Access Type

Open Access Dissertation

Date of Award

January 2023

Degree Type

Dissertation

Degree Name

Ph.D.

Department

Communication

First Advisor

Pradeep Sopory

Abstract

Many chronic illnesses can be managed by adhering to recommended medical regimens and through the avoidance of unhealthy behaviors, which foregrounds the importance of social control, a construct concerned with restricting/ regulating an existing unhealthy behavior or warning of a future unhealthy behavior (Craddock et al., 2015; Sarason & Sarason, 2001). This dissertation study investigated social control from a communication perspective by developing the concept of health-related communicative control (HRCC), which refers to the reduction, restriction, regulation, or elimination of undesirable health behaviors through persuasive verbal messages. Using this concept along with construal level theory (Trope & Liberman, 2010) from a communication perspective, the dissertation proposed the construal model of health-related communicative control (CMHRCC) and tested it via an online experiment that simulated a mobile phone intervention targeted at people with Type 2 diabetes. Participants (N = 183) were randomly assigned to conditions featuring level of abstraction (high, low) and interactivity (high, low) messages about controlling unhealthy behaviors (food choices, food portion, sedentary lifestyle). The study also investigated whether self-control and psychological reactance mediated the effect of message abstract level on behavioral intention, and if interactivity moderated the relationship between high/low abstract messages and the two mediators (i.e., self-control and psychological reactance), in a moderated mediated model with parallel mediators. The results showed that high abstract level communicative control messages increased behavior intentions and self-control mediated the effect of HRCC messages on behavioral intention. Although psychological reactance increased, the salience of high threatening themes in the messages from health-care providers seemed to motivate recipients to comply with targeted health compromising behaviors. Interactivity moderated the relationship between abstract level and self-control. Participants who received the combination of high abstract level and high interactivity level HRCC messages reported the highest level of behavioral intention. The results suggest using CMHRCC to further examine message design and effects in the use of mHealth in the context of chronic illness.

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