BACKGROUND: Pretesting is the key to understanding how the intended audience will react to the message. Resistant reactions affect message processing or can lead to undesirable boomerang effects. The objective of this study was to develop a rating scale for measuring active (reactance) and passive (disengagement) resistance to persuasive health messages. METHODS: Six candidate items (3 items for disengagement and 3 items for reactance) were generated based on literature review. A web-based survey was conducted among Japanese adults aged 25-64 years to verify the reliability and validity of the 6-item resistance scale. Participants were asked to rate one of the advance care planning (ACP) promotion messages. All scale items were scored on a 1-to-5 point Likert scale and they were averaged to produce the resistance score. RESULTS: Explanatory factor analysis revealed a two-factor solution that agreed with the disengagement and reactance domains, respectively. Correlation coefficients between each set of items ranged between 0.30-0.69. Cronbach alpha (0.86) indicated satisfactory internal consistency of the set of items. Confirmatory factor analysis showed a good fit of the two-factor model with CFI = 0.998, SRMR = 0.011, and RMSEA = 0.041. The resistance score showed a moderate positive correlation with negative emotional responses (displeasure γ = 0.55, anger γ = 0.53) and was significantly inversely related to the persuasiveness score (γ = -0.50). Multivariable logistic regression analysis showed that the odds ratio for ACP intention per 1-point increase in the resistance score was 0.47 (95% confidence interval 0.40-0.56) with adjustment for the persuasiveness score. CONCLUSION: The 6-item resistance scale exhibited adequate reliability and validity for measuring audience resistance when applied to the ACP promotion messages in Japanese people. The scale will be useful for pretesting health messages to make them more acceptable to the intended audience. TRIAL REGISTRATION Not applicable; this is not a report of intervention trial.
Adult ; Factor Analysis, Statistical ; Humans ; Intention ; Middle Aged ; Persuasive Communication ; Psychometrics ; Reproducibility of Results ; Surveys and Questionnaires

BACKGROUND: The persuasive effect of health messages can depend on message features, audience characteristics, and target behaviors. The objective of this study was to compare the responses to persuasive messages encouraging professional help seeking for depression between individuals with and without psychological distress. METHODS: A cross-sectional web-based survey was conducted on Japanese adults aged 35-45 years, who randomly received one of three persuasive messages that aimed to promote help-seeking intentions for depression. The primary message statements were as follows: (1) depression can happen to anyone, (2) depression needs treatment, and (3) depression improves with treatment. Participants rated the messages in terms of comprehensibility, persuasiveness, emotional response, and intended future use. Help-seeking intention for depression was measured using vignette methodology before and after exposure to the messages. Eligible participants who had not received medical treatment for their mental disorders were classified as either distressed (K6 score ≥ 5, N = 824) or non-distressed (K6 score < 5, N = 1133) and analyzed. RESULTS: No significant differences in comprehensibility or persuasiveness scores were observed between the messages, but the distressed group had significantly lower scores than the non-distressed group. Negative emotional responses such as surprise, anger, fear, sadness, guilt, and anxiety were significantly stronger when reading message 2, while a positive emotional response such as happiness was significantly stronger when reading message 3. These emotional responses were more prominent in the distressed than in the non-distressed group. After reading messages 1, 2, and 3, the proportions of participants in the distressed group who reported having a positive help-seeking intention increased by 35.1%, 32.1%, and 27.7%, respectively, and by 6.4%, 17.3%, and 15.2%, respectively in the non-distressed group. Multiple logistic regression analysis among participants having no help-seeking intention before exposure to the messages showed that message 2 had a significantly greater effect of increasing help-seeking intentions in the non-distressed group. CONCLUSION: The exposure to persuasive messages may promote help-seeking intentions for depression. It seems likely that loss framing will work better than neutral and gain framing. Meanwhile, the responses to persuasive messages may differ to some extent between distressed and non-distressed individuals, as individuals with psychological distress are likely to be more susceptible to persuasive messages than those without. TRIAL REGISTRATION Not applicable; this is not a report of intervention trial.
Adult ; Cross-Sectional Studies ; Depression ; therapy ; Female ; Health Promotion ; statistics & numerical data ; Help-Seeking Behavior ; Humans ; Intention ; Male ; Middle Aged ; Persuasive Communication ; Stress, Psychological ; psychology ; Surveys and Questionnaires

