Date Published: April 18, 2019
Publisher: Public Library of Science
Author(s): Joëlle Ooms, John Hoeks, Carel Jansen, Wolfgang Himmel.
Stories are often used in health communication because of accumulating evidence of their potential to affect people’s attitudes and health behavioral intentions. Similarity between the reader and the story’s protagonist appears to positively influence narrative persuasion, but the exact role of similarity on persuasive outcomes is debated, as some research finds clear effects of similarity manipulations whereas others do not. Possibly, these mixed results were found because the similarity manipulations were not always relevant to the topic of the story. We conducted an experiment (N = 582) in which we varied the age and gender of the protagonist, features that were of central relevance to the story’s topic, namely breast cancer versus testicular cancer. There were two groups of participants: 324 students (mean age: 21.46 years) and 258 older adults (mean age: 56.83 years). Age similarity (but not gender similarity) had an effect on identification with the protagonist, transportation (i.e. the experience of being absorbed into a story), and the intention to donate, but only for students. For older adults, age or gender of the protagonist did not seem to matter, as nearly no differences in persuasive measures were found. As far as the underlying mechanism is concerned, the results of structural equation modeling showed that the concept of ‘perceived similarity’ would be a relevant addition to models of narrative persuasion, as it was significantly related to the narrative processes of transportation and identification, which, in turn, predicted attitudes and behavioral intentions, both directly—in the case of transportation—or indirectly, via the emotion of compassion. We conclude that both manipulated and perceived similarity are important for narrative persuasion, and that it should be kept on the research agenda of health communication.
Stories, or narratives, are increasingly studied in a health context by scholars from different disciplines [1, 2]. A well-known type of narrative in this domain is the illness narrative—also referred to as health narrative, testimonial, anecdote or patients story—which can be defined as a “first-person story about experiences with illness and its personal consequences” (: p 28). Illness narratives can thus be seen as a form of meaning making which enables patients to give voice to their suffering [4, 5]. However, these narratives can also help other people in the decision making process concerning their own health.
The following section is divided into two parts. First, the hypotheses concerning the effects of manipulated similarity are tested. Please note that, for brevity reasons, from here we will use the term similarity to indicate manipulated similarity. Otherwise, the term perceived similarity will be used. The second part focuses on testing the hypothesized model. A correlation matrix of all measured variables can be found in S3 Appendix.
In this study, we investigated whether manipulated similarity with a protagonist affected the persuasive outcomes of narratives, through perceived similarity, transportation, identification, self-referencing, and the emotions of fear, compassion, and sadness. We conducted an experiment in which we varied the age and gender of the story protagonist to make him/her less or more similar to the participants, who were females and males, either of student age or above 40 years old (further abbreviated to ‘students’ versus ‘adults’). Similarity in age and similarity in gender were assumed to be relevant to the chosen health theme of cancer, since the susceptibility for breast cancer and testicular cancer is age and gender sensitive: breast cancer most often affects older women, and testicular cancer is most often found in young men. We hypothesized that a protagonist with the same age and gender as the reader would induce higher perceptions of similarity, higher levels of identification and transportation, and higher scores on persuasive measures than a protagonist with a different age and gender.