{"doi":"10.3389/fpubh.2026.1782478","title":"The effects of gain-loss framed message on physical activity attitudes, intentions, and behaviors in physically inactive adults: a systematic review and meta-analysis","abstract":"<jats:sec>\n                    <jats:title>Background</jats:title>\n                    <jats:p>Physical inactivity poses serious health risks. Message framing is a strategy to encourage healthy behaviors, but its effectiveness in promoting physical activity (PA) is unclear, creating challenges for professionals in choosing optimal strategies.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective</jats:title>\n                    <jats:p>To compare the effects of gain-framed versus loss-framed messages on PA attitudes, intentions, and behaviors among inactive adults.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods</jats:title>\n                    <jats:p>\n                      Seven electronic databases were searched from inception to December 15, 2024. Randomized controlled trials examining gain- versus loss-framed messages targeting physically inactive adults were included. Independent reviewers selected the studies, extracted the data, and performed the risk of bias. Standardized mean differences (SMDs) and 95% confidence intervals (CIs) werepooled using random-effects models. Heterogeneity was assessed using\n                      <jats:italic>I</jats:italic>\n                      <jats:sup>2</jats:sup>\n                      and Q statistics. Subgroup and sensitivity analyses were conducted to explore heterogeneity sources and assess result stability.\n                    </jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Results</jats:title>\n                    <jats:p>\n                      Ten RCTs involving 1,355 participants were included. Three articles tested the gain-loss framing effect through PA attitudes, and eight studies each tested message framing through PA intentions and behaviors. There were no statistically significant differences between gain-framed and loss-framed messages in promoting PA attitudes [SMD:−0.60, 95%CI: (-2.09, 0.90),\n                      <jats:italic>P</jats:italic>\n                      = 0.44], intentions [SMD: 0.10, 95%CI: (-0.12, 0.33),\n                      <jats:italic>P</jats:italic>\n                      = 0.37] and behaviors [SMD: 0.15, 95%CI: (-0.04, 0.34),\n                      <jats:italic>P</jats:italic>\n                      = 0.13]. Subgroup analyses suggested that gain-framed messages may have a potential advantage in promoting PA behaviors among general populations [SMD: 0.39, 95%CI: (0.03, 0.55),\n                      <jats:italic>P</jats:italic>\n                      = 0.03] and young adults [SMD: 0.38, 95%CI: (013, 0.63),\n                      <jats:italic>P</jats:italic>\n                      = 0.003].\n                    </jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions</jats:title>\n                    <jats:p>Current evidence does not demonstrate a clear overall advantage of gain- over loss-framed messages in promoting PA among inactive adults. However, gain-framed messages may be more promising for general and young populations. Further high-quality trials with standardized methodologies and longer follow-up periods are needed to clarify their effectiveness.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration</jats:title>\n                    <jats:p>\n                      <jats:ext-link>https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023482474</jats:ext-link>\n                      , identifier CRD42023482474.\n                    </jats:p>\n                  </jats:sec>","journal":"Frontiers in Public Health","year":2026,"id":615373,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":858104,"name":"Yuan Zhao","orcid":"0000-0001-8553-8114","position":1,"is_corresponding":false},{"id":1586098,"name":"Qunyan Xu","orcid":null,"position":2,"is_corresponding":false},{"id":1586099,"name":"Panpan Tang","orcid":null,"position":3,"is_corresponding":false},{"id":370801,"name":"Xueqing Wang","orcid":"0009-0001-3854-9715","position":4,"is_corresponding":false},{"id":1586100,"name":"Yunyu Guo","orcid":null,"position":5,"is_corresponding":false},{"id":607967,"name":"Yue Zhao","orcid":"0000-0003-0365-5291","position":6,"is_corresponding":false},{"id":564098,"name":"Jing Shao","orcid":null,"position":7,"is_corresponding":false},{"id":1586101,"name":"Leiwen Tang","orcid":"0000-0003-4058-0161","position":8,"is_corresponding":false},{"id":1586097,"name":"Yueying Jiang","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"The effects of gain-loss framed message on physical activity attitudes, intentions, and behaviors in physically inactive adults: a systematic review and meta-analysis","abstract":"<jats:sec>\n                    <jats:title>Background</jats:title>\n                    <jats:p>Physical inactivity poses serious health risks. Message framing is a strategy to encourage healthy behaviors, but its effectiveness in promoting physical activity (PA) is unclear, creating challenges for professionals in choosing optimal strategies.