOVA results for the regression equation employing the only
independent variable in predicting the overall attitudinal change.
171
Table 27
Significance of the Regression Equation Employing Four Independent Variable in
Predicting Overall Attitudinal Change among the Participants
Model
df
Regression
Residual
SS
Fa
MS
1
315.421
315.421
61
3530.134
57.871
5.450
Pb
<.023
Total
62
3845.556
a
One Way Analysis of Variance
b
.05 Alpha Level for the Two-Tailed Test of Significance
The coefficient value, t value and corresponding significance level for the
independent variable retained in the regression equation predicting overall attitudinal
change among participants Table 28.
Table 28
Coefficient Values, Standard Errors, Standardized Coefficient Values, T Values, and
Significance Levels for Independent Variable Retained in the Regression Equation
Predicting Overall Attitudinal Change
Variable
Constant
β
-19.594
SE
Beta
11.195
GM3
6.924
2.966
.286
a
.05 Alpha Level for the Two-Tailed Test of Significance
GM = Grand Mean for Group 3
t
-.1.750
2.335
pa
.085
.023
The variables excluded from the regression equation and their corresponding t values and
significance levels are illustrated in Appendix F, Table 46
172
Supplemental Analysis
Also a supplementary data which was obtained by requesting participants to
provide comments on the messages presented for rating has been provided on Appendix
F (Table 41, Table 42 and Table 43). Participants were asked to provide comments so as
to find out if they thought about credibility of the messages before rating. These
comments were grouped under the six credibility items and comments that did not
contain information relating to credibility were grouped under “others”. All comments
are presented as written by the participants. Participants who did not provide comments
on the message ratings were not excluded from the data analysis. Themes were also
developed from the comments. Themes developed from participants’ comments per
group are provided in the tables below. Each group had its own unique messages (Group
1: emotive messages [Table 30], Group 2: logic messages [Table 31] and Group 3:
combination of emotive and logic messages [Table 32]), hence the need to have separate
tables for the themes generated per group with their supporting comments.
173
Table 29
Group One Participants’ Comments derived from the supplementary Analysis and the
Corresponding Themes Developed by the Researcher
Themes
Acceptance
Comments
“It will be a good idea for the children to start eating health
food”.
“I like the topic; how can we introduce this into homes to help
better the family’s lives”?
“Might be helpful to mention a few disorders that are
affecting our youth such as elevated cholesterol. Pediatricians
have begun testing children for a health issue that was once
limited to older adults”.
Helplessness
“Statistic are true and factual, but the message doesn't tell how
to change this situation or what can be done to make this
change. I believe people are aware of this fact in a general
sense, but what can we do”?
“Fact remains fact...foods that are less healthy are cheaper and
healthy foods are considerably more costly. Families will
have to choose what remains within their budget. Seniors are
living on fixed incomes. Healthy foods need to be made more
affordable so that people can afford to choose the more
healthy options”.
It is true overweight is becoming a big problem, there are
many fast food and many family who are always at work and
do not have time to cook. We need to provide health
education”.
Eye opener
“This is very interesting and something that I never knew”.
“It is funny to read about these myths. Now I can educated
my friends on the facts”.
“I was one of those who thought that just "eat another steak"
was a good way to get more protein into your body. Good
information”.
174
Table 29 Cont.
Themes
Comments
Socioeconomic Status “I agree with the message stated above. As someone who
purchases healthy food regularly, it does tend to cost more.
This may suggest that people with limited incomes may
choose unhealthy and cheaper food choices due to their
budget”.
“It says what consumers do when prices are high, that won't
change. We can only afford so much. A table showing the
breakdown of the lower price high sugar foods vs the more
nutritional foods would be helpful. Maybe when prices are
high they can still afford some fruits and see the value”.
“Fact remains fact...foods that are less healthy are cheaper and
healthy foods are considerably more costly. Families will have
to choose what remains within their budget. Seniors are living
on fixed incomes. Healthy foods need to be made more
affordable so that people can afford to choose the more healthy
options”
Education
“While it is true that children are limited to what their parents
supply, I still believe that educating them while in school and
offering them healthier options is imperative. It may give
them the opportunity to try different food they do not get at
home and they could potentially share what they learn with
care givers who may not be aware of the information”.
“I don't know whether this comment will "improve" this
message, but I strongly believe that decisions made regarding
children's nutrition should be made at home. I don't believe
that a teacher (or a bureaucrat for that matter) should decide
whether the snake sent to school is nutritious or appropriate.
When children are taught about nutrition at home, they will
make smarter decisions in school. So yes, adult education is
key”.
“I agree that it needs to start with adult education. If you are
giving your child junk food at home, they are more likely to
only want junk food at school as well. I wonder does income
status have any role in which children are eating the junk
food”?
175
Table 29 Cont.
Themes
Suggestions
Comments
“I think the author supported the argument well. The message
could improve by providing suggestions that could increase
parental support of this initiative. For example, schools could
communicate the importance of the initiative and encourage
them to send healthy snacks with them to school. Suggestions
for healthy snacks should also be included”.
“I think this message is very informative and evidence based.
It is very true that healthy foods are more expensive. Some
choose not to be healthy due to a low income. We need to help
find ways to eat healthy in a less expensive way”.
“Other than the statistic from 1986, there is nothing here to
motivate the obese person to lose weight. Truthfully, there are
obese people that are unsuccessful at losing weight because all
of his or her efforts fail. This message definitely sends the
message that weight loss is work but it lacks how one could
become successful”.
Role Models
“I absolutely agree. If parents are sitting home watching TV
and never getting exercise, their children will tend to follow in
their footsteps”.
“Again, this is all true, but how will this be accomplished.
This is something that is large and many parents are already set
in his or her ways of eating habits. Unless parents change his
or her own eating habits, their example will be what the
children see and copy”.
“This message hit home hard. As a nurse, I teach about
nutrition on a daily basis, and there are also days that I drive
through McDonalds. We must practice what we preach. I may
be at a healthy size but size does not always matter if you are
eating foods that are bad for your health. Catchy logo above:)
176
Table 29 Cont.
Themes
Motivation
Comments
“It was interesting thought, in order to accomplish
our goal we all have to work hard nothing comes
easy. Losing weight takes time and it is very hard”.
“You are right, being fit is hard work and I need to
get on board. My grandmother loves watching the
biggest loser, I need to watch it for encouragement.
Thanks for sharing”.
“It is a good message to remember because most of
the time we are in denial and we do not pay
attention to our body”.
References/Evidence/Credibility “I am not sure where these facts were taken from,
but I do think that this message gets the point across
well using vague information”
“There is no research cited in this message. While it
seems logical and appropriate, it could just be a
strongly worded opinion. I am certain that I believe
that eating fresh is cheaper than buying processed
food - if not just for the longevity of the foods. But
I don't really buy processed foods so I this is merely
an educated guess”.
“This message is written in a very simplified
manner, but if the message is for adults it may be
too simple. Adding more facts to support the
message would definitely be needed”.
“Again, perhaps citing the resource of the
information would cause people to trust the
information. However, I thought it was very
informative and easy to understand. I have a better
grasp on protein from reading this paragraph”.
“Where were the statistics found? Need reference
info to know if message founded on research”
177
Table 30
Group Two Participants’ Comments derived from the supplementary Analysis and the
Corresponding Themes Developed by the Researcher
Themes
Doubts
Comments
“Educate on ways to be more physically active in a
challenging socioeconomic environment”.
“I know that exercise is important every week, it is a
struggle to do it. It becomes quite frustrating for
me”.
“I feel this message will cause controversy with
some parents but the message is good”
Choices
“I do believe that a lot of people dealing with
obesity is portion size and calories. People find
comfort in food and some people simple enjoy that
and do not want to change their eating habits”.
“I don't know why the lower socioeconomic choose
more expensive protein. That does not make sense
to me. Maybe it's just lack of knowledge”?
“I found the message to be beneficial and made me
think about buying healthy food options over junk
food”
References/Evidence/Credibility “The comment could be improved by including
where the facts were derived from. It is not clear to
the reader that this statement is founded on
research”
“References always help the reader identify where
the information came from and how accurate it may
be”.
“Again, I believe that statistical data to back up the
information given in the article would be great
advice for whoever is writing it”.
178
Table 30 Cont.
Themes
Education
Comments
“I do think that schools should improve their food. Oftentimes, it
is very unhealthy food that our children have to choose from and
this makes for bad habits, especially when the children get older”
“In order for people to change I believe it is helpful for them to
see the reason behind the change or the need for change”
“Examples of portion sizes and cost. Most people believe that
eating healthy is expensive, so a comparison would be helpful”.
“Changing eating habits for most people is not about being an
expert in science of nutrition. It is most important that they learn
balance, moderation and knowing the importance of whole foods”.
Socioeconomic
Status
“It seemed too pointed at socioeconomic status”
“More information. Is poor nutrition because the poor economic
status or is their poor nutrition and economic status a result of lack
of ambition, education, and poor upbringing”?
"In actual fact, it is not expensive to eat healthful." does not seem
like a true statement. For example, recently I talked with a client
who says that when she watches her sister’s children and hers
there are 10 kids. I asked, what do you feed them? She replied
macaroni & cheese, hot dogs, which is less expensive than
purchasing foods from all the categories above”.
“It is true most health food are very expensive, so people turn to
unhealthy food”.
Recommendations “Provide options for healthful choices to counter these lifestyle
difficulties”.
“Perhaps provide examples of diet choices, both bad and good, to
illustrate how these mechanisms work in lay terms”.
“The percentages of what you actually need of total fat, saturated
fat, trans fat and cholesterol would've been helpful in this
message
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Table 30 Cont.
Themes
Beneficial
Comments
“Again, I knew water was important to the body, but did not
realize all it did. I need to drink more water myself. I am
terrible at drinking water”.
“I found this to be very interesting. I struggle with my
weight on a daily basis”.
“I would share this with others, because I like that it conveys
the message that exercise can be play, it doesn't always have
to be scheduled time at the gym”.
“I liked the examples in this message. I will use them with
my children”.
Insightful
“I always knew that vitamins were important to the body, but
I did not realize just how essential they are. There are often
many complications when vitamin levels are too low of too
high”.
“Following a low card diet has been on the rise lately and I
personally follow it myself, it is also important to note that
in addition to potatoes some vegetable are starchy as well”.
“I did not realize there was so much obesity in the lower
class. I found this to be very interesting”.
Severe
“The message may be true, but it is conveyed in a harsh
manner. People might be resistant to learning from it, and be
dismissive of it, because of the way it is presented”.
“I think we are using a stereotype. I think our society is
getting lazier and therefore more obese”.
“It more of an attack on the low socioeconomic. This
message comes across as harsh ("you will die") and doesn't
seem to contain any researched factoids”.
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Table 31
Group Three Participants’ Comments derived from the supplementary Analysis and the
Corresponding Themes Developed by the Researcher
Themes
Insightful
Comments
“The message is informative and clearly explains the importance of
adjusting calories in and calories out. Provide an example of a food
item that is equivalent to 150 calories. I do not think people realize
how quickly calories add up”!
“Literature from the textbook suggests that many factors determine
how weight is gained, not just more calories consumed than burned”.
“I feel there are other factors that contribute to obesity in addition to
eating too much. Lack of exercise, leading a sedentary life, and poor
nutrition are some examples”.
“Even if the healthiest meals could be served, kids will not always eat
them. Kids do not care about healthy, they want it to taste good. It
has been found that schools throw more food away now than ever
before since they instituted Michelle Obama's plan”.
Questions
“I wonder. If a person takes in sufficient vitamin D through diet.
Then adds a supplement. Are they still at risk for toxicity”?
“I am curious as to whether the malabsorption is due to age, chronic
illness or some predisposition. It is really sad to learn that somebody
is doing all they can to eat healthy balanced meals but still getting
poor results”.
“McDonald's and Burger King offer healthier meal options. How
many individuals choose healthy options opposed to unhealthy”?
Initiative
“I wish more fast food chains offered better menu choices. I'm happy
that McDonalds has yogurt and cuties now but all of them need to do
better”.
“McDonald's and Burger King offer healthier meal options. How
many individuals choose healthy options opposed to unhealthy”?
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Table 31 Cont.
Themes
Comments
Norms
“I think the detrimental relationship and employment outcomes
are more due to societal conditioning that bigger people are
lazier and incompetent than obesity actually being a health
risk”.
“This discussion has more to do with an establishment, meaning
schools taking a lead and actually serving healthy choices to our
children. I think that the fast food should be taken out of the
school altogether, schools state that they give healthy option,
but they also still have fast food. Which do you think our
children will pick if the choice is left up to them? An example,
schools put pizza on the menu, and on the menu it is not
counted as a carbohydrate or fat, it is counted as a vegetable
because of the sauce. That is just crazy”.
Education
“I believe this is a more eye-opening direct statement. I feel this
message could be on a brochure for those pending a serious
lifestyle change or life or death situation regarding their obesity.
As well, those teenagers who are at a plateau and needing some
quick information”.
“This message was great and it thoroughly explained all of the
necessary elements of what fuels one’s body. I feel there needs
to be more education on general health science for people to
realize and understand the cause and effect of what they eat and
do during their life”.
“People are mostly aware of how bad fast food is and the health
implications of eating it. I think people are desensitized to the
shock value of how bad fast food is, or how many calories are in
a fast food meal. To change eating habits about fast food I think
that there would have to be a comparison or something to help
people understand how insane it is to have one food item with
710 calories.
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Table 31 Cont.
Themes
Comments
Choices
“So sad that even though people know all of this to be true, and
can be educated in such matters....they remain unable or
unwilling to change their habits”.
“Again I come back to the fact that unless a person is within the
stages of change. Although the information is accurate, change
will not occur”.
“McDonald's and Burger King offer healthier meal options.
How many individuals choose healthy options opposed to
unhealthy”?
Motivation
“The message almost scares people into eating better and
changing their lifestyle. Many people need this tactic though.
The message is very straight forward and full of information. I
would not change anything about it”.
“You make it sound easy but really it is all not as simple as that.
I agree as far as exercise but when it comes to losing weight, not
that easy”.
Solution
“I think the information is accurate and correct according to The
World Health Organization, but I do not think information is
enough without some sort of recommendation as to what
someone reading this information can do to change their own
habits”.
“I enjoyed the reading. As a mother of four, I'm constantly
struggling to get enough protein in their bodies and mine. I do
use a lot of protein mixes. This is the troubling part of the
article. I'm presented with a possible problem with absorption,
but no solution”
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Table 31 Cont.
Themes
Comments
References/Evidence “The 400,000 deaths. Obesity is not the primary cause. I feel it
/Credibility
is inappropriate to make that claim. Obesity is the leading risk
factor for many of the leading causes of death. Or obesity can
be linked to 400,000 deaths. No citations to back up statements
So would not share”.
“Citing more research would give more credibility to the
statement”.
“It would be nice to see where the writer is getting the
information, which I should have written on all the articles thus
far, so that the person reading it could look into the information
in more depth if they chose to”.
“Again, no references are listed so although I assume this
information to be true, I cannot be 100% sure. If I were sure
the statistics were fact based, I would change my ratings. I can
only rate its accuracy on what I already have knowledge on”.
Summary
This chapter provided the results of the main study. Multiple regression analysis
was used to analyze the quantitative data. Data collected was presented, starting with
instrumentation which was followed by reliability analysis using Cronbach’s Alpha (α) to
determine the internal consistency of the data collected. Factor analysis to support
construct validity, data collection and cleaning, descriptive of the sample with descriptive
data, and, regressions analysis were also presented. To investigate the effect of perceived
message credibility and content of messages (in terms of argumentation style) can predict
nutritional attitude change and this chapter presented results which set the stage for a
detailed discussion in the next chapter.
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Chapter 5: Discussions, Recommendations and Conclusions
This chapter begins with recapping of the purpose and design of the study. A
discussion of the sample, supplemental analyses and implications are presented.
Important information garnered from the data are discussed and the directions for future
research are presented as well.
The Purpose and Design of the Study
The main purpose of this study was to investigate the effect of perceived message
credibility and content of messages (in terms of argumentation style) on nutritional
attitude change among undergraduate students. Specifically, the study addressed the
research questions:
1. Does knowledge of a communicator’s expertise correlate with learner’s
attitude change?
2. Does fairness, as defined by a two-sided argument versus a one sided
argument, correlate with attitude change?
3. Which message of persuasion has the most impact on attitude change?
4. What combination of factors best explains a significant portion of the
attitudinal change as measured by the predictors (tools of persuasion and the
demographic characteristics (gender, age, and race/ethnicity).
This study targeted students enrolled in an online Introduction to Nutrition class was
developed by a large Midwestern University. The participants were randomly assigned to
three groups. The instruments were delivered in two formats. The first method had
participants rate on a 1 to 10 scale the credibility of messages (emotive, logic and
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combination of emotive and logics messages) assigned to the three groups. The second
method employed an attitudinal questionnaire which used the retrospective pre-test
design (how participants perceive themselves at current and instantly after responding to
each item on this manner, participants were asked to provide answer to the same item
again, but this time in allusion to how they perceive themselves before they commenced
the Introduction to Nutrition course). Both instruments were administered via the
Midwestern University Qualtrics websites. The final response count was 192 which
represented 74.71% and this based on participants completing all exercises or responding
to the instruments.
Discussions for the Findings
Discussions per each research question is discussed below.
Research question 1.
The importance of credibility on attitudinal change has been well documented
(Arora & Arora, 2004; Bednar & Levie, 1993; Campbell, et al., 1999; Deìrdöğen, 2010;
Heinrich, 2013; McCroskey & Young, 1981; McCroskey & Teven, 1999; Simonson &
Maushak, 1996), and the results from this study has provided further support to this
assertion. Results from the study (Table 22) indicated that the message credibility as
measured by attitudinal change questionnaire had on average a significant effect on
participants nutritional attitude change. This was evident in the participants rating the
credibility of the messages from good to very good (Table 21), thus indicating that on a
scale of 1 to 10, the participants on the average rated the messages from 5 to 8.
Referencing the works of Gottlieb and Sarel, (1991), and, Ward and McGinnies, (1974),
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it is reported that a highly credible message source is more effective in eliciting positive
attitude change and behavioral intentions. A study has not only reported of the influence
message framing and credibility has on participants attitude and intention toward
following the guidelines for healthy eating and preventing cancer but credibility having
an effect on attitude change as well as intention (Arora & Arora, 2004). These same
characteristics was exhibited in this current study.
This study further emphasizes the role technology plays in nutrition intervention
and counseling. This study not only reached out to almost 200 participants but was able
to measure on average a significant effect on participants nutritional attitude change
within five weeks. Supporting other studies that have reported huge successes in
changing relevant health-related behaviors (Brug, et al., 1999; Brug, et al., 1997). While
this study did not access the role of digital technology as a variable in attitudinal change,
or its ability to reach larger populations (Bowen et al., 2003; Oenema, et al., 2001;
Saperstein, et al., 2007), its flexibility (Oenema et al, 2005; Ramadasa, et al., 2005;
Wantland, et al., 2004) or its cost effective (Tate, et al., 2009; Golsteijn et al., 2014; Raus
et al., 2010; Schulz et al., 2014) it throws more light on its importance in instructional
delivery.
While the debate on the definition and conceptualization of attitude lingers on, the
researcher is of the view that the attitude change occurred based on the constructionist
view point (Bohner & Dickel, 2011). Referencing the work of Bohner and Dickel (2011),
they are of the view that the constructionist “see attitude not enduring personal
dispositions but rather as evaluative judgments that are constructed in the situation based
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on currently accessible information” (p. 393). For attitude change to have occurred,
participants might have given thought to their past nutritional activities and compared
them with the current nutritional information provided. A situation further amplified by
Bohner and Dickel (2011) who asserted that “… attitude change involves both retrieval
of stored evaluations and the consideration of new evaluative information to varying
extent” (p. 397). Alternatively, Bohner and Dickel (2011), pointed out that “context
dependent variations in evaluative judgments may then depend on which of the stored
evaluations is more accessible in a given situation and on the individual’s motivation and
ability to reflect on his or her attitude” (p. 397). This is further reiterated when Bohner
