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How media multitasking during narrative viewing affects persuasion: the mediating roles of transportation, engagement, identification, enjoyment, and emotion

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How media multitasking during narrative viewing affects persuasion: the mediating roles of transportation, engagement, identification, enjoyment, and emotion

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Content HOW MEDIA MULTITASKING DURING NARRATIVE VIEWING AFFECTS
PERSUASION: THE MEDIATING ROLES OF TRANSPORTATION, ENGAGEMENT,
IDENTIFICATION, ENJOYMENT, AND EMOTION

by

Jin Huang

A Dissertation Presented to the
FACULTY OF THE USC GRADUATE SCHOOL
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment of the
Requirements for the Degree
DOCTOR OF PHILOSOPHY
(COMMUNICATION)

May 2018

ii
DEDICATION
To my mom, dad, and grandmother, my foundation.
To my husband, my anchor.
To my children, my everything.

iii
ACKNOWLEDGEMENTS
I would like to thank the members of my doctoral committee for their extreme
patience in the face of obstacles. I would like to thank Sheila Murphy, my adviser, for
expanding my knowledge and providing me with opportunities to pursue my goals. I would
like to thank Michael Cody for his generous support of my research. I am forever grateful to
Lourdes Baezconde-Garbanati for the stories that tie us together. I would like to thank Arlene
Luck, Larry Gross, and Imre Meszaros for believing in me and inviting me to the wonderful
team at International Journal of Communication. I would like to thank Sandra Ball-Rokeach
and Michael Parks for opening the door of research to me when I knew little about academia.
I would like to thank Janet Fulk, my mentor, for accepting me for who I am. I would like to
thank Tom Goodnight for engaging me in philosophical conversations. I would like to thank
Peter Monge for providing me with rigorous methodological and theoretical training.
Importantly, several young Annenberg faculty members and alumni have trained my abilities
as a researcher through collaboration: Aimei Yang, Poong Oh, and Nancy Chen. I would like
to thank my fellow doctoral students for their support, feedback, and friendship: especially
Xin Wang, Renyi Hong, Lin Zhang, Nan Zhao, Chi Zhang, and Mina Park. I would like to
thank my students at COMM200 and COMM203 for trusting in me and engaging with me.
I would like to thank my friends in the U.S. and China for encouraging me and
keeping me grounded. I would like to thank my friend Chupei (Jennifer) Zhang especially.
Answering that roommate advertisement was one of the best decisions I’ve made. We
explored Los Angeles together. We searched our souls together. We cried on each other’s
shoulder. And we laughed together. Importantly, I would like to thank Li Lv for bringing me
the most beautiful gift I’ve ever received.
Finally, I’m grateful for world peace, without which none of my dreams could have
come true.

iv
TABLE OF CONTENTS

Dedication ii

Acknowledgements iii

List of Tables vi

List of Figures vii

Abstract ix

Chapter 1: Introduction 1
Introduction 1
Chapter Summaries 9

Chapter 2: Theoretical Framework 10
The Use of Narrative Persuasion in Health Communication 10
Narrative Impact 15
Media Multitasking During Video Viewing 20
Media Multitasking and Persuasive Outcomes 35
Media Multitasking and Narrative Mechanisms 40
Narrative Impact in a Media Multitasking Context 63

Chapter 3: Methods 66
Design and Manipulation 66
Manipulation Check 67
Participants 68
Video Material 69
Experimental Procedure 69
Measures 70
Analysis 74

Chapter 4: Results 76
Descriptive Statistics 76
Direct Impact of Media Multitasking during Narrative Viewing 78
Narrative Impact in a Media Multitasking Context 81
Indirect Influence of Media Multitasking: Narrative Mechanisms as Intermediaries 85

Chapter 5: Discussion and Conclusion 99
Media Multitasking and Narrative Persuasion 100
Narrative Impact in a Media Multitasking Context 101
Ecological Validity of Narrative Research 104
How Narrative Persuasion Works 105
Indirect Effects of Media Multitasking: Narrative Mechanisms as Mediators 106
Methodological Contributions 112
Practical Contributions 115
Limitations and Future Research 117
Conclusion 121

v

References 123

Appendices 194
Appendix A: Questionnaire (survey group) 194
Appendix B: Questionnaire (YouTube group) 240

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LIST OF TABLES

Table 3.1. Sample characteristics
Table 4.1. Bivariate correlations among main variables with means and standard deviations
reported
Table 4.2. Frequency of non-media multitasking in the past
Table 4.3. Frequency of media multitasking in the past
Table 4.4. Change in knowledge, attitudes, and behavioral intentions, and subjective
knowledge by multitasking groups
Table 4.5. Transportation, engagement, identification, enjoyment, and emotion by
multitasking groups
Table 4.6. Regression of change in knowledge, attitudes, and behavioral intentions, and
subjective knowledge on transportation, engagement, identification, enjoyment, and emotion
in YouTube group
Table 4.7. Regression of change in knowledge, attitudes, and behavioral intentions, and
subjective knowledge on transportation, engagement, identification, enjoyment, and emotion
in survey group
Table 4.8. Summary of difference of narrative impact between survey group and YouTube
group
Table 5.1. Mediation effects of media multitasking during viewing on change in knowledge,
attitudes, and behavioral intentions, and subjective knowledge via transportation,
engagement, identification, enjoyment, and emotion as intermediaries

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LIST OF FIGURES

Figure 1.1. Images for illustrative purposes about the Multi-link Screen feature of 2014
Samsung Smart Hub TV

Figure 1.2. An image for illustrative purpose about the mixed reality display released by Real
Fiction in 2018

Figure 2.1. Hypothesized direct effects of media multitasking during narrative viewing on
persuasive outcomes

Figure 2.2. Hypothesized relationships between narrative mechanisms and persuasive
outcomes in a context of higher media multitasking during narrative viewing

Figure 2.3. Hypothesized indirect effects of media multitasking during viewing on persuasive
outcomes in single-mediator models

Figure 2.4. Hypothesized indirect effects of media multitasking during narrative viewing on
persuasive outcomes in six-mediator models

Figure 2.5. Screenshots of two experimental conditions: survey group (lower media
multitasking during narrative viewing) and YouTube group (higher media multitasking during
narrative viewing)

Figure 4.1. Indirect effects of media multitasking during narrative viewing on change in
knowledge in single-mediator models

Figure 4.2. Indirect effects of media multitasking during narrative viewing on change in
knowledge in six-mediator models

Figure 4.3. Indirect effects of media multitasking during narrative viewing on subjective
knowledge in single-mediator models

Figure 4.4. Indirect effects of media multitasking during narrative viewing on subjective
knowledge in six-mediator models

Figure 4.5. Indirect effects of media multitasking during narrative viewing on change in
attitudes in single-mediator models

Figure 4.6. Indirect effects of media multitasking during narrative viewing on change in
attitudes in six-mediator models

Figure 4.7. Indirect effects of media multitasking during narrative viewing on change in
behavioral intentions in single-mediator models

Figure 4.8. Indirect effects of media multitasking during narrative viewing on change in
behavioral intentions in six-mediator models

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Figure 5.1. Results of the direct influence of media multitasking during narrative viewing on
persuasive outcomes and narrative mechanisms

Figure 5.2. Results of the relationship between narrative mechanisms and persuasive
outcomes in the YouTube group

Figure 5.3. Results of the relationship between narrative mechanisms and persuasive
outcomes in the survey group

Figure 5.4. Images for illustrative purposes about the wearable technology with software
developed for children with autism by Brain Power

ix

ABSTRACT
Scholars are increasingly concerned with studying the effectiveness of narrative
persuasion. A recent wave of research demonstrates that narratives have a substantial and
long-lasting impact on attitudinal and behavioral outcomes (Busselle & Bilandzic, 2008;
Green, 2006; Moyer-Gusé & Nabi, 2010; Murphy, Frank, Moran, & Patnoe-Woodley, 2011;
Murphy, Hether, Felt, & de Castro Buffington, 2012; Murphy, Frank, Chatterjee, &
Baezconde-Garbanati, 2013). However, narrative viewing is a process whereby stories are
experienced via media (Johnson, Ewoldsen, & Slater, 2015) and how we consume media
today is radically different from the audience behavior in the past. Along with the popularity
of TVs with a multi-link screen (e.g., Samsung, 2014) and the invention of augmented reality
display (e.g., Google Glass and Deep Frame), there is a drastic increase in the amount of
media stimulus that viewers are exposed to within a short duration of time. People now
consume media contents while they also routinely engage with two or more media activities
at any one time (Foehr, 2006; Holmes et al., 2006; Jeong & Hwang, 2014; Voorveld & Van
der Goot, 2013; Wang & Tchernev, 2012). Media multitasking during viewing, the real-
time action of engaging in two or more media tasks during video consumption in particular,
is prevalent among young audiences (Segijn, Voorveld, Vandeberg, Pennekamp, & Smit,
2017) as well as adults (eMarketer, 2017; Microsoft Advertising, 2014). Media multitasking
has been found to diminish various task performances (e.g., Jeong, Hwang, & Fishbein,
2010; Voorveld, 2011). But viewers still engage in media multitasking in entertainment-
based situations (Xu, Wang, & David, 2016) and even in work settings (Bryan College, 2017)
on a daily basis. The critical question to narrative effects, therefore, is: how might media
multitasking influence the power of narrative persuasion?
The purpose of this dissertation is threefold. First, this research asks: how might
media multitasking during viewing affect the final outcomes of narrative persuasion,

x
including change in knowledge, subjective knowledge, change in attitudes, and change in
behavioral intentions? And how might media multitasking during viewing affect the
underlying mechanisms of narrative persuasion, including being transported by the narrative,
engaging with the narrative, identifying with the characters, enjoying the narrative, and
emotional responses (including negative and positive emotions) to the narrative? Second, this
dissertation attempts to assess the power of narrative in a media multitasking context by
examining the association between narrative mechanisms and persuasive outcomes among
people who engage in a higher level of media multitasking during narrative viewing. This
research asks: how might main narrative mechanisms relate to key persuasive outcomes when
viewers are situated in a context of high media multitasking during viewing? Third, and
perhaps most importantly, this dissertation examines the roles of the aforementioned
narrative mechanisms as mediators of the effect of media multitasking during narrative
viewing on the final outcomes of narrative persuasion.
To gain insight into health narrative persuasion in a media multitasking context, an
online experimental study was conducted in which 478 Mexican American women aged
between 25 and 45 watched Tamale Lesson, a short narrative film about cervical cancer
detection and prevention. The level of media multitasking during viewing was manipulated.
Participants in the low-multitasking condition watched the film on a plain survey page, such
that they had fewer opportunities for media multitasking in the low-distraction context
(survey group). Participants in the high-multitasking condition watched the film on a
YouTube page, such that they had greater opportunities for media multitasking in the high-
distraction context (YouTube group). After viewing, key persuasive outcomes were
measured using an online survey, as well as potential mechanisms of narrative persuasion.
Findings from this dissertation indicate that a condition of higher media multitasking
during viewing was more effective in improving participants’ cervical cancer-related

xi
knowledge, subjective knowledge, and favorable attitudes towards Pap tests. Furthermore, a
condition of higher media multitasking during viewing was more effective in improving the
level of transportation into the narrative, engagement with the narrative, identification with
characters, enjoyment of the narrative viewing experience, and positive emotions experienced
during the viewing. A higher condition was more effective in reducing the level of negative
emotion experienced during viewing. Contrary to the diminishing effect implied by many
previous studies, this dissertation suggests that media multitasking during narrative viewing
may enhance narrative mechanisms and improve persuasive outcomes.
For participants in YouTube group, the regression models that included narrative
mechanisms as independent variables significantly predicted three persuasive outcomes:
change in knowledge, subjective knowledge, and change in behavioral intentions.
Interestingly, the model of narrative persuasion that predicted change in behavioral intentions
was only significant in YouTube group, but not in survey group. Specifically, for the
YouTube group, engagement, identification, and positive emotion increased knowledge
gained, while enjoyment resulted in less knowledge gained; engagement and enjoyment
increased subjective knowledge, while negative emotion decreased resulted in less subjective
knowledge; engagement increased favorable attitudes; and transportation increased
behavioral intentions. Interestingly, the media multitasking group condition moderated the
relationship between transportation and change in behavioral intentions, such that the
association was significant and positive in the YouTube group, but nonsignificant in the
survey group. Findings suggest that the relationship between narrative mechanisms and
persuasive outcomes is mostly significant and effective in a condition of higher media
multitasking during narrative viewing.
Mediation analyses indicated that media multitasking during narrative viewing
increased the levels of knowledge gained both directly and indirectly, through the mediation

xii
effect of identification, enjoyment, and positive emotion together. Media multitasking during
narrative viewing only indirectly increased participants’ subjective knowledge about cervical
cancer, through the mediation effect of engagement and enjoyment together. Media
multitasking during viewing only indirectly increased more favorable attitudes towards Pap
tests, through the mediation effect of engagement. Media multitasking during viewing only
indirectly increased participants’ intentions to receive a Pap test, through the mediation effect
of transportation. The findings underscore the importance of narrative mechanisms as
intermediaries leading media multitasking to the final outcomes of narrative persuasion.
In conclusion, this dissertation suggests that media multitasking during viewing
amplifies the narrative mechanisms of transportation, engagement, identification, enjoyment,
and emotion, as well as improving the final outcomes of narrative persuasion including
change in knowledge, subjective knowledge, change in attitudes, and change in behavioral
intentions. This suggests that the power of persuasive health narratives may not only be
undiminished but enhanced in a media multitasking context. These findings are discussed in
terms of their theoretical, methodological, and practical contributions.

Keywords: media multitasking, narrative persuasion, health communication

1

Chapter 1: Introduction
Narrative viewing is an important process whereby stories are consumed and
experienced (Johnson, Ewoldsen, & Slater, 2015). Many studies have documented the
potential effect of using narrative to promote changes in narrative-consistent attitudes,
beliefs, and behavioral intentions for preventive health purposes (see, for example, Murphy,
Frank, Chatterjee, & Baezconde-Garbanati, 2013). In comparison with non-narrative
approaches, narrative persuasion has been found to be a more effective means of changing
individuals’ real-life perceptions of depicted events, resulting ultimately in narrative-
consistent knowledge, attitudes, and behavior (Busselle & Bilandzic, 2008; Green, Garst,
Brock, & Chung, 2006; Moyer-Gusé & Nabi, 2010; Murphy, Frank, Moran, & Patnoe-
Woodley, 2011; Murphy, Hether, Felt, & de Castro Buffington, 2012; Murphy et al., 2013).
But how do we consume media today? Does the viewing experience differ from the past? If
so, how might it influence narrative persuasion?
Many media devices nowadays can introduce attention-grabbing distractions that
might interfere with the main viewing activity. Several, if not all, major consumer electronic
brands have recently launched products, such as the Samsung Smart TV, designed to bring a
rich media entertainment experience closer to the average media user. For example, the
function of “multi-link screen”, as shown in the advertisement below and Figure 1.1, is
highlighted as a key selling point for Smart TVs:
MULTI-LINK SCREEN
Fulfill your every multitasking need. A Multi-Link Screen lets you use up to four
screens on a UHD TV or two screens on a Full HD TV simultaneously on one screen.
This gives you the ultimate multi-viewing experience as you can watch TV and
YouTube videos, browse the web and watch TV, watch two different TV shows at the

2
same time, or watch TV and play with your apps. Samsung’s Multi-Link Screen brings
a whole new level of entertainment to your TV (Samsung, 2014).

[Insert Figure 1.1 here]

If TVs with a “multi-link screen” are how we consume media today, then the
invention of augmented reality display might be how we consume media in the future. For
example, Deep Frame, a 64-inch screen invented by a company named Real Fiction, uses
mixed-reality display technology. It displays multiple media contents together with the many
objects in physical surroundings all on the same screen at the same time. No special-effect
wearable device is required and a crowd of viewers can share the same viewing experience
simultaneously. People can watch Jurassic Park on the augmented reality display and the
many dinosaurs would be chasing each other in an exhibit hall or even living room.

[Insert Figure 1.2 here]

Crucially, advances and innovations in media technologies facilitate a drastic increase
in the amount of media stimulus that viewers are exposed to at a single point in time. People
now routinely engage with two or more media activities at any one time (Foehr, 2006;
Holmes et al., 2006; Jeong & Hwang, 2014; Voorveld & Van der Goot, 2013; Wang &
Tchernev, 2012). The routine interaction with two or more media tasks within a short
duration, media multitasking, radically differs from how we consume media in the past.
(Foehr, 2006; Holmes, Papper, Popovich, & Bloxham, 2005; Jeong & Fishbein, 2007; Jeong
& Hwang, 2015; Papper, Holmes, & Popovich, 2004; Voorveld, 2011; Voorveld & van der
Goot, 2013; Wang & Tchernev, 2012). Viewers may multitask on multiple devices, rapidly

3
changing focus between a reality show on a television, a sports game streaming on a laptop,
and instant messaging on a smartphone (Voorveld & Viswanathan, 2014). Or they may
browse the Internet, check emails, and use an instant messaging service all simultaneously on
a single device such as a laptop or smartphone (Carrier, Cheever, Rosen, Benitez, & Chang,
2009; Foehr, 2006; McFarlane, 1998; Yeykelis, Cummings, & Reeves, 2014). Media
multitasking has become an integral part of how people experience media in everyday life.
This radical departure from our collective past where audience members focused on one
screen and one program at a time calls for a careful re-examination of what we thought we
knew about media consumption and its effects.
Media multitasking during video viewing is particularly common among audiences.
In 2014, it was estimated that 7 out of 10 people simultaneously engaged in multiple media
activities, such as using a phone, tablet, or laptop, while watching TV (Microsoft
Advertising, 2014). In 2017, it was reported that 70.3 percent of U.S. adults preferred to surf
the web while watching TV (eMarketer, 2017). Watching TV while using new media, and
using new media and the Internet simultaneously, were found to be two of the most common
media multitasking combinations in a study conducted across six North American and
European countries (Voorveld, Segijn, Ketelaar, & Smit, 2014). Not only adolescents and
adults, many children, aged between three and six years old, now might also routinely engage
in media multitasking activities because of the ease of use and wide availability of
touchscreen devices. Moreover, many parents actually believe that the use of touchscreen
devices, along with media multitasking activities, might improve their children’s early
development (Kostyrka-Allchorne, Cooper, & Simpson, 2017). If media multitasking
continues to emerge as the new normal of media consumption, how much do we know about
the effects of media multitasking on narrative persuasion and the power of narrative impact in
a context of more media multitasking?

4
Currently, very little is known about the influences of media multitasking on narrative
persuasion. The media effects literature that has examined the impact of media multitasking
is relatively scarce and the previous studies are primarily interested in how multitasking
might interfere with academic/productivity tasks, such as reading comprehension and work
performance, or cognitive functions such as counterarguing (see, for example, Jeong &
Hwang, 2012). These studies provide the basis for this dissertation but they have yet raised
questions that are specifically pertinent to narrative research: how might media multitasking
influence the exact mechanisms of narrative persuasion and the final outcomes of narrative
persuasion?
The literature on the effect of media multitasking on cognition and task performance
presents inconclusive results. A dominant perspective would suggest detrimental effects of
media multitasking on persuasive outcomes. Most previous research follows the theory of
“attention and effort” (Kahneman, 1973) and/or the “limited capacity” theory (Lang 2000;
Zhang, Jeong, & Fishbein, 2010), and argues that multitasking diminishes cognitive
processing, comprehension, and task performance. This line of reasoning builds on the
premise that information processing (of media messages) demands attention and cognitive
effort. Since multitasking is a form of distraction that diminishes attention and uses up mental
resources, it is likely that media multitasking will be adversely related to task performances.
Some studies found that media multitasking disrupt the processing of media messages (Jeong
& Fishbein, 2007; Jeong, Hwang, & Fishbein, 2010), the completion of reading
comprehension and memory tasks in an academic setting (Pool, Koolstra, & van der Voort,
2003a), and recalling and recognizing branding messages (Voorveld, 2011). From this, it
would logically follow that media multitasking is likely to lower the quality of media
exposure and it will be implied that media multitasking should reduce the outcomes of
narrative persuasion and diminish the mental experiences of narrative involvement.

5
Conversely, some recent studies suggested positive influences that media multitasking
might have, which prior studies have largely neglected. Media multitasking during
entertainment tasks was found to positively correlate with college students’ social success,
sense of normalcy, and self-control (Xu, Wang, & David, 2016). Engaging in social media
activities while watching political debate might lead viewers to watch more of the debates,
i.e. more sustained viewing and prolonged exposure to political communication (Thorson,
Hawthorne, Swasy, & McKinney, 2015). And film with music soundtrack playing at the
background was found to be more persuasive than film without music (Costabile & Terman,
2013). In support of the recent findings, several earlier studies have found that chatting with
friends on social media while watching TV programs or live sports telecasts might correlate
with greater enjoyment of the show and more beneficiary social outcomes (Nielsen, 2013;
Shim, Oh, Song, & Lee, 2015). Similar evidence has also accumulated in the field of
advertising, wherein a handful of studies suggested that not all media multitasking
detrimentally affects advertising effectiveness. Media multitasking can improve viewers’
attitudinal and affective responses to TV commercials (Chinchanachokchai, Duff, & Sar
2015; Kazakova, Cauberghe, Hudders, & Labyt, 2016). Media multitasking might improve
advertising recall and recognition when the primary and secondary activities are congruent,
and secondary activities have a higher level of social accountability attached (Angell, Gorton,
Sauer, Bottomley, & White, 2016). Additionally, such positive impact can also garner
support from several cognitive psychology studies. People who frequently media multitask
might even perform better than those who multitask less on performances, such as fluid
intelligence (Minear, Brasher, McCurdy, Lewis, & Younggren, 2013), the ability to integrate
information from multiple sensory channels (Lui & Wong, 2012), and the allocation of visual
attention (Yap & Lim, 2013).

