Investigating the Persuasive Effects of Testimonials on the Acceptance of Digital Stress Management Trainings Among University Students and Underlying Mechanisms: A Randomized Controlled Trial

Jennifer Apolinário-Hagen; Lara Fritsche; Jeannette Wopperer; Frank Wals; Mathias Harrer; Dirk Lehr; David D Ebert; Christel Salewski

doi:10.3389/fpsyg.2021.738950

Investigating the Persuasive Effects of Testimonials on the Acceptance of Digital Stress Management Trainings Among University Students and Underlying Mechanisms: A Randomized Controlled Trial

Front Psychol. 2021 Oct 13:12:738950. doi: 10.3389/fpsyg.2021.738950. eCollection 2021.

Authors

Jennifer Apolinário-Hagen¹, Lara Fritsche², Jeannette Wopperer³, Frank Wals³, Mathias Harrer⁴, Dirk Lehr⁵, David D Ebert⁶, Christel Salewski²

Affiliations

¹ Institute of Occupational, Social and Environmental Medicine, Centre of Health and Society, Faculty of Medicine, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
² Department of Health Psychology, Faculty of Psychology, University of Hagen, Hagen, Germany.
³ Faculty of Psychology, University of Hagen, Hagen, Germany.
⁴ Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany.
⁵ Department of Health Psychology and Applied Biological Psychology, Institute of Psychology, Leuphana University Lueneburg, Lueneburg, Germany.
⁶ Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany.

Abstract

Objective: This experiment aims to investigate the influence of narrative information varying in the degree of perceived similarity and source credibility in supplemented testimonials on the acceptance of digital mental health services (digi-MHSs). Methods: In fall 2020, n=231 university students were randomly assigned to an active control group (aCG, n=55, "information only") or one of three intervention groups (IGs) receiving information plus different testimonials being presented either by nonacademic staff (IG1, n=60), university students (IG2, n=58) or experts (IG3, n=58). We assessed mediation effects of similarity and credibility on acceptance in terms of attitudes and usage intentions. Results: Exposure to testimonials was associated with higher usage intentions (d=0.50) and more positive attitudes toward digi-MHSs (d=0.32) compared to mere information (aCG). Regarding source-related effects, one-way ANOVA showed group differences in intentions ( $η_{p}^{2}$ =0.13) that were significantly higher after exposure to testimonials targeted at students than in the other groups after adjusting for baseline intentions ( $η_{p}^{2}$ =0.24). Concerning underlying mechanisms, there were full mediation effects of similarity (IG1 versus IG2) on attitudes [95%CI (0.030, 0.441)] and intentions to use digi-MHSs [95%CI (0.100, 0.528)] and of credibility on attitudes [IG2 versus IG3; 95%CI (-0.217, -0.004)], all favoring students' testimonials. Conclusion: Overall, this study indicates that the acceptance of digi-MHSs can be substantially increased by providing a simple, context-sensitive information intervention, including testimonials by university students. Since we identified mediating effects of credibility on cognitive attitudes and similarity on affect-driven intentions, a future trial could vary these features using narrative versus statistic information on digi-MHSs.

Keywords: attitude; eHealth; intention; mental health; personal narratives; stress; students.