and Dickel (2011) cited the work of Tormala, Brinol and Jarvis (2006) who asserted that
old attitudes that a person does not think of as suitable any longer are “deemed” in the
memory as false, a model Petty el al. (2006) refer to as “past attitudes are still past”
(PAST) (Figure 1).
Elaborating on attitude, Petty and Wegner (1998) are of the view that:
…, the factors involved in moving an individual with no attitude to adopt a
position favorable toward an advocacy are more similar to the factors involved in
making a person with a weak but existent attitude become more favorable toward
the advocacy than to the factors involved in making the same change in an
individual with a strong initial attitude (Petty & Wegener, 1998, p. 2).
With attitude being relatively stable and enduring, and, having a cognitive component
(Bednar & Levie, 1993) are of the view that “people’s retention from a persuasive
message is not of the information per se, but of their cognitive reactions that were
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aroused by the message” (p. 285), by this, the resultant attitude change by this
participants of this current study could linger on.
Another reason why the attitude change by participants of this study could linger
on or be enduring will as a result of the relevance under which this study was conducted.
Participants were enrolled in an Introduction to Nutrition class which was a requirement
and as such participants might have taken time to elaborate on or put thoughts into the
messages presented by the researcher. According to Petty and Cacioppo (1996) enduring
attitude change is likely to be dependent on the likelihood that an issue or argument will
be elaborated upon (though about). Petty and Cacioppo (1996) further indicated that if an
individual views a message to consist of strong and compelling arguments, the individual
puts thinking into the argument. This might be probable with this study as the
participants’ ratings on the credibility of the messages to be averagely good or very good.
Rating the messages as averagely good or very good could be as a result of the
following. Firstly, it could be that the messages were worded in such a way that
participants were able to assimilate the content of the messages for further elaboration.
Secondly, messages were based on the course modules and as such provided additional
information for their class discussion board and assignments and, finally with majority of
the participants in the nursing field they might have known some of the nutritional
information and outcomes of unhealthy dietary provided by the messages and as such
might realize the importance of the messages. This is further supported by the
elaboration-likelihood model, which indicates that “thoughts, the attitude changes that
result from issue elaboration will be just as enduring as those that results from message-
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argument elaboration (Petty & Cacioppo, 1996, p. 266). Further discussions on the
elaboration-likelihood and attitude change among the participants will provide in the later
part of this chapter.
Research question 2.
According to Bednar and Levie (1993), arguments are more effective if they are
relevant to the receiver’s needs and also generally two-sided arguments are slightly more
effective than one-sided messages. This statement was further amplied by this current
study. Firstly, for the current study, participants were enrolled students in an Introduction
to Nutrition class and the messages presented to them by the researcher were not only
relevant to them in terms of assisting them to learn for the class but also provided food
for thought about every day nutritional lives. Secondly, the messages with the two-sided
arguments (combination of logic and emotive messages) had on average significantly
more effect on participants attitude change than either only logic messages or only
emotive messages.
The result from the current study is supported by the work of Petty & Caccioppo,
(1984) who indicated in their study that participants showed more agreement in response
to a message containing six arguments (3 strong and 3 weak) than messages containing
either three strong or three weak arguments. Also, the number of arguments and message
factors such as length of the arguments and the complexity of the language employed in
the message might also inform as simple cues as the validity of the message (Petty &
Cacioppo, 1984). While in the current study, the two-sided arguments had a stronger
effect on participants’ attitude than a one-sided argument, the researcher of the study is of
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the view that participants’ response to the two-sided argument could be the result of the
number of arguments in the messages but not really the content. It is reported that the
number of arguments in a message serves as a peripheral cue under low involvement
(Petty & Cacioppo, 1984). There might be low involvement among participants in this
current study especially when they are to complete 10 modules (Including 2 exams, 2
assignments and 10 discussion board responses) in five weeks to make up grades in order
to pass the class. In order to attend to other class activities instead of taking time to go
through all the messages, participants of this current study might have taken the
peripheral route from the number of arguments in the message to rate the message instead
of rating the messages based on the arguments presented in the messages (the central
route).
Even though the current research participants were not directly informed who was
conducting the research, they were aware that the links to the research study sites were
provided by the researcher who was a facilitator in the class. All facilitators provided
background information (including education, work experience, pictures to mention a
few) about themselves. This information might have swayed the way the research
participants rated the messages, that is, they might have employed the peripheral route
instead of the central route to elaborate on the messages before rating. Peripheral route
mainly focuses on factors as the attractiveness of the source, source credibility, and the
number of sources certifying a position (Dutta-Bergman, 2004), design topographies like
layout or colors (Flanagin & Metzger, 2007), affect like mood or fear (Petty, et al., 1991)
and central route processing depend on the quality of the message (Miniard, et al., 1991).
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This might call into question the motivation of the participants while completing the
research activities since they all have to complete the enrolled class activities as well.
For an individual to elaborate on a persuasive message, it is reported that the
individual will have to go through the following processes:
a) Attend to the appeal
b) Endeavor to access relevant relations, images, and experiences from memory
c) Inspect and elaborate upon the externally delivered message arguments in
light of the relations accessible from memory
d) Come to conclusions about the virtues of the arguments for a commendation
relaying on their analyses of the data gotten from the appeal and accessed
from memory
e) Subsequently develop an overall appraisal of, or attitude to, the commendation
(Cacioppo & Petty, 1984, p. 673).
Motivation and ability to involve in issue-relevant thinking are required to accomplish
these processes (Cacioppo & Petty, 1984; Petty & Wegener, 1988; Petty, et al., in press).
According to Petty et al. (in press) “the more motivated and able people are to assess the
central merits of an issue or position, the more likely they are to effortful scrutinize all
available issue relevant information” (p. 9). A situation the researcher beliefs might have
been called to doubt based on the thought that the participants of this current study might
employed the peripheral route to rate the messages.
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Research question 3.
Even though it is reported that credibility may be the most effective means of
persuasion one may possess (Roberts, 1954, cited in Deìrdöğen, 2010, p. 191), logic and
emotion remain relevant methods employed during persuasion and attitude change, be it
in marketing (Kelly & Rupert, 2009; Hamon & Coney, 1982; Eisend, 2006; Chu &
Kamal, 2008), health care (Brug et al., 1996; Brug et al., 1998: Campbell, et al., 1999;
Arora & Arora, 2004; Mayor & Coleman, 2012) or in politics (Sternthal, et al., 1978;
Teven, 2008). These three methods of persuasion together are deemed the basic tools of
rhetoric (Heinrichs, 2013).
Results from this current study showed that the emotive messages yielded a larger
mean then logic messages (Table 25). Even though the emotive messages had more effect
on the participants than the logic messages, the difference in effect was not significant,
that is, difference was not noticeable. Yet with the difference in effect not significant, the
larger mean of the emotive messages goes to show the importance of emotive messages
during persuasion. A sentiment shared by Cicero who is quoted as saying “a genuine
emotion persuades more than a fake one” (Heinrichs, 2013, p. 41). This is further
supported by DeSteno, Petty, Rucker, Wegener, and Braverman (2004) and, Griskevicius,
Shiota and Neufeld (2010) whose studies have reported the role of positive emotions on
message processes. A reason that may be given for a more effect of the emotive messages
could be the way the messages were presented or message content. The emotive
messages were mostly based on the outcomes of unhealthy dietary habits, that is, what
will happen to an individual if certain dietary measures are not taken. On the other hand,
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it be argued that the non-noticeable difference in effect between the emotive and logic
messages on the participants could be as a result of the content of the logic messages. The
logic messages had current data to nutritional and outcomes of unhealthful dietary
information. In this case the participants probably had the ability to process information
in logical ways.
Even though there was not a significant effect on the participants between the
emotive and logic messages, overall their immense contribution to a significance in the
attitudinal change in this study (Objective 1) are supported by other studies (Chaiken,
1979; Deaux, eta al., 1993; Eagly & Carli, 1981; Hovland, et al., 1957; Hovland &
Weiss, 1951; Jung, 2011; O’Keefe, 2002).
Research question 4.
Even though it is reported that persuasion through argument by character, logic
and emotion (Deaux, Dane & Wrightsman, 1993; Heinrichs, 2013; Jung, 2011; O’Keefe,
2002) are vital in attitudinal change, the role that other characteristics such as
demographic characteristics play a significant role in attitudinal change. Since the role of
culture and credibility in health communication important Carter (2013), the researcher
sort to find out what best model could be derived to achieve the nutritional attitudinal
change.
The best model of fit obtained was combination of emotive and Logic messages
which contributed significantly to the regression. While the following demographic
information, race/ethnicity, age, and gender did not significantly contributed to the
model, they provided their unique contributions individually. In reference to this study,
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almost 90 percent of the participants were Caucasian (dummy coded as ‘non-black’) and
as such, the race/ethnicity distribution was skewed one way hence making the nonsignificant contribution of race/ethnicity to the model. A noticeable contribution of
race/ethnicity to the model could have thrown more light in understanding diverse
cultural orientations. This also could have allowed for expatiation of social orientation,
commitment, responsibility, confrontation, communication and dealing with new
situations (Kim et al., 1998) when it comes to diverse cultures. According to Carter
(2013) “what one person deems a credible channel from which to receive health
information and thus deserving further thought or investigation may be labeled as
insignificant or unhelpful by another, even if both are trying to bridge a similar gap” (p.
20). Not only is credibility influenced by demographics (Kiousis, 2001), but factors used
to evaluate it can be influenced by the massage of time (Hovland & Weiss, 1951),
location of source (Gaziano & McGrath, 1986), and the effects of priority and quality
(Crano, 1977). Also “It is generally believed that by understanding the cultural
characteristics of a given group, public health and health communication programs and
services can be customized to better meet the needs of its members” (Kreuter & McClure,
2004, pp. 439).
The variables in the derived model goes to show the important message framing
in terms of message content play in persuasion. This model goes to inform that when
designing a nutritional messages with the purpose to persuade for attitudinal change, it
vital to consider what constitutes the message to be delivered for that purpose. In this
case, a message consisting of a combination of emotion and logic would produce the
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necessary attitudinal change. This model best suits for persuasion in that while a part of
the message is propelled from psychological appeals, the other remaining part is supports
the initial with facts that is, in a complementary manner.
Findings from the Supplementary Analysis
Comments made by the current research participants provided some useful
information on the thoughts they had on the messages they rated. While the three groups
were assigned different messages (emotive messages, logic messages and, combination of
emotive and logic messages) there were some salient commonalities in their comments.
Most noticeable common themes generated from the comments made by participants in
the three groups were, education, socioeconomic status and credibility issues.
The participants were in agreement that for effective attitudinal change to occur,
there is a need for education not only for children, but most importantly adults (as in
parents and guardian) and school authorities. The following statements further amplifies
the participants concern:
While it is true that children are limited to what their parents supply, I still believe
that educating them while in school and offering them healthier options is
imperative. It may give them the opportunity to try different food they do not get
at home and they could potentially share what they learn with care givers who
may not be aware of the information.
A participant also elucidated this point:
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I do think that schools should improve their food. Oftentimes, it is very unhealthy
food that our children have to choose from and this makes for bad habits,
especially when the children get older
Another participant also had this view;
People are mostly aware of how bad fast food is and the health implications of
eating it. I think people are desensitized to the shock value of how bad fast food
is, or how many calories are in a fast food meal. To change eating habits about
fast food I think that there would have to be a comparison or something to help
people understand how insane it is to have one food item with 710 calories.
While the blame may be shifted between parents, to schools and fast food places,
the researcher is of the view that parents’ involvement in healthy nutrition (either among
their children or themselves) is paramount. Even with various interventions have sought
to increase the physical activity levels during Physical Education (PE) lessons (Kelder, et
al., 2 003; McKenzie, Sallis, Kolody, & Faucette, 1997; McKenzie, et al., 2004) and
other programs such National school lunch and breakfast programs, Fight BAC, Eat
Smart, Play Hard, Nibbles for Health, and Power of Choice, just to mention a few
(United States Department of Agriculture [USDA], 2012) continue to contribute to the
wellbeing of children, parents involvement can help complement the above mentioned
efforts. The family is the main environment during childhood for children to learn and
develop food choices and practices, that is, decisions on what type and quantity of foods,
times these foods are consumed, and physical activities are made by adults or caregivers
(Epstein, Valoski, Wing, & McCurley, 1990; Contento, Manning, & Shannon, 1992).
197
Children eat what they are given at home. Parents are much aware of the toll
obesity can have on their children (physical and psychological) and majority of them will
do their best to avert these situations if they receive the right nutritional messages or
guidance. The right messages could provide parents with nutritional information as well
as the consequences of bad nutrition. Parents can therefore educate their children to make
the right nutritional choices. As pointed out by Knowles, Holton, and Swanson (2011),
adults are motivated to learn as the need arises, are able to relate to issues, and have a
deep need to be self-directing, thus, eliciting behavioral change through encouraging
individuals to willingly make healthful, economical food choices could be attained
through adult education. Education levels are positively associated to health knowledge
and leisure time physical activity (Luepker, et al., 1993).
It is the view of participants in this current study that while there is a willingness
to eat healthfully, the current economic situation makes it impossible that is, low
socioeconomic status place individuals in situations which they have no choice but
consume unhealthy foods on daily basis. As indicated by this participant:
I agree with the message stated above. As someone who purchases healthy food
regularly, it does tend to cost more. This may suggest that people with limited
incomes may choose unhealthy and cheaper food choices due to their budget.
Another participant is of this view:
In actual fact, it is not expensive to eat healthful." does not seem like a true
statement. For example, recently I talked with a client who says that when she
watches her sister’s children and hers there are 10 kids. I asked, what do you feed
198
them? She replied macaroni & cheese, hot dogs, which is less expensive than
purchasing foods from all the categories above.
It is reported that low socioeconomic status is linked with obesity (Bove, &
Olson, 2006; Gordon-Larsen et al., 2006; Datar, & Sturm, 2006). Also food insecurity
and absence of safe place for physical activities as a result of low socioeconomic status
has also been linked to obesity in children (Alaimo, et al., 2001). Furthermore, a number
of studies have indicated the link between participating in Supplementary Nutrition
Assistance Program (SNAP, formerly known as Food Stamps) and obesity (Guthrie et al.,
2007; Leung & Villamor, 2011; Ver Ploeg & Ralston, 2008). With low socioeconomic
status, impoverished homes may be faced with challenges of eating healthful as already
indicated by the current research participants. Research has shown that food purchases
are influenced by food costs (Drewnowski, & Darmon, 2005) and also diet costs has been
reported to be barrier to dietary change, especially individuals in low-income homes
(Drewnowski, & Spector, 2004). Furthermore, to attain a healthy diet, it may be required
to spend more money (Drewnowski, & Darmon, 2005).
While the debate on the cost of eating healthy continues, recent research indicates
that healthier food-based diet patterns cost $1.54 more than less healthy options (Roa,
Afshin, Singh, & Mozaffarian, 2013). This study conducted a systematic review and
metaanalysis of prices of healthier versus less healthy foods/diet patterns among 27
studies from 10 countries while accounting for key sources of heterogeneity (Roa et al.,
2013). With this new development, the suggested method of minimizing nutrition related
illnesses is through education and budgeting.
199
Questions were raised about the authenticity of the messages presented to the
participants. This was the case because each message presented to participants for rating
had no references hence, questioning the credibility of the messages. As participants
indicated below:
There is no research cited in this message. While it seems logical and
appropriate, it could just be a strongly worded opinion. I am certain that I believe
that eating fresh is cheaper than buying processed food - if not just for the
longevity of the foods. But I don't really buy processed foods so I this is merely
an educated guess.
References always help the reader identify where the information came from and how
accurate it may be. As amplified by this participant:
The 400,000 deaths. Obesity is not the primary cause. I feel it is inappropriate to
make that claim. Obesity is the leading risk factor for many of the leading causes
of death. Or obesity can be linked to 400,000 deaths. No citations to back up
statements so would not share.
For participants to question to credibility of the messages by indicating the
absence of references after each message insinuate that peripheral routes might not be the
only route used to rate the messages but the central route might have also used.
Employing the central route indicates that the research participants were motivated and
able to ponder over the messages that is, there was attention, comprehension, elaboration,
integration, leading to enduring attitude change (Petty & Cacioppo, 1996). The difficulty
200
associated with employing the central route (Petty & Cacioppo, 1996) further indicates
that the participants were motivated.
Overall, outside the three mentioned themes (education, socioeconomic status and
credibility) that were developed, participants also believe that even though people are
aware of the hazards associated with unhealthy dietary yet, they continue to make bad
dietary choices. Others are of the view that it is high time fast food restaurants take the
initiative to presenting consumers healthy food choices. While others hold the notion that
parents should serve as role models for their children, others are of the view that it is
easier said than done, that is people are just not motivated enough to change in country
where it is the norm to say big people are lazy.
Recommendations
Employing emotions as a persuasive tool has been a strong method used during
argumentation (Heinrich, 2013; DeSteno, et al., 2010) and the outcome of this current
study does not suggest otherwise. This current study further suggest that in addition to
emotion, logic also plays a vital role. In other words, for persuasion to occur, the message
should have a combination of emotive and logic messages. While literature supports the
importance role that emotive messages play during persuasion, the addition of logic
messages as support by the model developed in this study might have been due to this
study population being in the education field. In that as students, it important for them to
see supporting figures or references to complement the emotive message. While this
study did not access effect of these messages on people in school as against those not in
school, the research is of the view that when dealing with individuals that are in the
201
educational field, it is important to support emotive messages with logical messages.
Instructional designers and nutrition intervention and counseling experts should in other
words provided citations or references to information been provided to their clients.
Credibility as indicated by Gottlieb and Sarel, (1991), Ward and McGinnies,
(1974) and, (Arora & Arora, 2004) undoubtable plays a vital role in attitudinal change.
With this current study, the researcher is of the view that it important for instructors or
individual’s involving in nutrition intervention and counseling to let their clients know
their background and their accomplishment in their field they belong to. These
background information and accomplishment which this study amplifies has been
suggested by Bednar and Levie (1993).
While this study employed written messages through the internet, it will be
interesting to find out what the outcome of the research would have been if this was
conducted through videos. In other words, will the attitude change be lingering or will the
effect size be more less than medium with Cohen’s d. Employing video meant that
participants will have the opportunity to see the researcher which could have had an
effect on the credibility ratings. It is reported that perceived attractiveness has effect on
credibility (Bednar & Levie). According to Greenberg and Zanetis (2012), interaction
with video content can help people learn by relating to visual content which leads to
engagement and thus, the transfer of knowledge occurs and memory retained.
Data was collected by employing the explicit method. Measuring explicit attitude
employs a period of time to self-report (Bohner & Dickel, 2011; Petty et al., in press) and
some implicit measures employs spontaneous evaluations (Petty et al., in press).
202
Replicating this study by employing the implicit method will further add up to the
literature that supports that both yield the same result (Greenwald, Poehlman, Uhlman &
Banaji, 2009, cited in Petty et al., in press) or produce different results ((Hofmann,
Gawronski, Gschwendner, Le, & Schmitt, 2005; Rydell, McConnell, Strain, Claypool, &
Hugenberg, 2007).
Literature indicates that credibility is influenced by demographics (Kiousis, 2001)
and even though this current study did not have any of the demographics contribute to the
research model, the research still believes culture has a role in credibility rating and as
such the tendency to have a positive or negative effect on attitude change. The question
that remains to be answered is if this study was conducted among a different population
situated in a different country would the result have been significantly different. While