6
The critical question to narrative effects, therefore, is: how might media multitasking
influence the power of narrative persuasion against the backdrop of inconclusive findings of
media multitasking effects and lack of research on multitasking and narrative persuasion?
How do viewers comprehend narratives, become engaged with narratives, and become
moved or persuaded by narratives in a context of higher media multitasking?
The first objective of this dissertation asks: how might media multitasking during
narrative viewing affect key outcomes of narrative persuasion, including change in
knowledge, subjective knowledge, change in attitudes, and change in behavioral intentions to
perform the recommended behavior? Furthermore, how might media multitasking during
narrative viewing affects the underlying mechanisms of narrative persuasion, including being
transported by the narrative, engagement with the narrative, identifying with the characters,
enjoying the narrative, and emotional responses (including negative emotion and positive
emotion) to the narrative?
After determining the main effects of media multitasking on narrative persuasion, this
dissertation attempts to assess the power of narrative in a media multitasking context by
examining the link between narrative mechanisms and persuasive outcomes among people
who engage in a higher level of media multitasking. This research asks: how might main
narrative mechanisms relate to key persuasive outcomes when viewers are situated in a
context of higher media multitasking during viewing?
Finally, and perhaps most importantly, this dissertation seeks to understand the
process by which media multitasking during narrative viewing influences persuasive
outcomes. This dissertation asks: whether media multitasking during narrative viewing
affects persuasive outcomes directly or indirectly? If indirectly, via what intermediaries? To
be specific, how might media multitasking during narrative viewing influence the outcomes

7
of persuasion by way of narrative transportation, narrative engagement, identification,
enjoyment, and emotion as intermediaries?
The overall contributions of this dissertation are to determine the effect of media
multitasking during narrative viewing on narrative persuasion; assess the power of narrative
persuasion in a media multitasking context; and examine the indirect effect of media
multitasking during narrative viewing on persuasive outcomes, through the mediation of
narrative mechanisms. Additionally, this dissertation differs from existing work on narrative
persuasion in its consideration of subjective knowledge as a key persuasive outcome.
Subjective knowledge, in this context, refers to people’s confidence in their own knowledge,
or their perceptions of how much they know (Brucks, 1985; Park & Lessig, 1981). This
remains relatively understudied in health narrative research, as factual knowledge, as a
measurable outcome, is usually the primary focus. Several studies have argued for the
importance of subjective knowledge in facilitating preventive health behaviors, such as
cancer screening (Phillips, 1993), HIV testing among college students (Hou, 2004), and
breast or testicular self-examination (Nabi, Roskos-Ewoldsen, & Dillman, 2008). But the
question remains: how do narrative mechanisms relate to subjective knowledge? To address
this, the following chapters consider subjective knowledge as one of the key outcomes of
narrative persuasion, together with changes in knowledge, attitudes, and behavioral
intentions.
This dissertation aims to examine health narrative communication by testing an
existing narrative material aimed at Mexican-American women, developed for the purpose of
preventive health. Ethnic minorities and women are especially vulnerable when exposed to
health risks, particularly in terms of cancer prevention. However, many previous studies on
narrative or media multitasking were conducted among college students or a younger age
group, in which ethnic populations are usually underrepresented. The impact of media

8
multitasking on ethnic minorities is therefore relatively unknown. Further, much health
narrative research focuses on variations within message content or among targeted
population. Relatively less health research has examined the viewing context in which the
health messages are conveyed, especially when that context that involves media multitasking.
To gain insight into health narrative persuasion in a media multitasking context, an
online experimental study was conducted in which 478 Mexican American women aged
between 25 and 45 watched Tamale Lesson, a short narrative film about cervical cancer
detection and prevention. The level of media multitasking during narrative viewing was
manipulated by having participants watch the narrative video on either a minimum-
distraction survey page or on a high-distraction YouTube webpage. The survey webpage only
displayed survey content and featured minimal distracting or irrelevant information, such that
the participants in this group had reduced opportunities for media multitasking and it would
be more inconvenient to switch out of the survey page in order to media multitask. By
contrast, typical YouTube webpages display banner advertisements, recommended videos in
the sidebar, and users’ viewing histories besides the chosen video. Participants watching the
narrative video on this viewing platform may therefore have had both greater temptation and
more convenient access to multitasking opportunities.
After viewing, key persuasive outcomes including knowledge, subjective knowledge,
attitudes, and behavioral intentions were measured using an online survey, as well as
potential mechanisms of narrative persuasion such as transportation into the story,
engagement with the narrative, identification with characters, enjoyment during narrative
viewing, and emotion experienced during narrative viewing.
In sum, this dissertation uses an existing health narrative that promotes cervical
cancer prevention among Mexican American female and examines (1) the main effect of
media multitasking during narrative viewing on the final outcomes of narrative persuasion—

9
change in knowledge, subjective knowledge, change in attitudes, and change in behavioral
intentions— and the mechanisms of narrative persuasion, including transportation,
engagement, identification, enjoyment, and emotion; (2) the relationship between the
aforementioned narrative mechanisms and persuasive outcomes in a condition of high media
multitasking during narrative viewing; and (3) the indirect effect of media multitasking
during narrative viewing on persuasive outcomes through the aforementioned narrative
mechanisms as intermediaries.
Chapter Summaries
Chapter 2 provides the theoretical framework for this study. As the theoretical
framework is developed, the hypotheses and research questions for this study are proposed.
Chapter 3 describes the methods used in this study, namely, on online experiment conducted
among Mexican-American women to gain more insights into the experiences of narrative
viewing in a context involved media multitasking. Media multitasking during narrative
viewing was manipulated. Persuasive outcomes—change in knowledge, subjective
knowledge (only post-test), change in attitudes, and change in behavioral intentions—were
measured in both pre-test and post-test surveys. Mechanisms of narrative persuasion—
transportation, engagement, identification, enjoyment, and emotion—were assessed in the
online survey post-narrative viewing. The data were analyzed using t-tests, regression
analyses, and mediation analyses in SPSS. Chapter 4 presents results from the hypothesis
testing. Finally, Chapter 5 describes the findings from this study, focusing on its
methodological, theoretical, and practical contributions, as well as its limitations.
Implications for future research are also discussed.

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Chapter 2: Theoretical Framework

The Use of Narrative Persuasion in Health Communication
Narrative, or storytelling, is one of the oldest forms of communication. The power of
narrative has been recorded for thousands of years (Fisher, 1985, 1987). A narrative can be
defined as “a representation of connected events and characters that has an identifiable
structure, is bounded in space and time, and contains implicit or explicit messages about the
topic being addressed” (Kreuter, Green, Cappella, Slater, Wise, Storey, & Woolley, 2007, p.
222). Narrative persuasion refers to the extent to which narratives affect individuals’ real-
world attitudes, beliefs, perceptions, and behaviors (Appel & Richter, 2007; Green & Brock,
2000; Green, Brock, & Kaufman, 2004; Slater, 2002).
Narratives faciliate the creation of meaning (Bruner, 1986, 1991; Kerby, 1991; Shank,
1990; Wentzel, Tomczak, & Hermann, 2010; Wise, Kim, & Kim, 2009) because the story-
like format organizes the rich details of an event in a temporal manner, such that the event
and its surrounding context are described with a clear narrative structure. A narrative
structure usually includes a distinct beginning, middle, and end. It is capable of presenting an
event wherein characters enact goals and actions, and achieve some sort of outcomes in a
linear sequence (Bruner, 1986, 1991; Labov & Waletzky, 1967; Pennington & Hastie, 1992;
Sarbin, 1986). By portraying an event as a sequential story, a narrative facilitates the drawing
of causal inferences among otherwise unrelated elements of an event, allowing viewers to
create meaning more effortlessly (Woodside, Sood, & Miller, 2008). Further, classic studies
have shown that people remember details of stories about life events using “episodic”
memory, which heavily relies on the sequential presentation of information bits (Chaffee,
1973; Tulving, 1972). People remember the details of events better if they mentally construct

11
narratives about them (Sarbin, 1986), because the mental construction of story is considered
an important heuristic that facilitates information processing (Robinson & Hawpe, 1986).
A growing body of research suggests that narrative content has a substantial and long-
lasting impact on attitudinal and behavioral outcomes (Appel & Richter, 2007; Bruner, 1986;
Diekman, McDonald, & Gardner, 2000; Gerrig, 1993; Murphy et al., 2011, 2013; Strange &
Leung, 1999). It has been found that information embedded in narratives is easily processed,
resulting in greater acceptance and stronger persuasive effects than for non-narrative
messages (see, for example, Appel, 2008a; Appel & Richter, 2007, 2010; Dahlstrom, 2010;
Graesser, Olde, & Klettke, 2002; Green & Brock, 2000; Jensen, Bernat, Wilson, &
Goonwardene, 2011; Mazzocco, Green, Sasota, & Jones, 2010; Morgan, Movius, & Cody,
2009; Murphy et al., 2011, 2013; Schank & Abelson, 1995; Slater & Rouner, 2002; Slater,
Rouner, & Long, 2006). Specifically, narrative improves information processing in several
ways: by strengthening information recall (Wyer, Adaval, & Colcombe, 2002); by increasing
ease of comprehension (Graesser et al., 2002; Hoeken, Kolthoff, & Sanders, 2016); by
reducing cognitive resistance to accepting new information (Green et al., 2006; Kreuter et al.,
2007; Schank & Abelson, 1995; Slater, 2002); by reducing the generation of
counterarguments (Green et al., 2006; Niederdeppe, Shapiro, & Porticella, 2011; Slater,
2002); and by encouraging the adoption of new behavioral models through increasing self-
efficacy (Bandura, 1986, 2002; Moyer-Gusé, 2008; Singhal & Rogers, 2004; Slater, 2002).
Narratives in health communication. The use of narrative persuasion in health
communication has, in recent years, received considerable attention from scholars (Green et
al., 2006; Hinyard & Kreuter, 2007; Kreuter et al., 2007; Murphy et al., 2013). It is believed
that narrative has the potential to serve as “a promising set of tools for motivating and
supporting health-behavior change” (Hinyard & Kreuter, 2007, p. 789) and “promising
alternatives” (Kreuter et al. 2007, p. 222) for achieving health intervention goals. Health

12
narrative communication is commonly defined as “a representation of connected events and
characters that has an identifiable structure, is bounded in space and time, and contains
implicit or explicit messages about the (health) topic being addressed” (Krueter et al., 2007,
p. 22). Narrative health messages typically feature “storylines that follow a standard format
with an initial development of story and character background, a subsequent buildup to a
climax, and a final resolution” (Baranowski, Buday, Thompson, & Baranowski, 2008, Green
& Brock, 2000). Health narratives integrate health information into entertaining stories, and
usually includes health-relevant anecdotes, testimonials, and forms of stories (Hinyard &
Kreuter, 2007; Singhal & Rogers, 2004). These characteristics make narratives particularly
attractive for health communication scholars.
Narrative viewers are likely to expect to be entertained by a story-like format rather
than being persuaded or educated by a factual, more didactic format. In this way, narrative
viewers are more likely to show affective responses to health information that is presented
through the narrative, and less likely to expend cognitive effort on analytically processing the
didactic health materials in a logical and critical manner (Green & Brock, 2000; Moyer-Gusé,
2008; Slater, 2002; Wentzel et al., 2010). In addition, people are familiar with making sense
of their lives and experiences through stories (Fisher, 1984). Viewers are given the
opportunity to observe and model themselves on characters in a narrative, and potentially to
change their health attitudes and behaviors in accordance with the narrative (Bandura, 1977;
Green et al., 2006).
Narrative persuasion can have a particular positive effect on cancer prevention,
diagnosis, and treatment. It is a daunting to experience the emotional, relational, and
existential challenges of being diagnosed with cancer, of battling to survive it, or of
supporting loved ones suffering from it (Armstrong & Chung, 2000; Mathieson & Stam,
1995). Naturally, people may seek to avoid discussions about the implications of cancer. The

13
National Cancer Institute makes it a dedicated mission to create health interventions that
encourage individuals to “(a) behave in ways that lessen their risk of cancer and (b)
recommend actions to detect cancer in its earliest stages” (Dillard & Nabi, 2006). Narratives
may help achieve the goals of cancer control because narratives “can express the nuances,
contradictions, and aesthetics of illness and cancer’s existential dilemmas more effectively
than didactic formats” (Ezzy, 2000, pp. 605–617; Kreuter et al., 2007; Polkinghorne, 1988).
Along the cancer control continuum (prevention, detection, diagnosis, treatment, and
survivorship), health narrative may elicit less counterargument to cancer-prevention
messages among individuals, facilitating better processing of cancer information, while also
providing social and emotional support (Kreuter et al., 2007).
Narrative, health disparities, and ethnic minorities. Underserved populations
experience health disparities and are especially vulnerable to health threats. A “health
disparity” refers to “difference in the incidence, prevalence, mortality, and burden of diseases
and other adverse health conditions” (Rimal et al., 2013). Health disparities are commonly
explained as the differences in populations’ access to health resources, as well as their
differing environments, health conditions, and health outcomes (Carter-Pokras & Baquet,
2002). Based on the knowledge gap hypothesis (Tichenor, Donohue, & Olien, 1970), society
tends to experience disparities in knowledge, as different social groups gain knowledge at
different rates, even when they are exposed to the same information (Viswanath & Finnegan,
1996). As a result, people who are more knowledgeable to begin with may receive greater
benefit from an intervention than people who are less knowledgeable in the first place. Thus
the disparities in society are further exacerbated (Gaziano, 1983; Tichenor, Donohue, &
Oilen, 1970; Viswanath & Finnegan, 1996).
Health disparities are a form of structural inequality in society (Rimal et al., 2013)
that is commonly associated with minority status (Partin & Burgess, 2012), discrimination

14
(Nelson, 2002), poverty (Niederdeppe, Bu, Borah, Kindig, & Robert, 2008), and lack of
access to social services (Sambamoorthi & McAlpine, 2003). Because limited income and
poor education can inhibit people’s access to health information and reduce their capabilities
to process the messages (Viswanath & Bond, 2007), groups such as ethnic minority
populations may become less advantaged at acquiring health knowledge from conventional
health interventions aimed at the general public. Furthermore, ethnic minorities are likely to
trust health care providers the least, especially when it comes to life-threatening diseases, and
distrust usually leads to resistance to information delivered via health interventions
(Boulware, Cooper, Ratner, LaVeist, & Powe, 2003). The Mexican-American community is
of particular interest to researchers of health disparities. For instance, in an obesity study of
people from preschool to adulthood, Mexican-American children seemed to be more
overweight than children from other racial and ethnic groups (Ogden, Carroll, Kit, & Flegal,
2012). It is possible that many Mexican-American parents are restricted by their relatively
low income, limited education, and lack of English proficiency, and thus encounter greater
difficulties with acquiring and comprehending information about their children’s health
(Davis, Cole, McKenney-Shubert, Jones, & Peterson, 2017).
One potential means of alleviating health disparities is to tailor narrative persuasion
for less advantaged population. It is feasible to customize health narratives for populations
affected by health disparities, as culture-specific rules and contexts could shape the process
of creating a narrative (Banks-Wallace, 2002). One example is The Witness Project, an
integration of health intervention with culture-specific narrative, which features African-
American female cancer survivors talking about their experiences in order to encourage
breast and cervical cancer screening among the African-American community (Erwin, Spatz,
Stotts, Hollenberg, & Deloney, 1996; Erwin, Spatz, Stotts, & Hollenberg, 1999). More
importantly, the reception and comprehension of culture-specific narrative may be especially

15
effective and much needed among populations affected by health disparity. Storytelling has
long been proven as an effective form of communication, able to quickly disseminate a
message among a community more easily while also requiring relatively little prior
knowledge or skills of comprehension. Integrating tailored health information in culture-
specific narrative is likely to be widely accessible to and easily comprehended by people who
are less educated, less literate, and more marginalized in terms of access to medical
resources. Ethnic minorities such as Mexican Americans and African Americans may find
viewing health narrative videos or reading health narrative brochures more accessible and
comfortable than expository, factual advertisements (Davis et al., 2017; McQueen, Kreuter,
Kalesan, & Alcaraz, 2011; Murphy et al., 2013).
Narrative Impact
Traditional outcomes: knowledge, attitudes, and behavioral intentions.
Knowledge is perhaps the most important persuasive outcome that can be directly measured
and expected by health promotion campaigns. According to the social cognitive perspective
(Bandura, 2004), knowledge of health-related risks and benefits is the cornerstone of
encouraging effective health practices. That is, knowledge about a particular health topic
serves as a precondition for change in the health behavior. Acquisition of health-related
knowledge is also an important indicator of the level of health literacy. Health literacy is
explained as the extent to which people are able to seek, comprehend, and use information
about health and health services (Batterham, Hawkins, Collins, Buchbinder, & Osborne,
2016; Parker, Baker, Williams, & Nurss, 1995). Moreover, “health literacy implies the
achievement of a level of knowledge, personal skills and confidence to take action to
improve personal and community health by changing personal lifestyles and living
conditions” (Kickbusch & Nutbeam, 1998). According to the theory of reasoned action and
planned behavior (Ajzen, 1991), attitudes are important to persuasion research as people’s

16
attitudes toward or beliefs about a certain behavior are usually associated with the extent to
which they intend to engage in the behavior. In a similar vein, behavioral intentions are
usually explained as a behavioral goal’s proxy: they indicate the extent to which people aim
or intend to engage in a particular health behavior. Crucially, behavioral intentions are
usually associated with the actual health behaviors (Bandura, 2004).
The acquisition of health-related knowledge, attitudes, and behavioral intentions are
common expected outcomes of health interventions because they are necessary for desired
behavioral change in health practices. Thus, the majority of health narrative research is
focused on establishing associations between narrative and changes in narrative-consistent
attitudes and beliefs (Green & Brock, 2000; Green et al., 2004), health-related behavioral
intentions, and knowledge about a particular health topic (see, for example, Chang, 2008;
Hernandez & Organista, 2013; Kim, Bigman, Leader, Lerman, & Cappella, 2012; Kreuter,
Holmes, Alcaraz, Kalesan, Rath, Richertm…, & Clark, 2010; Murphy et al., 2011, 2013).
Subjective knowledge and narrative persuasion. The fact-based knowledge that
narrative researchers most commonly examine may not include all types of knowledge that
are necessary for health practices. Classic psychology research (Alba & Hutchinson, 2000;
Bearden, Hardesty, & Rose, 2001; Brucks, 1985) typically conceptualizes prior knowledge in
two ways: objective (factual) knowledge and subjective (perceived) knowledge (Brucks,
1985; Park & Lessig 1981). Objective knowledge refers to accurate knowledge or factual
information stored in long-term memory (Bettman & Park, 1980) whereas subjective or self-
assessed knowledge refers to a confidence in the state of knowledge, or people’s perceptions
of how much they know (Brucks, 1985; Park & Lessig 1981). Subjective knowledge
indicates “a person’s knowledge, beliefs, and feelings about his capabilities and skills”
(Boekaerts, 1991, p. 2), as well as a person’s self-perception about his or her abilities,

17
specifically, his or her “feelings and knowledge about [these] abilities [and] skills” (Byre,
1984, p. 428).
Although the two are related, subjective knowledge is not always a proxy for
objective knowledge. First, they are measured differently (Brucks 1985; Park, Mothersbaugh,
& Feick, 1994), such that scores of fact questions about a particular issue usually indicate
objective knowledge whereas the assessment of individuals’ perceived knowledge levels on a
particular issue indicates subjective knowledge. Further, subjective knowledge is not always
consistent with objective knowledge (Brucks 1985; Park et al., 1994; Radecki & Jaccard,
1995), such that people may perceive themselves to know less (under-confidence) or more
(overconfidence) than they actually know in reality. If subjective knowledge outweights
objective knowledge, individuals become overconfident about what they think they know;
this is one of the “most consistent, powerful, and widespread” psychological biases in human
decision making (Johnson & Fowler, 2011) and one of the most prominent antecedents to
decision making (see Rozenbilt & Keil, 2002). A high level of subjective knowledge may
imply overestimating one’s knowledge or capabilities, and/or underestimating the challenges
or potential risks of a task (Johnson & Fowler, 2011).
Certain preventive health behaviors, such as cancer screening (Phillips, 1993), may be
particularly relevant to subjective knowledge. Subjective knowledge is an important
construct in understanding how individuals seek information (Brucks, 1985; Rao & Sieben,
1992) and how they process that information (Alba & Hutchinson, 1987; Bettman & Park,
1980; Johnson & Russo, 1984; Rao & Monroe, 1988). It may affect people’s information-
seeking and decision-making behavior through a mechanism that is different from that of
factual knowledge (Moorman, Diehl, Brinberg, & Kidwell, 2004; Radecki & Jaccard, 1995;
Raju, Lonial, & Mangold, 1995). The need for self-consistency (see Swann, Rentfrow, &
Guinn, 2002) may drive people to seek information at places consistent with their subjective

18
knowledge, such that people who are confident about their nutrition knowledge are likely to
locate themselves at healthy places for grocery shopping. Consequently, such location
decisions are likely to affect the quality of people’s choices on food (Moorman et al., 2004).
Regarding cervical cancer screening, subjective knowledge about cervical cancer prevention
can refer to the extent to which people are confident about their knowledge of cervical cancer
and Pap tests, whereas factual knowledge, as defined earlier, indicates how accurately people
actually know facts related to cervical cancer and Pap tests. The key point is that people may
turn to locations, people, or situations that are aligned with their perceptions about
themselves for cancer-related information.
The role of subjective knowledge in health communication has been examined in a
handful of studies, while most health research treats objective knowledge as the most
important knowledge outcome. Phillips’ (1993) study was the first to incorporate both
objective and subjective knowledge in health research. The study examined the association
between objective and subjective AIDS general knowledge, as well as how they relate to the
use of voluntary HIV testing based on data collected from a National Health Interview
Survey among the U.S.’s adult population. The association between subjective knowledge
and objective knowledge was only marginally significant. Importantly, HIV testing use was
only significantly and positively related to subjective knowledge, not objective knowledge. In
a later study about HIV testing among young adults in college (Hou, 2004), subjective
knowledge about HIV testing specifically was found to be significantly and positively related
to prior HIV testing behaviors, not objective HIV knowledge. A more recent study among
college students (Nabi et al., 2008) examined how perceived knowledge about breast or
testicular self-examination contributes to the persuasive outcomes of fear-based persuasive
appeals. It found that individuals with higher perceived knowledge reported stronger
intentions to perform a self-examination when they were exposed to less fear, whereas those

19
with lower perceived knowledge reported stronger behavioral intentions when they were
exposed to more fear appeals. The key implication is that those who think they know more
may be willing to accept messages that are less emotional. A recent study on vaccine
knowledge (McKeever, Mckeever, Holton, & Li, 2016) offers direct evidence that a
mismatch between subjective and objective knowledge may in fact engender desired
consequences in the context of preventive health specifically. Individuals who overconfident
about what they know about childhood vaccinations were found to be more outspoken about
this particular matter as compared to those who were less overconfident about their
knowledge but actually know more about the scientific evidence of why vaccination is
important. The findings suggest that subjective health knowledge seems to be more important
than objective knowledge in influencing individuals’ responses to fear-based persuasive
appeals, as well as individuals’ decisions to take action based upon acquired health
information.
It is not the purpose of this dissertation to determine which knowledge construct is
more important than the other. Instead, the present study focuses on portraying a full picture
of health knowledge (Phillips, 1993; Rao & Monroe, 1988) by including measures of both
subjective and objective knowledge in the same study design. After all, subjective knowledge
seems to be capable of indicating behavioral intention just as well as objective knowledge
(Phillips, 1993). Some scholars have called for health-prevention programs that are specially
designed to increase subjective knowledge related to preventive behavior (Hou, 2004).
Considering the paramount importance of subjective and objective knowledge in a health
context (Nabi et al., 2008), the present study thus proposes to include subjective knowledge
about cervical cancer screening as a new final outcome of narrative persuasion alongside
objective knowledge, attitudes, and behavioral intentions. The potential relationships between

20
key narrative processing mechanisms and subjective knowledge will be further hypothesized
and explored in later sections.
To recap, the literature on narrative persuasion reviewed so far suggests that health
narratives can be a more compelling form of persuasion than non-narrative expository health
material and, moreover, that narratives or stories may be especially useful among populations
negatively affected by health disparities. Meanwhile, the main narrative persuasive outcomes
include knowledge, attitudes, behavioral intentions, and the newly introduced subjective
knowledge. The next section introduces definitions and theoretical frameworks of media
multitasking.
Media Multitasking During Video Viewing
Multitasking with media has largely been enabled by new interactive technologies
and ready access to a wealth of information abundances in society. Contemporary
communication technologies bring great versatility and convenience to media users, both
youth and adults, who can now easily access a variety of digital, social, and mobile media
platforms. Individuals are afforded the unprecedented opportunity to integrate work, social
interactions, and play into one seamless communication process (see, for example, Carrier et
al., 2009; David, Kim, Brickman, Ran, & Curtis, 2015; Rosen, Carrier, & Cheever, 2013;
Srivastava, 2013).
The phenomenon of engaging with, or being exposed to, two or more media
simultaneously is referred to as media multitasking (Foehr, 2006; Holmes et al., 2005; Jeong
& Fishbein, 2007; Jeong & Hwang, 2014; Papper et al., 2004; Pilotta & Schultz, 2005;
Voorveld, 2011; Voorveld & van der Goot, 2013; Wang & Tchernev, 2012). It represents a
type of audience behavior by which the same media consumers experience “multiple
exposures to various media forms at a single point in time” (Pilotta, Schultz, Drenik, & Rist,
2004, p. 285). For example, people may listen to radio or music while driving, or they may

