Effectiveness of Message Framing Interventions on Improving Health Outcomes for Individuals in Diabetes Health Education Communication: A Systematic Review

Objectives: To identify the effects of message-framing interventions on improving health outcomes of individuals in diabetes health education communication. Methods: Four electronic databases including Web of Science, PubMed, EMBASE, and the Cochrane Library were the search engines used. The period of literature search was from their inception until December 2023. Randomized controlled trials (RCTs) and quasi-experimental trials reporting the effects of message-framing interventions for diabetes were included. Results: The review included 10 studies. Many studies have investigated multiple health outcomes. Of the seven studies that evaluated behavioral health-related outcomes, all studies (7/7, 100%) found a positive effect, and four studies (4/7, 57.1%) found that there was no significant difference between gain and loss framing. Of the seven studies that assessed nonbehavioral health-related outcomes, six studies (6/7, 85.7%) reported a positive postintervention effect, whereas four studies (4/7, 57.1%) found that loss-framed messages were more effective. One study (1/7, 14.3%) reported that there was no effect of the message framing on mental health-related outcomes. Conclusions: In diabetes health education communication, message framing of gain and loss framing has a positive effect on health outcomes for individuals. The advantage of the loss framing is more significant in improving nonbehavioral health-related outcomes. Practice Implications: When constructing a message to promote health outcomes for patients with diabetes, the message framing is worth applying, and the advantages of loss framing can be considered more. Trial Registration: PROSPERO registration ID: CRD42023445074. https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=445074