the researcher encourages others in this field to undertake this study in a different cultural
context, the nest step for the researcher is to undertake this study again in a different
cultural context as well. It is reported that different cultures have different ways in
dealing with new situation, how they communicate, how they deal with or handle
confrontations, how they take responsibility or commit to issues (Kim et al., 1998). With
all this variables, it will be interesting to know how researchers will frame their messages
or made videos to elicit positive nutritional attitude change.
Conclusion
The significance of credibility and how messages are framed or delivered to
persuade individuals in attitudinal change cannot be overstated. Whether people are faced
with challenges like lack of nutritional education or low socioeconomic status, it is
203
paramount for individuals delivering nutrition intervention and counseling to note the
importance of credibility and message content in achieving attitudinal change.
Result from this study not only confirms the numerous studies that mentioned the
importance of credibility on attitudinal change (Deìrdöğen, 2010; Heinrich, 2013;
McCroskey & Teven, 1999; McCroskey & Young, 1981; Olson & Zann, 1993) but also
reiterates others studies that have equally proven the significance of message framing
(message content) on attitudinal change (Bednar & Levie, 1993; Cacioppo & Petty, 1989;
Leshner & Cheng, 2009; Petty & Cacioppo, 1984; Tversky & Kahneman, 1981 ). Based
on the high ratings on the credibility of the messages, there was a significant attitudinal
change in the research participants. Secondly, the result from this research also indicates
that for an effective attitudinal change, messages should be composed of emotions and
logic. An outcome that goes to inform instructional designers, trainers and individuals
involve in nutrition intervention and counseling not only to count on their credibility but
also pay attention to how they frame their messages or information delivered to their
clients.
This research also expatiates on the cues that are employed by individuals when
they are dealing with messages. As indicated in this research, it is the opinion of the
researcher that participants used both peripheral and central routes to rate the credibility
of the messages. While these routes could lead to attitudinal change, it is vital for
instructional designers, trainers and individuals involved in nutrition intervention and
counseling to consider the lasting effect of the outcome of the attitudinal change. It is
reported that while the receiver in central route directs more thoughtfulness to the
204
argument that appears in the message and tends to fathom the message more, peripheral
routes relays on simple implication about the argument without complex cognitive
processing (Jung, 2011). Indicating that clients who employ the central route could have
a more enduring attitudinal change than those who use the peripheral route. To achieve a
lasting attitudinal change, it befalls on those who are delivering the message to have their
clients motivated to elaborate on the delivered messages. The researcher is of the opinion
the more usage of the central route by the research participants further explains why the
addition of logical messages to model 1 further strengthened model 2 (Table 27 & Table
29).
This study has provided further in sight in amplifying studies (Brug, et al., 1999;
Bowen et al., 2003; Oenema, et al., 2001; Oenema et al, 2005; Tate, et al., 2009;
Wantland, et al., 2004) on the contributions of digital technologies in nutrition
intervention and counseling. This goes to show that the future of employing digital
technology to achieve nutrition intervention and counseling result is not bleak. As
compared to on-site nutrition and counseling, it still holds some competitive edge in
terms of cost effectiveness, reaching a larger population and its flexibility. While this
study did not look into the effectiveness of digital technology in nutrition intervention
and some may still doubt its effectiveness, it will take studies like this current one and the
preceding ones to convince people about the effectiveness of digital technology in
nutrition intervention and counseling. The researcher is in no way encouraging
committing 100 % usage of digital technology in nutrition intervention and counseling
205
but instead advocating not for only equity based on informed decision but where digital
technology and on-site nutrition intervention and counseling can complement each other.
Since the messages made participants aware of the pro and cons of dietary intake
and referencing their comments further buttresses the importance of dietary awareness in
encouraging people to change to healthful diets (Oenema, et al., 2001). Comments made
by participants in this study indicates that majority of the participants have gone through
the first two stages of Weinstein’s Precaution Adoption model. The stages which entails
individuals coming to an understanding that they have heard of the health risk related
with a particular behavior, knowing that the risk behavior is widespread and finally that
they are engaging in the risk behaviors themselves (Weinstein, 1988, cited in Oenema et
al., 2001). However, there are few who attained the third stage.
Education in the researcher’s opinion remains fundamental for successful
nutrition intervention and counseling, that is, if an individual is educated other concern
(low socioeconomic status, bad choices, lack of initiatives etc.) raised by the participants
can be minimized. Studies shows that the highest obesity rates were linked to the lowest
income and low educational levels (Schoenbom, Adams, & Barnes, 2002).
Adult learning influences an individual’s income and employability (Field, 2011),
in addition, attitudes and behaviors that have an effect on people’s mental well-being
(Field, 2012; Center for Research on the Wider Benefits of Learning, 2003). Through
adult education, the desire to seek information through reading and instilling discipline in
children is critical. Parents or Guardians insight of likely obesity risk factors and family
practices influence children’s health (Gable and Lutz, 2000) will be heightened. The
206
tendency for children to participate in physical activity is ascertained in early childhood
and go on through adulthood (Kohl & Hobbs, 1998) if this discipline is instilled. For
families that have had the unfortunate illnesses to their children as a result of obesity,
adult education will provide the need to have the knowledge and skill to appreciate food
groups and their contents, so they can make an inform decision about what is best for the
body. Also it has been reported of the difficulty of parental involvement in schools’
physical and nutrition interventions (Perez-Rodrigo, & Aranceta, 2003) and there is no
better instrument to these difficulties than education.
Researcher’s Reflection
As an advocate for proper nutrition, results from this study has been humbling.
While there were diverse views on the onset of bad eating habits, the researcher
completely agrees that the solution lies in education. Message content remains a vital
instrument in achieving proper nutrition. While dietician and other providers of nutrition
instruction continue to help minimize unhealthy eating, they cannot rest on their oars. For
a healthy future, the foundation has to start with children. Children learn from their
environment and their current environment encompasses their school and home.
Literature shows that schools are doing their part in this regard and parents’ involvement
in physical and nutrition intervention are minimal. While efforts are made at schools it is
paramount to note that the solution lies in incorporate parents in the endeavor to help
minimize nutrition related illnesses. The researcher believes it is paramount that
instructors, be it instructional designers, trainers, nutritionist or dietician understand that
assumptions cannot be made when it comes to matters of nutrition when they are dealing
207
with their clients. As it can be found in this study population that even though majority of
them are in the nursing field they found the messages to be an eye opener, insightful and
beneficial. Like Lewin (1936) puts it, behavior is a function of the individual in their
surroundings (Sansone, Morf & Panter, 2004) and we need to pay attention to what
happens in our surroundings.
Limitations
Respondents’ honesty and their variances in the interpretation/understanding of
the questions played a vital role this study. The questionnaire elicited responses that
represent perceptions of participants. This may have been swayed by other variables not
mentioned in this study. The sample size could not be chosen from the pilot study as the
sample for this study was dependent on the number of students who enrolled for the
Introduction to Nutrition class that is, sample size could not controlled. Most of the
participants in the study were in the nursing field and have known some of the nutritional
information and outcomes of unhealthy and this prior knowledge may have swayed their
responses. Participants chose to be part of the study and this may reflect a personal
interest in the subject matter. Even though the researcher (a facilitator in the class) did not
make himself known to the students as the one conducting the research, results from this
study might be influenced since the researcher was the one sending the research links to
them for participation. Furthermore the informed consent form that participants had to
read and consent to or not had researcher’s name amongst the research team and this may
have influenced their responses for rating the messages.
208
Summary
Data from this study indicates that for nutritional attitudinal change, not only
should the credibility of a message be taken into account but the message should be
composed of both emotion and logic. While results from the main analysis indicates that
participants employed the peripheral route to rate the credibility of the messages, the
supplementary analysis further indicated that the central route was also accessed to rate
the messages as well. This study reiterates the efficacy of employing digital technology in
nutrition intervention and counselling. Finally, comments from participants support other
studies that report that socioeconomic status continue to be a leading cause of obesity and
its related illnesses and that education remains the strongest tool that can be employed to
minimize obesity epidemic and its related illnesses.
209
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Appendix A: Recruiting Tool
Hello Class,
You are being asked to participate in a research. For you to be able to decide
whether you want to have your responses used as a data source in this project, you should
understand what the project is about, as well as the possible risks and benefits in order to
make an informed decision. This process is known as informed consent. This form
describes the purpose, procedures, possible benefits, and risks. The link to consent form
will be made available to you for you to make your decision before attempts are made to
use your responses as data source. It also explains how your personal information will be
used and protected.
In order to determine a better way of designing an effective discussion board for
future class purposes and also look at the outcomes in term of nutritional attitude change
as result of this class, an extra credit exercise will be offered for participation for this
research purposes. The extra credit exercise will entails 10 messages which require that
after reading each message you rate the message based on 8 items. Each message with its
corresponding scale rating will take approximately 5 minutes to complete. Two messages
will be made available per week for completion. After the completion of the 10th message
and its scale rating, you will be required to complete a questionnaire made up of three
parts. It will take approximately 15 minutes to complete the questionnaire. Upon
completion of the 10 messages with their corresponding rating scale of 8 items and
questionnaire, 10 points will be awarded to you as an extra credit. However point will be
awarded if you choose to discontinue the exercise. For example, points will be awarded
247
to you depending on your last completed exercise. That is if you complete 3 messages
and their corresponding scale rating items and choose not to continue with the exercise,
you will be awarded 3 points.
If you have any questions regarding this study, please contact the investigator (Abednego
Bansah, [email protected], 740-274-2922) or advisor (David Moore,
[email protected], 740-597-1322 and David Holben, [email protected], 740-5932875).
Thank you
Wish you all the best as you undertake this class.
Abednego Bansah
(Researcher)
248
Appendix B: Messages and Scale Rating
Group1 Message 1
Our nation stands at a crossroads. Today’s epidemic of overweight and obesity threatens the
historic progress we have made in increasing American’s quality and years of healthy life. Twothird of adults and nearly one in three children are overweight or obese. In addition, many racial
and ethnic groups and geographic regions of the United States are disproportionately affected.
The sobering impact of these numbers is reflected in the nation’s concurrent epidemics of
diabetes, heart disease, and other chronic diseases. If we do not reverse these trends, researchers
warn that many of our children, our most precious resource will be seriously afflicted in early
adulthood with medical conditions such as diabetes and heart disease. This future is unacceptable.
On a scale of 1 to 10, how will you rate the following based on the above message?
1-Lowest
10- Highest
Scale Descriptive
1-2
Poor
3-4
Fair
5-6
Good
7-8
Very Good
9-10
Excellent
1. The usefulness of the message
2. The message is open-minded
3. The message’s ability to help change eating habits for the better
4. The accuracy of the message.
5. Message convincingness
6. Your willingness and ability to share this message with others.
7. Message founded on research
8. Please provide any comment(s) that could improve the message
above………………………………………………………………………………
………………………………………………………………………………………
………………………………………………………………………………………
………………………………………………………………………………………
……………………………..
249
Group 1 Message 2
USDA recently published practical, science-based nutrition standards for snack foods and
beverages sold to children at school during the school day. The standards, required by the
Healthy, Hunger-Free Kids Act of 2010, will allow schools to offer healthier snack foods to
children, while limiting junk food. While this is a brilliant initiative, the question still remains on
the role of parents in this initiative. Children will eat what they are given at home and
decisions as to a child joining a physical activity group or not are made by parents. The
main environment of the child is the parents or the care giver environment and unless
their environment is willing to change the success of these programs would be farfetched.
I strongly believe adult education is the key.
On a scale of 1 to 10, how will you rate the following based on the above message?
1-Lowest
10- Highest
Scale Descriptive
1-2
Poor
2-3
Fair
5-6
Good
7-8
Very Good
9-10
Excellent
1. The usefulness of the message
2. The message is open-minded
3. The message’s ability to help change eating habits for the better
4. The accuracy of the message.
5. Message convincingness
6. Your willingness and ability to share this message with others.
7. Message founded on research
8. Please provide any comment(s) that could improve the message
above………………………………………………………………………………
………………………………………………………………………………………
………………………………………………………………………………………
………………………………………………………………………………………
……………………………..
250
Group 1 Message 3
While things might be improving a bit, the economy is still pretty tough right now. I am sure that
this is not news to any of you. When food prices soar, people often substitute healthful foods,
like fresh produce, with less healthful alternatives that are loaded with fat or sugar - or both.
True, sugar is a carbohydrate, but the mainstay of our diet should be more healthful foods rich in
carbohydrates like whole grains, vegetables, and fruit. In fact, at the end of summer 2009, the
American Heart Association published guidelines on sugar intake in adults.
On a scale of 1 to 10, how will you rate the following based on the above message?
1-Lowest
10- Highest
Scale Descriptive
1-2
Poor
2-3
Fair
5-6
Good
7-8
Very Good
9-10
Excellent
1. The usefulness of the message
2. The message is open-minded
3. The message’s ability to help change eating habits for the better
4. The accuracy of the message.
5. Message convincingness
6. Your willingness and ability to share this message with others.
7. Message founded on research
8. Please provide any comment(s) that could improve the message
above………………………………………………………………………………
………………………………………………………………………………………
………………………………………………………………………………………
………………………………………………………………………………………
……………………………..
251
Group 1 Message 4
It is so amazing to me to see all of the muscles and structures of the body and to learn how they
work. As you might imagine, I am constantly amazed at what our body can do and everything
that takes place in the body. When I think about the health of my body, I have to be sure to utilize
all of the tools available to eat right. However, this can be a challenge. A while ago (or
yesterday, perhaps), I had a hamburger kids meal at a chain quick service restaurant. My
hamburger paper had this written on it, "it's what I eat and what I do." That got me thinking
about the dangers of eating at restaurants and what this could be doing to my remarkable body.
What make up my remarkable body include cells, tissues, organs and body systems and good
nutrition keeps them functioning at their optimum best. That was a heads up statement yet, a great
number of people visiting these fast places at least five times in a week. I wonder how many
people who purchase this kid’s meal saw this statement not to even mention pondered about it.
Hmmm……. “it’s what I eat and what I do”
On a scale of 1 to 10, how will you rate the following based on the above message?
1-Lowest
10- Highest
Scale Descriptive
1-2
Poor
2-3
Fair
5-6
Good
7-8
Very Good
9-10
Excellent
1. The usefulness of the message
2. The message is open-minded
3. The message’s ability to help change eating habits for the better
4. The accuracy of the message.
5. Message convincingness
6. Your willingness and ability to share this message with others.
7. Message founded on research
8. Please provide any comment(s) that could improve the message
above………………………………………………………………………………
………………………………………………………………………………………
………………………………………………………………………………………
252
Group 1 Message 5
First, "a label that says 95% fat-free means that only 5% of the calories come from fat."
This is a myth - 5% of the food product by weight is fat. The calories from fat may still
be high. The nutrition facts panel can help you to determine how many calories come
from fat. Second, "certain foods -- such as grapefruit, celery, or cabbage soup -- help
burn fat." This, too, is a myth. There is no single food that can help an individual to burn
fat. Are there any myths that you believed about fat? Are you ready to hang up your
cabbage soup habit and try eating fewer calories and exercise more?
On a scale of 1 to 10, how will you rate the following based on the above message?
1-Lowest
10- Highest
Scale Descriptive
1-2
Poor
2-3
Fair
5-6
Good
7-8
Very Good
9-10
Excellent
1. The usefulness of the message
2. The message is open-minded
3. The message’s ability to help change eating habits for the better
4. The accuracy of the message.
5. Message convincingness
6. Your willingness and ability to share this message with others.
7. Message founded on research
8. Please provide any comment(s) that could improve the message
above………………………………………………………………………………
………………………………………………………………………………………
………………………………………………………………………………………
………………………………………………………………………………………
……………………………..
253
Group 1 Message 6
Proteins are nutrients crucial to metabolic functions in your body, such as muscle
building and hormone production. As you age, your body’s natural ability to break down
and absorb proteins can decrease. Increasing the amount of protein in your body is not as
simple as eating an extra steak or drinking more milk. If your body lacks the ability to
absorb protein well, you may need to adjust other aspects of your diet or daily routine to
compensate. When you eat your protein can also affect how well your body utilizes the
amino acids. Consuming protein immediately before and after you exercise appears to
have the greatest effect on how well your body absorbs amino acids. This is because
exercise stimulates a process called muscle protein synthesis. During this process, your
body is actively trying to make new protein chains and seeks out amino acids. By
consuming protein at a time when your body is craving it, you are more likely to absorb
it.
On a scale of 1 to 10, how will you rate the following based on the above message?
1-Lowest
10- Highest
Scale Descriptive
1-2
Poor
2-3
Fair
5-6
Good
7-8
Very Good
9-10
Excellent
1. The usefulness of the message
2. The message is open-minded
3. The message’s ability to help change eating habits for the better
4. The accuracy of the message.
5. Message convincingness
6. Your willingness and ability to share this message with others.
7. Message founded on research
8. Please provide any comment(s) that could improve the message
above………………………………………………………………………………
………………………………………………………………………………………
254
Group 1 Message 7
When I was growing up, my Dad sometimes forgot to flush the toilet after he urinated. I
would sometimes walk into the bathroom, and we had the most beautiful toilet water
ever! It was sometimes green. Not from the toilet bowl cleaner in the water, but from the
vitamins that my Dad had taken. I did not realize at the time the principles of nutrient
absorption. Some vitamins are water-soluble and some are fat-soluble. The water soluble
ones get excreted via urine most of the time. My Dad was urinating away his expensive
Amway vitamins. If you or your child is taking vitamin, I can help but ponder, have you
ever thought about this? Urinating your precious vitamins away?
On a scale of 1 to 10, how will you rate the following based on the above message?
1-Lowest
10- Highest
Scale Descriptive
1-2
Poor
2-3
Fair
5-6
Good
7-8
Very Good
9-10
Excellent
1. The usefulness of the message
2. The message is open-minded
3. The message’s ability to help change eating habits for the better
4. The accuracy of the message.
5. Message convincingness
6. Your willingness and ability to share this message with others.
7. Message founded on research
8. Please provide any comment(s) that could improve the message
above………………………………………………………………………………
………………………………………………………………………………………
………………………………………………………………………………………
255
Group 1 Message 8
Water is vital to staying healthy and performing most duties. Here is someone’s story, “I
was at this four day music festival. Everyone was encouraged to drink lots of water
because it was about 85 degrees on average. I drank plenty of water the first day and
didn't have a problem. But for some reason the next day I didn't make a definite effort to
stay hydrated (not a good idea). I wanted to see this band play in the afternoon, so I ended
up sitting in the sun in a metal folding chair watching another band before it play. I didn't
feel thirsty or even too hot. When the concert was almost over and the lead singer was
talking, I began to feel strange. The symptoms hit fast without any warning. A sort of
panic was rising inside me--my heart rate was probably faster. I wanted to sit down in the
middle of the mosh pit because something wasn't right, but I didn't because I felt sort of
stupid--like maybe I was overreacting (next time I'll listen to my body). Still, the effects
of dehydration rapidly worsened, and within thirty seconds my muscles in my stomach
were cramping slightly and my vision blurred and spiraled downward. I turned around
and grabbed my knees and I met the eyes of one of my friends. My friend saw something
was wrong and asked if I was okay. I tried to shake my head in response to say "no", but I
had already blacked out.
On a scale of 1 to 10, how will you rate the following based on the above message?
1-Lowest
10- Highest
Scale Descriptive
1-2
Poor
2-3
Fair
5-6
Good
7-8
Very Good
1. The usefulness of the message
2. The message is open-minded
3. The message’s ability to help change eating habits for the better
4. The accuracy of the message.
5. Message convincingness
6. Your willingness and ability to share this message with others.
9-10
Excellent
256
7. Message founded on research
8. Please provide any comment(s) that could improve the message
above………………………………………………………………………………
………………………………………………………………………………………
………………………………………………………………………………………
……………………………………………………………………………….……
………………………………………………………………..
257
Group 1 Message 9
Reality TV anyone? I will admit it, I loved watching Jamie Oliver's Food Revolution. I
also love The Biggest Loser. We are in the midst of an obesity crisis. Why do I love the
above reality shows? I enjoy watching interventions in action. In 1986, less than 10% of
Americans were overweight or obese. Look around...things are much worse now. I have
learned one thing in my life...close the mouth and move the legs! Being fit is very hard
work. Our Olympic athletes always show us this. Do our swimmers win by luck? Are our
gymnasts or figure skaters world-class because of the cute outfits? Did your favorite
baseball team win this week because of their new stadium? Food for thought!
On a scale of 1 to 10, how will you rate the following based on the above message?
1-Lowest
10- Highest
Scale Descriptive
1-2
Poor
2-3
Fair
5-6
Good
7-8
Very Good
9-10
Excellent
1. The usefulness of the message
2. The message is open-minded