21
check their digital social media accounts while watching online streaming videos on a laptop,
respond to instant messages on a smartphone, and watch a show on TV all at once. The
combination of listening to music, texting, and social networking online is found to be one of
the most common media multitasking activities among youth (Moreno, Jelenchick, Koff,
Eikoff, Diermyer, & Christakis, 2012). In today’s environment, media content is often
saturated and access to numerous media platforms is convenient. It can be difficult for
individuals to only stick to one medium at a time.
The reported amount of media multitasking has increased substantially in recent
years. In 2017, the average American adults were estimated to spend an average of 12 hours,
the equivalent of half a day, consuming media. And more than 25% of that total media time
was estimated to involve media multitasking (eMarketer, 2017). This is a significant increase
from 2009. Back then, the average American aged between 8-18 years old consumed
multiple media formats for more than 7.5 hours per day, which was a significant increase of
more than 1 hour per day in comparison with the preceding five years. A majority of these
American teenagers reported engaging in multitasking “most” or “some” of the time
concurrently with listening to music (73% of participants), watching TV (68%), using a
computer (66%), and reading (53%) (Rideout et al., 2010; Roberts, Foehr, & Rideout, 2005).
Besides children and youths, adults are also not strangers to media multitasking. A study
(Carrier et al., 2009) identified a total of 66 combinations of media tasks, i.e. ways of pairing
up multiple media tasks to practice simultaneously. “Net Geners” (those born after 1978)
reported having engaged in 37.5 combinations on average; “Gen Xers” (those born between
1965 and 1978) reported 32.4 combinations; and “Baby Boomers” (those born between 1946
and 1964) reported 23.2 combinations. In a recent study on mobile usage among students
(David et al., 2015), participants were asked to freely estimate time spent on media and
communication activities in a typical day, and they reported an average of nearly 39 hours of

22
media consumption in a 24-hour day. Similarly, marketing research (Research and Markets,
2006) has shown that U.S. consumers normally spend 43 hours on activities in a 24 hour day,
and that 16 of these 43 hours are spent on engaging with media and communication
technology. Similarly, a survey by the Kaiser Family Foundation (Roberts et al., 2005) also
reported that youths aged between 8 and 18 managed to consume 8.5 hours of media content
within 6.5 hours of time spent actually consuming media in an average day. Multitasking is
believed to be the main contributor to the overestimation or time compression phenomenon,
such that viewers can squeeze more media content into less time by engaging in multiple
activities concurrently, potentially leading to inconsistent judgment of physical time and
psychological time.
The ubiquitous phenomenon of media multitasking has generated considerable
interest in the relationship between multitasking and fundamental aspects of life. Indeed,
when society begins to widely adopt a new technology, there is always a dramatic increase in
interest in the potential influence of that technology on human cognition, behavior, and
society as a whole (Cardoso-Leite, Kludt, Vignola, Ma, Green, & Bavelier, 2016).
Particularly relevant to communication research is the birth of TV, for example. In the 20
years after 1941, ownership of a TV set among average American families rose from 0% to
over 90% (Gentzkow & Shapiro, 2008). The prevalence of TV directly triggered a number of
studies examining the effects of TV-viewing on a wide array of topics such as individuals’
visual and motor skills (Guba, Wolf, de Groot, Knemeyer, Van Atta, & Light, 1964), learning
performance (Greenstein, 1954), and political participation (Glaser, 1965; Simon & Stern,
1955). Likewise, interactive technology such as the high-speed Internet and portable tablets
and smartphones is of significant interest today. The new information technology makes
available a large array of information, messages, and images for viewers to consume, and
gives rise to the behavior of media multitasking. Media multitasking is particularly important

23
to media effects research. Traditional media effects research tends to assume that viewers pay
full attention to the single medium that conveys media exposure content, and thus uses media
exposure as the primary (and sometimes only) independent variable in effects research (see,
for example, Bartels, 1993; Bissell & Zhou, 2004; Gerbner, Gross, Morgan, & Signorielli,
1980). The rise of concurrent usage of multiple media has changed viewer behavior in a
fundamental way, such that a more complex viewing experience of media content is
emerging. The potential influence of media multitasking on media exposure and effects is yet
to be fully realised.
The main focus of this research is on media multitasking during viewing, which is
defined as the act of simultaneously engaging with multiple media tasks that occurs during
and alongside another (primary) media activity. Media multitasking that occurs in real time as
media consumption shows a high level of synchronicity of social interaction (Wang &
Tchernev, 2012; Xu, Wang, & David, 2016) because immediate responses or actions are
typically required. Media multitasking during viewing is commonly captured by designing
behavioral manipulations in experimental studies (e.g., V oorveld & Viswanathan, 2015;
Yeykelis et al., 2014) or by recording individuals’ media multitasking action through
observation (Pool, Koolstra, & van der V oort, 2003b). Building on this prior line of research,
this study designs an online experiment to manipulate media multitasking during narrative
viewing.
Media multitasking and theoretical approaches. The theoretical framework that is
most commonly used to explain the impacts of media multitasking is the theory of attention
and effort (Kahneman, 1973), as well as the limited capacity theory (Lang, 2000; Zhang et
al., 2010). According to both perspectives, there is only a limited amount of cognitive
resources available for information processing. One of the most important resources is
attention, which is also finite. Thus, people need to allocate attention among several tasks

24
during multitasking, and consequently diminish their performances on processing
information for each task. As a result, media multitasking has been found to diminish the
productivity and quality of tasks that involve various content, especially if the tasks are
complex and demand great attention (see Junco, 2012; Junco & Cotten, 2011, 2012; Koch,
Lawo, Fels, & Vorlander, 2011; Ophir, Nass, & Wagner, 2009; Rosen et al., 2013; Wood,
Zivcakova, Gentile, Archer, De Pasquale, & Nosko, 2012).
A number of studies have begun to explore the relationship between media
multitasking and cognitive performance. For the most part, media multitasking has been
found to diminish the productivity of information processing and working memory. The
potential disruptive effects of media multitasking have raised concerns among researchers
from all fields of work. To educators, media multitasking appears to weaken the processing
and verification of written messages (Gilbert, Tafarodi, & Malone, 1993), and lower the
comprehension and memory retrieval in academic work (Armstrong, Boiarsky, & Mares,
1991; Pool et al., 2003a). As a result, academic performance overall seems to suffer from
media multitasking, with a deterioration in students’ attention allocated to lectures,
comprehension of course material, and grade point averages (Fried, 2008; Junco, 2012; Junco
& Cotten, 2011, 2012; Kirschner & Karpinski, 2010; Lau, 2017; Ophir et al., 2009; Rosen et
al., 2013; Wood et al., 2012). To advertisers, media multitasking has been found to lower the
persuasive effectiveness of advertising messages (Bellman, Kemp, Haddad, & Varan, 2014;
Bellman, Rossiter, Schweda, & Varan, 2012; Jayasinghe & Ritson, 2013; Varan, Murphy,
Hofacker, Robinson, Potter, & Bellman, 2013). Empirical evidence in cognitive psychology
research suggests that chronic media multitasking can diminish cognitive control ability in
adolescents, such that heavy media multitaskers are more affected by irrelevant stimuli and
are less effective at switching tasks than light media multitaskers (Ophir et al., 2009). Prior
research mostly shows a negative association between multitasking and human cognition,

25
with reduced performance in terms of memory, comprehension, and critical analysis
(Armstrong & Chung, 2000; Bowman, Levine, Waite, & Gendron, 2010; Furnham &
Bradley, 1997; Furnham, Gunter, & Peterson, 1994; Jeong et al., 2010; Junco & Cotten,
2011; Kononova & Chiang, 2015; Levine, Waite, & Bowman, 2007; Pool et al., 2003; Zhang
et al., 2010). That is, the majority of the literature suggests that media multitasking is
negatively related to performances of various tasks.
The limited capacity model. The dominant perspective in examining the effects of
media multitasking comes from the limited capacity model (Lang, 2000; Lang, Bradley, Park,
Shin, & Chung, 2006). The cognitive model is particularly relevant to studying media
multitasking because it attributes poor performance in information processing and memory
tests to underlying cognitive mechanisms that describe how individuals engage with media
(Wise & Reeves, 2007). The limited capacity model (Lang, 2000) is built upon Kahneman’s
(1973) theory of attention and resource allocation theory (Kanfer & Ackerman, 1989). A
central premise of the model is that people have limited cognitive resources to spend on
information processing, and insufficient resources for tasks will lead to ineffective task
performance. First, in a process called “orienting,” media viewers decide how to allocate
cognitive resources among tasks based on their goals and personal interests. Second, the
stages of information processing begin, including encoding, comprehending, and retrieving
information from the external environment. Encoding stands for the selection of stimuli that
people will later store as mental representations of the world around them, and retrieving
means how humans mentally activate this information. This dominant perspective generally
argues that there will not be enough cognitive resources for multiple tasks, as the human
brain only has a finite amount of cognitive capability to handle more than one task at a time.
Without sufficient resources, information processing becomes less effective and task
coordination becomes impaired, such that actions are delayed and task completion is

26
prolonged (see, for example, Rubenstein, Meyer, & Evans, 2001). Overall, this line of
cognitive psychology research argues that multitasking may diminish or inhibit task
performance.
Among the many cognitive resources is memory, which is crucial to narrative
processing and engagement. Closely related to the limited capacity model, the cognitive load
theory (Sweller, 1988) suggests that (a) the capacity of working memory is limited, (b) the
capacity of long-term memory is almost unlimited, (c) during a learning process, working
memory needs to actively process and comprehend external information, and then encode
information into long-term memory, and (d) an overloaded working memory diminishes the
effectiveness of learning. In this sense, cognitive overload means the amount of mental effort
expended on working memory, or on any other cognitive resource, is beyond the person’s
capacity, and it is usually associated with a high number of external activities that demand
attention.
People who multitask may need to allocate their cognitive resources among several
tasks simultaneously. Thus, fewer resources may be available for each task, which may
restrict the performances of each task (Lang et al., 2006; Rubenstein et al., 2001). A cognitive
bottleneck usually develops because the simultaneous performance of multiple tasks requires
more resources, yet there people’s cognitive capabilities are finite, as the limited capacity
model suggests. Especially when the secondary tasks compete with the primary task for
similar channels for encoding (e.g., two auditory tasks, such as listening to the reading and
talking on the phone) (Navon & Miller, 1987), or the secondary tasks are highly demanding
(Adler & Benbunan-Fich, 2015), people in a media multitasking condition usually remember
less or less accurately the information delivered though the primary activity (Brasel & Gips,
2011). Consequently, people may underperform during media multitasking, such as when
reading or doing homework with background television sounds (Armstrong & Chung 2000;

27
Pool, van der Voort, Beentjes, & Koolst, 2000), attending to lectures while using a laptop
(Sana, Weston, & Cepeda 2013), and driving while using a mobile phone (Strayer &
Johnston, 2001).
In addition to non-media cognitive tasks (see Adler & Benbunan-Fich, 2015; Pool et
al., 2003a, 2003b), more recent studies have found similar patterns on the way people process
media messages while multitasking (see, for example, Angell et al., 2016; Jeong & Hwang,
2012; Zhang et al., 2010). Processing TV content also requires viewers to allocate sufficient
cognitive resources, without which their chances of learning are reduced (Lang, Bolls, Potter,
& Kawahara, 1999). Several prior studies grounded in the limited capacity model (Jeong &
Hwang, 2012; Zhang et al., 2010) have reported that multitasking seems to reduce viewers’
likelihood of learning from TV. Their main explanation is that multitasking may have used
up the cognitive resources available for processing TV content. A recent in-depth study on
media multitasking and processing of advertisement content offers direct observation on this
matter (Bardhi, Rohm, & Sultan, 2010). Media users self-reported that they paid less
attention to a specific task, needed a longer time to decode media content, procrastinated
during task completion, and acquired less knowledge, mainly because media multitasking is
attention-demanding and too much of a distraction. In a study of brand recall and recognition,
participants performed more poorly in recalling and recognizing brands appearing on online
banner advertising when they simultaneously browsed the Internet with the radio on as
compared to with the radio off (Voorveld, 2011). Similarly, in a study of recall and
recognition for an online news story about a college soccer team, participants who read the
online news while listing to a podcast about the university’s history performed worse in
recalling and recognizing the reading material than those who read the story without
distraction (Srivastava, 2013). As such, previous studies suggest that media multitasking is

28
commonly linked to reductions in cognitive control and memory performances (Minear et al.,
2013).
Nonetheless, multitasking with some types of activities, such as skilled tasks
(Schumacher, Seymour, Glass, Fencsik, Lauber, & Kieras, 2001), or habit-learning tasks
(Foerde, Knowlton, & Poldrack, 2006), seem to have relatively little influence on people’s
performances. Overall, however, the majority of research following the limited capacity
model (see Adler & Benbunan-Fich, 2015; Jeong & Hwang, 2012; Zhang et al., 2010)
suggests that media multitasking reduces people’s capabilities for processing information and
sustaining memory. Similar to how media multitasking reduces academic outcomes, study-
related behaviors and attitudes, and perceived academic learning (Lau, 2017, Van der Schuur,
Baumgartner, Sumter, & Valkenburg, 2015), in this sense, media multitasking is likely to be
negatively associated with the effects of narrative persuasion, because the distraction of
simultaneously performing several tasks will give people a harder time to receive,
comprehend, and memorize the information conveyed via health narratives.
Threaded cognition model. Related to the limited capacity model, another frequently
used theoretical framework for media multitasking studies is the threaded cognition model
(Salvucci & Taatgen, 2008, 2011). In this model, each task is explained as a cognitive thread,
such that watching TV while talking on the phone would be represented as two separate
threads. Each thread can be activated and executed independently (Salvucci & Taatgen,
2008). Only a single thread can be processed at a time, so media multitasking then becomes a
matter of switching between multiple threads to process. The process of executing multiple
threads sequentially, instead of concurrently, comes with inevitable costs. For instance, a
delay in time and errors are likely to occur when other threads are temporarily put on hold
while the central processor is executing a single thread (Altmann & Gray, 2008), which

29
usually results in poor performance during task switching (Meiran, Chorev, & Sapir, 2000).
In this sense, media multitasking is likely to be negatively associated with narrative
persuasion as the cognitive overloads caused by lining up several media activities and
processing one activity at a time tend to diminish people’s learning performances after
watching a narrative video.
Attention, media multitasking, and persuasion. So far, the argument has been built
on the assumption that information processing demands attention, so media multitasking will
reduce persuasion effectiveness if multitasking diminishes attention. On another note,
however, is it always better for people to pay more attention to persuasive content? In
particular, is more attention always better for effective persuasion? What if media
multitasking results in people paying less attention to persuasive contents, which in fact
increases their susceptibility to the persuasive effects of narrative?
First, a person paying limited attention to external information may still be under a
degree of persuasive influence. Messages can be processed subliminally, below
consciousness, and they may still influence viewers. In a few studies, the subconscious
processing of information has been shown to affect attitudes, although the effect conditions
are less clear, such that the effects may be due to viewers’ favorable attitudes towards the
stimulus, instead of changes in opinions about a topic (Krosnick, Betz, Jussim, & Lynn,
2002; Kunst-Wilson & Zajonc, 1980). Similarly, the elaboration likelihood model (ELM) of
persuasion (Petty & Cacioppo, 1986) indicates that people sometimes pay limited attention to
the information source and process the information based on cues less relevant to the core
content of the message; this is called peripheral processing. Even such automatic information
processing is still likely to be accompanied by some levels of attitude change among viewers.

30
Second, paying limited attention to persuasive messages may reduce people’s critical
examination of information, reduce counterarguing, and thus increase message acceptance
(Baron, Baron, & Miller, 1973; Festinger & Maccoby, 1964; Gilbert et al., 1993). Both the
thought disruption hypothesis (Petty, Wells, & Brock, 1976) and the counterarguing
inhibition hypothesis (Keating & Brock, 1974) suggest that distraction may reduce
counterarguing and consequently result in increased acceptance of persuasive information.
Media multitasking is a form of distraction that involves complex and concurrent information
processing (Jeong & Hwang, 2012). Divided attention during multitasking may reduce
opportunities for counterarguing and thus increase the persuasive effect on viewers,
compared with those devoting their full attention to the content (Jeong & Hwang, 2012; Petty
& Cacioppo, 1986; Petty & Wegener, 1997; Petty, Wells, & Brock, 1976). As such, it is
possible that divided attention due to media multitasking may be sufficient and beneficial for
exposure to narrative persuasion, such that media multitaskers who pay limited attention to a
health narrative may be subliminally influenced by it. They may also be less skeptical about
the motivation/messages in the narrative, compared with those viewers who pay full attention
to narrative viewing.
Motivated cognition and attention. Both the limited capacity model and the threaded
cognition model emphasize that attention is a key yet finite resource and attention is a finite
or limited amount of resource. It is because the attention resource is limited that performing
multiple media activities that require cognitive resources at the same time is likely to
diminish task performance (David et al., 2015). However, what if there are circumstances
under which media multitasking can increase people’s cognitive processing efficiency?
Would such improved efficiency free up additional cognitive resources and thus actually
improve the task performances?

31
A motivated cognition perspective (Lang et al., 2006; MacInnis, Moorman, &
Jaworski, 1991) emerges based on the limited capacity theories (Lang, 2000) and the
Elaboration Likelihood Model (Petty & Cacioppo, 1986). This perspective suggests that the
motivation, ability, and opportunity to process information positively affect the extent to
which people elaborate media messages. Motivation is explained as how much people are
willing to expend cognitive effort in processing information during multitasking and it is
related to how involved people are with the media activities (MacInnis et al., 1991).
According to this perspective, people are motivated to balance between appetitive and
aversive systems, whereby the appetite systems attempt to optimize positive affect and the
aversive systems attempt to avoid negative affect (Cacioppo & Berntson, 1994; Lang et al.,
2006). That is to say, people who are highly motivated are more likely to allocate cognitive
resources to tasks during multitasking. Ability is explained as the skills and knowledge that
people need to have for decoding information (MacInnis et al., 1991). And opportunity is
explained as the extent to which exposure time and distractions affect people’s attention to
media messages (MacInnis et al., 1991). In this sense, if people are highly involved in tasks,
then the cognitive efficiency of encoding and comprehending information is likely to increase
(Srivastava, 2013). That is to say, goals and interests influence how people decide to allocate
cognitive resources to different tasks (Lang, 2000; Lang et al., 1999). If some tasks, either the
primary or secondary, keep people more engaged, then cognitive capacities may improve and
people may have enhanced abilities to perform multiple tasks simultaneously (Angell et al.,
2016; Duff & Sar, 2015).
A control perspective on media multitasking. Many studies have attempted to
conceive media multitasking in terms of control, with mixed results. It is unclear whether
media multitasking indicates stronger or weaker control. This is an important question
because the role of control relates to narrative constructs in many ways, and an inconsistent

32
view of what media multitasking means in terms of control would confuse our understanding
of media multitasking and narrative constructs. One potential reason why inconsistency exists
regarding media multitasking and control may be that the literature fails to distinguish
between control over media and control over self. The existing literature tends to discuss the
effects of media multitasking on control in general, and uses the distinct issues of control,
self-control, and control over media interchangeably. However, the present study argues that
the literature actually suggests control over media and self-control are associated with media
multitasking in different ways, and thus may cause the inconsistent understanding. The next
two sections review media multitasking and control over media, and self-control respectively.
It is assumed that the prevalence of new media technology such as tablets and
smartphones should facilitate media multitasking and allow users to exercise greater control
over their media choice behaviors and consumption experiences (see, for example, Wang &
Tchernev, 2012; Wise et al., 2009). The ability to exert control over media is often
considered a defining feature of new media that are facilitated by interactive communication
technology (Steuer, 1992). The need to exert control over information consumption is
conceptualized as a habitual need (Wang & Tchernev, 2012), which refers to routinized
media use that users seek to maintain certain stability or structure in their life or to construct
a familiar background (Katz, Blumler, & Gurevitch, 1973). Based on this literature synthesis,
gaining control is thought to be among the most commonly sought after needs that motivate
users to consume media (Katz et al., 1973; Wang & Tchernev, 2012). In an empirical sense,
this argument is persuasive. The need to exert control is found to be one of the most popular
motivational needs among users who multitask with computers (Zhang & Zhang, 2012).
Furthermore, a recent study recorded the actual behaviors of computer users who proactively
controlled the pace and sequence of switching between tasks within a short amount of time,

33
and found that users do actively participate in shaping their media consumption experiences
in natural settings to a considerable degree (Yeykelis et al., 2014).
In an in-depth study of young consumers’ media multitasking habits and processing
of branding information (Bardhi et al., 2010), media users reported that they experienced a
heightened sense of control over their media consumption during media multitasking.
Specifically, users felt that they could actively determine what media content to consume, as
well as when, where, and in what way. Through actively pursuing desired content, or
screening out undesired content, users tend to become more involved and interested in media
consumption (Bardhi et al., 2010; Marcias, 2003). It is argued that the control over media
afforded by media multitasking may provide users with more opportunities and better
capabilities to engage in communication processing to a greater extent.
Unlike the emphasis on behavior inherent to questions about people’s control over
media, the issue of self-control is more properly construed as a cognitive concept. Self-
control is explained as an individual’s executive function or capacity in controlling or
regulating one’s emotion, affect, behavior, and cognition (Baumeister, 1998; Baumeister,
Vohs, & Tice, 2007; Gottfredson & Hirschi, 1990). Self-control typically refers to people’s
self-regulatory mechanisms that allows them to enact change in their responses to situations,
practice desired behaviors, or avoid undesired behaviors to pursue their goals or fulfill their
obligations (Muraven & Baumeister, 2000). Aspects of self-control include cognitive tasks
such as memory performance, distractor filtering, and various task performances. Self-control
is often viewed as a type of cognitive resource that is limited (Baumeister, Schmeichel, &
Vohs, 2007; Calderwood, Green, Joy-Gaba, & Moloney, 2016; Uncapher, Thieu, & Wagner,
2016). A lack of self-regulation may lead individuals to report a sense of “loss of control
behaviors” (Kim & LaRose, 2004; LaRose, Lin, & Eastin, 2003), and it may cause

