See discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/347507677 Effects of Narratives and Behavioral Involvement on Adolescents’ Attitudes toward Gaming Disorder Article in Health Communication · December 2020 DOI: 10.1080/10410236.2020.1862397 CITATIONS READS 2 82 2 authors: Yuchen Ren Fuyuan Shen Shenzhen University Pennsylvania State University 4 PUBLICATIONS 46 CITATIONS 62 PUBLICATIONS 1,611 CITATIONS SEE PROFILE Some of the authors of this publication are also working on these related projects: mHealth approach to promoting physical activity View project All content following this page was uploaded by Fuyuan Shen on 19 December 2021. The user has requested enhancement of the downloaded file. SEE PROFILE Health Communication ISSN: (Print) (Online) Journal homepage: https://www.tandfonline.com/loi/hhth20 Effects of Narratives and Behavioral Involvement on Adolescents’ Attitudes toward Gaming Disorder Yuchen Ren & Fuyuan Shen To cite this article: Yuchen Ren & Fuyuan Shen (2020): Effects of Narratives and Behavioral Involvement on Adolescents’ Attitudes toward Gaming Disorder, Health Communication, DOI: 10.1080/10410236.2020.1862397 To link to this article: https://doi.org/10.1080/10410236.2020.1862397 Published online: 17 Dec 2020. Submit your article to this journal View related articles View Crossmark data Full Terms & Conditions of access and use can be found at https://www.tandfonline.com/action/journalInformation?journalCode=hhth20 HEALTH COMMUNICATION https://doi.org/10.1080/10410236.2020.1862397 Effects of Narratives and Behavioral Involvement on Adolescents’ Attitudes toward Gaming Disorder Yuchen Ren a and Fuyuan Shenb a School of Media and Communication, Shenzhen University; bDonald P. Bellisario College of Communications, Pennsylvania State University ABSTRACT This paper examines the impact of using narratives to communicate a controversial health issue, gaming disorder, on adolescents’ issue attitudes. In a between-subjects experiment, 115 adolescent participants read either a narrative or an informational message on gaming disorder. Results indicated that compared to the informational message, the narrative health message generated more positive attitudes toward the medical view of problematic gaming and greater attitude certainty. Transportation mediated the narra­ tive’s effect on attitudes. Behavioral involvement moderated the narrative’s effect on attitudes and attitude certainty, such that the positive effects of the narrative on attitudes and attitude certainty were more pronounced for high-involvement adolescents than for low-involvement adolescents. In addition, behavioral involvement also enhanced the effect of message absorption on attitudes. By extending our research on narrative effects to the adolescent population, this study presents findings with both theoretical and practical implications. In recent years, much research has examined the role of narra­ tives in the fields of advertising, journalism, and health com­ munication (Oliver et al., 2012; Redondo et al., 2018; Shen et al., 2017; van Krieken & Sanders, 2019). Although there exists some variations in narrative effects that can be attributed to individual differences (Slater et al., 2006; Thompson & Haddock, 2012), there is a general belief that narratives are effective in producing message-consistent attitudes in audi­ ences by increasing engagement, reducing counterarguing, and evoking specific feelings (Green & Clark, 2013; Ooms et al., 2017; Shen et al., 2014). This belief has been validated in various health communication contexts, such as communi­ cating health risk (Janssen et al., 2013), reducing stigma (Heley et al., 2020), and promoting detective and preventive health behaviors (Dillard et al., 2010; Volkman & Parrott, 2012). In studying the persuasive effects of narratives, the existing body of research, including that on entertainment-education, has often focused on adults (for reviews, see Braddock & Dillard, 2016; Shen & Han, 2014). Little is known, however, about whether the effects of narratives and the underlying psychological mechanisms can be generalized to adolescents, who differ from adults both biologically and psychologically. Further investigations are therefore clearly warranted to better understand the impact of narrative messages among adoles­ cents. To contribute to the current literature on narrative persuasion, the present study will go beyond the adult popula­ tion and examine how narrative messages, as compared to informational messages, influence adolescents’ attitudes and attitude certainty. Additionally, this study will also examine the moderating role of adolescents’ behavioral involvement in relation to the narrative’s effects. In doing so, it will extend prior research on the individual differences in narrative CONTACT Fuyuan Shen fus1@psu.edu © 2020 Taylor & Francis Group, LLC persuasion. Finally, this study will explore the above research issues within the important and controversial health context of gaming disorder. In 2019, the World Health Organization (WHO) officially included gaming disorder in its latest version of the