Transportation into an Entertainment Narrative about the MMR Vaccine: An Investigation of Self-Referencing and Issue-Related Thoughts in Narrative Persuasion

"...helps to create a more complete picture of the way individuals experience persuasion in a narrative context and offer[s] evidence of how real-world entertainment narratives can shape attitudes about childhood vaccination."

Recent years have seen an increase in the number of parents who have chosen not to follow the recommended childhood vaccination schedule for non-medical reasons. This study considers an entertainment narrative that depicts the negative consequences of not vaccinating a child against measles. The focus is not on persuading those with strong attitudes against vaccination; rather, it is on audience members who are less prone to counterarguing. Specifically, the study explores the role of counterarguing by testing cognitive mechanisms of narrative persuasion - namely, self-referencing and positive issue-related thoughts.

In reviewing the literature, the researchers discuss previous investigations of the role of engagement with entertainment narratives as a mechanism of narrative persuasion. "Engagement" is used here to capture a handful of related constructs referring to the unique way in which viewers become engrossed in a story world (e.g., absorption, immersion, transportation). Research has demonstrated that this process of being swept up into a narrative is a key component of narrative influence. The literature shows that narratives can shape attitudes toward vaccination. The role of counterarguing as a mediator in this process is less clear, perhaps given that in some cases audience members are not particularly resistant and thus not predisposed to generate counterarguments in the first place.

Beyond counterarguing, this study considers additional issue-related thoughts that may be important to understanding how a vaccine narrative will lead to story-consistent attitudes. It tests two such mechanisms: self-referencing (the process of relating message components to the self, where individuals connect incoming information to their own complex structure of memories) and positive issue-related thoughts (where the focus is on the overall importance and significance of the underlying issue being depicted in the narrative).

Undergraduate students (N = 145) at a large university in the United States (US) took part in the study. Participants in the experimental condition watched an episode of the TV medical drama Private Practice ("Contamination", season 2, episode 11). The episode depicts a family whose oldest son is autistic, which the mother falsely believes was caused by his having received the measles, mumps, and rubella (MMR) vaccine. Consequently, her two youngest children have not been vaccinated, which has led to one of them contracting measles. That child is hospitalised, and the doctor tries to talk the mother into vaccinating her youngest child, which she refuses. After the infected child dies, the doctor vaccinates the youngest child against the mother's wishes. (Participants in the control condition watched an episode of the medical drama Grey's Anatomy that does not contain any child patients or references to vaccination but does include the death of a character and other medical issues.)

The study found that exposure to the television narrative depicting the importance of the MMR vaccine led to more favourable attitudes toward childhood vaccination as compared to the control group. As is consistent with narrative persuasion theorising, transportation into the narrative predicted vaccine attitudes. In contrast to typical theorising and some empirical results, counterarguing did not mediate that relationship; however, self-referencing and positive issue-related thinking did.

The researchers stress that the narrative used in the present study is a popular entertainment television show rather than one constructed specifically to change attitudes or for research purposes. This fact suggests that even a relatively imperfect narrative - one with multiple storylines intersecting, featuring a character who endorses the false belief that vaccination causes autism in children - can lead to story-consistent attitudes. Of note, prior endorsement of the false belief that the MMR vaccine leads to autism did not moderate this effect.

A next step could involve examining the extent to which an entertainment narrative could motivate parents of young children to have their child vaccinated if the choice were in front of them. Future research could examine such behavioural measures using immediate and delayed posttests.

In conclusion: "this research has advanced our understanding of the potential persuasive effects of an entertainment narrative. Moreover, this work has taken steps toward improving our understanding of the mechanisms of narrative persuasion and answers the call to consider other types of issue-related thoughts within a narrative context beyond counterarguing and further demonstrate the value in doing so..."