34
problematic behaviors and social maladaptation, such as impulsive and risky behaviors
(Gottfredson & Hirschi, 1990).
Behavioral addiction is often coupled with a lack of self-control. Addictive media
behaviors in particular can be explained as “the overuse of media to the extent that it disturbs
the user's daily life” (Demirci, Orhan, Demirads, Akpinar, & Sert, 2014). Media activities
such as heavy usage of the Internet and gaming (Kwon, Lee, Won, Park, Min, & Hahn,
2013), and smartphones (David et al., 2015) are commonly assumed to be linked with
deficient self-control. It has been found that self-control is negatively linked to Internet
addiction (Li, Dang, Zhang, Zhang, & Guo, 2014; Özdemir, Kuzucu, & Ak, 2014) and
smartphones (Jeong, Kim, Yum, & Hwang, 2016), such that individuals with lower self-
control are more likely to be addicted. Although not all media multitasking is as severe as an
addiction, it can often involve some defining characteristics of addictive behavior. In a study
of mobile phone usage and media multitasking, individuals who frequently engage in mobile
phone multitasking perceived stronger interference in life by mobile technologies, and
reported a greater sense of perceived loss of control due to multitasking than those who
multitask with phones less frequently (David et al., 2015). Heavy media multitasking is found
to be associated with diminished self-control in the forms of loss of cognitive control and
poor memory performance (Minear et al., 2013), and poor capacity in filtering out distractors
during tasks (Cain & Mitroff, 2011; Ophir et al., 2009). Additionally, it seems that
individuals are generally aware that self-control may diminish along with media multitasking
(Panek, 2014). However, one study found that media multitasking can lead to stronger self-
control. In a study about the effects of media multitasking on the state of well-being (Xu et
al., 2016), self-control is conceived as an important indicator of well-being, and it is
positively associated with multitasking during entertainment-based media tasks. Overall,
despite the exception, a majority of multitasking research following the limited capacity

35
model (such as Adler & Benbunan-Fich 2015; Jeong & Hwang, 2012; Zhang, Jeong, &
Fishbein, 2010) tend to use overload to self-regulation to explain how media multitasking
may diminish individuals’ capabilities of information processing and memory recall. Some
even explicitly suggest viewing self-control as a main mechanism to account for media
multitasking’s impairment effects on task performance (Zhang & Zhang, 2012).
Chaotic viewing experience. The constant connection of information communication
technologies (ICT) brings users not only convenience but also stress. Contemporary media
technologies such as computer (Hjortskov, Rissén, Blangsted, Fallentin, Lundberg, &
Søgaard , 2004), digital media (Mark, Gudith, & Kloecke, 2008), and email (Mark, Voida, &
Cardello, 2012) have been found to be common stressors for people at work. College students
who spent a longer time on a computer and multitasked with computer tasks are found to be
more stressful than those who used computer and multitasked less (Mark, Wang, & Niiya,
2014). Besides current stress, ICT usage is even found to be positively related to stress one
year later (Thomée, Eklöf, Gustafsson, Nilsson, & Hagberg, 2007). For decades, brain and
behavioral research has found that multitasking with more than one cognitive task creates
stress and challenges for individuals (Wallis, 2010). In particular, media multitasking can
create a media environment of chaos and disorder. Users have described their media
multitasking experiences as chaotic and stressful. More importantly, users have also reported
that they felt guilty for either not being able to process information effectively in a media
multitasking situation (Bardhi et al., 2010), or for being so absorbed in media multitasking
that they turn into someone who is not “present” and “authentic” in face-to-face interaction
(Ames, 2013). Rather than being a distractor, media multitasking may impact the mental or
emotional state of users overall by creating a chaotic and stressful media environment, in
effect reducing users’ capability of processing information.
Media Multitasking and Persuasive outcomes

36
After reviewing the mechanisms most commonly used to explain the effects of media
multitasking, this section draws on the existing literature to hypothesize about the direct
impact that media multitasking may have on narrative outcomes.
Knowledge, attitudes, and behavioral intentions. As discussed above, most studies
examining the effects of media multitasking follow the limited capacity model (Adler &
Benbunan-Fich, 2015; Jeong & Hwang, 2012; Zhang, Jeong, & Fishbein, 2010) and posit that
the cognitive overload caused by media multitasking may reduce individuals’ cognitive
control, capabilities of information processing, and memory recall (Minear et al., 2013). This
dominant perspective suggests that media multitasking adversely relates to cognitive
performance (Armstrong & Chung, 2000) and cognitive functions (Ophir et al., 2009).
Acquiring factual knowledge, narrative-consistent attitudes, and behavioral intentions from
viewing health narratives is similar to learning knowledge in an academic setting. Media
multitasking has been consistently found to associate with diminishing academic
performance (see, for example, Calderwood et al., 2016; Junco, 2012; Junco & Cotten, 2012;
Karpinski, Kirschner, Ozer, Mellott, & Ochwo, 2013; Lau, 2017; Rosen et al., 2013; Wood et
al., 2012). Completing academic assignments while watching TV is found to be associated
with poor performance on reading comprehension and recalling of the assignment content
(Armstrong, Boiarsky, & Mares, 1991; Pool, Koolstra, & van der Voort, 2003). Attitudes and
behaviors related to academic study have also been found to negatively associate with media
multitasking (van der Schuur et al., 2015).
Based on the well-documented impairment of academic task performances in a media
multitasking situation, as well as the generally assumed deterioration of cognitive processing
capabilities, it can be expected that the final outcomes of narrative processing—knowledge,
attitudes, and behavioral intentions—are likely to be among the many cognitive tasks that
suffer from the inhibitory influences of media multitasking. That is, the dominant perspective

37
is likely to suggest that narrative viewers with a higher level of media multitasking would
acquire less knowledge from viewing health-related narratives, and experience fewer changes
in attitudes and behavioral intentions that are consistent with narratives compared to those
with a lower level of media multitasking.
However, an alternate perspective in media multitasking would assume that the loss
of cognitive control of media multitaskers might also enhance learning outcomes in some
ways. Media multitasking seems to cause individuals to be less able and/or willing to filter
out irrelevant distractors from the external environment than light media multitaskers (Lui &
Wong, 2012). There may be instances where the irrelevant information from distractions later
becomes useful. Narrative in particular is not an explicit form of persuasion and may contain
media content that appears to be irrelevant to persuasive messages. In fact, when narratives or
advertisements are not in alignment with individuals’ other primary or media activities, the
viewing of narratives can itself be considered a distractor (Duff & Faber, 2011). Those who
multitask frequently seem to better utilize the “irrelevant” information than those who
multitask less (Cain & Mitroff, 2011; Lui & Wong, 2012). A possible explanation is that
individuals who multitask frequently may develop a way of processing information that is
different from those who multitask less. Light multitaskers typically use depth of information
and selectively pick out the best information whereas heavy multitaskers may be equipped
with better “multisensory integration” and accustomed to use breadth of information, such
that they may process information more democratically and acquire information from more
than one source (Cain & Mitroff, 2011; Lin, 2009). Information processing based on
attentional breadth (Duff, Yoon, Wang, & Anghelcev, 2014) may help multitaskers absorb
more seemingly irrelevant information (such as narrative cues), which may contribute to the
comprehension of narrative messages as a whole. It is suspected that individuals who are
accustomed to heavy multitasking may prefer complexity to simplicity, and be equipped with

38
a more creative mentality. In addition, the broader attentional scope may encourage
“reinstatement of” relevant memories (Kuhl, Rissman, Chun, & Wagner, 2011; Shohamy &
Wagner, 2008), which may give rise to cognitive schemas that benefit learning outcomes
(Uncapher et al., 2015). Following this logic, media multitasking may in fact increase the
knowledge gained from narrative viewing, and potentially cause greater changes in attitudes
and behavioral intentions that are consistent with narratives.
However, it is also possible that the inhibitory effects of media multitasking may
temper the potentially positive effects of media multitasking, and thus no significant
influence of media multitasking on the final outcomes of narrative persuasion may be found.
A recent study of the effects of multitasking on opinion change (Jeong & Yoori, 2015) seems
unable to find a significant relationship between opinion change and multitasking. That is to
say, the final outcomes of narrative persuasion may not necessarily correlate with the level of
media multitasking. Following these considerations, then, this dissertation seeks to address
the following research questions:
RQ1. How does media multitasking during narrative viewing relate to changes in
knowledge acquired from narrative viewing?
RQ2. How does media multitasking during narrative viewing relate to changes in
narrative-consistent attitudes?
RQ3. How does media multitasking during narrative viewing relate to changes in
narrative-consistent behavioral intentions?
Media multitasking and subjective knowledge. Research on media multitasking
and subjective knowledge is relatively sparse, but the existing literature on the psychological
consequences of media multitasking can provide some insight into the topic. A handful of
studies suggest that individuals’ self-perceptions may be negatively related to media
multitasking. Heavy media multitaskers tend to think of themselves as being more impulsive,

39
lacking self-control (Minear et al., 2013; Sanbonmatsu, Strayer, Medeiros-Ward, & Watson,
2013), and experiencing more everyday attentional failures (Ralph, Thomson, Seli, Carriere,
& Smilek, 2015), while in fact they perform as well as light media multitaskers on tasks. As a
result, it has been found that individuals tend to overestimate the extent to which multitasking
diminishes task performance (Finley, Benjamin, & McCarley, 2014). An exploratory analysis
on media multitasking and students’ homework performance found that more than half of
students forecasted underperformance of homework assignment in a media multitasking
situation, while 23.4% forecasted over-performance, and the rest forecasted no difference
(Calderwood et al., 2016). Similarly, perceptions of the benefit one may gain from academic
learning are also found to be negatively associated with media multitasking among students
(van der Schuur et al., 2015). In this sense, media multitasking should negatively affect
individuals’ confidence in comprehending and recalling knowledge.
However, findings from more recent studies seem to suggest that individuals may
overestimate their abilities during multitasking (Sanbonmatsu, Strayer, Medeiros-Ward, &
Watson, 2013). Individuals may report that they experience a greater sense of control during
multitasking and feel stronger competence in comprehending and processing information. A
recent study on media multitasking and political news consumption (Ran, Yamamoto, & Xu,
2016) found that individuals who engage in media multitasking more frequently tend to
overestimate their knowledge gains from political news consumption, while in fact they are
the same or even less politically knowledgeable than light media multitaskers. That is, it is
also possible that individuals in a media multitasking situation may feel greater confidence in
the knowledge that they possess.
One way to explain the potential positive influence of media multitasking on
subjective knowledge is that multitasking may only limit people’s ability to store and recall
information, whereas the information that can be readily retrievable through simple and

40
direct recognition may remain unaffected by multitasking. Declarative (explicit) memory
supports the gaining of knowledge that can be flexibly applied to new situations and
concisely recalled later. Non-declarative (implicit) memory supports procedural habit and
skill formation that is less flexible and not consciously accessible (Rovee-Collier, Hayne, &
Colombo, 2000; Tulving, 1985). A study of college students (Armstrong & Chung, 2000)
found out that those who studied science material with background TV on reported relatively
poorer recall of the material but performed just as well as those without distraction on
recognizing the material. A similar study (Foerde et al., 2006) found that those who learned a
weather prediction with distraction acquired relatively less explicit knowledge about the cues
for weather prediction but did just as well as those without distraction on performance
accuracy. It is argued, therefore, for short-term learning task with simple procedures, people
who multitask may acquire the same level of information as those who do not, and can
recognize the acquired information as clearly as non-multitaskers, leading to confidence in
what they think they know. Since participants in most media multitasking and narrative
studies are tested on their knowledge gain immediately after experimental stimulation or
survey completion, a hypothesis is thus proposed:
H1. Media multitasking during narrative viewing will be significantly and positively
related to subjective knowledge.
So far, it is posited that media multitasking may directly influence the final outcomes
of narrative persuasion, including knowledge, attitudes, behavioral intentions, and subjective
knowledge. Besides these outcomes of narrative persuasion, the underlying mechanisms of
narrative persuasion may also be under the influences of media multitasking. The next
section therefore examines the direct influences of media multitasking on narrative
mechanisms.
Media Multitasking and Narrative Mechanisms

41
Transportation. People often make sense of meaning by processing stories.
Characterized as the simulation of experience (Mar & Oatley, 2008), narrative processing
often leads to a phenomenological experience of being absorbed and immersed into a
storyline. The experience of “being lost in a story” is referred to as “transportation” (Gerrig,
1993; Green & Brock, 2000, 2002; Moyer-Gusé, 2008) or “absorption” (Slater & Rouner,
2002). Specifically, narrative transportation is defined as “a convergent process, where all
mental systems and capacities become focused on events occurring in the narrative” (Green
& Brock, 2000, p. 701). According to the conceptualization of transportation (Gerrig, 1993;
Green & Brock, 2000), individuals tend to become immersed in the experiences of reading or
viewing a narrative, a process in which they may fully focus on the narrative and its
characters, temporarily lose awareness about themselves, and pay less attention to their
external surroundings (Green & Brock, 2000; Slater, 2002; Slater & Rouner, 2002). As an
important indicator of audience engagement with narrative (Kim, Shi, & Cappella, 2016),
transportation can describe the experience of entering into the story world, immersing oneself
into the story, getting “lost” in the story, and becoming detached from the real world (Gerrig,
1993; Green & Brock, 2000). The immersive experience of narrative transportation
distinguishes it from other persuasive formats that mostly contain explicit messages (Moyer-
Gusé, 2008).
Engagement. Related to transportation, narrative engagement (Busselle & Bilandzic,
2009) is a similar but different theoretical model of narrative persuasion that is primarily
based on a mental models approach to narrative processing. More precisely, narrative
engagement is a construct that describes a holistic experiential engagement in narratives and
it depicts the full immersion into a story world. Although narrative engagement overlaps with
transportation to a great extent (Appel & Malečkar, 2012), it differs from transportation in the
sense that narrative engagement differentiates among four dimensions of narrative

42
experiences: “narrative understanding, attentional focus, emotional engagement, and
narrative presence” (p.321, Busselle & Bilandzic, 2009). As well as transportation, narrative
engagement has been found to be a useful construct in predicting persuasive outcomes such
as narrative consistent-attitudes (Busselle & Bilandzic, 2009).
Identification. While transportation is explained as involvement with a narrative in
general, identification is characterized by the specific experience of being drawn to particular
characters portrayed in the narrative (Murphy et al., 2011). Although related, identification is
a narrative mechanism distinct from transportation (Tal-Or & Cohen, 2010). Identification is
defined as the process by which viewers adopt the perspective of story characters, and
consequently show empathic emotions and become deeply involved with narrative characters
(Cohen, 2001, p. 251; Moyer-Gusé, 2008; Slater & Rouner, 2002). When viewers identify
with narrative characters, “the reader takes on the protagonist’s goals and plans” (Oatley,
1999, p. 445). The viewers’ feelings, hopes, and goals are likely to fuse with those of the
narrative characters (Cohen, 2001). In contrast, when an individual is transported into a
narrative (Green & Brock, 2000) or experiences “narrative presence” (Busselle & Bilandzic,
2009), he or she becomes “an unobserved observer in scenes of the lives of characters in the
story world. He or she stands in their bedrooms, hovers at their dining tables, drives with
them in theirs cars” (Oatley, 1999, p. 445). In a sense, identification can be understood as a
form of vicarious experience, which involves experiencing things that people cannot or have
not experienced, temporarily taking on different identities, or adopting the perspectives of
other people. Identification gives viewers a chance to imagine themselves living vicariously
through the narrative characters (Cohen, 2001). Crucially, the experience of vicarious
learning is typically enduring and lasting, whereas identification describes a temporary and
fleeting mental state in which viewers see events through the viewpoints of narrative
characters, and develop attitudes that are consistent with the characters’ perspectives

43
(Busselle & Bilandzic, 2008; Cohen, 2001; Moyer-Gusé, 2015).
Identification has been examined in various forms, including in terms of perceived
similarity to narrative characters (Basil, 1995; Eisenstock, 1984; Liebes & Katz, 1990; Slater
& Rouner, 2002), liking of narrative characters (Basil, 1996; Eisenstock, 1984; Liebes &
Katz, 1990), feelings of “knowing” narrative characters (Murphy et al., 2011), and the
adoption of a character’s perspective in the narrative (Cohen, 2001; Oatley, 1999; Sanders &
Redeker, 1996).
Media multitasking, transportation, engagement, and identification. Researchers
have examined the narrative-specific factors that can influence transportation. Richer details
in a narrative (Green et al., 2004) and higher production quality of a narrative video (Murphy
et al., 2013) are among some of the narrative construction factors that can enhance
transportation. Besides narrative structure, factors external to a narrative may also influence
narrative experiences. It has been speculated that stimuli from naturalistic settings, such as
noises, may be able to interfere with transportation, as they can draw viewers’ attention to the
surroundings and disengage them from being transported into a narrative (Green et al., 2004).
There is, however, limited empirical evidence to support the claim. It is unclear if media
multitasking can serve as one of these external stimuli that may influence narrative
experiences.
Information technology may allow users to automate their actions, and thus encourage
greater disconnection, passivity, and disruption (Mick & Fournier, 1998). In a naturalistic
setting, many media multitasking activities such as texting, emailing, and online social
networking often present frequent interruptions to users’ main tasks as these activities usually
notify users as alerts or pop-up screens and require prompt responses (Aboujaoude, 2012).
Such constant interruptions and distractions may encourage shallow engagement and prohibit

44
users from deeply engaging with processing the content of primary media. Consistent with
the limited capacity model, it can be argued that media multitasking may diminish users’
cognitive control, thus reducing their capacity to resist distractors (Ophir et al., 2009). It is
commonly assumed that a higher tendency to multitask should be associated with less
capability to screen out distracting information in the surroundings (see, for example, Duff,
Yoon, Wang, & Anghelcev, 2014). Heavy multitaskers have reported that they tend to get
less involved with processing primary content, and become more disconnected from paying
attention and devoting cognitive effort to media activities (Bardhi et al., 2010).
Transportation, on the other hand, is indeed characterized as a cognitive flow state of mind
wherein users construal mental models (Busselle & Bilandzic, 2008). As such, interruptions
created by media multitasking are likely to disengage users from the flow state, and diminish
narrative engagement. Based on this line of argument, it can be assumed that a higher level of
media multitasking might reduce the level of transportation and vice versa.
However, an alternative argument may suggest that media multitasking can be
positively associated with narrative engagement. The idea can be partially supported by the
research of negative affect as a motivator for media consumption. As discussed above, media
multitasking can create a chaotic and stressful media-viewing environment. Stress has been
proven to encourage (or lead to) greater willingness for media consumption. Previous
research has documented a positive connection between stress and the usage of Internet
(Leung, 2007; Li, Zhang, Li, Zhen, & Wang, 2010) and smartphones (Jeong et al., 2016).
Similarly, mass media research has found that a negative mood (Christensen et al., 2015;
Greenwood & Long, 2009), a depressive state of mind (Potts & Sanchez, 1994), stress
(Anderson, Collins, Schmitt, & Jacobvitz, 1996), or a sense of failure (Moskalenko & Heine,
2003) tend to drive viewers to spend more time and effort on watching TV. The connection
between stress and media consumption can be explained through the notion of escapism

45
(Henning & Vorderer, 2001; Katz & Foulkes, 1962), which argues that media, especially in
narrative genre, often provides a mental retreat for users to temporarily avoid difficulties in
life, and use media consumption as a means to optimize and regulate mood (Zillmann, 1988).
Besides such considerations of affect management or mood regulation, a more recent
study (Johnson et al., 2015) proposes an alternative perspective for examining the
relationship between “a state of depleted self-control” and narrative engagement. Narrative
experience is theorized as a function providing opportunities for viewers to “temporarily
expand the boundaries of the self” (TEBOTS; Slater, Johnson, Cohen, Comello, & Ewoldsen,
2014) in order to realize three fundamental motivators in life: agency, autonomy, and
affiliation (Deci & Ryan, 1990; Slater et al., 2014). Self-control, however, is conceived as a
limited cognitive and energy resource, as in the limited capacity model. It is a resource that is
needed to control one’s executive decision-making and behavior (Baumeister, 1998;
Baumeister et al., 2007). When self-control is depleted or exhausted, it is assumed that
individuals are likely to expand their self-boundaries, relax their self-control functions, and
bring back more self-control resources. One such way to restore self-control may be through
consuming narrative content. According to the TEBOTS perspective, viewers can live
vicariously through narrative viewing, transcend their real-life boundaries, and momentarily
realize their intrinsic needs through the perspectives of narrative characters. In the recent
study (Johnson et al., 2015), participants whose self-control was minimized reported greater
transportation into narrative and enjoyment, while identification was non-significant. Taken
together, this line of research suggests that media multitasking may create stress and use up
cognitive resources such as self-control, hence leading individuals to turn to deeper narrative
engagement for relief and restoration of strength.
Moreover, the possibility of a positive relationship between media multitasking and
transportation can be supported more directly by a recent study revealing the hedonic aspect

46
of media multitasking experiences (Bardhi et al., 2010). This study suggests that media
multitasking may allow users to be exposed to multiple sensory stimuli such that they find
the experience of media multitasking more engaging and involving than the experience of a
single medium alone. Meanwhile, both transportation and identification are experiences
wherein viewers become deeply involved and lose their self-awareness (Fiske, 1989). That is
to say, media multitasking can become an immersive and engaging experience of media
consumption in itself, which is compatible with narrative experience in this sense.
In addition, classic studies about limited attention and peripheral processing can also
inform us about the potential positive influence of media multitasking on transportation and
identification. In a study of transportation into crime narratives (Zhang, Hiemolowski, &
Busselle, 2007), participants who completed distraction tasks (namely, recording changes of
scene in the drama) reported higher levels of transportation into the narrative, as well as
higher perceived realism and enjoyment of the narrative. It is argued that the distraction tasks
caused viewers to spend less attention and cognitive effort on processing the narrative
message, thus leading to less critical examination of the content and less counterargument.
Such explanation of how media multitasking works regarding critical readings of messages is
also compatible with (or similar to) the way transportation and identification function at
reducing resistance to persuasion. It is also argued that identification leads viewers to process
information in a less elaborated manner, and to develop a less critical attitude towards
narrative messages, thus leading to greater acceptance of attitudes and beliefs held by
narrative characters (Cohen, 2001). Based on the above literature, it is possible to posit that
media multitasking can also be positively related to transportation and identification. Thus,
the following hypotheses are proposed:

47
H2. Media multitasking during narrative viewing will be significantly and positively
related to the extent to which viewers are transported into a narrative.
H3. Media multitasking during narrative viewing will be significantly and positively
related to the extent to which viewers are engaged with a narrative.
H4. Media multitasking during narrative viewing will be significantly and positively
related to the extent to which viewers identify with narrative characters.
Transportation, engagement, identification, and narrative outcomes.
Transportation has been shown to strongly correlate with most outcomes of persuasive
communication. Research has consistently shown that narrative transportation is positively
associated with the acceptance of story-consistent attitudes (see, for example, Zwarun &
Hall, 2012), and story-consistent behavioral intentions (So & Nabi, 2013). More importantly,
it is believed that individuals may effectively incorporate narrative messages into their long-
term memory and belief systems, and have increasing affirmation and confidence in
narrative-consistent information (Appel & Richter, 2007).
The potential effects of transportation on persuasive outcomes can be explained
through the power of transportation in reducing persuasive resistances. Overall,
transportation may increase elaboration of narrative information (Slater, 2002; Slater et al.,
2006). According to the extended elaboration likelihood model (E-ELM), “absorption in the
narrative may motivate deeper processing of a different kind” (Slater & Rouner, 2002, p.
187), and transportation may help viewers overcome various resistances to persuasion. For
instance, narrative transportation may reduce counterarguing with the persuasive messages
embedded in narrative (Green & Brock, 2002). Unlike rhetorical communication, the story
format of a narrative (Dal Cin, Zanna, & Fong, 2004) tends to make narrative persuasion
appear less like an explicit persuasive effort and so may elicit less counterarguments. Also,

