Graduation Year


Document Type




Degree Granting Department


Major Professor

Jason W. Beckstead, Ph.D.

Committee Member

Mary E. Evans, Ph.D., RN, FAAN

Committee Member

Frances M. Rankin, Ph.D., ARNP, FAANP

Committee Member

William P. Sacco, Ph.D.


Behavior Change, Health Behaviors, Health Communication, Message Framing, Message Tailoring, Nursing


The world is experiencing a rapid rise in chronic health problems, which places an enormous burden on health care services. Modifiable health behaviors such as physical inactivity are largely responsible for this high prevalence and incidence of chronic diseases. Message tailoring is a well-established approach for constructing health communication and has been shown to increase the persuasiveness of messages in the promotion of healthy behaviors. Message framing is an effective strategy that has been well-studied in psychology over the past 20-plus years across a breadth of health-related behaviors but has received little attention in the nursing research literature. Based on prospect theory, temporal construal theory, and motivational orientation theories, the present study examined how two individual differences factors - consideration of future consequences (CFC) and motivational orientation - combine to moderate temporal proximity and valence framing effects on intentions to increase physical activity. A mail survey was conducted using Dillman's Tailored Design Method. Two hundred and eighteen adults with type 2 diabetes were randomly assigned to receive one of four versions of a health message aimed to increase regular physical activity. Messages were framed using a 2 (immediate- vs. distal-framed) x 2 (gain- vs. loss-framed) design. After reading the message, participants rated their intention to increase physical activity. They also completed a measure of CFC and two measures of motivational orientation. Participants who read a message with a temporal proximity or valence frame congruent with their CFC or motivational orientation, respectively, did not show greater intentions to increase physical activity when compared to those who read a health message that was incongruent with these individual differences. Plausible explanations for these negative results are considered. Several interesting findings emerged from supplemental analyses. For instance, participants who perceived the health message as more believable tended to have greater intentions to increase physical activity. Suggestions for future research applying message congruence to promote complex health behaviors in at-risk populations are given. Implications of message framing and other message tailoring strategies for nursing research, education, and practice are discussed.