3. The message’s ability to help change eating habits for the better
4. The accuracy of the message.
5. Message convincingness
6. Your willingness and ability to share this message with others.
7. Message founded on research
8. Please provide any comment(s) that could improve the message
above………………………………………………………………………………
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258
Group 1 Message 10
Routine physical activity, among all ages, is not just about exercising to improve your
outward appearance. In addition to reducing body mass index (BMI) and body fatness,
habitual physical activity is associated with improvements across many health outcomes,
which may not be apparent to most individuals. Research studies have found daily
physical activity among children and youth is associated with: increased health-related
fitness, improvements in cardiovascular and metabolic disease risk profile, decreased risk
of cardiovascular disease in adulthood, decreased risk of developing type 2 diabetes in
childhood and adulthood, boosts in bone health and development, improvements in
mental health and well-being, improvements in cognitive and academic performance,
betterments in motor control and physical functioning.
On a scale of 1 to 10, how will you rate the following based on the above message?
1-Lowest
10- Highest
Scale Descriptive
1-2
Poor
2-3
Fair
5-6
Good
7-8
Very Good
9-10
Excellent
1. The usefulness of the message
2. The message is open-minded
3. The message’s ability to help change eating habits for the better
4. The accuracy of the message.
5. Message convincingness
6. Your willingness and ability to share this message with others.
7. Message founded on research
8. Please provide any comment(s) that could improve the message
above………………………………………………………………………………
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259
Group 2 Message 1
Your choice of diet profoundly affects your health, both today and in the future. Persons
are not motivated to change their unhealthful eating habits due to fact that they are
unaware of their personal dietary behavior. Lack of awareness is also a major obstacle in
encouraging people to change to healthful diets. As a result, it is vital to make people
aware of their dietary intake as an initial step to behavioral change. A nutritious diet must
have five characteristics. First is adequate: the food provide enough of each essential
nutrient, fiber, and energy. Second is balance: the choices do not overemphasize one
nutrient or food type at the expense of another. Third is calorie control: the foods provide
the amount of energy you need to maintain appropriate weight- no more, not less. Fourth
is moderation: the foods do not provide excess fat, salt, sugar, or other unwanted
constituents. Fifth is variety: the foods chosen differ from one day to the next. In actual
fact, it is not expensive to eat healthful.
On a scale of 1 to 10, how will you rate the following based on the above message?
1-Lowest
10- Highest
Scale Descriptive
1-2
Poor
2-3
Fair
5-6
Good
7-8
Very Good
9-10
Excellent
1. The usefulness of the message
2. The message is open-minded
3. The message’s ability to help change eating habits for the better
4. The accuracy of the message.
5. Message convincingness
6. Your willingness and ability to share this message with others.
7. Message founded on research
8. Please provide any comment(s) that could improve the message
above………………………………………………………………………………
260
Group 2 Message 2
The following nutrition standards are vital for a child’s health. Any food sold in schools
must: be a “whole grain-rich” grain product; or have as the first ingredient a fruit, a
vegetable, a dairy product, or a protein food; or be a combination food that contains at
least ¼ cup of fruit and/or vegetable; or contain 10% of the Daily Value (DV) of one of
the nutrients of public health concern in the 2010 Dietary Guidelines for Americans
(calcium, potassium, vitamin D, or dietary fiber). Foods must also meet several nutrient
requirements: calorie limits (Snack items: ≤ 200 calories and Entrée items: ≤ 350
calories); sodium limits (Snack items: ≤ 230 mg and Entrée items: ≤ 480 mg); fat limits
(Total fat: ≤35% of calories, Saturated fat: < 10% of calories and Trans fat: zero grams);
and sugar limit (≤ 35% of weight from total sugars in foods).
On a scale of 1 to 10, how will you rate the following based on the above message?
1-Lowest
10- Highest
Scale Descriptive
1-2
Poor
2-3
Fair
5-6
Good
7-8
Very Good
9-10
Excellent
1. The usefulness of the message
2. The message is open-minded
3. The message’s ability to help change eating habits for the better
4. The accuracy of the message.
5. Message convincingness
6. Your willingness and ability to share this message with others.
7. Message founded on research
8. Please provide any comment(s) that could improve the message
above………………………………………………………………………………
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261
Group 2 Message 3
Obesity as a result of behavioral and environmental factors stem from low socioeconomic status,
a characteristic shared by major impoverished homes or families. Obesity has been linked to low
socioeconomic status. Food insecurity and lack of a safe place for physical activities as a result of
low socioeconomic status has also been linked to obesity in children. With low socioeconomic
status, impoverished homes may be faced with challenges of eating healthful. Carbohydrates have
a bigger impact on blood sugar than fat or protein. Although many sugary sweets are high in
carbs and impact blood sugar, starchy carbs, like potatoes, also raise levels. Being overweight and
sedentary raises your risk for developing type 2 diabetes, which is an endocrine disease involving
blood sugar regulation. Watching your intake of carbs and balancing them with other foods is
essential if you're pre-diabetic or already have the disease.
On a scale of 1 to 10, how will you rate the following based on the above message?
1-Lowest
10- Highest
Scale Descriptive
1-2
Poor
2-3
Fair
5-6
Good
7-8
Very Good
9-10
Excellent
1. The usefulness of the message
2. The message is open-minded
3. The message’s ability to help change eating habits for the better
4. The accuracy of the message.
5. Message convincingness
6. Your willingness and ability to share this message with others.
7. Message founded on research
8. Please provide any comment(s) that could improve the message
above………………………………………………………………………………
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262
Group 2 Message 4
Technology has its drawbacks since fewer children are playing basketball and the majority of
them “surf the net” instead. Children consuming diets high in fat often displace nutrient dense
foods such as whole grains, fruits and vegetables. Diets high in fat are also typically low in fiber
because of the lack of complex carbohydrates. Complex carbohydrates are often high in fiber,
which is associated with lower cholesterol levels, improved digestive function, and decreased risk
of cardiovascular disease and some forms of cancer. Increasing dietary fiber among children may
be preventative in the development of childhood obesity. The high salt content of fast foods also
pose many threats to the health of Americans, young and old. Salt consumption is associated with
high blood pressure, strokes, and kidney function. In addition, some studies have shown that
calcium competes with sodium. In other words, as the intake of sodium increases, there is an
increase in the urinary excretion of calcium. This increased excretion of calcium may be
responsible for reduced peak bone mass and increased bone demineralization which, in turn,
increases the risk for osteoporosis and bone fractures among women.
On a scale of 1 to 10, how will you rate the following based on the above message?
1-Lowest
10- Highest
Scale Descriptive
1-2
Poor
2-3
Fair
5-6
Good
7-8
Very Good
9-10
Excellent
1. The usefulness of the message
2. The message is open-minded
3. The message’s ability to help change eating habits for the better
4. The accuracy of the message.
5. Message convincingness
6. Your willingness and ability to share this message with others.
7. Message founded on research
8. Please provide any comment(s) that could improve the message
above………………………………………………………………………………
263
Group 2 Message 5
Triglycerides, phospholipids and sterols are the most common members of the lipids
family, the class of nutrients made up primarily of dietary fats. Lipids are naturally
occurring compounds that all share one trait in common: they’re insoluble in water.
Although fats often get a bad rap, the body needs a certain amount of lipids to function
properly. However, trouble can occur if your body’s lipid levels are either too high or too
low. Read food labels: total fat, saturated fat, trans fat, and cholesterol; compare
products; % daily value vs. % kcalories from fat.
On a scale of 1 to 10, how will you rate the following based on the above message?
1-Lowest
10- Highest
Scale Descriptive
1-2
Poor
2-3
Fair
5-6
Good
7-8
Very Good
9-10
Excellent
1. The usefulness of the message
2. The message is open-minded
3. The message’s ability to help change eating habits for the better
4. The accuracy of the message.
5. Message convincingness
6. Your willingness and ability to share this message with others.
7. Message founded on research
8. Please provide any comment(s) that could improve the message
above………………………………………………………………………………
………………………………………………………………………………………
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264
Group 2 Message 6
Protein, protein, protein, all foods made from meat, poultry, seafood, beans and peas,
eggs, processed soy products, nuts, and seeds are considered part of the Protein Foods
Group. Beans and peas are also part of the Vegetable Group. Beans and peas are unique
foods because not only are they an excellent source of protein, they are also an excellent
source of fiber, folate and potassium. Yet with these qualities low socioeconomic
household still spend the little they have on more expensive protein sources like meat,
fish and poultry.
On a scale of 1 to 10, how will you rate the following based on the above message?
1-Lowest
10- Highest
Scale Descriptive
1-2
Poor
2-3
Fair
5-6
Good
7-8
Very Good
9-10
Excellent
1. The usefulness of the message
2. The message is open-minded
3. The message’s ability to help change eating habits for the better
4. The accuracy of the message.
5. Message convincingness
6. Your willingness and ability to share this message with others.
7. Message founded on research
8. Please provide any comment(s) that could improve the message
above………………………………………………………………………………
………………………………………………………………………………………
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265
Group 2 Message 7
Vitamins allow your body to grow and develop. They also play important roles in bodily
functions such as metabolism, immunity and digestion. There are 13 essential vitamins,
including vitamins A, C, D, E, and K and B vitamins such as riboflavin and folate.
According to the U.S. National Library of Medicine, the best way to meet your vitamin
needs is to eat a balanced diet containing a variety of foods. If you can't meet your needs
through food alone, you may require dietary supplements. Seek guidance from your
doctor or dietitian before taking supplements, however.
On a scale of 1 to 10, how will you rate the following based on the above message?
1-Lowest
10- Highest
Scale Descriptive
1-2
Poor
2-3
Fair
5-6
Good
7-8
Very Good
9-10
Excellent
1. The usefulness of the message
2. The message is open-minded
3. The message’s ability to help change eating habits for the better
4. The accuracy of the message.
5. Message convincingness
6. Your willingness and ability to share this message with others.
7. Message founded on research
8. Please provide any comment(s) that could improve the message
above………………………………………………………………………………
………………………………………………………………………………………
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266
Group 2 Message 8
Water makes up more than two-thirds of the weight of the human body. Without water,
humans would die in a few days. All the cells and organs need water to function. Water
serves as a lubricant. It makes up saliva and the fluids surrounding the joints. Water
regulates the body temperature through perspiration. It also helps prevent and relieve
constipation by moving food through the intestines. Your skeleton provides motility,
protection and support for the body. It also stores minerals and other nutrients. Though
they appear hard and unyielding, your bones are actually constantly being reabsorbed and
reformed by your body. Several minerals make up the lattice architecture of your bones.
On a scale of 1 to 10, how will you rate the following based on the above message?
1-Lowest
10- Highest
Scale Descriptive
1-2
Poor
2-3
Fair
5-6
Good
7-8
Very Good
9-10
Excellent
1. The usefulness of the message
2. The message is open-minded
3. The message’s ability to help change eating habits for the better
4. The accuracy of the message.
5. Message convincingness
6. Your willingness and ability to share this message with others.
7. Message founded on research
8. Please provide any comment(s) that could improve the message
above………………………………………………………………………………
………………………………………………………………………………………
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267
Group 2 Message 9
An important part of maintaining energy balance is the amount of ENERGY OUT
(physical activity) that you do. People who are more physically active burn more calories
than those who are not as physically active.
The same amount of ENERGY IN (calories consumed) and ENERGY OUT
(calories burned) over time = weight stays the same
More IN than OUT over time = weight gain
More OUT than IN over time = weight loss
Your ENERGY IN and OUT do not have to balance every day. It's having a balance over
time that will help you stay at a healthy weight for the long term. Children need to
balance their energy, too, but they’re also growing and that should be considered as well.
Energy balance in children happens when the amount of ENERGY IN and ENERGY
OUT supports natural growth without promoting excess weight gain.
On a scale of 1 to 10, how will you rate the following based on the above message?
1-Lowest
10- Highest
Scale Descriptive
1-2
Poor
2-3
Fair
5-6
Good
7-8
Very Good
1. The usefulness of the message
2. The message is open-minded
3. The message’s ability to help change eating habits for the better
4. The accuracy of the message.
5. Message convincingness
6. Your willingness and ability to share this message with others.
7. Message founded on research
9-10
Excellent
268
8. Please provide any comment(s) that could improve the message
above………………………………………………………………………………
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269
Group 2 Message 10
The 2008 Physical Activity Guidelines for Americans recommends children and youth
engage in a minimum of 60 minutes of moderate-to-vigorous physical activity daily,
including vigorous-intensity on an at least 3 days per week. These 60 minutes should also
include muscle and bone-strengthening activities 3 days per week. Moderate-to-vigorous
physical activity includes activities which makes you sweat or breathe hard, such as
running, swimming and bicycling. Muscle-strengthening activities include exercises that
make your muscles work harder than during daily life, such as doing push-ups, play tagof-war or climbing monkey bars. Bone-strengthening exercises produce force on the
bones to promote bone growth and strength, such as when your feet make contact with
the ground when playing sports or jumping rope.
On a scale of 1 to 10, how will you rate the following based on the above message?
1-Lowest
10- Highest
Scale Descriptive
1-2
Poor
2-3
Fair
5-6
Good
7-8
Very Good
9-10
Excellent
1. The usefulness of the message
2. The message is open-minded
3. The message’s ability to help change eating habits for the better
4. The accuracy of the message.
5. Message convincingness
6. Your willingness and ability to share this message with others.
7. Message founded on research
8. Please provide any comment(s) that could improve the message
above………………………………………………………………………………
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270
Group 3 Message 1
Sixty-five percent of the world's populations live in countries where overweight and
obesity kill more people than underweight. Obesity has been the cause of 400,000 deaths
each year in the United States, making obesity the second leading cause of death after
smoking. Seventeen percent of youth in the U.S. are obese. Food intake (energy intake)
that exceeds energy expended (less exercise or less physical activity) over prolonged
period of time has been cited as being the cause of overweight or obesity which results
from the accumulation of body fat. Overweight and Obesity does not only weigh down on
the body, cause cardiovascular diseases, diabetes, musculoskeletal disorders and some
cancers, it also affects academic outcomes, and mental health. Obesity is also linked to
deprived employment and relationship outcomes.
On a scale of 1 to 10, how will you rate the following based on the above message?
1-Lowest
10- Highest
Scale Descriptive
1-2
Poor
2-3
Fair
5-6
Good
7-8
Very Good
9-10
Excellent
1. The usefulness of the message
2. The message is open-minded
3. The message’s ability to help change eating habits for the better
4. The accuracy of the message.
5. Message convincingness
6. Your willingness and ability to share this message with others.
7. Message founded on research
8. Please provide any comment(s) that could improve the message
above………………………………………………………………………………
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271
Group 3 Message 2
This is a crucial moment for school meals. More families are struggling and relying on
free and reduced-price school meals in order to make ends meet. Work at the national and
state levels is increasing low-income children’s participation in the school lunch and
breakfast programs. The nation has a serious obesity epidemic as well as a hunger
problem, so the meals that are being served must be the healthiest possible. And there are
important efforts under way at the federal, state, and local levels to improve the quality of
school nutrition. All of these efforts need to be supported. About 25% of U.S. adults
consume the recommended five or more servings of fruits and vegetables each day,
below 25% of adolescents eat the recommended five or more servings of fruits and
vegetables each day, above 50% of American adults do not get the suggested amount of
physical activity to provide health benefits and more than a third of young people in
grades 9–12 do not regularly engage in vigorous physical activity.
On a scale of 1 to 10, how will you rate the following based on the above message?
1-Lowest
10- Highest
Scale Descriptive
1-2
Poor
2-3
Fair
5-6
Good
7-8
Very Good
1. The usefulness of the message
2. The message is open-minded
3. The message’s ability to help change eating habits for the better
4. The accuracy of the message.
5. Message convincingness
6. Your willingness and ability to share this message with others.
7. Message founded on research
9-10
Excellent
272
8. Please provide any comment(s) that could improve the message
above………………………………………………………………………………
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273
Group 3 Message 3
The Standard American Diet (SAD) is overloaded with non-nutritive carbohydrates, such
as refined sugar, white flour, and heavily processed foods that have been stripped of their
nutrition. As a result, the calorie consumption of many Americans has gone up
dramatically, while the nutrient value has gone down. The unused calories that are not
burned up by the body are stored as fat. As a result, many people feel hungry, have more
cravings, and eat more—while losing ground in maintaining adequate nutrition. This sets
the stage for chronic problems with obesity, diabetes, hormone imbalances, and
significant nutrient deficiencies that lead to chronic conditions. While restriction of
carbohydrates from your diet, may result to in mood swings, nausea, dizziness, weakness
and depression, too much consumption may have diverse consequences. Diets rich in
dietary fiber have been shown to have a number of beneficial effects, including decreased
risk of coronary heart disease and improvement in laxation. There is also interest in the
potential relationship between diets containing fiber-rich foods and lower risk of type 2
diabetes.
On a scale of 1 to 10, how will you rate the following based on the above message?
1-Lowest
10- Highest
Scale Descriptive
1-2
Poor
2-3
Fair
5-6
Good
7-8
Very Good
1. The usefulness of the message
2. The message is open-minded
3. The message’s ability to help change eating habits for the better
4. The accuracy of the message.
5. Message convincingness
6. Your willingness and ability to share this message with others.
7. Message founded on research
9-10
Excellent
274
8. Please provide any comment(s) that could improve the message
above………………………………………………………………………………
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275
Group 3 Message 4
In a society that functions at a high speed, fast food has quickly been adopted as the
preferred food of choice. Fast food restaurants and their advertisements are permeating
our neighborhoods, schools, television, and culture. Burger King and Big Mac burgers
have become defining foods of the typical American diet. Corporate goals aim to make
these chains more geographically accessible, adding more and more chains to our
neighborhood streets. These industries are successful because they offer consumers a
quick, cheap, convenient and tasty meal that is all too often high in fat and salt content
and low in fiber and calcium. Unhealthy processed foods such as these are a potential
health threat since they contribute to the increased prevalence of obesity and chronic
disease among Americans. new Spanish omelet bagel contains 710 calories, 40 grams of
fat, 275 mg of cholesterol and 1,520 mg of sodium. High fat diets and bigger portions in
combination with decreased physical activity play major roles in the obesity epidemic.
On a scale of 1 to 10, how will you rate the following based on the above message?
1-Lowest
10- Highest
Scale Descriptive
1-2
Poor
2-3
Fair
5-6
Good
7-8
Very Good
9-10
Excellent
1. The usefulness of the message
2. The message is open-minded
3. The message’s ability to help change eating habits for the better
4. The accuracy of the message.
5. Message convincingness
6. Your willingness and ability to share this message with others.
7. Message founded on research
8. Please provide any comment(s) that could improve the message
above………………………………………………………………………………
276
Group 3 Message 5
While both carbohydrates and lipids provide the fuel to energize your body,
carbohydrates are the most readily available source of energy, and lipids function
primarily as the body’s backup energy reserves. However, your body is able to store far
more energy in the form of lipids than in glycogen, the carbohydrate-based energy stores.
When glycogen available to the body is exhausted, it begins to use lipid-based energy.
Gram for gram, lipids outstrip glycogen in terms of available energy by more than two to
one. A gram of lipids yields 9 kilocalories, compared with 4 kilocalories in every gram of
glycogen. On the downside, particularly for those watching their weight, high-fat foods
contain more than twice the calories per gram as foods that are high in carbohydrate. It
vital to shop for lean and lean options of meat and meat alternative products, fat-free and
low-fat milk products, wide variety of vegetables, fruits, and whole grains. Avoid
invisible fat from high-fat cheese, baked & fried goods and choose wisely from many
available food products.
On a scale of 1 to 10, how will you rate the following based on the above message?
1-Lowest
10- Highest
Scale Descriptive
1-2
Poor
2-3
Fair
5-6
Good
7-8
Very Good
1. The usefulness of the message
2. The message is open-minded
3. The message’s ability to help change eating habits for the better
4. The accuracy of the message.
5. Message convincingness
6. Your willingness and ability to share this message with others.
7. Message founded on research
9-10
Excellent
277
8. Please provide any comment(s) that could improve the message
above………………………………………………………………………………
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278
Group 3 Message 6
One of the things that inspired me was the number of doctors who told me 80 percent of
the people walking into their offices -- regardless of what disease they had -- were protein
malnourished. Not because they weren't eating adequate protein, but because they were
not digesting and absorbing it properly. In order to try and improve that situation,
digestive enzymes or probiotics were used, but a lot of the doctors felt their patients still
needed supplemental protein. However, when they used the various protein powders,
shakes, and other protein sources that are available in the marketplace, they found that
they had little therapeutic value. They could get some therapeutic benefit from individual
amino acids or amino acid blends, but essentially what I learned was the real frustration
amongst the natural medicine community relative to protein metabolism issues in all
kinds of ill patients. I, for a variety of reasons, happened to come across research in the
critical care arena. Protein is a main component of the body. If you take the water out of
the body -- which is about 70 to 80 percent of the body's weight -- what is left is about 70
percent protein. Protein plays a role in every function of the body: hormones, tissue repair
agents, and enzymes are all protein derivatives. I became intrigued by this possibility that
protein malabsorption was a real problem for a wide variety of conditions. I went to the
library and looked for books on how the body digests, absorbs, and utilizes protein. I dug
in the medical literature looking for it and really could not find much. The only thing I
