Increase Health Compliance by Easing Stigma

The largest typeface used in the print ad was for the sentence, “A Lung Screening Could Save Your Life.” The offer read, “Mount Sinai Medical Center is proud to offer discounted low-dose CT screenings during the month of November, Lung Cancer Awareness Month,” and text at the bottom of the ad asked, “So what are you waiting for?”
     However, another question, this one at the very top of the ad, could easily undercut the effectiveness of the ad’s message, according to studies at Northwestern University and University of Washington: “Are You a Long-term Smoker?”
     The study results indicate that when a social stigma is attached to being a long-term smoker, that question at the top could interfere with the high moral identity of the ad, and high moral identity motivates compliance with health care recommendations. Long-term smokers reading the ad become resistant to appreciating the message. Further, the moral interference is so great that it can decrease compliance even among ad readers who don’t engage in the stigmatized behavior.
     We especially want to persuade people most at risk from a stigmatized behavior to follow health care advice. Here is two-pronged approach consistent with the study findings: 

• Activate a high moral sense in the target audience. In the studies, this was done by including in the health message a header reading, “You are kind and caring.” The theme is self-affirmation. 
• Deemphasize the highly-stigmatized behavior and highlight a low-stigmatized behavior or circumstance which has a risk in the same category. In the studies, this was done by highlighting air pollution as a cause of lung disease.

     Other studies assess the effects a health care professional’s reactions to non-compliance has on a patient’s subsequent behavior. The best approach, according to research at University of California-Santa Barbara, is to start by showing positive concern for the noncompliant patient and then follow this with an analysis of the reasons for the compliance shortfalls. The health professional’s attitude when showing positive concern should be enthusiasm. The attitude during the analysis and subsequent corrective action plan should be disappointment and impatience, but never blame. This works well because it fits patient expectations. Health care professionals are expected to be both caregivers and problem solvers.
     And modeling is always an influential tool for persuasion agents. Our customers, clients, and patients put more trust in what we recommend when we ourselves follow those recommendations which apply to us.

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