Targeting Type 2: Linguistic Agency Assignment in the Framing of Type 2 Diabetes Prevention

Introduction: The way disease transmission is framed linguistically affects perceptions of threat. McGlone et al. (2012) found that educational materials about H1N1 that linguistically assigned transmission agency to the virus (e.g., H1N1 infects people) led people to perceive the threat as more severe than materials assigning transmission agency to humans (e.g., people contract H1N1). The current study explored the effects of agency assignment on people’s perceptions of a chronic health threat – Type 2 diabetes – that requires long-term prevention efforts. 

Methods: Mechanical Turk recruits (N = 422) read a fictitious editorial describing the incidence of Type 2 diabetes among children and advocating that schools have programs promoting diet and exercise for at-risk children. Participants read one of four editorial versions in a 2 X 2 (Threat Agency X Prevention Agency) factorial design. Threat agency was assigned to the disease (e.g., diabetes puts children’s lives at risk) or to children (e.g., children who develop diabetes put their lives at risk); prevention agency was assigned either to the program (e.g., a healthy diet and regular exercise protect children) or to children (e.g., children who eat a healthy diet and regularly exercise protect themselves). Participants subsequently responded to items measuring perceptions of disease severity and the effectiveness of prevention programs.

Results: Analyses indicated that participants who read editorials assigning threat agency to diabetes rated the disease as a greater public health threat than others reading versions assigning agency to humans (M = 6.23 vs. 5.69, F(1,414) = 22.45, p <.001, d = .48).  In contrast, editorials assigning prevention agency to humans prompted higher ratings of prevention effectiveness than versions assigning agency to the recommended behaviors (M = 5.63 vs. 5.20, F (1,414) = 14.54, p <.001, d = .31). Editorials assigning prevention agency to humans prompted more favorable attitudes toward prevention programs than those assigning agency to behavior (M = 6.12 vs. 5.61, F (1,414) = 19.56, p <.001, d = 38).  

Conclusions: Assigning transmission agency to diabetes led people to perceive the threat as more severe than assigning agency to people.  However, human agency assignment for prevention led to more favorable prevention attitudes than assignment to behavior.  The latter findings contrast with previous studies of agency assignment in messages about acute threats.  These disparate results suggest that chronic health threats such as diabetes, which require long-term behavioral commitments to prevent, might better be framed in terms of human agency assignment for policy advocacy purposes.