Stop the sticks.  A recent meta-analysis on Internet based interventions for behavior change finds an effect size that is almost identical to meta results for mass media interventions we discussed from Leslie Snyder’s group and more recently from Blair Johnson’s team.  Here’s the key paragraph from this abstract.

Results: We found 85 studies that satisfied the inclusion criteria, providing a total sample size of 43,236 participants. On average, interventions had a statistically small but significant effect on health-related behavior (d+ = 0.16, 95% CI 0.09 to 0.23). More extensive use of theory was associated with increases in effect size (P = .049), and, in particular, interventions based on the theory of planned behavior tended to have substantial effects on behavior (d+ = 0.36, 95% CI 0.15 to 0.56). Interventions that incorporated more behavior change techniques also tended to have larger effects compared to interventions that incorporated fewer techniques (P < .001). Finally, the effectiveness of Internet-based interventions was enhanced by the use of additional methods of communicating with participants, especially the use of short message service (SMS), or text, messages.

That d of .16 is very close to Leslie’s r of .09 and Blair’s finding of a d at .21.  Thus, it appears that the average persuasion campaign aimed at behavior change can produce a Small Windowpane effect in that range of 45/55 and that this effect size holds across different media types.  And, of course, in a meta analysis of 85 studies there’s a lot more going on than just this headline, so read the paper.

Some observations . . .

1.  Media’s not the matter.

Stop looking for outcome differences in persuasion interventions by type of media used for delivery.  Unless you have a highly targeted Other Guy who only lives on Facebook or only watches Oprah or only reads Maxim, media is not a crucial variable.  You buy media with a checkbook to reach the Other Guy for a behavior change intervention.  Media in persuasion is not a theoretical construct of great value.  It is simply the practical means for buying Reception.  (Now, Reception is a huge deal because if you don’t get that nothing else matters in the Cascade, right?)

Of course, you can make persuasion plays in TV that are different from an iGizmo and you should capitalize on the unique qualities of each medium.  However, those kind of message specifics are not the motors of change.  Please reread the recent post describing the organ donor intervention from Tyler Harrison and Susan Morgan’s team.  Hit the TACT hard and often.  Look and feel.  Unity of effort.  Simplicity.  You can waste an enormous amount of effort and resource on a flash doohickey that will have no impact on downstream behavior change.

Use media to buy Reception and provide opportunities for Processing.  (Note, for example in the abstract, the enhancement effect for additional channels like SMS or email – that’s repetition, baby, you’re just saying Do The TACT many times through different media.  It’s not a media effect.)

2.  What’s the distribution of effect sizes?

As I’ve argued from Leslie Snyder’s data, these metas often reveal a decidedly non-normal distribution of effect sizes.  Instead of that lovely bell curve that would tend to indicate pure random variation among the different interventions, the curve typically has a lumpy left hand tail with a lot of near zero effects that suddenly drops to a longer right tail with just a few higher impact interventions.

Thomas Webb, Judith Joseph, Lucy Yardley, and Susan Michie report a fairly large Q statistic (896.67, p < .001) for all 85 studies, indicating a serious amount of heterogeneity in the distribution with a 95% confidence interval from .09 to .23.  They do not provide a summary table, so I’m reading the tea leaves here and all the potential stupidity that requires, but the Q statistic and the confidence band suggest lumpy left and longer right, just like with Leslie’s meta.  Thus, I’m betting that many of the interventions in this meta were essentially busted with maybe a third showing Small to Moderate Windowpane effects.

It sure would be nice to know which studies are producing above average effect sizes, wouldn’t it?  Some of the moderator analyses by Webb et al. place a spotlight on heavier use of theory, more repetitions, and more “tactics,” but exactly what that means is not clear.  It might be more profitable to run the moderator analysis backward here, by first selecting the larger effects, then working back to the differences.