The purpose of this study was to examine the perceptions, precedent tasks, positive and negative effects, and expandable professional tasks regarding the inclusion of dental hygienists (DHs) in the category of medical personnel. This study involved a survey of 259 DHs and 128 dentists. The findings were as follows: 94.2% of DHs and 46.9% of dentists were aware of inclusion in the category of medical personnel; 95.0% of DHs and 64.1% of dentists supported the idea; and 84.9% of DHs and 51.6% of dentists recognized its legitimacy. As for precedent tasks for inclusion in the category of medical personnel, both DHs and dentists scored high points in professional consciousness in the area of occupation. Both DHs and dentists scored the highest points in the quality management of DH education and the lowest points in the unification of school systems in the area of institution. In the area of society, DHs scored high points in the persuasion of the central government, whereas dentists scored high points in collaboration among concerned organizations. Regarding the positive effects of inclusion in the category of medical personnel, both DHs and dentists scored the highest points in the expanded perception of DHs. As for its negative effects, DHs scored high points in the aggravation of salary increase, whereas dentists scored high points in the aggravation of salary increase. Regarding expandable professional tasks after the inclusion of DHs in the category of medical personnel, the management of independent periodontal care programs recorded the highest percentage both in DHs and dentists. These findings highlight the need for adequate discussions about the meanings of the inclusion of DHs in the category of medical personnel and will hopefully contribute to the rational adjustment and legalization of DHs' works with regard to their inclusion in the category of medical personnel.
Consciousness ; Cooperative Behavior ; Dental Hygienists* ; Dentists ; Education ; Humans ; Illegitimacy ; Occupations ; Persuasive Communication ; Salaries and Fringe Benefits

OBJECTIVES: This study was conducted to evaluate the nutrition quotient (NQ) by mother's parenting style which may influence the NQ in preschool children. METHODS: Subjects were 310 mothers and their 4-6 year old children. The questionnaire composed of demographic characteristics, mother's parenting style at meal time and eating behavior as measured by NQ questions. The NQ questions consisted of 19 food behavior checklist items and all items were grouped into 5 factors: balance, diversity, moderation, regularity, and practice. Mother's parenting style was classified by using words for nutrition education at meal time. All data were statistically analyzed by SPSS program (Ver. 23) and the statistical differences in variables were evaluated by Student's t-test, χ²-test, One-way ANOVA. RESULTS: We observed that in children whose mothers use the parenting style at meal time of ‘explanation’ and ‘compliment & cheer up’ had high dietary regularity, diversity, practice. The children of mothers who use the parenting style at meal time of ‘persuasion’ and ‘reward’ were found to have a lower degree of balance, diversity, and practice. Especially, children of ‘reward’ style mothers had lower moderation of dietary life. On the other hand, among the parenting style at meal time of ‘comparison & demand’, ‘treating’ and ‘faire’, there was no significant difference in the NQ factor by each group. NQ grade was higher among those who used more explanation (p < 0.001) and persuasion (p < 0.01) and with use of less persuasion (p < 0.01) and reward (p < 0.01). The positive association observed between the frequency of dietary education of mothers and higher NQ grade indicated the degree of dietary practices of those children. On the other hand, the children of mothers who rarely practice the dietary education at home had lower NQ grade (p < 0.001). CONCLUSIONS: In order to promote children's proper dietary behaviors, it is important to provide nutrition education to children as well as provide guidance on parenting style at meal time.
Checklist ; Child ; Child, Preschool ; Education ; Feeding Behavior ; Hand ; Humans ; Meals* ; Mothers ; Parenting* ; Parents* ; Persuasive Communication ; Reward