could find that seemed to be of real scientific value was studies done in the body building
and the athletic markets, which did not seem to have a lot of implications for the
chronically ill.
On a scale of 1 to 10, how will you rate the following based on the above message?
1-Lowest
10- Highest
Scale Descriptive
1-2
Poor
2-3
Fair
5-6
Good
7-8
Very Good
1. The usefulness of the message
2. The message is open-minded
3. The message’s ability to help change eating habits for the better
4. The accuracy of the message.
9-10
Excellent
279
5. Message convincingness
6. Your willingness and ability to share this message with others.
7. Message founded on research
8. Please provide any comment(s) that could improve the message
above………………………………………………………………………………
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280
Group 3 Message 7
As a fat-soluble vitamin, vitamin D in excess is not flushed from your body through
urine. Although your body can become toxic from excessive supplemental intake, the
toxicity does not derive from vitamin D–rich foods or sun exposure, according to the
Office of Dietary Supplements. The maximum amount of vitamin D that adults can safely
obtain from supplements is 4,000 international units (IU) per day. If you exceed this
limit, the excess vitamin D stays in your blood, causing adverse effects such as
unintentional weight loss, anorexia and abnormal heart rhythms. Excess vitamin D can
raise your blood levels of calcium, causing heart, blood vessel and kidney damage.
Consuming smaller amounts -- for example, 1,000 IU per day -- along with calcium in
supplement form increases your risk for kidney stones. Sufficient intake of vitamin D for
most adults is 600 IU daily from food or supplements. Foods, dietary supplements and
sun exposure provide vitamin D. Getting sufficient amounts -- 600 IU daily for most
adults -- is vital for overall health. Your skeletal system requires vitamin D because the
vitamin facilitates calcium absorption, a key for healthy bones and development. Your
liver, not your bones, produces vitamin D in response to the sun's ultraviolet rays.
Valuable food sources of this vitamin include cod liver oil, seafood, such as salmon and
tuna, and fortified juices and dairy products. Eggs, margarine and fortified cereals contain
moderate amounts
On a scale of 1 to 10, how will you rate the following based on the above message?
1-Lowest
10- Highest
Scale Descriptive
1-2
Poor
2-3
Fair
5-6
Good
7-8
Very Good
1. The usefulness of the message
2. The message is open-minded
3. The message’s ability to help change eating habits for the better
4. The accuracy of the message.
5. Message convincingness
9-10
Excellent
281
6. Your willingness and ability to share this message with others.
7. Message founded on research
8. Please provide any comment(s) that could improve the message
above………………………………………………………………………………
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282
Group 3 Message 8
You get some of the water in your body through the foods you eat. Some of the water is
made during the process of metabolism. But drinking water is your main, and best source,
of water. You also get water through liquid foods and beverages, such as soup, milk, and
juices. Alcoholic beverages and beverages containing caffeine (such as coffee, tea, and
colas) are not the best choices because they have a diuretic effect -- they cause the body
to release water. If you do not drink enough water each day, the body fluids will be out of
balance, causing dehydration. When dehydration is severe, it can be life-threatening.
Experts usually recommend drinking six to eight 8-ounce glasses of water daily. Calcium
is the most abundant mineral in your body and is found in your bones and blood. Along
with the minerals phosphorus and magnesium, calcium gives your bones strength and
density. This mineral also builds and maintains strong, healthy teeth. Calcium deficiency
due to poor nutrition or illness can lead to osteoporosis, a condition in which the bones
become brittle and less dense, increasing the risk of fractures. Foods that are rich in
calcium include milk and other dairy products, green, leafy vegetables and canned fish
with bones.
On a scale of 1 to 10, how will you rate the following based on the above message?
1-Lowest
10- Highest
Scale Descriptive
1-2
Poor
2-3
Fair
5-6
Good
7-8
Very Good
1. The usefulness of the message
2. The message is open-minded
3. The message’s ability to help change eating habits for the better
4. The accuracy of the message.
5. Message convincingness
6. Your willingness and ability to share this message with others.
7. Message founded on research
9-10
Excellent
283
8. Please provide any comment(s) that could improve the message
above………………………………………………………………………………
………
284
Group 3 Message 9
Think of it as balancing your "lifestyle budget." For example, if you know you and your
family will be going to a party and may eat more high-calorie foods than normal, then
you may wish to eat fewer calories for a few days before so that it balances out. Or, you
can increase your physical activity level for the few days before or after the party, so that
you can burn off the extra energy. The same applies to your kids. If they’ll be going to a
birthday party and eating cake and ice cream—or other foods high in fat and added
sugar—help them balance their calories the day before and/or after by providing ways for
them to be more physically active. Here's another way of looking at energy balance in
real life. Eating just 150 calories more a day than you burn can lead to an extra 5 pounds
over 6 months. That’s a gain of 10 pounds a year. If you don't want this weight gain to
happen, or you want to lose the extra weight, you can either reduce your ENERGY IN or
increase your ENERGY OUT. Doing both is the best way to achieve and maintain a
healthy body weight.
On a scale of 1 to 10, how will you rate the following based on the above message?
1-Lowest
10- Highest
Scale Descriptive
1-2
Poor
2-3
Fair
5-6
Good
7-8
Very Good
1. The usefulness of the message
2. The message is open-minded
3. The message’s ability to help change eating habits for the better
4. The accuracy of the message.
5. Message convincingness
6. Your willingness and ability to share this message with others.
7. Message founded on research
9-10
Excellent
285
8. Please provide any comment(s) that could improve the message
above………………………………………………………………………………
………………………………………………………………………………………
………………………………………………………………………………………
………………………
286
Group 3 Message 10
To be healthy, your body needs to get enough vitamins, minerals, and other nutrients.
Eating healthy means getting plenty of vegetables, fruits, whole grains, and fat-free or
low-fat milk products, as well as seafood, lean meat and poultry, eggs, beans, peas, seeds,
and nuts. Eating healthy also means limiting cholesterol, sodium (salt), and added sugars,
trans fats (Trans fats may be in foods like cakes, cookies, stick margarines, and fried
foods), saturated fats (These fats come from animal products like cheese, fatty meats,
whole milk, and butter, refined grains (Food products with refined grains include white
bread, noodles, white rice, and flour tortillas). Physical activity increases your chances of
living longer. It can also help control your blood pressure, blood sugar, and weight,
Lower your “bad” cholesterol and raise your “good” cholesterol, prevent heart disease,
colorectal and breast cancer, and type 2 diabetes. Also being more active can be fun, help
you look your best, improve your sleep, make your bones, muscles, and joints stronger,
lower your chances of becoming depressed, reduce falls and arthritis pain, help you feel
better about yourself. People of all ages and body types benefit from physical activity.
Even if you feel out-of-shape or haven’t been active in a long time, you can find activities
that will work for you.
On a scale of 1 to 10, how will you rate the following based on the above message?
1-Lowest
10- Highest
Scale Descriptive
1-2
Poor
2-3
Fair
5-6
Good
7-8
Very Good
1. The usefulness of the message
2. The message is open-minded
3. The message’s ability to help change eating habits for the better
4. The accuracy of the message.
5. Message convincingness
6. Your willingness and ability to share this message with others.
9-10
Excellent
287
7. Message founded on research
8. Please provide any comment(s) that could improve the message
above………………………………………………………………………………
………………………………………………………………………………………
………………………………………………………………………………………
………………………………………………….…………………………………
…………………………………..
288
Appendix C: Attitudinal Change Questionnaire
Nutrition and Message
PART I: Demographic Information
1. Sex: (Mark the appropriate circle)
Female
Male
Other
2. Age:
18-25
26-35
36-45
46-55
56 and above
3. Race/Ethnicity: (Mark the appropriate circle)
American Indian/Alaskan Native
African-American/Black
Asian/Pacific Islander
Caucasian
Hispanic/Latino
African
Asian
Other (specify)…………………………………………………..
289
4. Which of the following best describes your academic level in college?
Freshman (1st year student)
Sophomore (2nd year student)
Junior (3rd year student)
Senior (4th year student)
Other (specify)………………………………………………….
5. Which of the following best describes you?
Part-time student and full-time worker
Full-time student and part-time worker
Full time student
Full time student and full-time worker
6. What is your major College or Department or School? Mark the appropriate circle.
Department of Social and Public Health
School of Applied Health Sciences and Wellness
School of Nursing
School of Rehabilitation and Communication Studies
College of Education
Other School, College or Department in Ohio University
(Specify)…………………………………………………
Other School, College or Department outside Ohio University
(Specify)…………………………………………..
7. What group were you assigned to?
Group 1
Group 2
Group 3
290
Part II: Participants Evaluation Of How They Perceive Themselves At The Current
Time
Indicate whether you agree or disagree with the following statements.
Please use the following scale for your evaluation:
SD = Strongly Disagree
D = Disagree
A = Agree
SA = Strongly Agree
SD
1
I have the knowledge to understand the dietary
information on a food package
2
I have the knowledge to share nutritional
information with friends, colleagues, or family
members
3
I am conscious of my portion size when I eat
4
I look for nutrient information when I pick food to
buy
5
I visit fast food places on a regular bases
6
I am conscious of the food choices I make
7
I cook most of the foods I eat
8
Someone cooks for me
9
I consciously buy fresh produce any chance I get
10
I incorporate fresh produce into my food when
eating
11
I drink soda, pop, and soft drinks almost everyday
12
It is expensive to eat healthful
D
A
SA
291
13
I am concern with who provides me with nutrition
information or messages
14
Making healthful eating decisions can be difficult
without reliable evidence
15
Choosing the right time to provide an individual
with nutrition information can make differences
about the use of information
16
This is the right time in my life to learn about the
importance of nutrition to human health
17
I wish I could have taken this class earlier
regardless of its requirements by my major program
18
The course Introduction to Nutrition has nothing to
do with my life outside of school
19
The Introduction to Nutrition course has nothing to
do with me buying healthful food items.
20
The Introduction to Nutrition Course has not
contributed to me advising people about good
nutrition
21
Learning about nutrition will have an effect on the
way I vote in elections.
22
Obesity leads to health hazard
23
Obesity weighs a lot on the world’s economy
24
I have the knowledge to provide nutrition
information to introduce change in how people e
select nutritious foods
25
I have the knowledge to use nutrition information
in my daily life
292
26
I have the knowledge to critically evaluate a
published nutrition article
27
I have the knowledge to analyze nutrition
information
28
I have the knowledge to interpret nutrition
information
29
I have the knowledge to judge the merit of all
essential nutrients
30
I consume vegetables on daily basis.
31
I consume fruits on daily basis
32
I can confidently say I have a strong background in
nutritional education
33
I look for more grains in foods that I consume.
34
Overall my eating habit has improved since I have
completed the course
35
The expertise of a person providing a nutrition
information is vital in changing nutrition attitudes
36
Overall the information provided in the messages
were credible
293
Part III. Participants Evaluation Of How They Perceive Themselves Before The
Commencement of Class
Indicate whether you agree or disagree with the following statements.
Please use the following scale for your evaluation:
SD = Strongly Disagree
D = Disagree
A = Agree
SA = Strongly Agree
SD
1
I have the knowledge to understand the dietary
information on a food package
2
I have the knowledge to share nutritional
information with friends, colleagues, or family
members
3
I am conscious of my portion size when I eat
4
I look for nutrient information when I pick food to
buy
5
I visit fast food places on a regular bases
6
I am conscious of the food choices I make
7
I cook most of the foods I eat
8
Someone cooks for me
9
I consciously buy fresh produce any chance I get
10
I incorporate fresh produce into my food when
eating
11
I drink soda, pop, and soft drinks almost everyday
12
It is expensive to eat healthful
D
A
SA
294
13
I am concern with who provides me with nutrition
information or messages
14
Making healthful eating decisions can be difficult
without reliable evidence
15
Choosing the right time to provide an individual
with nutrition information can make differences
about the use of information
16
This is the right time in my life to learn about the
importance of nutrition to human health
17
I wish I could have taken this class earlier
regardless of its requirements by my major program
18
The course Introduction to Nutrition has nothing to
do with my life outside of school
19
The Introduction to Nutrition course has nothing to
do with me buying healthful food items.
20
The Introduction to Nutrition Course has not
contributed to me advising people about good
nutrition
21
Learning about nutrition will have an effect on the
way I vote in elections.
22
Obesity leads to health hazard
23
Obesity weighs a lot on the world’s economy
24
I have the knowledge to provide nutrition
information to introduce change in how people e
select nutritious foods
25
I have the knowledge to use nutrition information
in my daily life
295
26
I have the knowledge to critically evaluate a
published nutrition article
27
I have the knowledge to analyze nutrition
information
28
I have the knowledge to interpret nutrition
information
29
I have the knowledge to judge the merit of all
essential nutrients
30
I consume vegetables on daily basis.
31
I consume fruits on daily basis
32
I can confidently say I have a strong background in
nutritional education
33
I look for more grains in foods that I consume.
34
Overall my eating habit has improved since I have
completed the course
35
The expertise of a person providing a nutrition
information is vital in changing nutrition attitudes
36
Overall the information provided in the messages
were credible
296
Appendix D: Ohio University Online Consent Form
Title of Research: The Effect of Message Credibility as Measured By Argumentation
Style on Attitude Change: In an Online Diet and Nutrition Course.
Researchers: Abednego Bansah, MS, MA., David Moore, Ph.D., David Holben, Ph.D.,
RDN., LD., FAND.
You are being asked to participate in a research. For you to be able to decide whether
you want to participate in this project, you should understand what the project is about, as
well as the possible risks and benefits in order to make an informed decision. This
process is known as informed consent. This form describes the purpose, procedures,
possible benefits, and risks. It also explains how your personal information will be used
and protected. Once you have read this form and your questions about the study are
answered, you will be asked to participate in this study. You may print a copy of this
document to take with you.
Explanation of Study
You are being asked to participate in a study that seeks to understand the effect of a
person’s credibility and argumentation style (message framing) on attitude change. An
extra credit will be offered during the course of this class. The extra credit exercise
entails 10 messages which require that after reading each message you rate the message
based on 8 items. Each message with its corresponding scale rating will take
approximately 5 minutes to complete. Two messages will be made available per week for
completion. After the completion of the 10th message and its scale rating, you will be
required to complete a questionnaire made up of three parts. It will take approximately 15
minutes to complete the questionnaire. Also your responses to class introductions will be
accessed and used as a data source for research purposes. You may contact the Instructor
of Record if you wish not to have your class introduction used for research purposes.
The information used in this study will not only be used to improve future discussion
board exercises but also help to promote healthful eating habits.
Risks and Discomforts
There are no known risks or discomforts to you as all messages will be nutrition based
and derived from your nutrition modules. Your participation is voluntary and you can
choose not to answer questions that make you uncomfortable or quit participating at any
time.
297
Benefits
Many individuals feel very strongly about being informed about the importance of good
nutrition. By participating you will benefit from the study as the messages will be based
on topics taught each week which will also prepare you for both exams and assignments
to be taken. Additionally you will have contributed to education instructional literature.
This study will offer health educators, instructors and policy makers the opportunity not
to only consider source credibility, emotion and logic when delivering nutritional
messages for attitudinal change but also consider the timing of delivering the message
and content. Research indicates that a number of individuals are not motivated to change
their unhealthy eating habits due to the fact that they are unaware of their personal dietary
behavior (Brug, Hospers, & Kok, 1997; Glanz, Brug, & Van Assema, 1997). Lack of
awareness has also been reported to be a major obstacle in encouraging people to change
to healthful diets (Oenema, Brug, & Lechner, 2001). As a result, it is vital to make people
aware of their dietary intake as an initial step to behavioral change (Oebema, 2001).
Confidentiality and Records
An excel sheet will be created matching your PID numbers to assigned numbers to
determine who completed the extra credit exercise for the points to be awarded. Also
your responses are anonymous and your names or PID will not be linked to them. The
printed out excel sheet will be stored in a locked file drawer and all information entered
in the computer will be on a password protected computer only accessible by the
researchers.
Your IP address will not be saved with your data, so there will be no way to trace the
information back to you or your computer.
Compensation
Upon completion of the 10 messages with their corresponding rating scale of 8 items and
questionnaire, 10 points will be awarded to you as an extra credit. However,
commensurate points will be also awarded if you choose to discontinue the exercise. For
example, points will be awarded to you depending on your count of completed exercises.
That is if you complete 3 messages and their corresponding scale rating items and choose
not to continue with the exercise, you will be awarded 3 points.
Contact Information
If you have any questions regarding this study, please contact, Abednego Bansah,
[email protected], 740-274-2922, David Holben, [email protected], 740-593-2875,
David Moore, [email protected], 740-597-1322
298
If you have any questions regarding your rights as a research participant, please contact
Chris Hayhow, Director of Research Compliance, Ohio University, (740)593-0664 or
[email protected].
By agreeing to participate in this study, you are agreeing that:
 you have read this consent form (or it has been read to you) and have been given
the opportunity to ask questions and have them answered;
 you have been informed of potential risks and they have been explained to your
satisfaction;
 you understand Ohio University has no funds set aside for any injuries you might
receive as a result of participating in this study;
 you are 18 years of age or older;
 your participation in this research is completely voluntary;
 you may leave the study at any time; if you decide to stop participating in the
study, there will be no penalty to you and you will not lose any benefits to which
you are otherwise entitled.
Version Date: [04/01/15]
I consent to have my responses used.
I DO NOT consent to have my responses used.
299
Appendix E: Institutional Review Board Approval Letter
300
Appendix F: Tables
Table 32
Distribution of Group Gain as Measured by Attitude Change Questionnaire in the Pilot
Study
Messages
Group 1 Gain
Group 2 Gain
Group 3 Gain
1
0.30
-0.09
-0.14
2
0.47
0.00
0.33
3
-0.06
-0.19
-.0.06
4
0.06
0.11
0.02
5
0.19
1.47
1.81
301
Table 33
Distribution of the Individual Gain as Measured by Attitude Change Questionnaire in the
Pilot Study
Gain
Frequency (N)
-0.19
1
-0.19
1
-0.14
1
-0.06
2
0.00
1
0.02
1
0.03
1
0.06
1
0.11
1
0.19
1
0.33
1
0.47
1
1.47
1
1.81
1
302
Table 34
Distribution of the Responses on Overall Eating Habit for the Pilot
Question
Group 1
Group 2
Overall my eating
habit has
improved since I
have completed
the course
Group 3
SD
0
0
0
D
2
0
0
A
1
4
3
SA
2
1
2
5
5
5
Total
Table 35
Reliability Analysis of the Message Instrument for the pilot Study
Credibility Items
The usefulness of message
Reliability: Cronbach’s Alpha
0.852
The message being open-minded
0.887
The message’s ability to help change
eating habits for the better
0.862
The accuracy of the message
0.865
The message convincingness
0.885
Message founded on research
0.870
303
Table 36
Pilot Study Respondent Credibility Themes
Respondent
1
Credibility Themes
The message was mostly negative and even though that could "scare"
people into changing, it could also overwhelm them and make them
feel bad about themselves. There also wasn't any tips on how to
change just stating the fact that change is needed.
2
I felt this message was more convincing because it brought in
relatable information. I think most people do go off of myths they hear
when it comes to nutrition and weight loss
3
I would go into the implications of too many or too llittle lipids a little
more. It would more likely convince the reader to make a change if
necessary.
4
The message was insightful and clear
5
The information was clear and useful.
6
I think this message should have more academic research provided.
304
Table 37
Group One Distribution for the Descriptive for Message Credibility Rating
Credibility Item
Rating
N
%
66
100
Poor (1-2)
-
-
Fair (3-4)
1
1.5
Good (5-6)
10
15.2
Very good (7-8) 33
50.0
Excellent (9-10) 22
33.3
66
100
Poor (1-2)
3
4.5
Fair (3-4)
5
7.6
Good (5-6)
18
27.3
Very good (7-8) 24
36.4
Excellent (9-10) 16
24.2
66
100
Poor (1-2)
2
3.0
Fair (3-4)
16
24.2
Good (5-6)
12
18.2
Very good
24
36.4
Excellent
12
18.2
Usefulness of the
message
Message being openminded
Message’s ability to
change eating habits
305
Table 37 Cont.
Credibility Item
Rating
N
%
66
100
Poor (1-2)
1
1.5
Fair (3-4)
3
4.5
Good (5-6)
10
15.2
Very good (7-8) 26
39.4
Excellent (9-10) 26
39.4
66
100
Poor (1-2)
-
-
Fair (3-4)
4
6.1
Good (5-6)
17
25.7
Very good (7-8) 25
37.9
Excellent (9-10) 20
30.3
66
100
Poor (1-2)
6
9.1
Fair (3-4)
9
13.6
Good (5-6)
9
13.6
Very good
16
24.3
Excellent
26
39.4
Accuracy of the message
Message convincingness
Message founded on
research
306
Table 38
Group Two Distribution of the Descriptive for Message Credibility Rating
Credibility Item
Rating
N
%
62
100
Poor (1-2)
-
-
Fair (3-4)
1
1.6
Good (5-6)
15
24.2
Very good (7-8) 32
51.6
Excellent (9-10) 14
22.6
62
100
Poor (1-2)
-
-
Fair (3-4)
4
6.5
Good (5-6)
19
30.6
Very good (7-8) 25
40.3
Excellent (9-10) 14
22.6
62
100
Poor (1-2)
1
1.6
Fair (3-4)
7
11.3
Good (5-6)
21
33.9
Very good
21
33.9
Excellent
12
19.3
Usefulness of the
message
Message being openminded
Message’s ability to
change eating habits
307
Table 38 Cont.
Credibility Item
Rating
N
%
62
100
Poor (1-2)
1
1.6
Fair (3-4)
4
6.5
Good (5-6)
13
20.9
Very good (7-8) 21
33.9
Excellent (9-10) 23
37.1
62
100
Poor (1-2)
-
-
Fair (3-4)
9
14.5
Good (5-6)
22
35.5
Very good (7-8) 21
33.9
Excellent (9-10) 10
16.1
62
100
Poor (1-2)
1
1.6
Fair (3-4)
5
8.0
Good (5-6)
20
32.3
Very good
20
32.3
Excellent
16
25.8
Accuracy of the message
Message convincingness
Message founded on
research
308
Table 39
Group Three Distribution of the Descriptive for Message Credibility Rating
Credibility Item
Rating
N
%
64
100
Poor (1-2)
-
-
Fair (3-4)
4
6.3
Good (5-6)
15
23.4
Very good (7-8) 24
37.5
Excellent (9-10) 21
32.8
Usefulness of the
message
Message being openminded
64
Poor (1-2)
1
1.6
Fair (3-4)
10
15.6
Good (5-6)
17
26.6
Very good (7-8) 20
21.3
Excellent (9-10) 16
25.0
64
100
Poor (1-2)
4
6.3
Fair (3-4)
13
20.3
Good (5-6)
19
29.7
Very good
17
26.6
Excellent
11
17.2
Message’s ability to
change eating habits
309
Table 39 Cont.
Credibility Item
Rating
N
%
64
100
Poor (1-2)
-
-
Fair (3-4)
3
4.7
Good (5-6)
15
23.4
Very good (7-8) 22
34.4
Excellent (9-10) 24
37.5
64
100
Poor (1-2)
-
-
Fair (3-4)
2
3.1
Good (5-6)
19
29.7
Very good (7-8) 24
37.5
Excellent (9-10) 19
29.7
64
100
Poor (1-2)
3
4.7
Fair (3-4)
5
7.8
Good (5-6)
17
26.2
Very good
20
31.3
Excellent
19
29.7
Accuracy of the message
Message convincingness
Message founded on
research
310
Group One Comments
Table 40
Comments Made by Participants in Group One with their Corresponding Credibility Item
Credibility Items
Usefulness
Participants’ Comment