3.  The stronger effect for TpB compared to the Transtheoretical Model or Self Efficacy is not compelling for me.  Yes, it is statistically significant and each theory has about a dozen interventions, but TpB is not crushingly better, say a d of .50 or better compared to the other theories coming in at .05.  Besides, there’s no compelling reason to prefer one theory over another.  If you apply them properly and execute a good intervention, all should work to produce a practical change.  You need to design TACTs that are tailored to your theory to make the theory work properly.

What’s missing from this meta is testing anything remotely like the Standard Model or Whatever You Call It for that flow of message through reception to processing to response to behavior change.  This meta does not, for example, partition effects by the amount of Reception they generated.  We know from Robert Hornik’s work in the 1990s about that.  This meta doesn’t look at any Processing differences (attention, number of repetitions with the message, attitude toward the message, etc.).  That is vital and to my knowledge (Blair, Leslie, other academic persuasion mavens???) no one has ever done a meta that partitions behavior change effects by various indicators of message processing.  Shootfire, as my great-grandfather Will Hains would say, this meta doesn’t partition effects by the various theory components (TpB with easy, fun, and popular or Efficacy, Attitude, and Norm).

We know from Leslie’s work nearly 15 years ago that communication based mediated interventions do produce behavior change.  Repeated individual studies, reviews, metas, and meta squareds have demonstrated that effect at roughly the same magnitude.  We can now move deeper.  If you want to make a contribution to our knowledge, do a meta on the Standard Model (or Your Label Preference Goes Here).  And, if you want an extra gold star, try working backwards from interventions with the biggest effects back to the components that drive them.  That, I am afraid, would require a very careful reading of the studies and a thorough and thoughtful analysis.  You could then code out what you find and test it forward in a standard moderator analysis.

If you’re running a persuasion class, get one of these metas, pull out the top effect sizes, then read the papers in class.  Tear them apart.  Act them out.  Contact the authors and get the materials they used.  Then get the bottom effect sizes and repeat the exercise.  Tell me what you see.

4.  Hey, there weren’t a lot of Health Beliefs Model interventions!  Are those guys not keeping up with the new fangled modern inventions like the Internets?

With surpassing sadness and regret I gave up my beloved 1999 Ford Explorer.  Best vehicle I’ve owned to date and a thirteen year relationship would still exist if the machine wasn’t nickel and dime-ing me, just waiting to expire on the road to an airport on a business trip for want of a worn out cable, pipe, or thingamabob costing $2.99.

So, I got a replacement.  Another 4WD Explorer, the 2011 from the first batch sold in the new model year.  They hit the dealerships in mid-January and I bought this one that first week after test driving both a new 2010 and the new 2011.  Unbelievable difference between the models in just that one model year.  The 10 felt very much like my much older 99 while the 11 felt like something new entirely.

Nice looking, isn’t it?

Ford did a great job in creating a new Explorer.  This vehicle is considerably quieter, smoother, and better handling than even the 2010 model year.  It costs about the same as my 99 Sport, but has more features, more safety elements, gets much better mileage, and is larger.

My biggest problem with it is just the change from 13 years in a highly similar vehicle to the new version.  The shifter is now on the floor; the old one was on the column.  Controls are in different locations and employ dials rather than switches.  Many settings are handled through a computer interface that is a bit clunky (like with microwaves, DVDs, etc.).  The driver’s left hand arm rest is much lower and farther out.  The sightlines are very similar, but with subtractions (much smaller rear window) and additions (exterior rear view mirrors have a blindspot mirror).  A new car requires a kind of relearning that causes you to make annoying errors until you get the habit.

The biggest difference I’ve noticed is how much quieter this vehicle is compared to both my old 99 and the new 2010 Explorers.  You can hear yourself breathe while tooling down the road.  No tire noise.  No engine roar.  They use doublepaned windows with some kind of space age lining that either blocks or absorbs noise.  It’s a huge difference.  And, while you still ride fairly high up, with a wider and longer wheelbase the ride is considerable less tippy than the old Explorers – remember all those rollover stories – even in high winds on sharp downhill mountain curves at high speeds.

