Examples illustrating different types of framing
The same information about health effects can be framed either in positive words or in negative words. Attribute framing refers to the positive versus negative description of a specific attribute of a single item or a state, for example, "the chance of survival with cancer is 2/3" versus "the chance of mortality with cancer is 1/3". Goal framing is the description of the consequences of performing or not performing an act as a gain or a loss, for example, "if you undergo a screening test for cancer, your survival will be prolonged" versus "if you don't undergo screening test for cancer, your survival will be shortened".
Summary
There is a widely held belief that framing of health information messages can lead to different decisions and different health behaviours; this is described as the 'framing effect'.
This systematic review identified 35 studies of 16,342 people testing this hypothesis. It found that both attribute and goal framing may have little if any effect on health consumers' behavior.
In one study of attribute framing, participants understood the message better when it was framed negatively than when it was framed positively. Positively-framed messages may have led to more positive perception of effectiveness than negatively-framed messages. There was little or no difference in persuasiveness in the context of attribute framing.
In the context of goal framing, loss messages led to a more positive perception of effectiveness compared to gain messages for screening messages, and may have been more persuasive for treatment messages.
The unexplained differences in the results of the included studies suggests the framing effect may exist under specific but yet undetermined conditions. Future research needs to investigate these conditions.