it will be a good idea for the children to start eating
health food
Statistic are true and factual, but the message doesn't
tell how to change this situation or what can be done
to make this change. I believe people are aware of
this fact in a general sense, but what can we do?
The message is informative in a basic way. It would
be a good start to a conversation to then be followed
with up with some more specific details.
I like the topic; how can we introduce this into
homes to help better the families lives?
Might be helpful to mention a few disorders that are
affecting our youth such as elevated cholesterol.
Pediatricians have begun testing children for a health
issue that was once limited to older adults.
Looking past the grammatical errors, this message is
base solely on opinion. While I am not against
sharing others opinions, especially if I agree or the
information is useful, there is not much here to share.
This is very interesting and something that I never
knew.
It is funny to read about these myths. Now I can
educated my friends on the facts.
I was one of those who thought that just "eat another
steak" was a good way to get more protein into your
body. Good information.
Now this message definitely expressed multiple
benefits to exercising.
Important message! Group 1
this message is good because it has more cause and
effect information.
The message is an important one. Staying hydrated
in hot weather is critical to the body's health. It feels
like the material is scattered around and could be
better organized. Also, more facts needed.
311
Table 40 Cont.
Credibility Items
Usefulness
Participants’ Comment




Open-minded





Group 1 I thought this is a very informative message.
There is a useful message within this paragraph, and it is
that you do excrete what the body doesn't absorb. If it was
written in a more scientific manner with facts added in, it
would be more convincing. It certainly made me chuckle!
This was straight forward and the message was a good one,
Group 1
This is useful information, especially for those who are
active and aging.
It says what consumers do when prices are high, that won't
change. We can only afford so much. A table showing the
breakdown of the lower price high sugar foods vs the more
nutrional foods would be helpful. Maybe when prices are
high they can still affod some fruits and see the value.
it is true most health food are very expensive, so people turn
to unhealth food.
Fact remains fact...foods that are less healthy are cheaper
and healthy foods are considerably more costly. Families
will have to choose what remains within their budget.
Seniors are living on fixed incomes. Healthy foods need to
be made more affordable so that people can afford to
choose the more healthy options.
While it is true that children are limited to what their
parents supply, I still believe that educating them while in
school and offering them healthier options is imperative. It
may give them the opportunity to try different food they do
not get at home and they could potentially share what they
learn with care givers who may not be aware of the
information.
I agree that it needs to start with adult education. If you are
giving your child junk food at home, they are more likely to
only want junk food at school as well. I wonder does
income status have any role in which children are eating the
junk food?
312
Table 40 Cont.
Credibility Items
Open-minded
Participants’ Comment




