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Does Your Message Have the Same Old Frame? . Message Framing and Health Disparities NPHIC Annual Conference September 2007. Sponsored by the Southern Center for Communication, Health & Poverty

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Does your message have the same old frame

DoesYour Message Have the Same Old Frame? 

Message Framing and Health Disparities

NPHIC Annual Conference

September 2007

Sponsored by the Southern Center for Communication, Health & Poverty

A CDC-Designated Center for Excellence in Health Communication and Marketing

Susan D. Kirby, Dr.P.H.

Message framing

Message Framing

  • Gain vs. loss framing

    • Usually aimed at direct health behavior audience

  • Strategic frame analysis

    • Used for policy and societal mobilization audiences

Gain versus loss framing

Gain versus Loss Framing

  • Gain = Lives saved

  • Loss = Lives lost

  • Gain promotes risk aversion

    • Prefer small certain gains to large possible gains

    • Best for prevention behaviors

  • Loss promotes risk seeking

    • Prefer possible large/small loss to any certain loss

    • Best for detection or screening behaviors

Gain versus loss framing1

Gain versus Loss Framing

  • If ‘certain’ of screening outcome

    • Gain framing is more effective

  • If ‘uncertain’ of screening outcome

    • Loss framing is more effective

  • Pointing out health disparities

    • Creates negative reaction

  • Cultural targeting

    • Enhances effectiveness with “right” frame

    • Not more effective if combined with ‘wrong’ frame

  • More disparity research needed

Cvd versus diabetes 35 overweight aa male

CVD versus Diabetes35 Overweight AA Male

‘Uncertain’ DiabetesYou can prevent losing a leg, foot, or toe by getting tested and treated for diabetes today

‘Certain’ CVDYou can add years to your life if you get tested and treated for CVD today

Strategic frame analysis

Strategic Frame Analysis

How we process information

How We Process Information

  • Mental shortcuts help us make sense

  • Communication has cues about where to fit information into existing knowledge

    • Helps us connect to shortcuts or “dominant frames”

  • New information seen through dominant frames

  • Our understanding is frame-based

    • Not fact-based

Strategic frame research

Strategic Frame Research

  • Identifies deep values, beliefs, and assumptions

  • Studies their impact on policy preferences

  • Uncovers ways to change how issues are framed

    • Communication shift attitudes and behaviors

Why it matters

Why It Matters …

  • Perceptions shaped by core beliefs

  • New thinking challenges core beliefs

  • If challenged we revert to familiar

    • Makes it hard for people to hear new messages

    • We have to connect people to a different frame

Does your message have the same old frame

By connecting an issue to an existing valued high-level frame, we can reframe how people think and feel about an issue.

Does your message have the same old frame

‘Estate tax’ is one way to frame tax debate

Does your message have the same old frame

‘Death tax’ reframed this tax debate

Framing strategy includes

Framing Strategy Includes

  • Connecting issue w/ valued frame

  • Thematic not episodic context

  • Simplifying model or metaphor

  • Social math

  • Messengers

  • Visuals

  • Tone

Framing levels

Framing Levels

Level One

Big ideas, like freedom, justice, community, success, responsibility

Level Two

Issue types, like the environment or child care

Level Three

Specific issues, like rainforests or earned income tax credits

Level one examples we want to live in a society that is




Community focused


Connected to others

Increasing Knowledge


Positive in Outlook


Safe/ Secure

Level One ExamplesWe want to live in a society that is …

Level two

Level Two

  • Level 2 frames can focus on issues like children, elderly, education, friendship, or corporate America

  • Level 2 can also be a new or novel way of grouping issues together

    • Prisons and education

    • Children and corporate America

Building a framing story

Building a Framing Story

  • Connect your issue to a Level 1 value

    • Ask what kind of world people want to live in

  • Ask what would that world look like?

    • Level 2 connected to level 1

    • Many issues can fit into Level 2 for different purposes

  • Level 3 specifies how Level 2 is achieved

  • Tell a story linking levels 1 to 2 to 3

Linking levels together

Linking Levels Together


  • Level 1 - We want to live in a truthful society

  • Level 2 - Companies are honest about their products

  • Level 3 – Policies that require disclosure of product contents


  • Level 1 -  We want to live in a hopeful society

  • Level 2 - Diseases like cancer can be cured

  • Level 3 – Program to identify cancer cures


Andy needed the support of others, and a solid town like Mayberry to avoid abusive situations as a single parent

Families should handle their own stuff, We should stay out of it. The family bubble.


Numbers social math

Numbers – Social Math

  • GOOD - In the 60s, about 11 of 25 kids walked or biked to school. By 2001, only 4 of them were getting exercise that way.

  • BETTER – Today lots of schools are ere farther away from their students. Now walking or biking to school is the equivalent of doing a 5K race or more - twice a day.

Messengers hiv and hispanic communities

MessengersHIV and Hispanic Communities

Visuals what are youth doing today

VisualsWhat are youth doing today?

Metaphor or model brain foundation architecture

Metaphor or ModelBrain Foundation = Architecture

  • Early experiences affect the architecture of the maturing brain.

  • The quality of that architecture establishes either a sturdy or a fragile foundation for all following development

  • Getting things right the first time is easier and less costly than trying to fix them later.


Disparity related framing the dominant frames we know

Disparity-related FramingThe Dominant Frames We Know

  • Individual responsibility

    • People are the ones who decide if they smoke!

  • In-Community responsibility

    • It’s that community’s fault!

  • Poverty isn’t the problem

    • Education is problem with poor health choices!

Disparity framing research

Disparity Framing Research

  • Disparity focus increases stereotyping

    • Stimulates negative reactions in all parties

  • ‘Quality of Life’ resonates

    • ‘Community conditions’ also

  • Civic wellbeing resonates

  • Cost prevention resonates

Disparity framing research1

Disparity Framing Research

  • Physical and org structures are useful terms

  • Include ‘elderly as examples’

  • Stay solutions focused

    • Community needs to involved

    • Use close to home examples

  • ‘Patchwork with gaps” metaphor

    • Does not trigger stereotypes

More framing advice

More Framing Advice

  • Focus messages on solutions not the problem - early in the message

  • Avoid negative stereotypes

  • Do not repeat the current ineffective frames

  • Repetition, repetition, repetition



  • Getting the Biggest Bang for Your Health Education Buck: Message Framing and Reducing Health Disparities. Schneider American Behavioral Scientist. 2006; 49: 812-822

  • FrameWorks Institute Report


  • Berkley Media Studies Group

  • Kirby Marketing Solutions at

  • Southern Center for Communication, Health & Poverty at

Question and answer

Question and Answer

Small Group Activity

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