International Classification of Diseases as a mental disorder. It defines gaming behavior as a disorder when it takes pre­ cedence over other daily activities and starts to impair a person’s relationships, school or work responsibilities for at least a year (World Health Organization, 2019). The med­ ical transformation of problematic video game playing has huge economic consequences for the gaming industry. It can also affect the way in which individuals with these types of behaviors are viewed and treated by their friends, parents, and teachers. Before discussing these possible social outcomes, it is important to note that this new classification drew criti­ cisms from some scholars and the gaming industry, who have argued that the medical view of problematic gaming lacks clear diagnostic criteria and scientific evidence (Electronic Software Association, n.d.; Wang et al., 2019). More impor­ tantly, the public may not accept this medical view of proble­ matic gaming that has been promoted by the public health authority (i.e., WHO). Adolescents may be especially reluc­ tant to accept this medical view because they are thought to be particularly vulnerable to gaming disorder (World Health Organization, 2019) and may suffer stigmas and even be forced to receive inappropriate medical treatments (Hu & Qin, 2009). Because gaming disorder is an important and controversial health concern for adolescents, it is essential to understand how media messages influence adolescents’ atti­ tudes toward gaming disorder (i.e., the extent to which they agree with the medical view of excessive gaming). Bellisario College of Communications, Pennsylvania State University, PA 16802, USA 2 Y. REN AND F. SHEN In the next section, we will review the relevant literature and propose a set of research questions. This will be followed by a detailed description of the research method for our study. We will then present the results and discuss the implications of our research findings. Literature review Impacts of narratives Narratives are the stories we tell. Hinyard and Kreuter (2007) defined a narrative as “any cohesive and coherent story with an identifiable beginning, middle, and end that provides informa­ tion about scene, characters, and conflict; raises unanswered questions or unresolved conflict; and provides resolution” (p. 778). Researchers have long noted that messages presented in the narrative format are often more persuasive than those presented in the informational format (Oliver et al., 2012; Shen et al., 2017; van Krieken & Sanders, 2019). Several models have been proposed to explain the advantages of narratives in persuasion, such as the Extended Elaboration Likelihood Model (Slater & Rouner, 2002) and the Entertainment Overcoming Resistance Model (Moyer-Gusé, 2008). Despite the differences in the specific constructs used, both models emphasize the role of narrative immersion, reduced negative cognition, and affective factors as potential mechanisms under­ lying narrative persuasion. Compared with informational messages, narrative messages are more absorbing. The story structure enables readers to be fully absorbed in the message and makes them feel connected with the characters in the story (Shen et al., 2014; van Krieken et al., 2015). The absorption can be described at two levels. At the story level, narrative messages induce transportation, “an integrative melding of attention, imagery, and feelings, focused on story events” (Green, 2006, p. 164). At the character level, narrative messages induce identification, whereby readers take on thoughts and feelings of characters and imagine being one of the characters in the text (Cohen, 2001). Both transportation and identification “highlight how people lose themselves in the story [. . .] and subsequently accept story-related beliefs without thought” (Hamby et al., 2018, p. 114). Narratives may also reduce counterarguing against the mes­ sage (Hoeken & Fikkers, 2014). Considering the hedonic nat­ ure of narratives, readers of narratives are prone to becoming involved in the enjoyment of the storyline and thus are less likely to engage in critical thinking (Slater, 2002). Narratives also do not usually have a clear and explicit standpoint. As a result, readers do not know what exactly to counterargue (Dal Cin et al., 2004). In addition, it is difficult to perceive the intent of a narrative to influence or persuade, and hence readers may be less defensive against the influence of narratives because they do not need to engage in critical thinking (Slater, 2002). Taken together, reduced counterarguing makes it easier for narratives to generate influences (Shen et al., 2014). Additionally, compared with non-narrative informational messages, narratives are more likely to evoke specific responses, such as fear, sadness, and surprise (Ooms et al., 2017; Yoo et al., 2014). Given that narratives are based on individual experience, they are easier for the readers to relate to characters in an experiential way and to have specific feel­ ings than informational messages (Oliver et al., 2012). By taking the protagonists’ perspective and perceiving