48
narrative often features other people’s life experiences (Slater, 2002) and viewers may find it
difficult to resist messages that are subtly implied. Furthermore, viewers may be transported
into a narrative even before they are aware of the differences between narrative-consistent
attitudes and their own attitudes. When they are ready to critically analyze the narrative
messages, viewers may have already been transported into the narrative and thus may be less
likely to counterargue with its premise (Dal Cin et al., 2004; Slater & Rouner, 2002). More
recently, the entertainment overcoming resistance model (EORM; Moyer-Gusé, 2008)
suggests that narrative transportation and identification may help alleviate more persuasive
resistances than just counterargument, such as selective avoidance and perceived
invulnerability (Frank, Murphy, Chatterjee, Moran, & Baezconde-Garbanati, 2015; Moyer-
Gusé & Nabi, 2010). Overall, individuals who report being more transported into a narrative
have reported stronger changes in story consistent attitudes and beliefs (Appel & Richter,
2007, 2010; Green, 2004; Green & Brock, 2000; Murphy et al., 2013; Zwarun & Hall, 2012),
knowledge about a particular health topic and behavioral intentions (Quintero Johnson &
Sangalang, 2017; Moyer-Gusé & Nabi, 2010; Murphy et al., 2013), risk perceptions (So &
Nabi, 2013), and behaviors (Kreuter et al., 2010).
As with transportation, identification also leads to changes in narrative outcomes.
Some even say that “one can hardly imagine any television texting having any effect
whatsoever without that identification” (Morley, 1992, p. 209). Specific to narrative
persuasion, identification is considered a mediator of the effects of narrative on attitudes,
knowledge, and behavioral intentions (de Graaf, Hoeken, Sanders, & Beentjes, 2012; Green,
2004; Slater & Rouner, 2002). Especially in health communication research, identification
with narrative characters has been found to enhance viewers’ character-consistent attitudes
and beliefs (Banerjee & Greene, 2012; Busselle & Bilandzic, 2009; de Graaf et al., 2011;
Igartua & Barrios, 2012; McQueen et al., 2011; Murphy et al., 2011, 2013). In studies that

49
use narratives with controversial content, viewers are still likely to merge their attitudes and
beliefs in accordance with those of the narrative characters, as mediated by identification
with main characters (Igartua & Barrios, 2012). After viewing movies with dealing with
topics such as the death penalty (Till & Vitouch, 2012) and mental illness (Caputo & Rouner,
2011), the extent to which viewers identify with characters has been found to mediate the
movie effects on viewers’ movie-consistent attitudes toward the death penalty and social
distancing toward people with a mental illness. Similarly, in a study using short narratives
about anti-drug and anti-drinking PSAs as well as beer advertisements, identification with
narrative characters has been found to significantly correlate with the outcomes of narrative
persuasion (Cho, Shen, & Wilson, 2014).
Identification may help achieve the goals of narrative persuasion in the following
ways. Based on the E-ELM and EORM, identification, which suggests the loss of self-
awareness (Fiske, 1989), is likely to reduce resistance to persuasion, counterarguments, and
critical examination of narrative messages (Moyer-Gusé & Nabi, 2010). According to social
cognitive theory (Bandura, 2004), individuals learn through observing and modeling the
behaviors of others. The vicarious experience of identifying with a specific character may
drive viewers to model the behaviors expressed by character, or accept the character’s
opinions though imagination. Viewers may broaden their social perspectives and affective
state of mind through identification with characters in narratives (Cohen, 2001).
Identification is believed to be the cornerstone mechanism through which most media
effects take place (Basil, 1996; Cohen, 2001; Maccoby & Wilson, 1957) because most media
interventions are based on the idea of learning through the modeling of behaviors (Sabido,
2004; Singhal & Rogers, 2004). Traditionally, entertainment education narratives would
include protagonists or role models who demonstrated the positive behaviors; antagonists or

50
negative role models who showed deviation from the desired behaviors; and transitional role
models who accepted and acquired the positive behaviors during the course of the narrative
storyline (Sabido, 2004). It is believed that the more people identify with a specific character,
the more likely they are to adopt the character’s attitudes and beliefs (Green & Donahue,
2009, p. 247). In fact, a recent experimental study (de Graaf et al., 2012) reported that
identification causes viewers to accept the attitudes conveyed by the characters from whose
perspective the narrative is told, rather than the attitudes conveyed by the narrative in general
(transportation). Thus, it becomes a prerequisite for viewers to “achieve identification” with
narrative characters in order for them to model the behaviors of antagonists or transitional
role models (Sabido, 2004, p. 70).
The positive impact of transportation and identification on changes in knowledge,
changes in attitudes, and behavioral intentions has been well documented. Thus, to
supplement the foregoing direct effect research questions, the following indirect effects
contributing to persuasive outcomes are proposed:
H5. Media multitasking during narrative viewing will be significantly related to
changes in knowledge through narrative transportation.
H6. Media multitasking during narrative viewing will be significantly related to
changes in attitudes through narrative transportation.
H7. Media multitasking during narrative viewing will be significantly related to
changes in behavioral intentions through narrative transportation.
H8. Media multitasking during narrative viewing will be significantly related to
changes in knowledge through narrative engagement.

51
H9. Media multitasking during narrative viewing will be significantly related to
changes in attitudes through narrative engagement.
H10. Media multitasking during narrative viewing will be significantly related to
changes in behavioral intentions through narrative engagement.
H11. Media multitasking during narrative viewing will be significantly related to
changes in knowledge through identification.
H12. Media multitasking during narrative viewing will be significantly related to
changes in attitudes through identification.
H13. Media multitasking during narrative viewing will be significantly related to
changes in behavioral intentions through identification.
Narrative enjoyment. Enjoyment is another concept at the core of the entertainment
experience (Oliver & Bartsch, 2011; V orderer, Klimmt, & Ritterfeld, 2004). Enjoyment is a
complex psychological construct (Green et al., 2004; Raney, 2004) that is considered a
central objective of consuming entertainment media (Tamborini, Grizzard, Bowman,
Reinecke, Lewis, & Eden, 2011). Enjoyment is related to emotion, such that enjoyment may
originate from the arousal of emotions (Nabi, Stitt, Halford, & Flinnerty, 2006). But
enjoyment is distinct from emotion, in that enjoyment describes how people make judgment
about a content that represents how people appreciate the experience of consuming the
content (Nabi & Krcmar, 2004), while emotion is merely people’s affective response toward
the content consumption. Enjoyment is, by definition, essential to any form of entertainment
experience. The experience of consuming entertainment content generally involves
enjoyment, pleasure, thrill, relaxation, and distraction from reality (Bosshart & Macconi,

52
1998; V orderer et al., 2004). Pleasure-seeking and entertainment are some of the oldest
pursuits of human culture and literature (Zillmann, 2000).
Grounded in the hedonic view of entertainment (Zillmann, 1988), the majority of
entertainment research (for example, Raney & Bryant, 2002, Tamborini, Bowman, Eden,
Grizzard, & Organ, 2010) uses the term enjoyment to merely refer to a pleasant experiential
state, or to “positive reactions toward the media and its contents” (V orderer et al., 2004, p.
388). For a long time, enjoyment has been used in communication research to solely describe
pleasurable and agreeable responses to media consumption experiences, as well as positive
arousal and affect (Oliver & Raney, 2011; V orderer et al., 2004). It is believed that enjoyment
of media entertainment satisfies people’s hedonistic motivations, such as mood optimization
(Zillmann, 1988) and escapism (Katz & Foulkes, 1962). More recently, however, the
understanding of enjoyment has been extended beyond pleasant experiences. Enjoyment is
conceived as also leading to meaningful and profound experiences that may reflect feelings
of appreciation or as providing individuals with deeply touching and insightful
meaningfulness into life (Oliver & Bartsch, 2010; Oliver & Hartmann, 2010; Oliver & Raney,
2011; Schramm & Wirth, 2010; V orderer & Reinecke, 2015; Wirth, Hofer, & Schramm,
2012). In these conceptualizations, the concepts of appreciation and meaningfulness are
explained as ‘‘the perception of deeper meaning, the feeling of being moved, and the
motivation to elaborate on thoughts and feelings inspired by the experience’’ (Oliver &
Bartsch, 2010, p. 76); and they are characterized as involving a relatively slow and ‘‘more
deliberative and interpretive process’’ (ibid., p. 58). This appreciative dimension of
enjoyment can be associated with media contents, such as drama or tragedy, that offer more
serious, sad, touching, and/or complex affective states, as well as offering viewers an
opportunity for self-improvement or finding purpose in life (V orderer & Reinecke, 2015;
Wirth et al., 2012). The inclusion of both positive and appreciative experiences in enjoyment

53
offers a more nuanced way of understanding how people experience and react to narratives
(Johnson et al., 2015).
Media multitasking and narrative enjoyment. Enjoyment has been found to be
among the many positive outcomes that associate with multitasking in entertainment-based
media consumption (Xu et al., 2016). When viewers watch a TV program or live sports event
with friends or fellow enthusiasts on social media, they seem to find the viewing experience
more enjoyable compared with when they watch it alone (Nielsen, 2013; Shim, Oh, Song, &
Lee, 2015). This may be because the process of media multitasking in itself can be an
enjoyable, fun, and immersive experience (Bardhi et al., 2010), so consuming entertainment
media while media multitasking is, by extension, also enjoyable. It can also be explained
with recourse to the motivated cognition and limited capacity perspective discussed above.
Viewers usually seek out entertainment genre to relieve stress, relax, and have fun. Even as a
primary task, consuming entertainment content is less of a cognitive assignment, but more of
a means of relaxation. Thus, relatively minimal cognitive and energy effort may be needed to
process an entertainment experience, leaving sufficient resources for media multitasking
activities. Thus, viewers may feel less pressure or stress due to media multitasking when
consuming entertainment media, and also suffer minimal diminishments in task performance
due to multitasking. Overall, viewers may find the combination of media multitasking and
entertainment viewing positive and enjoyable.
The classic perspective of uses and gratification (Katz et al., 1973; V orderer &
Reinecke, 2015; Wang & Tchernev, 2012; Zhang & Zhang, 2012), as reviewed above, can be
particularly helpful in explaining the relationship between narrative enjoyment and media
multitasking. A sense of enjoyment is typically expected when intrinsic needs are satisfied
(Tamborini, Bowman, Eden, Grizzard, & Organ, 2010). Consuming a good narrative can be a
satisfactory and rewarding experience that viewers find enjoyable. The satisfaction of

54
intrinsic needs (Ryan & Deci, 2000) plays an essential role in the enjoyment experience
(V orderer, 2011). Similarly, media multitasking is also capable of satisfying certain intrinsic
needs. The interactive nature of new media can provide users with a chance to fulfill intrinsic
needs such as “competence, autonomy, and relatedness” (Reinecke, V orderer, & Knop, 2014;
Tamborini et al., 2011; V orderer & Reinecke, 2015), or simply to pursue the goal of
relaxation and entertainment gratification (Bardhi et al., 2010). As such, the following
hypothesis is proposed:
H14. Media multitasking during narrative viewing will be significantly and positively
related to enjoyment of narrative viewing.
Narrative enjoyment and persuasive outcomes. Enjoyment can be seen as a
potential influencer of persuasive outcomes (Quintero Johnson & Sangalang, 2017). Studies
in persuasion and media psychology (Bilandzic & Busselle, 2011; Green et al., 2004) suggest
that enjoyment may have the potential to influence viewers’ affect, attitudes, and behavioral
intentions. Especially when viewers consume media content in everyday settings, they are
most likely to choose the stories or programs that they like most, and these decisions, as
implied by cultivation theory, are likely to last over a long period of time. Thus, enjoyment
may shape media outcomes in the long run (Bilandzic & Busselle, 2011).
However, although there are such assumptions, there is relatively little empirical
evidence for enjoyment’s association with persuasive outcomes, especially narrative
persuasive outcomes. Compared to transportation, identification, and emotion, enjoyment is
relatively understudied as an individual determinant of knowledge, attitudes, and behavioral
intentions consistent with health narratives. Enjoyment of meaningful media content has been
shown to elicit in viewers stronger altruism, feelings of connectedness with others, feelings
of deeper insight, better life purpose, and greater gratitude (Knobloch-Westerwick, Gong,

55
Hagner, & Kerbeykian, 2013; Wirth et al., 2012). These consequences of enjoyment are
clearly in alignment with at least some of the outcomes sought through health interventions.
As defined earlier, enjoyment is traditionally treated as a concept only related to
positive and pleasant experiences. Positive experience is not usually expected from media
campaigns or narrative communication about life-threatening diseases. Thus, in comparison
with transportation and identification, enjoyment is relatively understudied as a contributor to
narrative persuasive outcomes. However, as is explained above, more recent
conceptualizations of narrative enjoyment have included emotions with negative valences, or
feelings of sense-seeking, self-improvement, and propounding experiences. Enjoyment is
increasingly viewed as an entertainment experience with complex dimensions that goes
beyond simple hedonic pleasure (Vorderer, 2011). Many of these newly-added enjoyment
elements seem to be present at many health intervention materials and narrative materials. As
such, the following indirect effect of media multitasking via enjoyment contributing to
persuasive outcomes is proposed:
H15. Media multitasking during narrative viewing will be significantly related to
changes in knowledge through enjoyment.
H16. Media multitasking during narrative viewing will be significantly related to
changes in attitudes through enjoyment.
H17. Media multitasking during narrative viewing will be significantly related to
changes in behavioral intentions through enjoyment.
Emotion. Another integral part of the narrative experience is emotion. Emotions may
affect the information people pay attention to and recall (Dolan, 2002). It is believed that
stronger emotions may be related to a more sophisticated cognitive elaboration of media
messages (Bartsch & Oliver, 2011; Oliver, 2008; Schramm & Wirth, 2010). Strong emotions,

56
or the affective state of being moved, examined in psychological (Cupchik, 1995; Cupchik,
Oatley, & Vorderer, 1998) and entertainment research (Bartsch, 2012; Knobloch-Westerwick
et al., 2012; Oliver, 2008; Oliver & Bartsch, 2010; Wirth et al., 2012) include emotional
experiences with positive valence, negative valence, or mixed affects, as long as the emotions
are deep and powerful (Bartsch, Kalch, & Oliver, 2014; Watson, Clark, & Tellegen, 1988).
This dissertation uses negative emotion to refer to emotional responses with negative
valence, which may make people feel nervous or sad, and uses positive emotion to refer to
positive emotion that may make people feel relaxed and relieved.
The study of emotional issues related to stories and storytellers has a long tradition in
humanities research (Kreuter et al., 2007). Generally, narratives tend to elicit feelings,
memories, and thoughts in viewers (see, for example, Miall & Kuiken, 1994; Vorderer et al.,
2004). In particular, health narratives about life-threatening diseases are more likely to evoke
strong emotional reactions from viewers (Dillard & Nabi, 2006; McQueen et al., 2011).
Cancer, for example, is an unpleasant life event that can damage personal relationships,
diminish self-esteem, force people to make unwanted decisions, create uncertainty, diminish
people’s control over their future, and elicit strong feelings of fear and anger (Block, 2001;
Byock, 1997). People may feel scared to think about potentially being diagnosed with a
disease like cancer, or feel uncomfortable and embarrassed to remember something
unpleasant, or even feel sad about potential loss of life. Out of the fear of something
uninvited happening in the future, it is believed that people may be willing to change
attitudes, beliefs, and behavioral intentions under the condition of moderate fear. This is why
fear is commonly used in health interventions such as AIDS prevention campaigns (see
Dillard, Plotnick, Godbold, Freimuth, & Edgar, 1996).

57
Emotion and media multitasking. As discussed earlier, media multitasking can
create stress and chaos, potentially leading to negative affect and emotion. In a study about
media multitasking and homework completion (Calderwood et al., 2014), students who
multitasked for longer periods of time were found to experience stronger negative affect than
those who multitasked less. On the other hand, media multitasking can also satisfy users’
intrinsic needs, which usually leads to positive experiences. In a study using dynamic panel
analysis (Wang & Tchernev, 2012), participants reported that they preferred to practice
media multitasking to satisfy emotional needs (such as relaxation and entertainment),
habitual needs, and cognitive needs (such as acquiring information). Satisfying emotional
needs is reported to be the primary motivation for media multitasking. In particular, social
media use is found to be associated with positive affect and intensified arousal, suggesting
that users may experience a more positive affective state when using social media (Mauri,
Cipresso, Balgera, Villamira, & Riva, 2011). A more recent study on media multitasking and
affect (Calderwood et al., 2016) directly supports the hypothesized association between
media multitasking and positive emotion. Students in a laboratory experiment reported that
they experienced less negative affect after engaging in more media multitasking. That is, the
literature seems to suggest that media multitasking can elicit strong emotion, whether
emotion that makes people feel more intense or feel more relaxed. Stronger emotion,
including both negative and positive emotion, seems to be typically expected from immersive
narrative viewing, as discussed in the section on narrative mechanisms, above. As such, the
following hypotheses are proposed:
H18. Media multitasking during narrative viewing will be significantly and positively
related to negative emotions during narrative viewing.
H19. Media multitasking during narrative viewing will be significantly and positively
related to positive emotions during narrative viewing.

58
Emotion and narrative outcomes. In narrative research, emotional engagement is
explained as the emotions exhibited in a narrative, as well as viewers’ emotional reactions
toward the story and characters (Busselle & Bilandzic, 2009). Emotion may be considered an
inseparable part of transportation. By definition, transportation refers to an integrative state of
emotion and attention, “where all mental systems and capacities become focused on events
occurring in the narrative” (Green & Brock, 2000, p. 701). Transportation engagement is
exemplified by the extent to which narrative viewers devote emotional and mental efforts to
processing and comprehending messages in the narrative (Slater & Rouner, 2002). Strong
emotions, or a heightened emotional state, may serve as a necessary component of narrative
transportation (Green & Brock, 2000). Alternatively, recent developments in narrative
research suggest that emotion may be distinct from transportation or engagement, acting as a
mechanism of narrative processing in its own right. A 2011 study found that emotion evoked
by a health narrative is a stronger predictor of viewers’ narrative-consistent behavior change
than viewers’ levels of transportation (Murphy et al., 2011). Whether it affects narrative
persuasion by way of transportation or on its own, emotion seems to be a key determinant of
narrative persuasive outcomes.
Narrative effects we formerly assumed to be related to positive stories only (see, for
example, Adaval & Wyer, 1998, p. 240). However, many works of literature and much media
content explores more negative emotions, and people seem to enjoy reading those stories, or
consuming the media content, that elicits deep, profound, or suffering feelings. For example,
people may feel sad while watching a heart-breaking film or while listening to melancholy
jazz; they may, similarly, feel agitated while watching a TV mystery drama. Perhaps,
therefore, the efficacy of narrative persuasion extends to emotions with both negative and
positive valences? In an online experiment whereas participants read anti-smoking messages,
both positive and negative emotions have shown to increase effective processing of quit

59
smoking messages. But smokers seem to process information better under positive emotion
conditions and nonsmokers seem to process information better under negative emotion
conditions (Das, Vonkeman, & Hartmann, 2012). Just as with positively valenced stories,
processing a story that elicits negative emotion also seems to lead to changes in story-
consistent attitudes and beliefs (Green & Brock, 2000). As such, both negative emotion and
positive emotion are likely to be positively related to increases in knowledge, narrative-
consistent attitudes, and behavioral intentions.
H20. Media multitasking during narrative viewing will be significantly and positively
related to changes in knowledge through negative emotions.
H21. Media multitasking during narrative viewing will be significantly and positively
related to changes in attitudes through negative emotions.
H22. Media multitasking during narrative viewing will be significantly and positively
related to changes in behavioral intentions through negative emotions.
H23. Media multitasking during narrative viewing will be significantly and positively
related to changes in knowledge through positive emotions.
H24. Media multitasking during narrative viewing will be significantly and positively
related to changes in attitudes through positive emotions.
H25. Media multitasking during narrative viewing will be significantly and positively
related to changes in behavioral intentions through positive emotions.
After hypothesizing about the impact of media multitasking on traditional narrative
outcomes, the next section discusses the relationship between media multitasking, narrative
mechanisms, and subjective knowledge.

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Narrative mechanisms and subjective knowledge. There is minimal research on the
association between narrative mechanisms and subjective knowledge. Compared to factual
knowledge, attitudes, and behavioral intentions, it is mostly unknown how narrative
experience influences viewers’ perceived knowledge about topic portrayed in the narrative.
Similar to the concept of self-efficacy, subjective knowledge is also a cognitive
construct that is based on perceptions and beliefs. According to social cognitive theory
(Bandura, 2004), “perceived self efficacy that one can exercise control over one’s health
habits” is a key determinant of the way people transform knowledge into health behavior.
Self-efficacy indicates the extent to which people believe they are capable of taking actions
to produce expected outcomes. Likewise, subjective knowledge indicates the extent to which
people believe they can grasp knowledge. Both self-efficacy and subjective knowledge
indicate the extent to which people believe or become confident in their power to acquire and
process knowledge, and leverage the knowledge in creating desired behaviors.
Narrative experiences such as transportation, engagement, and identification have the
potential to increase viewers’ self-efficacy by reducing their resistance toward what narrative
characters achieve (Green & Brock, 2000). As viewers become more absorbed into a
narrative, they tend to develop stronger emotional bonds with the narrative and begin “to see
the real world through the filter of the media-created worlds” (Sestir & Green, 2010, p. 276).
Consequently, as characters in the narrative successfully overcome obstacles, change their
behaviors, and achieve their goals, the viewers are also more likely to believe in themselves
and have confidence that they can achieve similar success. Considering narrative
experience’s potential effect on self-efficacy, it is reasonable to suspect that narrative may
also give viewers more confidence about what they think they know.
More directly, subjective knowledge is a form of self-assessed knowledge (Brucks,
1985; Park, Gardner, & Thukral, 1988; Park & Lessig, 1981). It is a judgment process

61
wherein individuals search their memories for information cues that will help them assess
their level of knowledge about a particular issue. According to the Accessibility-
Diagnosticity Model, information cues that are highly accessible will come to mind more
quickly and so are more likely to be used by individuals as judgment cues to form assessment
knowledge, in comparison with information that is difficult to access (Biehal & Chakravarti,
1983; Herr, Kardes, & Kim, 1991; Kahneman & Tversky, 1982). Generally, and in
comparison with other communication methods, storytelling is believed to be more consistent
with the way people perceive, process, and communicate information about events (Fisher,
1985). It is asserted that people are naturally inclined to organize and interpret their life
experiences in a story-like format, as it is easier to create meaning in a narrative processing
way (see Bruner, 1986, 1990; Kerby, 1991; Schank, 1990). That is, it may be easier for
viewers to take in information, process information, and encode information into memory if
the information is presented through or in the form of a narrative. As such, narrative viewers
may find it easier to access information stored in memory and receive more information cues
within a shorter period of time, so will be more likely to find themselves more
knowledgeable on a specific topic.
Furthermore, information gained from personal and vivid experiences is found to be
more accessible for forming self-assessment knowledge, compared to information gained
without personal involvement. It is a heuristic for individuals to turn to personal experiences
in making self-assessment knowledge because personal involvement creates vivid memory
(Baumgartner, Sujan, & Bettman, 1992; Maclnnis & Price, 1987; Nisbett & Ross, 1980;
Taylor & Thompson, 1982) and thus stores information cues that are highly accessible (Park
et al., 1994). In consumer research (for example, Park et al., 1994), this means that
information gained from consumers actively seeking or personally using a product can create
a more vivid and long-lasting memory as compared to information gained from merely

62
browsing. It is only natural for consumers to retrieve cues of personal experiences at great
ease to evaluate the extent to which they know about the product. Regarding knowledge
gained from narrative viewing, the experiences of entering into a story world, vicariously
living through the perspective of narrative characters, and being affected by emotional
storylines all point to a high level of personal involvement with the information presented in
a narrative. Compared to declarative communication, knowledge gained from narrative
viewing is more likely to be stored as a vivid memory; it will therefore be easier to access for
forming self-assessment knowledge. Connecting subjective knowledge literature to narrative
research thus suggests that gaining knowledge from narrative viewing is likely to make
individuals find information clues more conveniently and so feel more confident about their
knowledge levels.
H26. Narrative mechanisms — transportation (a), narrative engagement (b),
identification (c), enjoyment (d), negative emotions (e), and positive emotions (f) —
will be significantly and positively related to subjective knowledge.
Following hypothesis H1, that media multitasking may significantly affect subjective
knowledge, the following indirect effects of media multitasking on subjective knowledge by
way of narrative mechanisms are also proposed:
H27. Media multitasking during narrative viewing will be significantly related to
subjective knowledge through narrative transportation.
H28. Media multitasking during narrative viewing will be significantly related to
subjective knowledge through narrative engagement.
H29. Media multitasking during narrative viewing will be significantly related to
subjective knowledge through identification.