The Explorer was always a bit like a station wagon in terms of its sexiness and sophistication.  This new one is a considerably hotter machine, more like an upscale SUV.

Ford did good on this one.

Jamaluddin Moloo, in the February 1, 2011 issue of Journal Watch, General Medicine abstracts a study of sexual activity in men over 75.  Moloo notes . . .

. . . and 31% had had sex at least once in the prior 12 months.  Among men who reported being sexually active, 43% had sex less often than desired.

And, you think there’s not a human nature for all faces and places, times and rhymes?

Extreme, true. Certainly the move from life to death is a change, but people do not resist death simply because it is change.  And people do not resist change because it causes death.  We see the differences, the points where the metaphor of change as death disconnects.  But death as a metaphor for change contains insights.

When change is like death, then those things that cause people to be more comfortable with death might also cause people to be more comfortable with change.  How do we theorize about people coping with the prospect of death?

I’ve only briefly mentioned Terror Management Theory (TMT) in this Blog (here and here) and never in the Primer.  TMT explains how people handle the terror of death primarily through the coping mechanisms of self esteem and cultural worldview bolstering.  When thinking about their own deaths, people feel great threat to their self esteem and their worldview.  When, however, we bolster their self esteem or worldview, then provoke thoughts of death, people are much less threatened, more rational, more controlled.

Do you see now how the change as death metaphor may pour meaning into practical persuasion?

Perhaps as both an article of faith and of science, it might be wise to follow a simple tactic before every persuasion play.  Always first bolster the Other Guys self esteem and/or worldview, then seek the change.  This is not merely praise or compliments where we seek a momentary boost in positive affect, but rather direct support for those crucial beliefs, attitudes, and values that form the core of our self concepts and cultural worldview.

TMT experiments address self esteem or worldview in many direct and simple ways.  With either concept, you must first know the Other Guys self concept/esteem and worldview.  Then merely support it, agree with it, provide evidence for it.  You can also invert this and take the opposite of someone’s self concept or worldview and instead dispute it, criticize it, marshal facts against it.  You may also simply instruct the Other Guy to think about their self concept or worldview and remember times in the past that confirmed, supported, or proved it.  And, of course, you can also invert it and ask the Other Guy to recall times where he saw the “opposite” of his self concept or worldview fail.

I’ve looked at similar plays in these prior PB posts on self affirmation with priming and health risk behaviors.  Each provides operational tactics for bolstering although each research team might prefer a different label for their work than my simplifying approach here.  You can also do you own search starting with Google and key terms like TMT, bolstering, self esteem, and worldview.  I’d also recommend you chase down TMT research with a good science search engine.

Realize that strengthening key elements of the Other Guys may actually make Them more amenable to change.

Normally we think of persuasion as that linear process of a Source Encoding a persuasive Message that is then delivered through Channels to a Decoding Receiver who Changes as a result of that persuasive Message.  Let’s add a wrinkle to this.

We tell people that they will be Senders of persuasive Messages to other Receivers so that we can persuade the Sender, not the future Receiver.

This is called Tuning and essentially we are dialing in the target’s expectation of their communication role.  While they are actually receiving a persuasive message from us, they process it as if they will be Senders.  This tuned difference between thinking like a Sender versus thinking like a Receiver is a powerful and subtle persuasion play.

Consider this 1990 Psychological Science paper from Boninger, Brock, Cook, Gruder and Romer.  They conducted a series of four experiments that manipulated that Sender versus Receiver tuning then provided a persuasive Arg on some attitude issue (leisure time, a new product).  In addition, there was a No Message control group.  All participants (Send or Receive Tune, Control) provided immediate attitude rating, but more importantly were also contacted days, weeks, or months later for a delayed attitude rating.