This review describes the types of psychiatric treatment studied during the Japanese colonial period of 1910–1945 in Korea, known at the time as Chosun. Twenty-nine research papers and abstracts on psychiatric treatment were reviewed, which were published in the Shinkeigaku-zassi (Neurologia), the Seishin-shinkei-gaku zassi (Psychiatria Et Neurologia Japonica) and the Journal of Chosun Medical Association, by faculty members of the department of neuropsychiatry, Chosun-Governor Hospital and Keijo (Seoul) Imperial University School of Medicine. The major research area was biological psychiatry and biological treatment, as Japanese pioneers in psychiatry at that time had introduced German psychiatry into Japan. Professor Kubo published the most papers, followed by Dr. Hattori, Dr. Hikari, and Professor Suits. In Chosun-Governor Hospital, research on prolonged sleep therapy was an active field. In the Imperial University Hospital, malarial fever therapy, sulphur-induced fever therapy, and insulin shock treatment were the most frequent research topics. Some were tried for the first time in the Japanese Empire, which reflected the pioneering position of the university. These achievements are attributed to Professor Kubo. Six papers on psychotherapy were published. Among them, two papers were on persuasion therapy, three papers were case reports of psychoanalytic therapy, and one paper on Freud. However, this psychoanalytic therapy research seemed to be limited trials conducted following literal guidance, and no further development was noted. Generally, research was characterized by simple design, small numbers of subjects, lack of objective evaluation method, lack of statistical treatment, and especially lack of ethical consideration comparing with today's standard.
Asian Continental Ancestry Group* ; Biological Psychiatry ; Humans ; Hyperthermia, Induced ; Insulin Coma ; Japan ; Korea* ; Methods ; Neuropsychiatry ; Persuasive Communication ; Psychiatry* ; Psychoanalytic Therapy ; Psychotherapy

PURPOSE: To examine the effects of a case management program on self-efficacy, depression and anxiety in pregnant women with gestational diabetes mellitus. METHODS: Thirty-seven patients who enrolled in a diabetes outpatient clinic were randomly assigned to either an experimental group (n=19) or a control group (n=18). The experimental group received a 2-week intervention composed of a series of one face-to-face interactive interview and five telephone interviews based on the National standards for diabetes self-management education and Bandura's self-efficacy resources of performance accomplishment, vicarious experience, verbal persuasion, and emotional arousal. The effects of the intervention were assessed by completion of a 9-item self-efficacy questionnaire, a 20-item depression questionnaire and a 20-item anxiety questionnaire prior to, and after the intervention. The statistical significances were examined using t-test. RESULTS: The change in self-efficacy was significantly greater in the experimental group than in the control group. Depression and anxiety changes in the experimental group were significantly greater compared to those in the control group. CONCLUSION: The results of study suggest that a case management program improves self-efficacy, and decreases depression and anxiety in pregnant women with gestational diabetes mellitus.
Ambulatory Care Facilities ; Anxiety ; Arousal ; Case Management ; Depression ; Diabetes, Gestational ; Female ; Humans ; Interviews as Topic ; Persuasive Communication ; Pregnancy ; Pregnant Women ; Surveys and Questionnaires ; Self Care