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H30. Media multitasking during narrative viewing will be significantly related to
subjective knowledge through enjoyment.
H31. Media multitasking during narrative viewing will be significantly related to
subjective knowledge through negative emotions.
H32. Media multitasking during narrative viewing will be significantly related to
subjective knowledge through positive emotions.
Narrative Impact in a Media Multitasking Context
A key objective of this dissertation is to empirically test the power of narrative
persuasion in a context of high media multitasking during narrative viewing. The intention is
to assess the strengths of narrative mechanisms in predicting persuasive outcomes among
participants who media multitask more during narrative viewing. As hypothesized earlier,
media multitasking is likely to be positively related to transportation and identification; thus,
the effect of transportation and identification on persuasive outcomes is less likely to be
weakened with the presence of media multitasking. Thus, the following hypotheses are
proposed:
H33 (a-d). For participants in the condition of high media multitasking during
narrative viewing, narrative transportation will be significantly and positively related
to changes in knowledge (a), subjective knowledge (b), changes in attitudes(c), and
changes in behavioral intentions (d).
H34 (a-d). For participants in the condition of high media multitasking during
narrative viewing, narrative engagement will be significantly and positively related to
changes in knowledge (a), subjective knowledge (b), changes in attitudes(c), and
changes in behavioral intentions (d).

64
H35 (a-d). For participants in the condition of high media multitasking during
narrative viewing, identification will be significantly and positively related to changes
in knowledge (a), subjective knowledge (b), changes in attitudes(c), and changes in
behavioral intentions (d).
As reviewed earlier, media multitasking is likely to satisfy people’s intrinsic needs,
and it was hypothesized that media multitasking would be positively related to enjoyment;
thus, the amount of enjoyment during narrative viewing should be less likely to diminish
given the presence of media multitasking.
H36 (a-d). For participants in the condition of high media multitasking during
narrative viewing, narrative enjoyment will be significantly and positively related to
changes in knowledge (a), subjective knowledge (b), changes in attitudes(c), and
changes in behavioral intentions (d).
Because it was hypothesized that media multitasking would intensify people’s
emotional responses during narrative viewing, emotion is likely to continue to facilitate
narrative persuasion effectively even when viewers multitask with media activities during
narrative viewing. Thus, a hypothesis is formed:
H37 (a-d). For participants in the condition of high media multitasking during
narrative viewing, negative emotions will be significantly and positively related to
changes in knowledge (a), subjective knowledge (b), changes in attitudes (c), and
changes in behavioral intentions (d).
H38 (a-d). For participants in the condition of high media multitasking during
narrative viewing, positive emotions will be significantly and positively related to

65
changes in knowledge (a), subjective knowledge (b), changes in attitudes (c), and
changes in behavioral intentions (d).
In summary, all research questions and hypotheses that involve media multitasking,
mechanisms of narrative persuasion and persuasive outcomes are summarized in Figure 2.1,
Figure 2.2, Figure 2.3, and Figure 2.4.

[Insert Figure 2.1 here]

[Insert Figure 2.2 here]

[Insert Figure 2.3 here]

[Insert Figure 2.4 here]

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Chapter 3: Methods
Design and Manipulation
This dissertation used a between-group online experimental design, including a high
media multitasking during narrative viewing group and a low media multitasking during
narrative viewing group. All participants received email invitations to an online survey,
which required them to watch an online video before completing a survey. The low
multitasking during narrative viewing group received link 1 and the high multitasking during
narrative viewing group received link 2. Both links contained the same survey questions; the
key difference was in how the video was presented. In link 1, the video was embedded on the
survey webpage. In link 2, the video was uploaded to YouTube and the YouTube hyperlink
was embedded on the survey webpage. More precisely, participants in the low multitasking
during narrative viewing group were instructed to watch the narrative video on the survey
page. In comparison, participants in the high multitasking during narrative viewing group
were instructed to temporarily leave the survey page, follow the hyperlink to watch the video
on YouTube, and then return to the survey webpage to complete the rest of the survey.
A YouTube page can provide viewers with a rich variety of media choices, such as
banner ads, recommendation videos on the sidebar, or past video record. Thus participants in
the YouTube group may have had convenient access and temptations to many multitasking
opportunities while watching the video. In comparison, the survey webpage offered limited
opportunities for multitasking, such that only survey content (the video) was displayed on the
webpage and little irrelevant information was displayed. Thus participants in the survey link
group would find it less convenient to open other webpages or applications, as survey content
(the video) occupies the entire webpage. As such, their temptation and opportunity to
multitask would have been minimal. Screenshots of the two experimental conditions are
captured in Figure 2.5.

67

[Insert Figure 2.5 here]

This manipulation aimed to direct participants in the high real-time multitasking
action group to an external website for video viewing and thus place them in a “free choice
environment” (Lang, Shin, Bradley, Wang, Lee, & Potter, 2005) where they were provided
with unlimited user control and the freedom to allocate their cognitive resources among
several tasks. By doing so, participants in the condition of high real-time multitasking may
have been voluntarily involved in more media multitasking than if they had been forced. By
contrast, the participants in the low real-time multitasking action group would have felt
naturally restricted by the distraction-free survey page and so more likely to eschew
multitasking actions while watching the video. The following sections use YouTube page
group versus survey page group to refer to the high and low multitasking-during-viewing
manipulation conditions.
Manipulation Check
The amount of two attention-heavy media multitasking activities during video
viewing was measured as a manipulation check of media multitasking action. Respondents
were asked the following questions: did you open more than one web page or window on
your browser when watching the video (1 = Y, 2 = N, reverse coded to 1=Y, 0 = N)? Did you
play music when watching the video (1 = Y, 0 = N). The scores of the two items were
aggregated to form a media multitasking score. As a manipulation check, it was determined
whether participants in the YouTube group engaged in a relatively higher level of media
activities during narrative viewing than those in the survey page group. The manipulation
used a t-test. The test was significant, t (476) = 3.45, p = .0005. Participants in the YouTube
page group (M = .36, SD = .52) received a significantly higher average score of media

68
multitasking during viewing as compared to those in the survey page group (M = .20, SD =
.42).This confirms that participants in the YouTube page group indeed engaged in a
relatively higher level of media activities when watching Tamale Lesson as compared to
those in the survey webpage group. Thus, the manipulation of media multitasking during
narrative viewing was considered successful.
Participants
Participants were recruited from an online panel hosted by Qualtrics, a private online
survey software provider. Participants received monetary incentives (or equivalent) through
Qualtrics for their participation. The survey was approved by the Institutional Review Board
(IRB) and was conducted during June 2016. The online survey was distributed in two
versions leading to two experimental conditions, as described above. Both links took about
15 minutes for completion. Qualtrics distributed both links to participants via online channels
and administered the survey completion. A total of 1,641 participants started the survey. A
response was considered incomplete if participants skipped one question. After subtracting
the incomplete surveys, 478 complete responses were retained.
The sample consisted of Mexican-American females aged between 25 and 45, with no
previous diagnosis of cervical cancer, who were fluent in English, and were owners of and
experienced with computers/laptops, TVs, and smartphones. A total of 65.5% of participants
were between 25 and 34 years old, and 34.5% were between 35 and 45 years old (SD = .476).
A total of 80.5% of participants had a college education or higher, and 19.5% had less than a
college degree. A total of 84.9% of the participants had some sort of health insurance. Table
3.1 shows the detailed demographic information of the participants in the sample.

[Insert Table 3.1 here]

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Video Material
All participants viewed the same health narrative video. The narrative video material
used was previously produced and used by Murphy and her colleagues (2013) in a larger
study about the relative effects of narrative versus non-narrative in health communication.
The video is an 11-minute English-language fictional film. It is named Tamale Lesson and is
designed to convey facts regarding the cause of cervical cancer (HPV), detection (Pap tests),
and preventive behaviors (HPV vaccine) in a narrative format. The story is about a Mexican
family’s preparation for their youngest daughter’s 15
th
birthday. During the preparation of
tamales, Lupita (the eldest daughter) tells Connie (the middle sister) that she had an abnormal
Pap test and was HPV positive, which can cause cervical cancer if unchecked. However,
Connie is a 21-year-old who has never had sex, never had a Pap test, and never heard of
HPV. Lupita and Connie then discuss several important facts about cervical cancer. Blanca
(the sisters’ mother) and her 50-year-old friend Petra join the sisters’ conversation. Petra says
that she is experiencing abnormal bleeding, and has also never taken a Pap test. To reduce
Connie and Petra’s fears towards Pap tests, Lupita demonstrates the Pap test procedure on a
chicken that was being prepared for the birthday party. The short film ends with a scene in
which Connie, Blanca, and Petra accidentally meet at a local clinic where they are ready to
take Pap tests. Tamale Lesson proved to be a successful, high-quality health narrative video
that elicited significant, positive effects in narrative-consistent knowledge, attitudes, and
behavioral intentions among narrative viewers (Murphy et al., 2013).
Experimental Procedure
In the online study, participants first completed a pre-test featuring a set of questions
that aimed to assess their levels of knowledge, attitudes, and behavioral intentions about Pap
tests. Then, participants were divided into two manipulation groups to view Tamale Lesson.

70
Afterwards, participants reported: their level of narrative experiences (transportation,
identification, enjoyment, and emotion); their level of persuasive outcomes (knowledge,
attitudes, behavioral intentions, and subjective knowledge), and their level of multitasking
habits (prior frequency of non-media multitasking and prior frequency of media
multitasking).
Measures
Change in knowledge. Respondents were assessed in open-ended and multiple-
choices formats at both pretest and posttest. The eight questions included: Do some clinics
offer pap tests for little or no cost? Does a woman need a pap test is she is not sexually
active? How treatable is cervical cancer if it is caught early? How is HPV transmitted? What,
if anything can prevent females from contracting the Human Papilloma Virus? What is the
youngest age the HPV vaccine is recommended for? How many shots of the vaccine does it
take before it is completely effective? Now I’d like you to imagine 10 randomly selected
women in the United States. By the time they turn 50, how many of them will have HPV (not
the vaccine, the virus)? For the open-ended format, answers were coded into a predetermined
list of response categories, and correct answers were coded 1 while incorrect answers were
coded 0. Scores of the eight items were aggregated to form a knowledge score. The variable
of change in knowledge was formed by subtracting the pretest knowledge score from posttest
knowledge score (M = .51 [-2, 6], SD = 1.12), with higher scores indicating more knowledge
gained about Pap tests from viewing Tamale Lesson.
Subjective knowledge. Subjective knowledge was measured using a scale composed
of five items (a = .74). Among the five items, four were adapted from the subjective
knowledge scale developed by Brucks (1985), which was widely used in research in
consumer behavior (e.g., Moorman et al., 2004). Viewers were asked to rate the extent to
which they agreed with the following statements (1 = disagree; 7 = agree): I feel confident

71
about my ability to comprehend pap tests information on media; I know a lot about pap tests;
I am knowledgeable about pap tests. Viewers were also asked to rate the extent to which they
knew about pap tests compared to other women (1 = A lot less than other women; 7 = A lot
more than other women). In addition, one item was selected from the attitudes scale (Murphy
et al., 2013). Viewers were asked the extent to which they agreed with the following
statement (1 = strongly disagree; 10 = strongly agree): I don’t know what Pap tests are
(reverse). The five items were aggregated to form an additive index (M = 30.40, [8, 38], SD =
5.71), with higher scores indicating greater subjective knowledge about pap tests.
Change in attitudes. A total of six items were adapted from the Pap test attitudes
scale (Murphy et al., 2013) to measure viewers’ attitudes towards Pap tests at both pretest
and posttest. Respondents were asked to rate the extent to which they agreed with the
following statements (1 = strongly disagree; 10 = strongly agree): Pap tests are embarrassing;
pap tests are physically painful; pap tests are important; pap tests are expensive; and pap tests
are time consuming; pap tests are scary. All items except important were reverse worded, and
the scores were reverse coded so that higher scores indicate more favorable attitudes towards
Pap tests. The variable of change in attitudes was formed by subtracting the pretest attitudes
score from posttest attitudes score (M = 1.93, [-25, 27], SD = 6.32), with higher scores
indicating more favorable attitudes toward Pap tests gained from viewing Tamale Lesson.
Change in behavioral intentions. Change in behavioral intentions was measured at
both pretest and posttest. The items were adapted from the questionnaire used in Murphy et
al., (2013). Viewers were asked to rate the extent to which they agreed with the following
statements (1 = strongly disagree; 10 = strongly agree): I will get a Pap test within the next 2
years; I will return for follow-up treatment, of an abnormal Pap test result if necessary; If I
had a 13 year old daughter, I would have her vaccinated against HPV; The HPV vaccine has
also been approved for males. If I had a 13-year-old son, I would have my son vaccinated

72
against HPV. The four items were aggregated to form an additive index with higher scores
indicating stronger behavioral intentions to adopt Pap tests. The variable of change in
behavioral intentions was formed by subtracting the pretest intent score from posttest intent
score (M = 1.01, [-14, 27], SD = 4.81), with higher scores indicating stronger behavioral
intentions to adopt Pap tests gained from viewing Tamale Lesson.
Narrative transportation. Four items from the narrative transportation scale (Green
& Brock, 2000) as adapted by Murphy et al., (2013) for narrative video viewing formed the
first scale (a = .71). All selected items loaded on one factor. Viewers were asked to rate the
extent to which they agreed with the following statements (1 = strongly disagree; 10 =
strongly agree): I wanted to learn how the narrative ended; I was mentally involved in the
narrative while watching it; While viewing the narrative, I forgot myself and was fully
absorbed; and I found my mind wandering while watching the narrative (reverse). A higher
score indicates a higher level of being transported into Tamale Lesson (M = 25.42, [4, 40],
SD = 8.2).
Narrative engagement. Seven items from the narrative engagement scale (Busselle
& Bilandzic, 2009) were adapted for narrative video viewing by this dissertation and formed
the second scale (a = .80). All items selected loaded on one factor. Viewers were asked to
rate the extent to which they agreed with the following statements (1 = strongly disagree; 10
= strongly agree): At points, I had a hard time making sense of what was going on in the
narrative (reverse); My understanding of the characters is unclear (reverse); I had a hard time
recognizing the thread of the narrative (reverse); I found my mind wandering while the
narrative was on (reverse); While the narrative was on I found myself thinking about other
things (reverse); I had a hard time keeping my mind on the narrative (reverse); During the
narrative, my body was in the room, but my mind was inside the world created by the story.

73
A higher score of indicates stronger engagement with Tamale Lesson (M = 51.4, [16, 70], SD
= 11.86).
Identification. Identification with characters was assessed using the identification
scale developed by Murphy et al., (2013) for narrative video viewing. For each of the four
characters, Lupita, Petra, Connie, Blanca, viewers were asked to assess the four components
of identification: liking, similarity, felling like you know, and wanting to be like (1 = not at
all, 10 = a great deal). For instance, viewers were asked to indicate what they think of Petra,
the mother’s friend: How much did you like Petra, the mother’s friend; How similar are you
to Petra, the mother’s friend; How much do you feel like you know Petra; How much would
you like to be Petra? The reliabilities of identification with Lupita, Petra, Connie and Blanca
were α of .84, .85, .90, and .88 respectively. Then, the sixteen items (all four characters) were
aggregated to form an additive index (M = 84.98, [16, 160], SD = 32.03), with higher scores
indicating stronger identification with the main narrative characters in Tamale Lesson.
Enjoyment. Twelve items were adapted from the Audience Response Scale (Oliver
& Bartsch, 2010) to measure viewers’ enjoyment of the narrative. This scale has been used in
prior research to measure narrative enjoyment (Johnson et al., 2015). Respondents were
asked to rate the extent to which they agreed with the following statements (1 = strongly
disagree; 10 = strongly agree): It was fun for me to watch this narrative; I had a good time
watching this narrative; The narrative was entertaining; I found this narrative to be very
meaningful; I was moved by this narrative; The narrative was thought provoking; This
narrative will stick with me for a long time; I know I will never forget this narrative; The
narrative left me with a lasting impression; I was at the edge of my seat while watching this
narrative; This was a heart-pounding kind of narrative; The narrative was suspenseful. Then,
the twelve items were aggregated to form an additive index (M = 72.87, [12, 120], SD =

74
26.31, α = .944), with higher scores indicating stronger enjoyment towards watching Tamale
Lesson.
Emotion. Five words selected from the Mood Adjective Checklist refined (Matthews,
Jones, & Chamberlain, 1990) were used to measure viewers’ emotional response to the
narrative. The five words included: amused, depressed, impatient, nervous, and relaxed,
covering hedonic tone, anger tone, and tense-arousal tone. The items were measured using
10-point scale asking the extent to which the narrative made the viewers feel each of the five
emotions. An Explorative Factor Analysis revealed that the words loaded on two factors:
negative and positive emotions.
Negative emotion. Three words were selected to form the scale for negative emotion:
depressed, impatient, and nervous (α = .86). The responses were aggregated to form a
composite index (M = 10.53, [3, 30], SD = 6.6), with higher scores indicating more
intensified emotions (or stronger tension) during viewing Tamale Lesson.
Positive emotion. Two words were selected to form the scale for positive emotion:
amused and relaxed (α = .69). The responses were aggregated to form a composite index (M
= 9.81, [2, 20], SD = 4.81), with higher scores indicating more positive emotions (or the
feeling of more relaxed) during viewing Tamale Lesson.
Analysis
First, a series of independent sample t-tests were conducted to examine the direct
influence of media multitasking during narrative viewing on persuasive outcomes and
narrative mechanisms. Second, two series of ANOVA analyses were conducted to examine
the relationship between narrative mechanisms and persuasive outcomes in the YouTube
group and in the survey page group. Third, a series of mediation analyses was conducted

75
using PROCESS macro (Hayes, 2013) to determine the indirect influences of media
multitasking during narrative viewing on persuasive outcomes via each narrative mechanism
as the intermediary. Model 4 was selected for the one-step mediation models.
The assumption of multicollinearity based on the values for tolerance was examined,
which was between 1 and 10 for all models. Normal probability plots of the regression
standardized residual and the scatterplot were also were checked to ensure that the
assumptions of linearity, normality, independence of residuals, and homoscedasticity were
satisfied.

76
Chapter 4: Results
Descriptive Statistics
The results section begins with descriptive statistics of the outcomes of narrative
persuasion and narrative mechanisms that accompanied the viewing of Tamale Lesson,
followed by bivariate correlations among all study variables. The means, standard deviations,
and bivariate correlations for the study variables are presented in Table 4.1.
Between media multitasking during narrative viewing and persuasive outcomes,
media multitasking during narrative viewing was positively correlated with change in
knowledge (r = .164, p < .01), subjective knowledge (r = .099, p < .05), and change in
attitudes (r = .090, p < .05). The correlation between media multitasking and change in
intents was nonsignificant (r = -.010, p = .835). Between media multitasking during narrative
viewing and narrative mechanisms, media multitasking during narrative viewing was
positively correlated with transportation (1) (transportation) (r = .119, p < .01), transportation
(2) (narrative engagement) (r = .175, p < .01), identification (r = .092, p < .05), enjoyment (r
= .108, p < .05), and positive emotion (r = .186, p < .01). Media multitasking during narrative
viewing was negatively correlated with negative emotion (r = -.115, p < .05).
Between narrative mechanisms and persuasive outcomes, change in knowledge was
positively correlated with transportation (1) (transportation) (r = .140, p < .01), transportation
(2) (narrative engagement) (r = .155, p < .01), identification (r = .116, p < .05), and positive
emotion (r = .177, p < .01). Change in knowledge was negatively correlated with negative
emotion (r = -.117, p < .05). The correlation between change in knowledge and enjoyment
was nonsignificant (r = .039, p = .394). Subjective knowledge was positively correlated with
transportation (1) (transportation) (r = .299, p < .01), transportation (2) (narrative
engagement) (r = .336, p < .01), identification (r = .241, p < .01), enjoyment (r = .306, p <

77
.01), and positive emotion (r = .181, p < .01). Subjective knowledge was negatively
correlated with negative emotion (r = -.131, p < .01). Change in attitudes was positively
correlated with transportation (2) (narrative engagement) (r = .212, p < .01) and was
negatively correlated with negative emotion (r = -.131, p < .01). The correlations between
change in attitudes and transportation (1) (transportation) (r = .045, p = .327), identification
(r = -.010, p = .825), enjoyment (r = -.005, p = .907), and positive emotion (r = .044, p =
.340) were nonsignificant. Change in intents was positively correlated with transportation (1)
(transportation) (r = .187, p < .01), transportation (2) (narrative engagement) (r = .086, p =
.059, marginally significant), identification (r = .119, p < .01), and enjoyment (r = .126, p <
.01). The correlations between change in intents and negative emotion (r = .038, p = .402)
and positive emotion (r = .033, p = .475) were nonsignificant.

[Insert Table 4.1 here]

Prior habits of multitasking. As part of the study, participants reported their prior
habits of multitasking with non-media tasks and their prior habits of multitasking with media
tasks. Although not the focal point of this dissertation, people’s prior habits of multitasking
can give us a general sense of the extent to which people actually engage in multitasking in
daily life. Participants scored high on the multitasking propensity scale (M = 67, ranging
from 14 to 98). Findings indicated that participants had a relatively high frequency of
multitasking with non-media tasks in daily life. The descriptive statistics of non-media
multitasking habit is reported in Table 4.2.

[Insert Table 4.2 here]

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In terms of multitasking with media tasks during media consumption, 89.3% of
participants reported that they sometimes or always media multitask when consuming video
content on a computer in daily life (10.7% reported seldom or never). 86.8% of participants
reported that they sometimes or always media multitask when consuming video content on a
TV in daily life (13.2% reported seldom or never). And 83.3% of participants reported that
they sometimes or always media multitask when consuming video contents on a phone in
daily life (16.7% reported seldom or never). The descriptive statistics of media multitasking
habit is reported in Table 4.3.