Quick recap.  People are randomly assigned to Send or Receive and then read a persuasive Message (while the No Message Control sits quietly).  Everyone then reports attitude immediately, then later in the future.  Here’s a table that shows a graphic summary of all four experiments.

Take a minute and get oriented.  Each panel is a different experiment with different participants.  The horizontal X axis is time and displays either immediate or delayed attitude.  The vertical Y axis has the attitude score.  Within the body of the table you see the three different condition (Send, Receive, or Control).  Okay?

Now, realize that both Send and Receive show immediate persuasion compared to the No Message Control.  They all received a strong Arg.  Now, the interesting pattern to follow is what happens over time.  In all four experiments we see a strongly persisting attitude for people tuned as Senders while we observe an obvious drop among the Receivers as their attitude score retreats down to the No Message Control.  While you cannot possibly discern this from the table, the effect sizes here are those 35/65 Medium Windowpane magnitudes for both the amount of immediate change for the Sender and Receivers compared to Control and for the amount of loss between Sender and Receiver over time.

An ELM interpretation of this is fairly straightforward.  Given the pattern of results, while the Message was persuasive, it clearly functioned differently for the Senders compared to the Receivers.  The persistence of attitude change among the Senders is the clear and unmistakable tell tale sign of high WATT Central Route processing.  The tuning instruction that turned the participants into future Senders clearly dialed up the WATTage dimmer switch and made them seek, scrutinize, and elaborate upon the persuasive Message.

By contrast, the Receivers brought a low WATT bulb to the scene and considered only obvious, surface considerations.  All the Messages in the four experiments were attributed to highly credible sources and thus the simple CLARCCS Cue of Authority was available.  That Cue would lead to immediate change, but since there was no Long Conversation in the Head, that change decayed and dissipated over time.

Realize that this is a theory based interpretation.  The experiments did not include a full monte ELM study with strong and weak Args along with positive and negative Cues.  However, the pattern of data here are consistent with other studies and, of course, with theory principles.

Thus armed with theory and research, let’s consider practical persuasion.

1.  Tuning people into Senders clearly affects WATTage.  When we expect to talk to others about an idea, we dial up the dimmer switch, and pay attention.  We are also likely to engage in imaginary conversations with branching lines of talk – if he says what about This, I’ll say That – and how to handle different people.  Notice, too, that this WATTage switch appears to activate Objective rather than Biased processing.  People are more open minded, thoughtful, and careful.  They tend to follow information to conclusions rather than cutting the information to fit a pre-existing belief.

2.  Tuning produces big enough effects to be useful in the real world.  Hey, these are experiments with randomization, control, comparison, and counting.  This is pretty reliable information.  And, it’s replicated not only in this report, but in several others going back to the first Tuning study from Robert Zajonc in 1960.  (Look it up:  Use Zajonc, Tuning, 1960).  If you like those Relative Ratios so favored in epi, health, and safety, the Medium Windowpane here translates into an RR of 400%.  It might actually work.

3.  How do you actually do Tuning?  It is not complicated.  Just tell your targets that you are giving them information that they will then “pass on” to other people.  That’s it.  “Here, look at this then tell other people about it.”  You can intensify the play with more detail about the “pass it on” situation.  Ask the targets to think of their own Gang of Likely Suspects, for example.  You do not need to supply an obvious and immediate instruction set regarding that future communication.  Just direct them to “pass it on” to others.  They don’t even have to actually “pass it on” in this persuasion play.

David S. Boninger, Timothy C. Brock, Thomas D. Cook, Charles L. Gruder, and Daniel Romer. (1990).  Discovery of Reliable Attitude Change Persistence Resulting From a Transmitter Tuning Set.  Psychological Science, July 1, vol. 1 no. 4 268-271.

P.S.  I strongly recommend you chase down the 1960 Zajonc paper from the Journal of Abnormal and Social Psychology.  Zajonc is always worth reading.