PURPOSE: The purpose of this study was to develop a comprehensive self-management program promoting self efficacy for Type 2 diabetic patients. METHODS: The study was a methodological research design in which previous related research was reviewed to develop the comprehensive self-management program promoting self efficacy using self efficacy theory. RESULTS: Comprehensive self-management programs promoting self efficacy included the whole range of eight self-management domains: diet, exercise, medication, self-testing of blood glucose, complication or foot, stress, time, and general health, and consisted of four sources of self efficacy: enactive mastery experience, vicarious experience, verbal persuasion, and physiological and affective states, as strategies to promote self efficacy. Developmental methods included, in addition to large and small group education, individual education or counseling, and telephone counseling. CONCLUSION: Further studies are needed in community health centers or hospitals to establish the effects on self-management compliance and glycemic control of the comprehensive self-management program promoting self efficacy.
Blood Glucose ; Community Health Centers ; Compliance ; Counseling ; Diabetes Mellitus, Type 2 ; Diet ; Foot ; Humans ; Persuasive Communication ; Research Design ; Self Care ; Self Efficacy ; Telephone

OBJECTIVES: Based on the debate between paternalism and rights-driven view, to investigate the effects of coercion on the recovery attitudes of patients with mental illness. METHODS: The participants were 352 patients with schizophrenia (79.8%) and mood disorders (major depressive disorder 9.1%, bipolar 11.1%), who were in hospital or who were enrolled in a community mental health center or a social rehabilitation center. All were interviewed. Coercion was divided into family and experts, depending on coercer and was divided into positive and negative coercion such as persuasion, inducement, asked preference, threat, physical force and so on, depending on types of coercion. Recovery attitudes were subdivided into subjective clinical recovery attitudes and life recovery attitudes. RESULTS: When socio-demographic and disorder characteristics were controlled, positive coercion by family and experts had a significant effect on life recovery attitudes, and positive coercion by experts had a significant effect on subjective clinical recovery attitudes. The level of symptoms was found to be an important predictor of recovery attitudes. CONCLUSION: The findings of this study propose the important of the control of mental symptoms, more realistic training in family education, the secure of human rights protection guidelines applicable in the field and so on.
Coercion ; Depressive Disorder ; Human Rights ; Humans ; Mental Health ; Mood Disorders ; Paternalism ; Persuasive Communication ; Rehabilitation Centers ; Schizophrenia

OBJECTIVES: Based on the debate between paternalism and rights-driven view, to investigate the effects of coercion on the recovery attitudes of patients with mental illness. METHODS: The participants were 352 patients with schizophrenia (79.8%) and mood disorders (major depressive disorder 9.1%, bipolar 11.1%), who were in hospital or who were enrolled in a community mental health center or a social rehabilitation center. All were interviewed. Coercion was divided into family and experts, depending on coercer and was divided into positive and negative coercion such as persuasion, inducement, asked preference, threat, physical force and so on, depending on types of coercion. Recovery attitudes were subdivided into subjective clinical recovery attitudes and life recovery attitudes. RESULTS: When socio-demographic and disorder characteristics were controlled, positive coercion by family and experts had a significant effect on life recovery attitudes, and positive coercion by experts had a significant effect on subjective clinical recovery attitudes. The level of symptoms was found to be an important predictor of recovery attitudes. CONCLUSION: The findings of this study propose the important of the control of mental symptoms, more realistic training in family education, the secure of human rights protection guidelines applicable in the field and so on.
Coercion ; Depressive Disorder ; Human Rights ; Humans ; Mental Health ; Mood Disorders ; Paternalism ; Persuasive Communication ; Rehabilitation Centers ; Schizophrenia

To determine whether a pass/fail system is more appropriate for medical education instead of a grade-based system, a survey of medical students and faculty members of Hallym University, Korea, was taken. A questionnaire was delivered to 54 junior students and 36 faculty members from a medical school in Korea and analyzed. Of these participants, 37.7% of students and 36.1% of faculty agreed to the pass/fail system, while 28.3% of students and 52.8% of faculty objected to it. The most frequent reason for objection was the potential decrease in learning achievement. A pass/fail system should be considered after persuasion of the students and faculty to think positively of this system.
Education, Medical ; Humans ; Korea* ; Learning ; Persuasive Communication ; Schools, Medical* ; Students, Medical ; Surveys and Questionnaires