Kurzfassung: |
The quality of health care and road traffic safety are two public health concerns that have received increased attention from the World Health Organization over time and continue to impose challenges on public health. The promotion of advance care planning to increase the people-centeredness of care and preventing distracted driving for greater road safety have beenproposed as important pathways forward. Existing research has recognized the potential of social marketing for the promotion and prevention of health-related behaviors; however, up to now, social marketing has received little attention in the field of advance care planning. Similarly, in the context of road safety, much uncertainty still exists about message design for the prevention of risky driving behaviors. In particular, to date, very little is known about how prevalent advance care planning is in Austria and what hinders people from engaging in this health behavior. In the literature, debate continues about the best strategies for engaging people in the advance care planning process. The purpose of this cumulative dissertation was to investigate a) how prevalent are advance care planning documents in Austrian intensive care units, and what are peoples' barriers to engaging in advance care planning; b) how are health messages in mediated advance careplanning interventions designed, and how does the message design relate to intervention effectiveness, and c) how are fear appeal messages designed in road safety communication practice, and what hinders practitioners from applying a theory-based message design. To address the research questions, this dissertation uses a social marketing and social marketingadvertising perspective. A multi-theoretical, multi-method approach was selected, including a clinical study, expert interviews, focus groups, a content analysis of real-world campaigns, and a systematic literature review. The research showed that intensive care patients in Austria rarely used advance care planning documents. Through qualitative research, multiple perceived barriers on the individual, societal, and system level were identified that hinder people from engaging inadvance care planning. In contrast to previous systematic reviews in the literature, it was found that mediated advance care planning interventions effectively engaged people in advance care planning. Different message design techniques were identified. The analysis of real-world road safety campaigns showed a gap between theory and practice, which limits the effective prevention of distracted driving. Based on the literature, the thesis explains why fear appeals are misapplied in practice and offers recommendations for improving those appeals. |