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Ability
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Parents support and education are important, but do
not discount the power of a nine year old in
purchasing power.
Mention the socioeconomics of obesity and cultural
aspect.
It was intresting thought, in order to accomplish our
goal we all have to work hard nothing comes easy.
Losing weight takes time and it is very hard.
I think the author supported the aurgement well. The
message could improve by providing suggestions that
could increase parental support of this intiative. For
example, schools could communicate the importance
of the initiative and encourage them to sendhealthy
snacks with them to school. Suggestions for healthy
snacks should also be included.
I don't know whether this comment will "improve"
this message, but I strongly believe that decisions
made regarding children's nutrition should be made at
home. I don't believe that a teacher (or a beurocrat
for that matter) should decide whether the snak sent to
school is nutritious or appropriate. When children are
taught about nutrition at home, they will make
smarter decisions in school. So yes, adult education
is key.
The message was a bit vague. The article insinuates
that high cost goes with healthy foods. I feel that this
depends on what and how you buy your food. A little
more information is needed.
I agree with the message stated above. As someone
who purchases healthy food regularly, it does tend to
cost more. This may suggest that people with limited
incomes may choose unhealthy and cheaper food
choices due to their budget.
It is not what you eat that will make change to you
body,but how much you eat and how often you eat
that kind of foods. adding exercise activities in your
daily life,may have improve your well-being.
313
Table 40 Cont.
Credibility Items
Ability
Participants’ Comment
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Accuracy
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Very good example of why it is important to stay
hydrated!
You are right, being fit is hard work and I need to
get on board. My grandmother loves watching the
biggest loser, I need to watch it for encouragement.
Thanks for sharing.
Maybe a few exercises that help improve our way of
living and can get us out enjoying life.
It is a good message to remember because most of
the time we are in denial and we do not pay attention
to our body.
I’ve completed a paper in this program regarding
obesity and childhood. This is a great message
It is true overweight is becoming a big problem,
there are many fast food and many family who are
always at work and do not have time to cook. we
need to provide health education
This message hit home hard. As a nurse I teach
about nutrition on a daily basis, and there are also
days that I drive through McDonalds. We must
practice what we preach. I may be at a healthy size
but size does not always matter if you are eating
foods that are bad for your health. Catchy logo
above:)
This message is very accurate, in that the way the
body breaks down and absorbs proteins is different
for individuals. Even those with renal disease, with
poor renal function, and those on dialysis, must have
a diet with lower protein.
It had a good knowledge about the need of protein
before and after exercising.
It is true with good exercise and health diet can
improve our well-being. We need to teach our
children the importance of exercise and practicing
health nutrition habits.
314
Table 40 Cont.
Credibility Items
Accuracy
Participants’ Comment
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Convincingness
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Childhood obesity is on the rise. It is partly on
the rise because more children are staying inside
playing video games rather than being outside
riding a bike or interacting physically with
friends. Thanks for sharing.
I think this message was very fun and
informational. Much truth behind it, as it also
grabs our attention.
I think this message is very informative and
evidence based. It is very true that healthy foods
are more expensive. Some choose not to be
healthy due to a low income. We need to help
find ways to eat healthy in a less expensive way.
I think this got the point across very well
Its true people buy affordable food that are not
healthy for them.
Again, this is all true, but how will this be
accomplished. This is something that is large and
many parents are already set in his or her ways of
eating habits. Unless parents change his or her
own eating habits, their example will be what the
children see and copy.
I absolutely agree. If parents are sitting home
watching TV and never getting exercise, their
children will tend to follow in their footsteps.
I am not sure where these facts were taken from,
but I do think that this message gets the point
across well using vague information.
I agree with this message. People do not think
about what they are putting in their bodies.
315
Table 40 Cont.
Credibility Items
Convincingness
Participants’ Comment
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Founded on
research
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This message is an eye opener. I have succumbed
to the food choices that I have made and often eat
with my kids at a fast food place or just when I am
on the road for work, which I am a lot. This is a
good message
The message was worded well and sounded
convincing, but would be more believable if backed
by a credible source.
Message gets the point across.
Fascinating topic! No research so, although it
sounds convincing, I am uncertain if I can trust the
accuracy of the information.
Other than the statistic from 1986, there is nothing
here to motivate the obese person to lose weight.
Truthfully, there are obese people that are
unsuccessful at losing weight because all of his or
her efforts fail. This message definitely sends the
mesage that weight loss is work but it lacks how
one could become successful.
There is no research cited in this message. While it
seems logical and appropriate, it could just be a
strongly worded opinion. I am certain that I believe
that eating fresh is cheaper than buying processed
food - if not just for the longevity of the foods. But
I don't really buy processed foods so I this is merely
an educated guess.
This message could improve by including the
AHA's guideline for sugar intake.
The statement ended abruptly, can you add
anymore regarding the information from the
American Heart Association? More data from
them might strengthen the statement.
Why mention American Heart Association
published guidelines if not going to include at least
a summary of the content? Really not much info in
the message.
316
Table 40 Cont.
Credibility Items
Founded on
research
Participants’ Comment
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No citation was included in this statement, so I am
unable to follow any source to check that message is
founded on research. This also affects the accuracy of
this message, since I am unsure if the data presented is
accurate.
IIt is okay to teach adults when kids are young but by
middle school and teenage years kids become more
independent so they need to b taught as well. Listing
statistical data and a cite to refer to would make a
stronger stance.
For me, I am glad schools are taking an initiative. I
think both adults and children need to be educated on
nutrition.
Where were the statistics found? Need reference info
to know if message founded on research.
More statistics need to be given to full understand the
seriousness of the epidemic
I'm not absolutely sure the message was founded on
research since there is no citation for the source of
information. However, I think this is an alarming
statistic and really opens my eyes to how severe this
situation is.
Maybe adding some statistical data on children’s
obesity would be helpful
Needs evidence to back up opinions of this topic.
Research needs to show a study.
Curious to where the information came from for the
message.
I feel the problem was well-defined and not
exaggerated. Stating the source of the research findings
could improve this message. However, I do believe
they are accurate.
Utilize a reference to strengthen the message.
Information is well organized but as a standard
statement there is no proof/ resources to back up these
statements.
I would have liked to hear about the research that
debunked the myths.
317
Table 40 Cont.
Credibility Items
Founded on
research
Participants’ Comment
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Include source and research about often people eat fast
food. The following sentence may need to be rewritten
for clarity: "What make up my remarkable body include
cells, tissues, organs and body systems and good
nutrition keeps them functioning at theiroptimum best."
Use an example from a food label. or a box of cereal
and then reference it.
Again, perhaps citing the resource of the information
would cause people to trust the information. However, I
thought it was very informative and easy to understand.
I have a better grasp on protein from reading this
paragraph.
If the message has no appropriate cites used how would
one know if it was founded from research?
The message should make reference to research studies
that make claim stated more verifiable without outside
research being conducted by the reader.
Maybe list the research materials
Unsure of accuracy of message or if founded on
research. No sources sited.
Include where research information was obtained.
Many people take vitamins and believe in them; it may
be a touchy subject for some. Including some evidencebased research would be helpful.
Group 1 List the type of research study and where it
can be found.
Excellent reference to current research. Great listing of
the many benefits of exercise.
There does not appear to be a message, only simply a
general statement that water is important. It then relates
a story about dehydration. I would recommend adding
information about a recommended amount of water and
the need to increase water intake durin certain
conditions.
318
Table 40 Cont.
Credibility Item
Founded on Research
Participants’ Comment
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This message is written in a very simplified
manner, but if the message is for adults it may
be too simple. Adding more facts to support the
message would definitely be needed.
Add what the AHA had to say in regards to the
intake of sugar into the message.
I do not feel that there is enough information in
this article to substantiate the claims that are
being made. Although I do agree with the
article and that the key does rely in adult
education, more statistical research and
evidence needs to be provided to support the
idea.
State the specific website that the USDA uses
for the results of the research.
statistics would be good
Again, no citation, unable to verify validity of
message and data. But I do agree with the
statement that adult education is key to
changing behaviors at home and therefore
affecting the childs actions.
I did not see anything in the paragraph that
stated WHERE the information came from.
Perhaps listing the resource of the information
would make it more convincing to the reader.
No clue if based on research. Doesn't site
sources.
I do not know if this was founded on research or
not. Needs to have a reference if it was.
I like that you included a statistical fact. Shut
mouth and move legs is great advice!
List a site where people could go to verify the
nation obesity status. Then a link to the biggest
loser success stories.
319
Group 2 Comments
Table 41
Comments Made by Participants in Group 2 with their Corresponding Credibility Item
Credibility Items
Usefulness
Participants’ Comment
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The message is very good and very true, however, getting
someone to change by reading a message will not do this.
It was an informed message.
As a nurse I felt the message was very informative and
succinct. A consideration that I had while reading it,
however, was that it may be too complex for the general
public. I imagine reading this to many of my patients and
them nodding there heads with bank stares. Having to
explain in greater detail what constitutes "excess
constituents" or "essential nutrients". I was told once,
make your instruction readable by the average fourth
grader and they will be understood and followed better.
Eye opener!
Very informative.
I FEEL THIS MESSAGE WILL CAUSE
CONTROVERSY WITH SOME PARENTS BUT THE
MESSAGE IS GOOD
Appreciated the fact that this one had more specific
information as opposed to
Message was informative but short
I like that this is written in simple terms. It's an
uncomplicated message written in a way that is also easy
to understand.
Very useful. Would have been nice to know what the
value ratios should be.
Very good article
This message was informational
Good information to know; however, need to elaborate
more on benefits of being active and disadvantages of
inactivity from different age groups. For instance,
atherosclerosis starts forming at the age of 15.
The capitalized words put an emphasis on the energy
aspect of balance. I thought it was easy to read and
informative.
320
Table 41 Cont.
Credibility Items
Open-minded
Participants’ Comment
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Give examples of food choices that are good and bad.
I do believe that a lot of people dealing with obesity is
portion size and calories. People find comfort in food
and some people simple enjoy that and do not want to
change their eating habbits.
I know that exercise is important every week, it is a
struggle to do it. It becomes quite frustrating for me.
Educate on ways to be more physically active in a
challenging socioeconomic environment.
I think we are using a sterotype. I think our society is
getting more lazy and therefore more obese
Assuming that these standards are being used in
schools today. Now how do we get the kids to eat
everything.
Reasons why this is important, like childhood obesity
rates and juvenile diabetes.
It seemed too pointed at socioeconomic status
I do think that schools should improve their food.
Oftentimes, it is very unhealthy food that our children
have to choose from and this makes for bad habits,
especially when the children get older.
In order for people to change I believe it is helpful for
them to see the reason behind the change or the need
for change.
Provide options for healthful choices to counter these
lifestyle difficulties.
Perhaps provide examples of diet choices, both bad
and good, to illustrate how these mechanisms work in
lay terms.
There does not appear to be an actual message, only a
vague statement that water is important and a story
about dehydration. I would add a message about a
recommended amount of water and the need to
increase water intake during certain conditions.
I did not receive criteria, details or how lipids
tranlates to total fats/ sat. fats or unsat. fats.
321
Table 41 Cont.
Credibility Items
Open-minded
Participants’ Comment
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I don't know why the lower socioeconomic choose more
expensive protein. That does not make sense to me.
Maybe it's just lack of knowledge?
Talking about the benefits of carbohydrates and also
eating in moderation in the message could make it more
educational.
This message was good, including the recommendation
to take supplements and eat a healthy, balanced diet
with doctor supervision.
perhaps the writer should have included what can
happen when an individual eats too little or too much
lipides. That would make the reader want to share it
more.
The message could include the danger of burning too
much energy.
The should include the many serious effects of
dehydration.
The message may be true, but it is conveyed in a harsh
manner. People might be resistant to learning from it,
and be dismissive of it, because of the way it is
presented.
more information. is poor nutrition because the poor
economic status or is their poor nutrition and econmic
status a result of lack of ambition, education, and poor
upbringing?
I would discuss how to determine an energy balance,
however briefly, or make a recommendation for followup information for those who are interested.
I would include more information on the other proteinrich legumes.
Would like more specific info
what are the most common deficiencies in terms of
vitamins?
What are the first signs of dehydration ? how much
water should a person consume each day ?.
322
Table 41 Cont.
Credibility Items
Ability
Participants’ Comment
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i FOUND THE MESSAGE TO BE BENEFICIAL
AND MADE ME THINK ABOUT BUYING
HEALTHY FOOD OPTIONS OVER JUNK FOOD
Message should include more examples of exercises.
I would share this with others, because I like that it
conveys the message that exercise can be play, it
doesn't always have to be scheduled time at the gym.
Examples of portion sizes and cost. Most people
believe that eating healthy is expensive, so a
comparison would be helpful.
I would add examples for some of the statements,
especially the last two, because many will initially
scoff at these notions.
I liked the examples in this message. I will use them
with my children
Explaining why this is necessary would help...i.e., to
prevent obesity, to prevent early onset of chronic
disease, to maintain health...etc..
providing information on what happens is a child
leads a sedentary lifestyle.
None. I have enjoyed these. They have an impact on
me both personally and professionally. Thank you.
The only change I would make would be to include a
comment about if the recommended time for each
activity needed to be continuous or if it was
acceptable to break those times up, such as doing
activity for twenty minutes three times in a day.
Examples of common things high in fiber, high in
salt, ect.
better information to assist with choices that are
good choices
Very interesting facts that I have never heard before,
this would be good information to send to others
I did not realize there was so much obesity in the
lower class. I found this to be very interesting.
I found this to be very interesting. I struggle with my
weight on a daily basis.
323
Table 41 Cont.
Credibility Items
Ability
Participants’’ Comment
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Accuracy
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Following a low card diet has been on the rise lately
and I personally follow it myself, it is also important
to note that in addition to potatoes some vegetable
are starchy as well.
Water is a very under rated topic; thanks for
highlighting it in our x-tra credit
"...eat a balanced diet containing a variety of foods."
This statement should say whole foods or nutritious
foods or following the food pyramid. Otherwise, I
could eat a balanced diet of variaties of junk food
and think it's ok
Again, I knew water was important to the body, but
did not realize all it did. I need to drink more water
myself. I am terrible at drinking water.
I always knew that vitamins were important to the
body, but I did not realize just how essential they
are. There are often many complications when
vitamin levels are too low of too high.
"In actual fact, it is not expensive to eat healthful."
does not seem like a true statement. For example,
recently I talked with a client who says that when
she watches her sisters children and her's there are
10 kids. I asked what do you feed them, shereplied
macroni & cheese, hot dogs. Which is less
expensive than purchasing foods from all the
categories above.
Very true
This article was very factual.
I believe this message to be true
Having witnessed some of these school-based
lunches, the quality of the food is sub-par and fruit
juice from
concentrate is included as the fruit content, even
though it is nutrient-poor and high in sugar.
I worked in geriatrics for ten years and I saw a lot of
women with osteoporosis. I wish kids would stop
with the computersand would get more involved in
physical activities.
324
Table 41 Cont.
Credibility Items
Convincingness
Participants’ Comment
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Founded on
research
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The message is not convincing or compelling
This message may have factual content but it just
seems like discrimination about the poor. What
about the abdunance of the weatlhy
I like how you broke down the steps.
This message was good, including the
recommendation to take supplements and eat a
healthy, balanced diet with doctor supervision.
Simple to understand.
Easy to understand. Would be able to use this to
teach/educate pateints.
Great content but what can we do about this
problem? The message does not sound complete.
The part about child was the most convincing part,
as well as the calorie to expenditure ratio.
This message was easy to understand / interpret.
Message was short but very convincing
The message is very convincing; foods high in
calcium and low in soduim can be part of the
message.
This was very short, simple and easy to understand.
This is the most convincing message so far. I would
again like references that are cited.
In order to provide adequate research to substantiate
the evidence I feel that providing the reader with
literature or a reference would be key.
Could have used a reference at the end.
I feel that providng some reference links would
make this message more meaningful.
There are no references supporting any claims\
The message could be expanded to include good
nutritional sources of the various vitamins
Reference links.
This message comes across as harsh ("you will die")
and doesn't seem to contain any researched factoids.
References
actual statistics would strengthen this paper
325
Table 41 Cont.
Credibility Items
Founded on
research
Participants’ Comment
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What concerns me the most is that is does not have
any references. If the point is to influence people, the
message has to be backed up with facts and examples
which this post provides neither. It is a major
misconception that it is expensive to eat healty, show
them why it is not expensive.
The comment could be improved by including where
the facts were derived from. It is not clear to the
reader that this statement is founded on research.
References always help the reader identify where the
information came from and how accurate it may be.
resources and examples should be provided to
complete the circle of understanding for the reader.
Examples should be provided as to why these
standards should be followed and the consequences
of not following a sensible diet.
I feel this message is off to a great start but is lacking
in research. The message does not say normal values
of the lipid levels so a person can read the nutrition
label and still not know if it's healthy or not.
It could be improved by supplying statistical data to
back up information and citing resources.
Where did you get the information and facts?
providing evidence based research would give
credence to the message, as well as providing
solutions to the given problem.
Where or how was the information gathered about
the facts?
It is unknown if this message is founded on research
as there are no references. Alternatives to food and
exercise should be provided.
Provide references. Need new paragraph when
changing subject to skeleton and its importance. Tell
what minerals are importance to the skeleton. More
details please.
Some research and references would make this
message have a lot more influence and power.
326
Table 41 Cont.
Credibility Items
Founded on
Research
Participants’ Comment
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This message is lacking research. Statistics
need to be added to the low socioeconic class
that buy all forms of protein. Nutritional
values of protein can be added.
Again, I believe that statistical data to back
up the information given in the article would
be great advice for whoever is writing it.
Not sure what resources this used to back up
their facts and doesn't really say how much of
the daily value of protein these things give
you.
provide references
327
Group 3 Comments
Table 42
Comments Made by Participants in Group Three with their Corresponding Credibility
Item
Credibility Items
Usefulness
Participants’’ Comment
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Valuable information.
Once again a wealth of information is obtained during this
message and all very useful. You explained the cause and
affect and what to do about it.
There was a lot of good information, but the flow of
information was poor
Very insightful information given
I learned a lot from this reading. It was very informative.
The message started out talking about water, but the last
half did not correlate with the opeining topic. While both
messages are informative, choicing one specific topic will
produce greater results.
Lots of good information, but didn't flow very easily.
Almost tried to pack too much in
This is a great message. One thing would be watching the
grammar. Some sentences aren't written correctly.
interesting message.
great information
I found this infoprmation interesting because I have a
family member with a very high Vitamin D level.
This is very useful information since this is a topic that
applies to everyone everywhere and it provides some
direction on how to better manage situations that are
common food occurrences.
I enjoyed reading about this! Thanks for sharing!
This message contained a lot of information and all of it
may not be retained.
This paragraph was cumbersome. Too much good
information in one paragraph. I found myself having to
read it 3 times to get understand.
I feel as if this message was very informative and broke
down the balancing act very nicely.
328
Table 42 Cont.
Credibility Items
Usefulness
Participants’ Comment
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Open-minded
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Out of all of these I have done this one was the most
confusing. I think expanding a little bit more about what
things are in this might help. Just a suggestion. Other than
that I thought I was good!
This message seems like it should have been either two
separate messages or at least two different paragraphs. It
started out talking about water and suddenly switched to
calcium with no obvious bridge or connection. Individually,
both messages were inforative and useful but because of the
lack of connection between the two I was a little confused.
Thanks
The message is informative and clearly explains the
importance of adjusting calories in and calories out.
Provide an example of a food item that is equivalent to 150
calories. I do not think people realize how quickly calories
add up!
great article. no improvement
very good message. One I will share as so often fat is
viewed as only a bad thing.
I would suggest listing some s/s of dehydration as well, but
overall, very good.
Many fast food chains are now offering healthier food
options.
I am curious as to weather the malabsoption is due to age,
chronic illdeness or some predisposition. It is really sad to
learn that somebody is doing all they can to eat healthy
balanced meals but still getting poor results.
I wonder. If a person takes in sufficient vit D through diet.
Then adds a supplement. Are they still at risk for toxicity?
Maybe more information on as far as water intoxication.
Literature from the textbook suggests that many factors
determine how weight is gained, not just more calories
consumed than burned.
This is simple and to the point. It gives tips to the reader
and doesn't tell you what you are doing wrong, but what
you can do differently to help. Great job
329
Table 42 Cont.
Credibility Items
Open-minded
Participants’’ Comment
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Causes of obesity are not discussed. Is it the food we eat,
less activity or both? I basically took away from this that
if you get overweight, you will have lots of health
problems and this is an epidemic. It doesn't provide any
suggestions on how to combt this.
I feel there are other factors that contribute to obesity in
addition to eating too much. Lack of exercise, leading a
sedentary life, and poor nutrition are some examples.
I would be interested in knowing the age group range
when you state youth. Are chronic diseases occurring
now at a much younger age.
maybe explain how being obese can deprive
relationships and employment outcomes.
By stating that all of these efforts need to be supported
creates a closed minded message. Healthier eating starts
at the home and should not only be blamed on
'unhealthy' school lunches.
I think the detrimental relationship and employment
outcomes are more due to societal conditioning that
bigger people are lazier and incompetent than obesity
actually being a health risk.
Even if the healthiest meals could be served, kids will
not always eat them. Kids do not care about healthy, they
want it to taste good. It has been found that schools
throw more food away now than ever before since they
instituted Michelle Obama's plan.
This discussion has more to do with an establishment,
meaning schools taking a lead and actually serving
healthy choices to our children. I think that the fast food
should be taken out of the school altogether, schools
state that they give healthy option, but they also still
have fast food. Which do you think our children will
pick if the choice is left up to them? An example,
schools put pizza on the menu, and on the menu it is not
counted as a carbohydrate or fat, it is counted as a
vegetable because of the sauce. That is just crazy.
Maybe explain why people in 9-12 grade are not active.
330
Table 42 Cont.
Credibility Items
Open-minded
Participants’ Comment