their suffer­ ing, readers can feel compassion (Goetz et al., 2010; Lazarus, 1991). Oliver et al. (2012) found that news stories about mem­ bers of stigmatized groups were more effective than the nonnarratives at inducing compassion toward the stigmatized group, which positively changed their attitudes toward stigma­ tized groups. In summary, narrative messages are effective in generating story-consistent attitudes toward important social issues. Although some scholars have suggested that there are signifi­ cant variations in the impacts of narratives (Nan et al., 2017), there is a general belief that narratives can shape people’s issue attitudes by increasing their transportation and identification (e.g., Green & Clark, 2013), decreasing counterarguments (e.g., Shen et al., 2014), and evoking specific affective responses (e.g., Ooms et al., 2017). Narratives are particularly suitable for framing controversial issues by immersing the participants in a particular perspective (e.g., Shen et al., 2014). Prior studies have found narrative to be effective in communicating health risk (Janssen et al., 2013), reducing stigma (Heley et al., 2020), and promoting detective and preventive health behaviors (Dillard et al., 2010; Volkman & Parrott, 2012). However, extant research is predominantly focused on adults. It remains unknown whether the effects of narratives and the hidden psychological mechanisms can be generalized to adolescents. Narrative messages and adolescents Despite the paucity of research on the impact of narratives among adolescents, research in developmental psychology and media studies has suggested that adolescents process messages in several unique ways. First, adolescents are at a stage of exploring identity and particularly vulnerable to peer influ­ ences (Steinberg & Monahan, 2007). By identifying with char­ acters in the story, they would be tempted to, consciously or not, take on the beliefs and attitudes endorsed by these characters (Green & Clark, 2013). Second, adolescents are more emotional than adults and are prone to consult their feelings as a source of information in judgment making (Albert & Steinberg, 2011). As narratives are more emotion­ ally engaging, adolescents may be more influenced by them. Finally, adolescents have a more limited cognitive capacity than adults (Rushton & Ankney, 1996). Prior research sug­ gests that the inverted pyramid structure, which is often used by informational news, heavily taxes cognitive resources, while a chronological sequencing of events, which is often used by narrative news, demands fewer cognitive resources (Sternadori & Wise, 2010). In this sense, narrative messages may fit the cognitive needs of adolescents and outperform informational messages in influencing their attitudes. Perhaps this is why entertainment-education has been found to be effective in health interventions that target youth (Glik et al., 2002). It therefore seems plausible that the positive effect of narra­ tive messages can be generalized to adolescents. However, empirical evidence tends to be mixed across the few existing studies. In one experiment conducted among 706 German adolescents (Emde et al., 2016), those exposed to narrative HEALTH COMMUNICATION news about the minimum wage were found to have more affective and cognitive involvement than those exposed to its non-narrative counterpart, but this effect was not observed for news on youth protests with the same group of participants. Adding to the ambiguity, scholars in health communication found that narrative and non-narrative messages in the written form were, at best, equally effective in influencing adolescents’ issue attitude toward alcohol drinking (Zebregs et al., 2015) and smoking (de Graaf et al., 2017); narrative materials could even have an unintended effect for adolescents by making attitudes toward smoking more positive (de Graaf et al., 2017). Beyond the written communication context, scholars have found that various forms of entertainment-education, including live performance (Lalonde et al., 1997) and TV series (Hecht et al., 1993; Moyer-Gusé et al., 2020), could help pro­ duce message-consistent attitudes among adolescents. However, these studies did not directly compare the effective­ ness of narratives against non-narrative control groups. Further investigations are therefore clearly warranted in order for us to better understand the impact of narrative health messages among adolescents. In addition, prior studies have not explored the impact of narratives on attitude certainty. Attitude certainty refers to the extent to which an individual is sure that his or her attitude is correct (Gross et al., 1995). As research suggests, attitude certainty may be equally, if not more, predictive of future actions than attitude itself, and it is more resistant to change when challenged (Petty & Krosnick, 1995). As people need to infer valuable information from narratives, they could have less confidence in their judgment than those who obtain explicit information from informational messages. This may be of special

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