[Insert Table 4.3 here]

Consistent with the many reports on media multitasking, findings from this
dissertation indicated that most participants chose to multitask when watching videos on
various media devices. Furthermore, participants multitasked the most when watching videos
on a computer, followed by TV , and phone. The prevalence of multitasking during video
viewing on a computer offers external validity to the experimental design and manipulation
used in this dissertation. Crucially, the overall popularity of media multitasking during video
viewing confirms and justifies why is it essential to study the influence of media multitasking
during narrative viewing on narrative persuasion (especially in a video format): most people
do engage in multiple media tasks when watching videos and they do seem to rarely
concentrate exclusively on video viewing.
Direct Impact of Media Multitasking during Narrative Viewing

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This section reports results of a series of independent-samples t tests. The level of
persuasive outcomes and narrative mechanisms were compared between survey page group
(low multitasking condition) and YouTube page group (high multitasking condition).
Change in knowledge. The test was significant, t (476) = 3.630, p = .0005.
Participants in the YouTube page group (M = .70, SD = 1.22) showed a greater increase in
level of change in knowledge in comparison to the survey page group (M = .33, SD = .99).
Subjective knowledge. The test was significant, t (476) = 2.163, p < .05. Participants
in the YouTube page group (M = 30.97, SD = 5.92) showed a greater increase in subjective
knowledge in comparison to the survey page group (M = 29.84, SD = 5.45).
Change in attitudes. The test was significant, t (476) = 1.969, p < .05. Participants in
the YouTube page group (M = 2.49, SD = 6.31) showed a greater increase in favorable
attitudes towards Pap tests in comparison to the survey page group (M = 1.36, SD = 6.28).
Change in behavioral intentions. The test was nonsignificant, t (476) = .209, p =
.835. There were no significant differences in the means of change in behavioral intentions
between the survey page group (M = 1.05, SD = 4.82) and the YouTube page group (M = .96,
SD = 4.81).
Narrative transportation. The test was significant, t (476) = 2.610, p < .01.
Participants in the YouTube page group (M = 26.39, SD = 8.54) showed a higher level of
transportation in comparison to the survey page group (M = 24.44, SD = 7.74).
Narrative engagement. The test was significant, t (476) = 3.875, p = .0005.
Participants in the YouTube page group (M = 53.47, SD = 11.56) showed a higher level of
narrative engagement in comparison to the survey page group (M = 49.33, SD = 11.81).

80
Identification. The test was significant, t (476) = 2.013, p < .05. Participants in the
YouTube page group (M = 87.64, SD = 30.86) showed a higher level of identification in
comparison to the survey page group (M = 82.32, SD = 32.99).
Enjoyment. The test was significant, t (476) = 2.365, p < .05. Participants in the
YouTube page group (M = 75.70, SD = 25.96) showed a higher level of enjoyment in
comparison to the survey page group (M = 70.03, SD = 26.40).
Negative emotion. The test was significant, t (476) = 2.516, p < .05. Participants in
the YouTube page group (M = 9.78, SD = 6.20) showed a lower level of negative emotion in
comparison to the survey page group (M = 11.29, SD = 6.91).
Positive emotion. The test was significant, t (476) = 4.120, p = .0005. Participants in
the YouTube page group (M = 10.70, SD = 4.83) showed a higher level of positive emotion
in comparison to the survey page group (M = 8.92, SD = 4.63). In summary, results of the t
tests were reported in table 4.4 and table 4.5.

[Insert Table 4.4 here]

[Insert Table 4.5 here]

Additionally, this dissertation also compared the level of persuasive outcomes and
narrative mechanisms between participants in the YouTube page group who did media
multitask and did not media multitask, as indicated by the manipulation check. Results

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showed that there were no significant difference regarding change in knowledge, change in
attitudes, subjective knowledge, change in behavioral intentions, transportation, engagement,
identification, enjoyment, and positive emotion. The only significant difference was that
those who indeed multitasked (M = 10.95, SD = 6.79) in the YouTube page group
experienced stronger negative emotions as opposed to those in the YouTube page who didn’t
multitask (M = 9.19, SD = 5.81), t (237) = 2.09, p < .05, if equal variances assumed.

Narrative Impact in a Media Multitasking Context
This section reports the results from a series of regression analyses conducted on two
groups: the data from YouTube group (high multitasking condition) and the data from survey
page group (low multitasking condition). The independent variables included the narrative
mechanisms of transportation, engagement, identification, enjoyment, negative emotion and
positive emotion. The dependent variables included the persuasive outcomes of change in
knowledge, subjective knowledge, change in attitudes, and change in behavioral intentions.
YouTube group.
Change in knowledge. The ANOVA model was significant, F (6, 232) = 6.85, p =
.0005, η2 = .12. Specifically, participants who were more engaged with the narrative
acquired greater levels of knowledge (Beta = .022, t = 2.635, p < .01). Participants who
identified more with the characters acquired greater levels of knowledge (Beta = .758, t =
2.573, p < .05). Participants who experienced more positive emotions during narrative
viewing also acquired greater levels of knowledge (Beta = .060, t = 3.099, p < .01).
Participants who had greater enjoyment during narrative viewing actually learned less
knowledge (Beta = -.018, t = -3.297, p < .01). On the other hand, narrative transportation

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(Beta = -.002, t = -.167, p = .867), and negative emotion (Beta = -.013, t = -1.029, p = .305)
were nonsignificant.
Subjective knowledge. The ANOVA model was significant, F (6, 232) = 10.157, p =
.0005, η2 = 0.21. Specifically, participants who were more engaged with the narrative felt
more confident about their levels of cervical cancer-related knowledge (Beta = .132, t =
3.518, p < .01). Participants who enjoyed the narrative more also felt they knew more about
cervical cancer-related knowledge (Beta = .067, t = 2.655, p < .01). Participants who
experienced stronger negative emotion during narrative viewing felt they knew less about
cervical cancer-related knowledge (Beta = -.127, t = -2.096, p < .05). On the other hand,
narrative transportation (Beta = -.076, t = -1.141, p = .255), identification (Beta = 1.568, t =
1.155, p = .249), and positive emotion (Beta = -.052, t = -.589, p = .556) were
nonsignificant.
Change in attitudes. The ANOVA model was nonsignificant, F (6, 232) = 1.379, p =
.224, η2 = 0.03. Specifically, participants who were more engaged with the narrative
developed more positive attitudes about Pap tests (Beta = .101, t = 2.276, p < .05). On the
other hand, narrative transportation (Beta = -.098, t = -1.245, p = .214), identification (Beta
= -.203, t = -.127, p = .899), enjoyment (Beta = .002, t = .059, p = .953), negative emotion
(Beta = -.049, t = -.688, p = .492), and positive emotion (Beta = .085, t = .811, p = .418)
were nonsignificant.
Change in behavioral intentions. The ANOVA model was significant, F (6, 232) =
4.886, p = .0005, η2 = 0.112. Specifically, participants who were more transported by the
narrative developed a stronger intention to receive a Pap test in the near future (Beta = .188, t
= 3.287, p < .01). On the other hand, narrative engagement (Beta = .048, t = 1.492, p =
.137), identification (Beta = 1.171, t = 1.003, p = .317), enjoyment (Beta = -.037, t = -1.682,

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p = .094), negative emotion (Beta = .066, t = 1.263, p = .208), and positive emotion (Beta =
-.009, t = -.124, p = .901) were nonsignificant.
Survey group.
Change in knowledge. The ANOVA model was marginally significant, F (6, 232) =
2.005, p = .066, η2 = 0.049. Specifically, participants who were more transported into the
narrative acquired greater levels of knowledge (Beta = .032, t = 2.263, p < .05). Participants
who had greater enjoyment during narrative viewing actually learned less knowledge (Beta
= -.008, t = -1.990, p < .05). On the other hand, narrative engagement (Beta = -.005, t = -
.752, p = .453), identification (Beta = .178, t = .912, p = .363), negative emotion (Beta = -
.011, t = -1.074, p = .284), and positive emotion (Beta = .019, t = 1.159, p = .248) were
nonsignificant.
Subjective knowledge. The ANOVA model was significant, F (6, 232) = 5.470, p =
.0005, η2 = 0.124. Specifically, participants who were more engaged with the narrative felt
more confident about their levels of cervical cancer-related knowledge (Beta = .116, t =
3.216, p < .01). Other than that, narrative transportation (Beta = .038, t = .516, p = .606),
identification (Beta = .083, t = .080, p = .936), enjoyment (Beta = .019, t = .890, p = .374),
negative emotion (Beta = .001, t = .016, p = .987), and positive emotion (Beta = .064, t =
.750, p = .454) were nonsignificant.
Change in attitudes. The ANOVA model was significant, F (6, 232) = 3.320, p < .01,
η2 = 0.079. Specifically, participants who were more engaged with the narrative developed
more positive attitudes about Pap tests (Beta = .144, t = 3.372, p < .01). Other than that,
narrative transportation (Beta = -.002, t = -.021, p = .983), identification (Beta = .015, t =
.012, p = .990), enjoyment (Beta = -.030, t = -1.187, p = .237), negative emotion (Beta = -
.041, t = -.638, p = .524), and positive emotion (Beta = .096, t = .949, p = .344) were
nonsignificant.

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Change in behavioral intentions. The ANOVA model was nonsignificant, F (6, 232)
= 1.307, p = .255, η2 = 0.033. Specifically, participants who experienced stronger positive
emotion developed less intention to take a Pap test in the near future (Beta = -.159, t = -
1.987, p < .05). Other than that, transportation (Beta = .028, t = .404, p = .687), engagement
(Beta = -.033, t = -.975, p = .330), identification (Beta = .317, t = .330, p = .742),
enjoyment (Beta = .025, t = 1.238, p = .217), and negative emotion (Beta = .030, t = 1.238,
p = .217) were nonsignificant.
Results from the two sets of regression analyses on persuasive outcomes, using data
from YouTube group and data from survey group separately are reported in Table 4.6 and
Table 4.7.

[Insert Table 4.6 here]

[Insert Table 4.7 here]

Additionally, a set of post-hoc analyses were conducted to examine whether or not the
condition of YouTube group and survey group moderates the relationship between narrative
mechanisms and persuasive outcomes. Results indicated that the group condition successfully
moderated the relationship between transportation and change in behavioral intentions, such
that transportation significantly increased change in behavioral intentions for participants in
the YouTube group (b = .1697; 95% bs CI: .0994 to .2400), whereas there was no significant
relationship between transportation and change in behavioral intentions for participants in the
survey group (b = .0415; 95% bs CI: -.0361 to .1191). Other than that, there was no

85
significant group difference in narrative impact between YouTube group and survey group. A
comparison of narrative impact between YouTube group and survey group is reported in
table 4.8.

[Insert Table 4.8 here]

Indirect Influence of Media Multitasking: Narrative Mechanisms as Intermediaries
This section reports results from mediation analyses using Hayes’s (2013) PROCESS
macro in SPSS, which examined how might media multitasking during narrative viewing
influence persuasive outcomes indirectly through narrative mechanisms as intermediaries.
Model 4 was chosen. All models used 1,000 bootstraps. Media multitasking during narrative
viewing was the independent variable in all models. The dependent variables included the
final outcomes of persuasion. First, the six narrative mechanisms—transportation,
engagement, identification, enjoyment, negative emotion, and positive emotion—were
entered respectively as the single mediator in a series of one-step mediation models. Second,
all mechanisms were entered as mediators in the same model to evaluate their relative
strengths.
Change in knowledge. When narrative transportation was entered as the mediator,
the total effect of media multitasking during narrative viewing on change in knowledge was
significant (b = .3682; 95% bs CI: .1689 to .5675). Importantly, media multitasking during
narrative viewing indirectly affected change in knowledge through transportation (b = .0327;
95% bs CI: .0084 to .0782). In other words, multitasking more during narrative viewing
resulted in levels of knowledge gain greater than multitasking less, through the mediation
effect of transportation into the film. Meanwhile, the direct effect of media multitasking

86
during narrative viewing on change in knowledge was also significant (b = .3355; 95% bs
CI: .1361 to .5349). In other words, when controlling for the mediating effect of
transportation, multitasking more during narrative viewing directly resulted in levels of
knowledge gain greater than multitasking less.
When narrative engagement was entered as the mediator, the total effect of media
multitasking during narrative viewing on change in knowledge was significant (b = .3682; 95%
bs CI: .1689 to .5675). Importantly, media multitasking during narrative viewing indirectly
affected change in knowledge through narrative engagement (b = .0512; 95% bs CI: .0169
to .1035). In other words, multitasking more during narrative viewing resulted in levels of
knowledge gain greater than multitasking less, through the mediation effect of engagement
with the film. Meanwhile, the direct effect of media multitasking during narrative viewing
on change in knowledge was also significant (b = .3170; 95% bs CI: .1161 to .5179). In other
words, when controlling for the mediating effect of narrative engagement, multitasking more
during narrative viewing directly resulted in levels of knowledge gain greater than
multitasking less.
When identification was entered as the mediator, the total effect of media
multitasking during narrative viewing on change in knowledge was significant (b = .3682; 95%
bs CI: .1689 to .5675). Importantly, media multitasking during narrative viewing indirectly
affected change in knowledge through identification (b = .0209; 95% bs CI: .0030 to .0580).
In other words, multitasking more during narrative viewing resulted in levels of knowledge
gain greater than multitasking less, through the mediation effect of identification with the
characters. Meanwhile, the direct effect of media multitasking during narrative viewing on
change in knowledge was also significant (b = .3473; 95% bs CI: .1480 to .5466). In other
words, when controlling for the mediating effect of identification, multitasking more during
narrative viewing directly resulted in levels of knowledge gain greater than multitasking less.

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When enjoyment was entered as the mediator, the total effect of media multitasking
during narrative viewing on change in knowledge was significant (b = .3682; 95% bs
CI: .1689 to .5675). The indirect effect of media multitasking during narrative viewing on
change in knowledge through enjoyment was nonsignificant (b = .0052; 95% bs CI: -.0133
to .0287). The direct effect of media multitasking during narrative viewing on change in
knowledge was significant (b = .3630; 95% bs CI: .1623 to .5636). In other words,
multitasking more during narrative viewing only directly resulted in greater levels of
knowledge gain than multitasking less, when the effect of enjoyment was considered.
When negative emotion was entered as the mediator, the total effect of media
multitasking during narrative viewing on change in knowledge was significant (b = .3682; 95%
bs CI: .1689 to .5675). Importantly, the indirect effect of media multitasking during
narrative viewing on change in knowledge through negative emotion was significant (b
= .0257; 95% bs CI: .0031 to .0665). Meanwhile, the direct effect of media multitasking
during narrative viewing on change in knowledge was also significant (b = .3425; 95% bs
CI: .1427 to .5423). In other words, when controlling for the mediating effect of negative
emotion, multitasking more during narrative viewing directly increased levels of knowledge
gain greater than multitasking less.
When positive emotion was entered as the mediator, the total effect of media
multitasking during narrative viewing on change in knowledge was significant (b = .3682; 95%
bs CI: .1689 to .5675). Importantly, the indirect effect of media multitasking during
narrative viewing on change in knowledge through positive emotion was significant (b
= .0632; 95% bs CI: .0261 to .1181). Meanwhile, the direct effect of media multitasking
during narrative viewing on change in knowledge was also significant (b = .3050; 95% bs
CI: .1043 to .5057). In other words, when controlling for the mediating effect of positive

88
emotion, multitasking more during narrative viewing directly increased levels of knowledge
gain greater than multitasking less.
When all narrative mechanisms were entered as the mediator, the total effect of
media multitasking during narrative viewing on change in knowledge was significant (b
= .3682; 95% bs CI: .1689 to .5675). Importantly, the total indirect effect of media
multitasking during narrative viewing on change in knowledge through all narrative
mechanisms was significant (b = .1136; 95% bs CI: .0499 to .1933). Meanwhile, the direct
effect of media multitasking during narrative viewing on change in knowledge was also
significant (b = .2546; 95% bs CI: .0543 to .4548). In other words, when controlling for the
mediating effects of narrative transportation, narrative engagement, identification, enjoyment,
negative emotion, and positive emotion, multitasking more during narrative viewing directly
increased levels of knowledge gain greater than multitasking less.
In particular, the indirect effect of media multitasking on change in knowledge
through identification was significant (b = .0313; 95% bs CI: .0024 to .0875). The indirect
effect of media multitasking on change in knowledge through positive emotion was
significant (b = .0715; 95% bs CI: .0313 to .1313). The indirect effect of media multitasking
on change in knowledge through enjoyment was significant but in a negative direction (b = -
.0659; 95% bs CI: -.1436 to -.0098). On the other hand, the indirect effects through narrative
transportation (b = .0272; 95% bs CI: -.0018 to .0902), narrative engagement (b = .0326; 95%
bs CI: -.0067 to .0799), and negative emotion (b = .0170; 95% bs CI: -.0018 to .0582) were
nonsignificant.
A summary of the total, direct, and indirect effects of media multitasking during
narrative viewing on change in knowledge via each narrative mechanism is shown in Figure
4.1 and Figure 4.2.

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[Insert Figure 4.1 here]

[Insert Figure 4.2 here]

Subjective knowledge. When narrative transportation was entered as the mediator,
the total effect of media multitasking during narrative viewing on subjective knowledge was
significant (b = 1.1255; 95% bs CI: .1029 to 2.1481). Importantly, media multitasking during
narrative viewing indirectly influenced subjective knowledge through transportation (b
= .3949; 95% bs CI: .1225 to .7598). In other words, multitasking more during narrative
viewing resulted in greater confidence in cervical cancer-related knowledge, through the
mediation effect of transportation. The direct effect of media multitasking during narrative
viewing on subjective knowledge was nonsignificant (b = .7306, bs CI: -.2558 to 1.7170). In
other words, multitasking more during narrative viewing only indirectly increased the
confidence level in cervical cancer-related knowledge than multitasking less, when the effect
of transportation was considered.
When narrative engagement was entered as the mediator, the total effect of media
multitasking during narrative viewing on subjective knowledge was significant (b = 1.1255;
95% bs CI: .1029 to 2.1481). Importantly, media multitasking during narrative viewing
indirectly influenced subjective knowledge through narrative engagement (b = .6569; 95%
bs CI: .3651 to 1.0721). In other words, multitasking more during narrative viewing resulted
in greater confidence in cervical cancer-related knowledge, through the mediation effect of
narrative engagement. The direct effect of media multitasking during narrative viewing on
subjective knowledge was nonsignificant (b = .4687, bs CI: -.5144 to 1.4517). In other words,
multitasking more during narrative viewing only indirectly increased the confidence level in

90
cervical cancer-related knowledge than multitasking less, when the effect of narrative
engagement was considered.
When identification was entered as the mediator, the total effect of media
multitasking during narrative viewing on subjective knowledge was significant (b = 1.1255;
95% bs CI: .1029 to 2.1481). Importantly, media multitasking during narrative viewing
indirectly influenced subjective knowledge through identification (b = .2452; 95% bs
CI: .0287 to .5401). In other words, multitasking more during narrative viewing resulted in
greater confidence in cervical cancer-related knowledge than multitasking less, through the
mediation of identifying with the characters. The direct effect of media multitasking during
narrative viewing on subjective knowledge was nonsignificant (b = .8803, bs CI: -.1192 to
1.8798). In other words, multitasking more during narrative viewing only indirectly
increased the level of confidence in cervical cancer-related knowledge, when the effect of
identification was considered.
When enjoyment was entered as the mediator, the total effect of media multitasking
during narrative viewing on subjective knowledge was significant (b = 1.1255; 95% bs
CI: .1029 to 2.1481). Importantly, media multitasking during narrative viewing indirectly
influenced subjective knowledge through enjoyment (b = .3673; 95% bs CI: .0747 to .7274).
In other words, multitasking more during narrative viewing resulted in greater confidence in
cervical cancer-related knowledge than multitasking less, through the mediation effect of
enjoying the film. The direct effect of media multitasking during narrative viewing on
subjective knowledge was nonsignificant (b = .7583, bs CI: -.2245 to 1.7410). In other words,
multitasking more during narrative viewing only indirectly resulted in greater confidence in
cervical cancer-related knowledge than multitasking less, when the effect of enjoyment was
considered.

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When negative emotion was entered as the mediator, the total effect of media
multitasking during narrative viewing on subjective knowledge was significant (b = 1.1255;
95% bs CI: .1029 to 2.1481). Importantly, the indirect effect of media multitasking during
narrative viewing on subjective knowledge through negative emotion was significant (b
= .1584; 95% bs CI: .0381 to .3872). The direct effect of media multitasking during narrative
viewing on subjective knowledge was nonsignificant (b = .9671, bs CI: -.0558 to 1.9900). In
other words, multitasking more during narrative viewing only indirectly resulted in greater
confidence in cervical cancer-related knowledge than multitasking less, when the effect of
negative emotion was considered.
When positive emotion was entered as the mediator, the total effect of media
multitasking during narrative viewing on subjective knowledge was significant (b = 1.1255;
95% bs CI: .1029 to 2.1481). Importantly, the indirect effect of media multitasking during
narrative viewing on subjective knowledge through positive emotion was significant (b
= .3573; 95% bs CI: .1502 to .7022). The direct effect of media multitasking during narrative
viewing on subjective knowledge was nonsignificant (b = .7682, bs CI: -.2590 to 1.7954). In
other words, multitasking more during narrative viewing only indirectly resulted in greater
confidence in cervical cancer-related knowledge than multitasking less, when the effect of
positive emotion was considered.
When all narrative mechanisms were entered as the mediator, the total effect of
media multitasking during narrative viewing on subjective knowledge was significant (b =
1.1255; 95% bs CI: .1029 to 2.1481). Importantly, the total indirect effect of media
multitasking during narrative viewing on subjective knowledge through all narrative
mechanisms was significant (b = .8829; 95% bs CI: .4102 to 1.3425). The direct effect of
media multitasking during narrative viewing on subjective knowledge was nonsignificant (b
= .2426, bs CI: -.7337 to 1.2190). In other words, multitasking more during narrative viewing

92
only indirectly resulted in greater confidence in cervical cancer-related knowledge than
multitasking less, when the indirect effects of narrative transportation, narrative engagement,
identification, enjoyment, negative emotion, and positive emotion were considered.
In particular, the indirect effect of media multitasking on subjective knowledge
through narrative engagement was significant (b = .4974, bs CI: .2233 to .9334). The
indirect effect of media multitasking on subjective knowledge through enjoyment was also
significant (b = .2531, bs CI: .0447 to .6505). On the other hand, the indirect effects through
transportation (b = -.0431, bs CI: -.3498 to .1471), identification (b = .0607, bs CI: -.0825
to .3130), negative emotion (b = .0887, bs CI: -.0298 to .2862), and positive emotion (b
= .0262, bs CI: -.1690 to .2538) were nonsignificant.
A summary of the total, direct, and indirect effects of media multitasking during
narrative viewing on subjective knowledge via each narrative mechanism is shown in Figure
4.3 and Figure 4.4.

[Insert Figure 4.3 here]

[Insert Figure 4.4 here]

Change in attitudes. When narrative transportation was entered as the mediator,
the total effect of media multitasking during narrative viewing on change in attitudes was
significant (b = 1.1339; 95% bs CI: .0022 to 2.2656). The indirect effect of media
multitasking during narrative viewing on change in attitudes through transportation was
nonsignificant (b = .0521; 95% bs CI: -.0693 to .2711). Similarly, the direct effect of media
multitasking during narrative viewing on change in attitudes was also nonsignificant (b =
1.0818, bs CI: -.0585 to 2.2221).