I believe this is a good message, although sometimes its
hard to discuss thing with others that have financial
considerations.
This message contains a lot of information in a short bit, my
suggestion would be to expand on maybe the cause and
affect of why there is such a low compliance rate with
eating all five categories on a daily basis. As well as what
resources are available o them to fix it.
Maybe give a few examples.
What kind of foods have fiber in them
The information provided the reader with examples of nonnutritive carbohydrates, which is helpful to individuals that
are unfamiliar with the nutritional quality food items
represent. An explanation of why Americans are gaining
weight is thorough. Th paragraph gives the reader an
alternative or solution to non-nutritive carbohydrate diet,
one rich in fiber.
I would have liked to see more discussion on the way to
make these changes.
McDonald's and Burger King offer healthier meal options.
How many individuals choose healthy options opposed to
unhealthy?
Possibly including a short example foods list for "diets rich
in dietary fiber", since there are some examples of foods
considered in the "non-nutritive carbohydrates" part.
Instead of discussing restricting carbohydrates is should
discuss the importance of consuming the right
carbohydrates for the body to use such as whole grains,
fruits, and vegetables. Carbohydrates are essential to
maintaining a healthy diet and body.
There needs to be more examples of foods high in fiber
listed in order to for people to discuss this information with
others.
Not all fats are created equal! thousands of years ago diets
were higher in fat ( nuts, fruits, animal meats) and less
grains were consumed...i tend to feel better and can better
manage weight eating less carbs, grains and dairy and do
consume nuts and nu butters..so fat is a staple in my diet
just not all the bad fat!
331
Table 42 Cont.
Credibility Items
Ability
Participants’’ Comment












The message almost scares people into eating better and
changing their lifestyle. Many people need this tactic
though. The message is very straight forward and full of
information. I would not change anything about it.
The only reason I scored question 3 lower is because
regardless of the strength, people must have a willingness
or desire to want to change their eating habits.
It is easy to ignore the actual intake I consume everyday,
but messages like this inform me and remind me how
important it is to be "tuned in".
I believe this is a more eye-opening direct statement. I feel
this message could be on a brochure for those pending a
serious lifestyle change or life or death situation regarding
their obesity. As well, those teenagers who are at a plateau
and needing soe quick information.
I find this message concise and to the point. This is a style
that always works very well for me.
This message was great and it thoroughly explained all of
the necessary elements of what fuels ones body. I feel there
needs to be more education on general health science for
people to realize and understand the cause and affect of
what they eat and do dring their life.
The article left me wondering about proteiins ability to
produce the desired results within the human body.
give a list of good carbs to eat
The message clearly states the important role of Vitamin D
to promote optimal health within the human body.
Athough the information is factual, it is not until and
individual thinks about and goes through the changes of
change that they will benefit from the information.
So sad that even though people know all of this to be true,
and can be educated in such matters....they remain unable
or unwilling to change their habits.
More people need to realize the facts about these fast food
restaurants to avoid the obesity problems that we are
facing.
332
Table 42 Cont.
Credibility Items
Ability
Participants’ Comment











People are mostly aware of how bad fast food is and the
health implications of eating it. I think people are
desensitized to the shock value of how bad fast food is, or
how many calories are in a fast food meal. To change eating
habits about fast food I tink that there would have to be a
comparison or something to help people understand how
insane it is to have one food item with 710 calories. Also, I
think there may be a small part missing from the message. It
jumps right to the Spanish omelet and it doen't make a
whole lot of sense.
This message is completely true and I frequently discuss
this with people already. Well done.
How interesting that there was such little research on
protein absorption. Makes me want to dig into some
research. Bc it is very true that many chronically I'll suffer
from malnutrition.
I like the examples of the foods, it helps put into pespective
which foods to avoid or consume
More people need to realize the facts about these fast food
restaurants to avoid the obesity problems that we are facing.
None, I have already shared it with my husband!
I wish more fast food chains offered better menu choices.
I'm happy that McDonalds has yougurt and cuties now but
all of them need to do better
Good message. Lots of people lack the proper info on
vitamins and need for consumption.
I enjoyed the reading. As a mother of four, I'm constantly
struggling to get enough protein in their bodies and mine. I
do use a lot of protein mixes. This is the troubling part the
article. I'm presented with a possible problem with
absorption, but no solution
This article was good! It had a personal touch which made
it more relatable!
This as well was a great message and highly informative to
not only me a healthcare provider but the general public.
The goal of writing to the general public is to write at a 9th
grade reading level. I think this one is great!
333
Table 42 Cont.
Credibility Items
Ability
Participants’




Accuracy













For me this was the most useful message yet. It should be
helpful to anyone who reads it.
Still wondering how to better absorb protein.
You make it sound easy but really it is all not as simple as
that. I agree as far as exercise but when it comes to losing
weight, not that easy.
This is great over view of balancing in life. I am trying to do
that this summer with all the graduation parties going on.
I think the information is accurate and correct according to
The World Health Organization, but I do not think
information is enough without some sort of
recommendation as to what someone reading this
information can do to change their own habits.
I'm sure the numbers are accurate, but it would be nice if
there was a source cited for the numbers they supplied.
This is so accurate
I know some of our patients are prescribed Beneprotein
Again I come back to the fact that unless a person is within
the stages of change. Although the information is accurate,
change will not occur.
This is a great message, no improvement needed
It appears this is accurate information but there are no listed
links. It does tell you this is according to The Standard
American Diet (SAD); I googled it and there are multiple
sites. Which one did this information come from? Again, I
agree with the statistics stated but as a skeptical individual,
where is the proof?
Very nicely written. Compact, accurate, well-worded
I feel the information is is research based and correct.
There is really nothing else to add to the teaching.
I think it is somewhat correct but I also feel that you don't
want to encourage people to overconsume with an excuse to
cover it.
Interesting, explains the lipids and glycogen in kilocalories
well.
Good message, accurate.
I enjoyed this message an found it to be true even in my
own health
334
Table 42 Cont.
Credibility Items
Accuracy
Participants’’ Comment




Convincingness












This message is completely true and I frequently discuss
this with people already. Well done.
Again I come back to the fact that unless a person is
within the stages of change. Although the information is
accurate, change will not occur.
The message was accurate but provides info I already
know.
McDonald's and Burger King offer healthier meal options.
How many individuals choose healthy options opposed to
unhealthy?
Many fast food chains are now offering healthier food
options.
I wish more fast food chains offered better menu choices.
I'm happy that McDonalds has yougurt and cuties now but
all of them need to do better
People are mostly aware of how bad fast food is and the
health implications of eating it. I think people are
desensitized to the shock value of how bad fast food is, or
how many calories are in a fast food meal. To change
eating habits about fast food I think that there would have
to be a comparison or something to help people
understand how insane it is to have one food item with
710 calories.
This message is very nicely written and seems to grab the
readers attention and thought.
Sounds good.
This was intriguing, and makes me want to read more
Message is good but where is the source of the research to
back up the claims?
Sounds good.
This passage is wonderful. I would not change anything.
I agree that the majority of information about protein is
geared towards people trying to build muscle/bulk up
The message gives excellent information about how to live
a healthy life by including examples and lifestyle changes.
I would not change any information.
Well said,
335
Table 42 Cont.
Credibility Items
Convincingness
Participants’ Comment






Founded on
research







Would not change anything to improve message. Very
well worded. Very convincing. Will share.
This message was very well put, although it is a lot of
information in a short amount of words. It was
however nicely written.
I am curious to hear more about this because I had
always heard that people in the United States
consumed too much protein and that it has been linked
to many chronic illnesses?
This message was written in a way that many people
can understand. I liked that examples were given.
I like that way that the power of incremental changes
were highlighted
Wish there was more info on protein drinks. Especially
what the boys drink to help them build muscle and
weight lifting since it is very common in the teenage
and twenty some age group.
The 400,000 deaths. Obesity is not the primary cause. I
feel it is inappropriate to make that claim. Obesity is
the leading risk factor for many of the leading causes
of death. Or obesity can be linked to 400,000 deaths.
No citations to back up statements So would not share.
This sounds true but there are no references quoted so
is it? Since I already know that obesity has the listed
physical effects on the body, I tend to think that the rest
of the message is accurate. This message just states
what appears to be facts. No more, no less- that is why
it is not open-minded.
More specific research data relevant to majority of the
US population.
Source information would be good.
Citing more research would give more credibility to the
statement.
Where information or studies were found, and how
more information could be obtained.
336
Table 42 Cont.
Credibility Items
Founded on
research
Participants’’ Comment











As a scientific person, I would like to have been given
some more statistics and scientific proof of the
statments. Also, for lay men, please discuss in a little
more detail what the diseases are that are referenced
in the statement.
If the message is founded on research, the in text
citations are missing.
Would have been nice for the article to tell the
suggested amount of activity an adult needs.
I would like to see a source cited for this message, but
otherwise it was good.
I thought the message seemed confusing and could
have been stated differently. State the facts about
adults, then the facts about adolescents.
Sources of statistics are not cited to prove the
legitimacy of the claims. This sentence, "Work at the
national and state levels is increasing low-income
children’s participation in the school lunch and
breakfast programs." does not make sense to me. Wht
"work" is it. Is it the parents working low wage jobs
or political work?
It would be nice to see where the writer is getting the
information, which I should have written on all the
articles thus far, so that the person reading it could
look into the information in more depth if they chose
to.
Again, no references are listed so although I assume
this information to be true, I can not be 100% sure. If
I were sure the statistics were fact based, I would
change my ratings. I can only rate its accuracy on
what I already have knowledge on
Could have used statistics or references
I honestly wish to see the source for this valuable
information. I trust the researchers and I am sure the
sourses are credible too.
I think it might be useful to include some more
statistics about specific health consequences as a
result of so many people not eating enough fruits and
veggies!
337
Table 42 Cont.
Credibility Items
Founded on
research
Participants’ Comment












It would be nice to see where the writer is getting the
information, which I should have written on all the
articles thus far, so that the person reading it could look
into the information in more depth if they chose to.
As always..would like to see sources cited
Having sources to cite would give it more merit. I would
like to see examples of high fiber foods that the author
would recommend, not everyone knows what that would
be.
This is about one person doing research but doesn't lead
to any real meaning. What conclusion did they find, if
any? This statement is too general and open "I, for a
variety of reasons, happened to come across research in
the critical care arena." and doen't fit in the paragrapy. It
doesn't go anywhere afterwards and returns to how
protein acts in the body.
Again it will be great to see the source for this
information, onother thought is; is there a comparison to
healthier food prices to convince an avid fast food
shopper who survives on those cheap meals? Are there
any wide spread community educators to eduate the
community on how to read the menus(especially calorie
contents)? Is there anything that will beat this cheap,
tastier, fast and convinient food source. For all we know,
everyone needs to get healthier.
Group 3 No references listed
As always...I would like to see a source cited for this
message :)
Group 3 No references listed but I think this is all
accurate
To indicate this is evidence based research it should
mention something about where or who this idea came
from, not just state it
Should cite who the they is that is constantly referred to
in this article. Could be clarified a little.
Research info not provided and message needs to be
edited. Some sentences are poorly structured and there
are a few grammatical errors.
again...I would like to see sources cited
338
Table 42 Cont.
Credibility Items
Founded on
research
Participants’ Comment







Edit the message properly and provide references.
Message is good but where is the source of the research
to back up the claims?
As always, I would like to see a source cited. I do like
how examples of food that is high in Vit D were
provided.
Message is good but where is the source of the research
to back up the claims?
Missing a clear connection between topics
Too much information in one paragraph- I had to read the
paragraph 3 times to understand./
I feel that this message needs to be two different
paragraphs. One talking about the importance of water
and a second one about calcium. I think it would be
easier to share the information if it was not all missed
together.
339
Table 43
Distribution for the Scales Used for Rating the Credibility Items
1
Scales1
Descriptive1
1-2
Poor
3-4
Fair
5-6
Good
7-8
Very Good
9 - 10
Created by Researcher
Excellent
340
Table 44
Correlation Matrix to Determine if a Model Exists Which Would Explain a Significant
Portion of the Variance of Attitudinal Change as Measured by the Method of Persuasion
and the Demographic Characteristics Indicators (gender, age, and race).
Dpp
Dpp
1.000
GM1
GM2
GM3
R
AD
AD1
AD2
AD3
GM1
-.076
1.000
GM2
.071
-.083
1.000
GM3
.288
-.084
-.128
1.000
R
-.107
-.162
-.026
.068
1.000
AD
-.205
-.344
.134
.049
-.086
1.000
AD1
.000
.149
.001
-.050
-.074
.200
1.000
AD2
.150
.098
.118
-.071
-.008
-.246
-.572
1.000
AD3
-.048
-.062
-.241
.114
.157
-.142
-.331
-.407
1.000
G
.092
.089
-.184 .036
.105
DPP = Difference between post and pre-test
GM1 = Grand Mean for Group 1
GM2 = Grand Mean for Group 2
GM3 = Grand Mean for Group 3
R = Race/Ethnicity
AD = AgeDummy
AD1 =AgeDummy1
AD2 = AgeDummy2
AD3 = AgeDummy3
G = Gender
-.095
-.221
.058
.256
G
1.00
341
Table 45
Excluded Variables, Standardized Coefficients, T Values, Significance Levels, and
Partial Correlations for the Regression Equation Predicting Overall Attitudinal Change
Variable
Beta In
t
p
Partial Correlation
VIF
GM1
-052
-.421
.675
-.054
1.007
GM2
.109
.881
.382
.113
1.017
R
-.127
-1.034
.305
-.132
1.005
AD
-.219
-1.818
.074
.229
1.002
AD1
.015
.120
.905
.015
1.003
AD2
.172
1.406
.165
.179
1.005
AD3
-.082
-.662
.551
-.085
1.013
G
.103
.834
.408
.107
1.001
a
.05 Alpha Level for the Two-Tailed Test of Significance
DPP = Difference between post and pre-test
GM1 = Grand Mean for Group 1
GM2 = Grand Mean for Group 2
GM3 = Grand Mean for Group 3
R = Race/Ethnicity
AD = AgeDummy
AD1 =AgeDummy1
AD2 = AgeDummy2
AD3 = AgeDummy3
G = Gender
342
Table 46
Descriptive for Reporting and Interpreting Cohen’s d
Value
Interpretation of effect size
.20
Small effect size
.50
Medium effect size
.80
Large Effect size
Kotrlik, J. W., Williams, H.A. and Jabor, M. K. (2011). Reporting and interpreting effect
size in quantitative agricultural education research. Journal of Agricultural Education, 52
(1), 132-142.
343
Appendix G: Figures
Figure 5: Box plot to Determine Outliers for Message Ratings for Groups1
Figure 6: Box plot to Determine Outliers for the Differences between Post and Pre-test
for Group 1
344
Figure 7: Boxplot to Determine Outliers for Message Ratings for Group 2
Figure 8: Box plot to Determine Outliers for the Differences between Post and Pre-test
for Group 2
345
Figure 9: Boxplot to Determine Outliers for Message Ratings for Group 2
Figure 10: Box plot to Determine Outliers for the Differences between Post and Pre-test
for Group 3
346
Figure 11: Scatterplot of ZPRED and ZRESID
Figure 12: Histogram Showing the Distribution of Normality
347
Figure 13: Normality Plot for the Dependent Variable
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