Designing persuasive health materials using processing fluency: a literature review <s> Limit number of key points: retrieval fluency <s> The effects of imagined versus actual ease of self-generating product-related information were investigated. An ad invited recipients to name either one reason or 10 reasons for (against) choosing a BMW over a Mercedes. Participants who complied with the task experienced the retrieval of one reason as easier than the retrieval of 10 reasons. Participants who did not comply nevertheless imagined the former as easier than the latter. Independent of whether ease was actually experienced or merely imagined, participants evaluated BMW more (less) favorably and Mercedes less (more) favorably when the retrieval was easy rather than difficult. <s> BIB001 </s> Designing persuasive health materials using processing fluency: a literature review <s> Limit number of key points: retrieval fluency <s> Every year, new public health mass media campaigns are launched attempting to change health behavior and improve health outcomes. These campaigns enter a crowded media environment filled with messages from competing sources. Public health practitioners have to capture not only the attention of the public amid such competition, but also motivate them to change health behaviors that are often entrenched or to initiate habits that may be new or difficult. In what ways are public health mass media campaigns now attempting to succeed in a world crowded with media messages from a myriad of sources? What are the conditions that are necessary for a media campaign to successfully alter health behaviors and alter outcomes in the long term? To what extent can the successes and failures of previous campaigns be useful in teaching important lessons to those planning campaigns in the future? In this chapter we attempt to answer these questions, drawing from recent literature on public health mass media campaigns. <s> BIB002 </s> Designing persuasive health materials using processing fluency: a literature review <s> Limit number of key points: retrieval fluency <s> Quality healthcare outcomes depend upon patients' adherence to recommended treatment regimens. Patient nonadherence can be a pervasive threat to health and wellbeing and carry an appreciable economic burden as well. In some disease conditions, more than 40% of patients sustain significant risks by misunderstanding, forgetting, or ignoring healthcare advice. While no single intervention strategy can improve the adherence of all patients, decades of research studies agree that successful attempts to improve patient adherence depend upon a set of key factors. These include realistic assessment of patients' knowledge and understanding of the regimen, clear and effective communication between health professionals and their patients, and the nurturance of trust in the therapeutic relationship. Patients must be given the opportunity to tell the story of their unique illness experiences. Knowing the patient as a person allows the health professional to understand elements that are crucial to the patient's adherence: beliefs, attitudes, subjective norms, cultural context, social supports, and emotional health challenges, particularly depression. Physician-patient partnerships are essential when choosing amongst various therapeutic options to maximize adherence. Mutual collaboration fosters greater patient satisfaction, reduces the risks of nonadherence, and improves patients' healthcare outcomes. <s> BIB003 </s> Designing persuasive health materials using processing fluency: a literature review <s> Limit number of key points: retrieval fluency <s> Behavioral and economic theories have long maintained that actions are chosen so as to minimize demands for exertion or work, a principle sometimes referred to as the law of less work. The data supporting this idea pertain almost entirely to demands for physical effort. However, the same minimization principle has often been assumed also to apply to cognitive demand. The authors set out to evaluate the validity of this assumption. In 6 behavioral experiments, participants chose freely between courses of action associated with different levels of demand for controlled information processing. Together, the results of these experiments revealed a bias in favor of the less demanding course of action. The bias was obtained across a range of choice settings and demand manipulations and was not wholly attributable to strategic avoidance of errors, minimization of time on task, or maximization of the rate of goal achievement. It is remarkable that the effect also did not depend on awareness of the demand manipulation. Consistent with a motivational account, avoidance of demand displayed sensitivity to task incentives and covaried with individual differences in the efficacy of executive control. The findings reported, together with convergent neuroscientific evidence, lend support to the idea that anticipated cognitive demand plays a significant role in behavioral decision making. <s> BIB004 </s> Designing persuasive health materials using processing fluency: a literature review <s> Limit number of key points: retrieval fluency <s> There is no consensus on how best to assess the health literacy demands of health information materials. Comprehensive, reliable, and valid assessment tools are needed. The authors report on the development, refinement, and testing of Health Literacy INDEX, a new tool reflecting empirical evidence and best practices. INDEX is comprised of 63 indicators organized into 10 criteria: plain language, clear purpose, supporting graphics, user involvement, skill-based learning, audience appropriateness, user instruction, development details, evaluation methods, and strength of evidence. In a sample of 100 materials, intercoder agreement was high: 90% or better for 52% of indicators, and above 80% for nearly all others. Overall scores generated by INDEX were highly correlated with average ratings from 12 health literacy experts (r = 0.89, p < .0001). Additional research is warranted to examine the association between evaluation ratings generated by INDEX and individual understanding, behaviors, and improved health. Health Literacy INDEX is a comprehensive tool with evidence for reliability and validity that can be used to evaluate the health literacy demands of health information materials. Although improvement in health information materials is just one aspect of mitigating the effects of limited health literacy on health outcomes, it is an essential step toward a more health literate public. <s> BIB005 </s> Designing persuasive health materials using processing fluency: a literature review <s> Limit number of key points: retrieval fluency <s> Despite extensive pricing research focusing on price information processing, the importance of the role of fluency on price-perceived quality and monetary sacrifice remains unclear. Studies 1 and 2 demonstrate that consumers with high retrieval and processing fluency are more likely to evaluate price according to its implications for perceived quality and less likely to focus on price-perceived monetary sacrifice. By contrast, consumers with low retrieval and processing fluency are more likely to evaluate price according to its implications for monetary sacrifice and less likely to focus on price-perceived quality. Besides, study 2 further demonstrates the influence of fluency on purchase intention. Finally, the mediating role of the incidental affect induced by fluency in the theoretical link between fluency and price perceptions is also demonstrated. <s> BIB006
It is widely accepted that there is a general limit on human cognitive capacity  . Humans are "cognitive misers"  and conserve cognitive resources. Thus, people attempt to minimize the cognitive workload according to the law of least mental effort BIB004 . Accordingly, when patients or caregivers are overwhelmed with too much health information, their ability to comprehend, recall, and use this information can decline BIB003 . Nevertheless, written health materials tend to be information dense BIB002 BIB005 . Kaphingst et al. BIB005 reviewed health materials and found that only half limited the number of key points to five or fewer per section. When health materials are information dense, recipients generally have difficulty in memorizing them and recalling the content. As demonstrated in the "Results" section, the ease of recall of information influences judgment   BIB006 BIB001  . Furthermore, memory is an antecedent of behavior: information has to be memorized and recalled if a recipient is to perform the health behavior indicated  . Accordingly, as Brega et al.  suggest, health-care professionals should prioritize what needs to be discussed and limit information to three to five key points so that the content may be easily processed and recalled.