Message framing materials applied to healthy eating decision-making for pregnant women with gestational diabetes mellitus: An exploratory study

Xia Han; Nuo Xu; Sijing Chen; Jingjing Zhang; Ping Gu

doi:10.1371/journal.pone.0319416

Message framing materials applied to healthy eating decision-making for pregnant women with gestational diabetes mellitus: An exploratory study

PLoS One. 2025 Feb 24;20(2):e0319416. doi: 10.1371/journal.pone.0319416. eCollection 2025.

Authors

Xia Han¹, Nuo Xu², Sijing Chen³, Jingjing Zhang³, Ping Gu¹

Affiliations

¹ School of Nursing, Nanjing Medical University, Nanjing, China.
² Department of Nursing, Changzhou Health Vocational Technology College, Changzhou, China.
³ Department of Maternity, Women's Hospital of Nanjing Medical University, Nanjing, China.

Abstract

Aims: To develop and initially validate message framing materials for promoting healthy dietary decisions in GDM populations.

Methods: The Delphi survey involved 17 experts, and consensus was obtained after two rounds. In Pre-survey I, 30 participants randomly selected one material (gain framing vs. loss framing) and complete a manipulation check item to ensure that the stimulus material manipulation was valid. Pre-survey II involved 60 participants who rated all messages using a Likert 5 rating questionnaire, a Wilcoxon signed rank sum test was used to examine the message framing effects.

Results: After two rounds of Delphi surveys, experts reached consensus on the final materials, which contained two message framings, each containing 11 entries. The manipulation test for materials achieved 100% validity. The findings indicated significant message framing effects on healthy eating decisions among GDM populations, with loss-framed messages proving more persuasive.

Conclusion: Scientifically valid message framing materials were developed and initially applied, providing an empirical basis and direction for future related research.

Copyright: © 2025 Han et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

MeSH terms

Adult
Decision Making*
Delphi Technique
Diabetes, Gestational* / diet therapy
Diabetes, Gestational* / psychology
Diet, Healthy*
Female
Health Promotion* / methods
Humans
Pregnancy
Surveys and Questionnaires

Grants and funding

This work was supported by the Project of ‘Nursing Science’ Funded by the 4th Priority Discipline Development Program of Jiangsu Higher Education Institutions (Jiangsu Education Department 〔2023〕No.11) and the Priority Academic Program Development of Jiangsu Higher Education Institutions (2018, No. 87). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.