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective</jats:title>\n                    <jats:p>To compare the effects of gain-framed versus loss-framed messages on PA attitudes, intentions, and behaviors among inactive adults.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods</jats:title>\n                    <jats:p>\n                      Seven electronic databases were searched from inception to December 15, 2024. Randomized controlled trials examining gain- versus loss-framed messages targeting physically inactive adults were included. Independent reviewers selected the studies, extracted the data, and performed the risk of bias. Standardized mean differences (SMDs) and 95% confidence intervals (CIs) werepooled using random-effects models. Heterogeneity was assessed using\n                      <jats:italic>I</jats:italic>\n                      <jats:sup>2</jats:sup>\n                      and Q statistics. Subgroup and sensitivity analyses were conducted to explore heterogeneity sources and assess result stability.\n                    </jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Results</jats:title>\n                    <jats:p>\n                      Ten RCTs involving 1,355 participants were included. Three articles tested the gain-loss framing effect through PA attitudes, and eight studies each tested message framing through PA intentions and behaviors. There were no statistically significant differences between gain-framed and loss-framed messages in promoting PA attitudes [SMD:−0.60, 95%CI: (-2.09, 0.90),\n                      <jats:italic>P</jats:italic>\n                      = 0.44], intentions [SMD: 0.10, 95%CI: (-0.12, 0.33),\n                      <jats:italic>P</jats:italic>\n                      = 0.37] and behaviors [SMD: 0.15, 95%CI: (-0.04, 0.34),\n                      <jats:italic>P</jats:italic>\n                      = 0.13]. Subgroup analyses suggested that gain-framed messages may have a potential advantage in promoting PA behaviors among general populations [SMD: 0.39, 95%CI: (0.03, 0.55),\n                      <jats:italic>P</jats:italic>\n                      = 0.03] and young adults [SMD: 0.38, 95%CI: (013, 0.63),\n                      <jats:italic>P</jats:italic>\n                      = 0.003].\n                    </jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions</jats:title>\n                    <jats:p>Current evidence does not demonstrate a clear overall advantage of gain- over loss-framed messages in promoting PA among inactive adults. However, gain-framed messages may be more promising for general and young populations. Further high-quality trials with standardized methodologies and longer follow-up periods are needed to clarify their effectiveness.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration</jats:title>\n                    <jats:p>\n                      <jats:ext-link>https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023482474</jats:ext-link>\n                      , identifier CRD42023482474.\n                    </jats:p>\n                  </jats:sec>","is_dataset_classified":null,"base_score":0.0,"endowment":0.0,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"41919308","pmcid":"PMC13033674","openalex_id":"https://openalex.org/W7136196623","authors":[],"funders":[],"total_grants":0,"fwci":0.0,"citation_percentile":0.20481928,"influential_citations":0,"citation_trend":[],"oa_status":"gold","license":"cc-by","oa_locations":[{"url":"https://public-pages-files-2025.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2026.1782478/pdf","host_type":"journal"},{"url":"https://public-pages-files-2025.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2026.1782478/pdf","host_type":"publisher"},{"url":"https://www.frontiersin.org/articles/10.3389/fpubh.2026.1782478/full","host_type":"publisher"},{"url":"https://doi.org/10.3389/fpubh.2026.1782478","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/41919308","host_type":"repository"},{"url":"https://doaj.org/article/f236700b16c34b52b1a5ab213c9dac37","host_type":"repository"},{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13033674/","host_type":"repository"},{"url":"https://europepmc.org/articles/PMC13033674","host_type":"Europe_PMC"},{"url":"https://europepmc.org/articles/PMC13033674?pdf=render","host_type":"Europe_PMC"}],"fields_of_study":["Behavioral Health and Interventions","Physical Activity and Health","Motivation and Self-Concept in Sports","Medicine","Humans","Exercise","Intention","Health Promotion","Sedentary Behavior","Health Behavior","Adult","Attitude to Health"],"mesh_terms":["Adult","Attitude to Health","Health Promotion","Humans","Health Behavior","Exercise","Randomized Controlled Trials as Topic","Intention","Sedentary Behavior"],"keywords":["Physical activity","Framing (construction)","Randomized controlled trial","Confidence interval","Framing effect","Health communication","Health behavior","Health benefits","Meta-analysis","Systematic review","Message Framing","Gain-Framed Message","Loss-Framed Message","Physically Inactive Adults"],"sdg_mappings":[],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-02T19:50:00.295753Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}