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Copyright by Jisoo Ahn 2018 Copyright by Jisoo Ahn 2018 The Dissertation Committee for Jisoo Ahn Certifies that this is the approved version of the following Dissertation: The Effects of Modality Interactivity and Health Literacy on User Engagement and Processing of Public Health Information Committee: Michael Mackert, Supervisor Lee Ann Kahlor Lucy Atkinson Brad Love Erin Donovan The Effects of Modality Interactivity and Health Literacy on User Engagement and Processing of Public Health Information by Jisoo Ahn Dissertation Presented to the Faculty of the Graduate School of The University of Texas at Austin in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy The University of Texas at Austin May 2018 Dedication I would like to acknowledge my advisor, Dr. Michael Mackert for his assistance during my entire doctoral program. Working with him on projects and this dissertation, I have learned how to make good progress by working step-by-step. Also, his positive strategies for resolving conflicts and emotional support were very helpful to me to reach this stage. I would also like to acknowledge the expert guidance of Drs. Lee Ann Kahlor, Lucy Atkinson, Erin Donovan, and Brad Love from helping me build my research idea to refining this dissertation, leading me to finalize this work. All their suggestions and compliments helped to move me forward during this painful but valuable journey. I am also thankful to Dr. Jeeyun Oh who provided overall assistance on interactivity research and advice on my data analysis. Lastly, I would like to dedicate this dissertation to my family. Their endless love and support has helped me make it to where I am today. Needless to say, thank you also to my colleagues and friends in the United States and Korea! Abstract The Effects of Modality Interactivity and Health Literacy on User Engagement and Processing of Public Health Information Jisoo Ahn, Ph.D. The University of Texas at Austin, 2018 Supervisor: Michael Mackert Considering the importance of learning new information in the emerging disease context, this study examines how individuals cognitively process information with an interactivity feature on a website. Modality interactivity, which was operationalized as a slider, was used to identify its effects on user engagement (i.e., cognitive absorption: the degree to absorb the content) and attitudes and behavioral intentions serially. In addition, whether an individual characteristic, such as health literacy (i.e., the degree to read and understand health information), varies the effects was asked. A single factor (modality interactivity: slider vs. control) experiment was conducted on a health website which provides information about a new fictitious infectious disease, Logi. With 350 participants, the results revealed that modality interactivity increased cognitive absorption and in turn, enhanced favorable attitudes toward the website, the message, and the agency. The indirect effects of modality v interactivity also positively influenced the intentions of users to revisit the website, follow the recommendations in the message, and seek further information from the agency about the disease. These effects did not depend on health literacy; that is, participants at all levels of health literacy had similar effects of modality interactivity on attitudes and intentions through cognitive absorption. Discussion of theoretical and practical implications is presented. vi Table of Contents List of Tables ......................................................................................................................x List of Figures .................................................................................................................... xi Chapter 1: Introduction ......................................................................................................1 Chapter 2: Literature Review .............................................................................................5 Heuristic-Systematic Model .......................................................................................5 Interactivity and Information Processing ....................................................................8 Explication of Interactivity .............................................................................9 Theory of Interactive Media Effects: An Explanation of Interactivity Effects by Dual-Processing .....................................................................11 A Mediating Role of Cognitive Absorption .................................................14 Health Literacy and Information Processing ............................................................18 Chapter 3: Method ...........................................................................................................26 Overview ...................................................................................................................26 Participants................................................................................................................27 Procedure ..................................................................................................................28 Stimulus ....................................................................................................................30 Measurement .............................................................................................................35 Moderating Variable .....................................................................................35 Control Variables ..........................................................................................38 Mediating Variable .......................................................................................39 Dependent Variables .....................................................................................41 Demographics ...............................................................................................43 vii Analysis ....................................................................................................................43 Chapter 4: Results ............................................................................................................45 Manipulation Check ..................................................................................................45 Simple Mediation Analysis .......................................................................................50 Attitudes toward the Website/Message/Agency/Disease .............................51 Intentions regarding the Website/Message/Agency/Disease ........................54 Moderation of the Effect of Modality Interactivity on Absorption by Health Literacy ...............................................................................................................56 Moderated Mediation Analysis .................................................................................57 Attitudes toward the Website/Message/Agency/Disease .............................58 Intentions regarding the Website/Message/Agency/Disease ........................60 Unexpected Findings ................................................................................................62 Attitudes toward the Website ........................................................................63 Intentions regarding the Disease ...................................................................65 Chapter 5: Discussion ......................................................................................................67 Interpretation of Findings .........................................................................................67 Indirect Effects of Modality Interactivity on Attitudes through Cognitive Absorption ..............................................................................................67 Indirect Effects of Modality Interactivity on Intentions through Cognitive Absorption ..............................................................................69 Conditional Indirect Effects of Modality Interactivity on Attitudes/Intentions through Cognitive Absorption by Health Literacy ...................................................................................................69 Theoretical Implications ...........................................................................................72 viii The Role of Modality Interactivity to Shift the Modes of Information Processing ...............................................................................................72 The Importance of Engagement in the Learning Process .............................72 Reification of Attitudes and Intensions ........................................................74 Preservation of All Health Literacy Levels with Johnson-Neyman Technique................................................................................................74 Practical Implications ...............................................................................................75 Effects of Modality Interactivity for Public Health Education .....................75 Effects of Modality Interactivity for the Agency's Communication and Web Design Strategies ............................................................................76 Future Research ........................................................................................................77 Two Sides of Interactivity.............................................................................77 Tyes of Device Used for Web Browsing
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