Humor and Fear - Two Sides of the Same Coin?: Experimental Evidence on Humor Appeals in Health Communication Related to Childhood Vaccination

"[T]he use of storytelling, using emotional phrases or content, in the field of health communication needs to be tailored toward the recipients."

Entertainment-education, which consists of systematic storytelling, is a technique for communicating about health-related topics, such as vaccination. In these narratives, scientific knowledge can be combined with emotions, so that the reader is able to identify with or feel empathy for the story's characters. Research shows that the content and structure of stories can have a positive influence on the understanding and retention of information. This study aims to analyse how different text types used in health communication about vaccination - one formulated in a neutrally scientific way and the other as a humorous text applying the format of a fairytale - are appraised by participants in Germany, where there is a degree of vaccination hesitancy. The impacts of both text types on the knowledge and attitudes of parents toward childhood vaccinations are also investigated.

An experimental study was conducted among parents having at least one child up to 6 years old in Bielefeld, Germany. Study participants filled out a questionnaire, received an intervention directly afterwards in the form of a written text informing them about vaccination (in particular, the concept of herd immunity), and were asked some questions related to this text. Sixty-six parents read a neutrally formulated text published by the Federal Centre for Health Education (BZgA), and 54 people read a text written by a well-known German cabaret artist and comedian that used humorous elements in the form of a fairytale.

According to the self-reported information provided by the parents, 48.3% (n = 58) of children had an incomplete vaccination status; 15.0% (n = 18) of the children were fully vaccinated and 10.8% (n = 13) were not vaccinated at all.

The study participants were asked to mention all the channels they had used for gaining information about vaccination. Most of the respondents claimed they receive information related to vaccination from their physician (88.3%; n = 106). The second most commonly used information source was websites of institutions related to health, such as the BZgA, mentioned by about 37.5% (n = 45).

The researchers found a high positive attitudes toward vaccination, with 83.9% (n = 55) in the group reading the neutral text and 80.8% (n = 43) of the participants who read the humorous text indicating a positive attitude toward vaccination. In addition, 75.6% (n = 90) felt well or very well-informed about vaccination in general, while 24.4% (n = 29) felt less well or rather badly informed. However, an appraisal of the two statements to assess knowledge related to the concept of herd immunity found that both values are comparatively low, indicating missing knowledge related to herd immunity.

Appraisal of message credibility differed slightly, but not significantly, between the texts. However, a higher proportion of participants who read the neutrally formulated text by BZgA claimed a desire to read more texts of this kind (66.2%; n = 43), compared to those who read the humorous text (46.2%; n = 24).

Overall, there were no significant differences between the two groups in terms of sociodemographic characteristics, information, knowledge, attitudes, or behaviours related to vaccination. That is, the study results indicate no additional value in using the format of a humorous text in the form of a fairytale as an approach to informing readers about scientific evidence related to vaccination. The researchers speculate that parents who read a text on vaccination for information purposes want to see arguments and facts to facilitate their decision for or against vaccination. Since parents want to decide autonomously about the welfare of their children, there is a risk that a narrative story will distract from the relevant information if the plot and the information to be conveyed are not sufficiently closely linked.

In conclusion: "Although this study did not reveal any benefit of the humorous format of health communication compared to the traditional format, it should be considered that the appraisal and impact of both text types were almost equal. This result is important, because the humorous presentation might attract more interest and attention from the public than a neutrally or scientifically formulated text."