93
When narrative engagement was entered as the mediator, the total effect of media
multitasking during narrative viewing on change in attitudes was significant (b = 1.1339; 95%
bs CI: .0022 to 2.2656). Importantly, the indirect effect of media multitasking during
narrative viewing on change in attitudes through narrative engagement was significant (b
= .4463; 95% bs CI: .1963 to .8276). The direct effect of media multitasking during narrative
viewing on change in attitudes was nonsignificant (b = .6876, bs CI: -.4398 to 1.8150). In
other words, multitasking more during narrative viewing only indirectly resulted in more
favorable attitudes towards Pap tests than multitasking less, when the effect of narrative
engagement was considered.
When identification was entered as the mediator, the total effect of media
multitasking during narrative viewing on change in attitudes was significant (b = 1.1339; 95%
bs CI: .0022 to 2.2656). The indirect effect of media multitasking during narrative viewing
on change in attitudes through identification was nonsignificant (b = -.0215; 95% bs CI: -
.1926 to .0843). Importantly, the direct effect of media multitasking during narrative viewing
on change in attitudes was significant (b = 1.1554, bs CI:.0179 to 2.2929). In other words,
multitasking more during narrative viewing only directly resulted in more favorable attitudes
towards Pap tests than multitasking less, when the effect of identification was considered.
When enjoyment was entered as the mediator, the total effect of media multitasking
during narrative viewing on change in attitudes was significant (b = 1.1339; 95% bs
CI: .0022 to 2.2656). The indirect effect of media multitasking during narrative viewing on
change in attitudes through enjoyment was nonsignificant (b = -.0207; 95% bs CI: -.2145
to .0998). Importantly, the direct effect of media multitasking during narrative viewing on
change in attitudes was significant (b = 1.1546, bs CI: .0152 to 2.2940). In other words,
multitasking more during narrative viewing only directly resulted in more favorable attitudes
towards Pap tests than multitasking less, when the effect of enjoyment was considered.

94
When negative emotion was entered as the mediator, the total effect of media
multitasking during narrative viewing on change in attitudes was significant (b = 1.1339; 95%
bs CI: .0022 to 2.2656). Importantly, the indirect effect of media multitasking during
narrative viewing on change in attitudes through negative emotion was significant (b = .1761;
95% bs CI: .0320 to .4445). The direct effect of media multitasking during narrative viewing
on change in attitudes was nonsignificant (b = .9578, bs CI: -.1742 to 2.0898). In other words,
multitasking more during narrative viewing only indirectly resulted in more favorable
attitudes towards Pap tests than multitasking less, when the effect of negative emotion was
considered.
When positive emotion was entered as the mediator, the total effect of media
multitasking during narrative viewing on change in attitudes was significant (b = 1.1339; 95%
bs CI: .0022 to 2.2656). The indirect effect of media multitasking during narrative viewing
on change in attitudes through positive emotion was nonsignificant (b = .0656; 95% bs CI: -
.1525 to .3180). Similarly, the direct effect of media multitasking during narrative viewing on
change in attitudes was also nonsignificant (b = 1.0683, bs CI: -.0842 to 2.2208).
When all narrative mechanisms were entered as the mediators, the total effect of
media multitasking during narrative viewing on change in attitudes was significant (b =
1.1339; 95% bs CI: .0022 to 2.2656). Importantly, the total indirect effect of media
multitasking during narrative viewing on change in attitudes was significant (b = .5402; 95%
bs CI: .1988 to 1.0154). The direct effect of media multitasking during narrative viewing on
change in attitudes was nonsignificant (b = .5937; 95% bs CI: -.5516 to 1.7390). In other
words, multitasking more during narrative viewing only indirectly resulted in more
favorable attitudes towards Pap tests than multitasking less, when the indirect effects of
narrative transportation, narrative engagement, identification, enjoyment, negative emotion,
and positive emotion were considered.

95
In particular, the indirect effect of media multitasking during narrative viewing on
change in attitudes through narrative engagement was significant (b = .5170; 95% bs
CI: .1951 to .9414). On the other hand, the indirect effects through narrative transportation (b
= -.1175; 95% bs CI: -.4723 to .0895), identification (b = .0127; 95% bs CI: -.1575 to .2054),
enjoyment (b = -.0849; 95% bs CI: -.3898 to .0943), negative emotion (b = .0717; 95% bs CI:
-.0465 to .2997), and positive emotion (b = .1413; 95% bs CI: -.0957 to .4825).
A summary of the total, direct, and indirect effects of media multitasking during
narrative viewing on change in attitudes via each narrative mechanism is shown in Figure 4.5
and Figure 4.6.

[Insert Figure 4.5 here]

[Insert Figure 4.6 here]

Behavioral intentions. When narrative transportation was entered as the mediator,
the total effect of media multitasking during narrative viewing on change in behavioral
intentions was nonsignificant (b = -.0921; 95% bs CI: -.9582 to .7741). Importantly, the
indirect effect of media multitasking during narrative viewing on change in behavioral
intentions through narrative transportation was significant (b = .2178; 95% bs CI: .0675
to .4419). The direct effect of media multitasking during narrative viewing on change in
behavioral intentions was nonsignificant (b = -.3099, bs CI: -1.1673 to .5476). In other words,
multitasking more during narrative viewing only indirectly resulted in increase in stronger
intentions to receive a Pap test than multitasking less, when the effect of narrative
transportation was considered.

96
When narrative engagement was entered as the mediator, the total effect of media
multitasking during narrative viewing on change in behavioral intentions was nonsignificant
(b = -.0921; 95% bs CI: -.9582 to .7741). Importantly, the indirect effect of media
multitasking during narrative viewing on change in behavioral intentions through narrative
engagement was significant (b = .1528; 95% bs CI: .0071 to .3904). The direct effect of
media multitasking during narrative viewing on change in behavioral intentions was
nonsignificant (b = -.2449, bs CI: -1.1220 to .6323). In other words, multitasking more
during narrative viewing only indirectly resulted in increase in stronger intentions to receive
a Pap test than multitasking less, when the effect of narrative engagement was considered.
When identification was entered as the mediator, the total effect of media
multitasking during narrative viewing on change in behavioral intentions was nonsignificant
(b = -.0921; 95% bs CI: -.9582 to .7741). Importantly, the indirect effect of media
multitasking during narrative viewing on change in behavioral intentions through
identification was significant (b = .1064; 95% bs CI: .0089 to .2647). The direct effect of
media multitasking during narrative viewing on change in behavioral intentions was
nonsignificant (b = -.1985, bs CI: -1.0630 to .6660). In other words, multitasking more
during narrative viewing only indirectly resulted in increase in stronger intentions to receive
a Pap test than multitasking less, when the effect of identification was considered.
When enjoyment was entered as the mediator, the total effect of media multitasking
during narrative viewing on change in behavioral intentions was nonsignificant (b = -.0921;
95% bs CI: -.9582 to .7741). Importantly, the indirect effect of media multitasking during
narrative viewing on change in behavioral intention through enjoyment was significant (b
= .1329; 95% bs CI: .0259 to .3282). The direct effect of media multitasking during narrative
viewing on change in behavioral intentions was nonsignificant (b = -.2250, bs CI: -1.0900
to .6401). In other words, multitasking more during narrative viewing only indirectly

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resulted in increase in stronger intentions to receive a Pap test than multitasking less, when
the effect of enjoyment was considered.
When negative emotion was entered as the mediator, the total effect of media
multitasking during narrative viewing on change in behavioral intentions was nonsignificant
(b = -.0921; 95% bs CI: -.9582 to .7741). Similarly, the indirect effect of media multitasking
during narrative viewing on change in behavioral intentions through negative emotion was
nonsignificant (b = -.0417; 95% bs CI: -.2096 to .0652). The direct effect of media
multitasking during narrative viewing on change in behavioral intention was also
nonsignificant (b = -.0503, bs CI: -.9926 to .8219).
When positive emotion was entered as the mediator, the total effect of media
multitasking during narrative viewing on change in behavioral intentions was nonsignificant
(b = -.0921; 95% bs CI: -.9582 to .7741). Similarly, the indirect effect of media multitasking
during narrative viewing on change in behavioral intentions through positive emotion was
nonsignificant (b = .0638; 95% bs CI: -.0865 to .2478). The direct effect of media
multitasking during narrative viewing on change in behavioral intention was also
nonsignificant (b = -.1559, bs CI: -1.0378 to .7260).
When all narrative mechanisms were entered as the mediator, the total effect of
media multitasking during narrative viewing on change in behavioral intentions was
nonsignificant (b = -.0921; 95% bs CI: -.9582 to .7741). Similarly, the total indirect effect of
media multitasking during narrative viewing on change in behavioral intentions through all
mediators was also nonsignificant (b = .0781; 95% bs CI: -.2939 to .3926). The direct effect
of media multitasking during narrative viewing on change in behavioral intention was also
nonsignificant (b = -.1701, bs CI: -1.0511 to .7108).
In particular, the indirect effect of media multitasking on change in behavioral
intention through narrative transportation was significant (b = .2529, bs CI: .0505

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to .6410). On the other hand, narrative engagement (b = .0147, bs CI: -.1894 to .2329),
identification (b = .0169, bs CI: -.1350 to .2427), enjoyment (b = -.0200, bs CI: -.3000
to .2207), negative emotion (b = -.0734, bs CI: -.2837 to .0185), and positive emotion (b = -
.1131, bs CI: -.4145 to .1047) were nonsignificant.
A summary of the total, direct, and indirect effects of media multitasking during
narrative viewing on change in behavioral intentions via each narrative mechanism is shown
in Figure 4.7 and Figure 4.8.

[Insert Figure 4.7 here]

[Insert Figure 4.8 here]

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Chapter 5: Discussion and Conclusion

Communication scholars have long acknowledged that new communication
technologies, or innovative ways of using existing technologies, can deeply influence the
media viewing experience. Some of the most important modern technological advances in
human communication include: the Internet, computers, mobile devices, TV, and
smartphones. The relatively recent introduction of a plethora of interactive technologies gives
rise to the increasingly widespread behavior of media multitasking. Video content, including
health-related narrative content, is increasingly being consumed in a media multitasking
context. While previous research mostly studied the media multitasking behavior on young
adults and college students, this research contributed to the literature by examining the effect
of media multitasking on ethnic minority female adults. More importantly, this dissertation
investigated the impact of media multitasking during narrative viewing on the actual
mechanisms of narrative persuasion, specifically, on transportation into the narrative,
identification with the characters, enjoyment of the narrative viewing, and emotional
responses towards the narrative. The findings of the present research add to our
understanding of these two important processes that occur while watching videos in the new
media environment: narrative persuasion and media multitasking. Whereas previous research
has investigated primarily the narrative features (e.g., de Graaf et al., 2012) and the
characteristics of the viewers (e.g., Murphy et al., 2013) that affect the underlying
mechanisms of narrative persuasion, this dissertation underscores the impact of the media
multitasking context on these narrative mechanisms and the final outcomes of narrative
persuasion.
As this dissertation was particularly interested in whether health narrative persuasion
remains effective in influencing health-related knowledge, subjective knowledge, attitudes,

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and behavioral intention in a media multitasking context, 478 Mexican American women
aged between 25-45 participated in this online experiment study. Each participant watched a
cervical cancer-related short film (Tamale Lesson) via the Internet. The level of media
multitasking during narrative viewing was experimentally manipulated by asking participants
to watch the film on a plain survey page or on a YouTube page. Key persuasive outcomes
and main narrative mechanisms were measured in an online survey that followed the
narrative viewing. This research asks the following questions: (1) how might media
multitasking during narrative viewing influence persuasive outcomes, as well as narrative
mechanisms? (2) How might narrative mechanisms affect persuasive outcomes among
participants who are in a condition of higher media multitasking during narrative viewing as
opposed to participants who are in a condition of lower media multitasking during narrative
viewing? And (3) how might media multitasking during narrative viewing indirectly
influence persuasive outcomes through narrative mechanisms as intermediaries?
This section discusses the key implications of such findings. First, the main effect of
media multitasking during narrative viewing on persuasive outcomes and narrative
mechanisms is discussed. Next, the effectiveness of narrative persuasion in a media
multitasking context is evaluated via a discussion of the relationship between narrative
mechanisms and persuasive outcomes among participants in a condition of higher media
multitasking during viewing as opposed to participants in a condition of lower media
multitasking during viewing. Mediated effects are then discussed in terms of how media
multitasking during narrative viewing indirectly affects persuasive outcomes through
narrative mechanisms as intermediaries.
Media Multitasking and Narrative Persuasion
This dissertation demonstrated that a higher level of media multitasking during
narrative viewing, as indicated by participants in the YouTube group, was more effective in

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improving cervical cancer-related knowledge, subjective knowledge, and attitudes as
opposed to a lower level of media multitasking, as indicated by participants in the survey
page group. Similarly, a higher level of media multitasking during narrative viewing was
more effective in increasing participants’ transportation into the narrative, engagement with
the narrative, identification with the characters, enjoyment of the narrative viewing
experience, and the positive emotion during narrative viewing. A higher level of media
multitasking during narrative viewing was associated with less negative emotion as opposed
to a lower level of media multitasking (Figure 5.1). Crucially, a higher level of media
multitasking during narrative viewing improves all narrative mechanisms and all-but-
one persuasive outcomes (except change in behavioral intents) examined in this study.
It seems that the viewing context of media multitasking does influence narrative
persuasion, but surprisingly, in a positive direction. The findings from this study can be
fruitfully applied to the question of whether narrative impact is helped or hindered by a
viewing context that includes media multitasking. Contrary to the diminishing effect found in
many previous studies, this research suggests that media multitasking during narrative
viewing amplifies the immersive experience of narrative persuasion and improves persuasive
outcomes.

[Insert Figure 5.1 here]

Narrative Impact in a Media Multitasking Context
After determining the main effect of media multitasking on narrative persuasion, this
dissertation assesses the power of narrative in a media multitasking context by examining the
association between narrative mechanisms and persuasive outcomes among participants who
were in the YouTube group (high media multitasking condition). To make comparison, the

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regression analyses were also conducted among participants who were in the survey page
group (low media multitasking condition). Doing so allows this dissertation to assess if the
association between narrative mechanisms and persuasive outcomes differs between high
versus low media multitasking conditions.
Overall, using data from the YouTube group, the regression models that included
narrative mechanisms as independent variables significantly predicted three persuasive
outcomes: change in knowledge, subjective knowledge, and change in behavioral
intentions. The model was unable to significantly predict change in attitudes. That is, the
association between the aforementioned three persuasive outcomes and the combination of
transportation, engagement, identification, enjoyment, negative emotion, and positive
emotion remains to be significant and positive for participants in the YouTube group. In
comparison, using data from the survey group, the regression models significantly predicted
two persuasive outcomes: subjective knowledge and change in attitudes. The model that
predicted change in knowledge was marginally significant and the one that predicted change
in intentions was nonsignificant. That is, the association between the aforementioned two
persuasive outcomes and the combination of narrative mechanisms are significant and
positive for participants in the survey group.
Specifically, the predictive power of each narrative mechanism is reported. For
participants in the YouTube group: three mechanisms (engagement, identification, and
positive emotion) increased knowledge gained and one mechanism (enjoyment) decreased
knowledge gained; two mechanisms (engagement and enjoyment) increased subjective
knowledge and one mechanism (negative emotion) decreased subjective knowledge; one
mechanism (engagement) increased favorable attitudes; and one mechanism (transportation)
increased behavioral intentions. For participants in the survey page group: one mechanism
(transportation) increased knowledge gained and one mechanism (enjoyment) decreased

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knowledge gained; one mechanism increased subjective knowledge (engagement); one
mechanism increased favorable attitudes (engagement); and one mechanism decreased
behavioral intentions (positive emotion). A summary of the regression results in both groups
is reported in Figure 5.2 and Figure 5.3.

[Insert Figure 5.2. here]

[Insert Figure 5.3. here]

For participants who were in a condition of higher media multitasking during
narrative viewing, the combination of narrative mechanisms is still effective in predicting
change in knowledge, subjective knowledge, and change in behavioral intentions. The impact
of transportation, engagement, identification, enjoyment, and emotion are not weakened in a
media multitasking context. Crucially, the findings from this study suggest that narrative
impact may be less dependent upon a distraction-free viewing context than previously
thought. The power of narrative persuasion remains strong even when viewers are strongly
influenced by media multitasking.
Furthermore, the findings suggest that the combination of narrative mechanisms can
better predict change in behavioral intentions for participants in the YouTube group as
opposed to those in the survey page group. While many previous narrative studies found it
relatively difficult to predict change in behavioral intentions, the model of narrative
persuasion in this dissertation successfully predicted change in behavioral intentions only for
participants in the YouTube group. The influence of narrative persuasion seems to be only
effective on change in behavioral intentions when participants engage in a higher level of
media multitasking during narrative viewing. That is, the model of narrative influence is

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more effective in facilitating narrative-consistent intentional changes in a context of higher
media multitasking during narrative viewing than a context of lower media multitasking.
Ecological Validity of Narrative Research
The observation about the positive main effect of media multitasking on narrative
persuasion and the significant narrative impact in a media multitasking context has some
important implications. First, this finding may help validate the ecological validity of
narrative research. A recently published content analysis that covers most recent publications
on narrative research (Dahlstrom, Niederdeppe, Gao, & Zhu, in press) reveals that a majority
of narratives used in experimental research are created with less consideration of how
audiences experience narrative content in a real life setting. The authors argue that it would
be helpful to construct narrative stimuli or generate research questions/hypotheses based
upon a context that has higher external validity – using content individuals choose to watch
or at least as similar to such popular content as feasibly possible. The present empirical study
was designed to directly respond to the call of “selecting externally valid formats to serve as
contexts for narrative stimuli” (Dahlstrom et al., in press). Furthermore, this research is in
alignment with previous experimental studies in which a narrative stimulus is created for
experimental purposes and media multitasking during narrative viewing is manipulated. As
such, this dissertation complements previous studies in several respects. The narrative
viewing experience was situated in a real-life setting and the media multitasking during
narrative viewing was induced rather than externally enforced. Narrative viewers were placed
in a relatively “free choice environment” (Lang et al., 2005) wherein viewers were provided
with more user control and the freedom to allocate cognitive resources among several tasks.
Crucially, the findings from this research suggest that narrative impact may be less dependent
upon a distraction-free viewing context than previously thought. Narrative impact seems to
remain strong when viewers are also strongly influenced by media multitasking.

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This research highlights that media multitasking, as a key aspect of the modern
viewing experience, can be incorporated when studying narrative impact in an ecologically
valid way. But this is not to say that previous narrative research is stripped from an
ecologically valid context. For example, in Murphy et al. (2013), study participants received
the narrative video used in this dissertation, Tamale Lesson, in a CD format through the mail
and watched the video at their homes or in other familiar environments. It was highly likely,
therefore, that participants in the Murphy et al. (2013) study may have multitasked with
several media or non-media activities while watching the narrative video. Participants in the
2013 study were also situated in a real-life setting, despite the fact that media multitasking
was not the researchers’ main focus. The point, more generally, is that while few previous
narrative studies were specifically designed to examine narrative impact in a media
multitasking context, they may have nevertheless done so.
How Narrative Persuasion Works
Besides affirming the ecological validity of narrative research, the findings from this
study may extend our understanding of how narrative persuasion works. Most existing
theoretical frameworks used in narrative research build upon the premise that narrative
processing demands the investment of cognitive efforts, attention, memory, and energy. The
implication of this premise is that the presence of competing activities will decrease the
mental resources available for narrative processing, which will, in turn, diminish narrative
impact. One plausible explanation of the positive influence found in this study is that
multitasking seems to encourage an information processing style based on broad (rather than
deep) information acquisition. The breadth-based processing style may help individuals take
in information and cues from a variety of sources, both relevant and irrelevant, and store
these cues in memory for future use.

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Narrative processing is an immersive and engrossing mental experience wherein
viewers are fully transported into the whole narrative experience. Narrative viewers are quite
likely to acquire information from all aspects of narrative experience, such as the story
structure, message content, background noise, music, and the facial expressions, voice tone,
and clothing style of narrative characters. These aspects may be related, indirectly related, or
even unrelated to the main messages of narrative persuasion. This apparently less-focused
way of acquiring information may be less dependent upon the strict rules of full attention and
minimum distraction inherent to the cognitive processing style; rather, narrative processing
may be more in alignment with the breadth-based information processing style encouraged
by multitasking. That is to say, the mostly positive influence of media multitasking on
narrative impact found in this study may inspire researchers to examine narrative effects and
mechanisms from a new perspective.
Understanding the Effect of Media Multitasking: Narrative Mechanisms as Mediators
Mediation analyses were conducted to investigate the processes by which media
multitasking affects persuasive outcomes and explore the potential theoretical mechanisms
that might underlie the impact of media multitasking during narrative viewing. The mediation
effect of each mediator was examined, as well as the total and relative strengths of all
mediators combined.
Media multitasking during narrative viewing both directly and indirectly increased
the levels of knowledge gained. Mediation on change in knowledge was successful in the
single-mediator models that included narrative transportation, narrative engagement,
identification, and positive emotion as the sole mediator. The total mediation on change in
knowledge was successful when all mediators were included together and the specific
mediation paths through identification, enjoyment (negative), and positive emotion were
significant.

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Media multitasking during narrative viewing only indirectly increased participants’
confidence in their cervical cancer-related knowledge. Mediation on subjective knowledge
was successful in all single-mediator models, which included narrative transportation,
narrative engagement, identification, enjoyment, negative emotion, and positive emotion as
the sole mediator. The total mediation on subjective knowledge was successful when all
mediators were included together and the specific mediation paths through narrative
engagement and enjoyment were significant.
Media multitasking during narrative viewing both directly and indirectly increased
more favorable attitudes towards Pap tests. Mediation on change in attitudes was successful
in the single-mediator models that included narrative engagement. The total mediation on
change in attitudes was successful when all mediators were included together and the specific
mediation path through engagement was still significant.
Media multitasking during narrative viewing only indirectly increased participants’
intentions to receive a Pap test. Mediation on change in behavioral intents was successful in
the single-mediator models that included narrative transportation, narrative engagement,
identification and enjoyment. The total mediation on change in intents was successful when
all mediators were included together and the specific mediation path through narrative
transportation was significant.
The findings underscore the importance of narrative mechanisms as mediators leading
media multitasking during narrative viewing to the final outcomes of narrative persuasion
(Table 5.1). Greater knowledge gain, higher subjective knowledge, more favorable
attitudinal change, and more favorable changes in behavioral intentions are results of
higher media multitasking during narrative viewing and subsequent heightened
narrative mechanisms. The findings provide empirical support for integration between

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studies on media multitasking and narrative persuasion theory, as well as outlining possible
paths for encouraging attitudinal change and preventive health beliefs.

[Insert Table 5.1 here]

Change in knowledge and change in attitudes. In the models that included
enjoyment and emotion respectively, media multitasking during narrative viewing only
increased knowledge gained from narrative viewing directly. However, in the models that
included transportation and identification respectively, media multitasking during narrative
viewing increased change in knowledge both directly and indirectly. Participants in the study
are not only influenced by media multitasking during narrative viewing directly, as suggested
by the cognitive approaches to multitasking. People are also affected indirectly through the
impact of the real-time action of media multitasking on their transportation into the narrative
and identification with the characters, which, in turn, increased their levels of knowledge
gained from viewing the narrative.
Media multitasking only directly increased changes in favorable attitudes about Pap
tests in models that included identification, enjoyment, and emotion. However, in the model
that included transportation, media multitasking during narrative viewing only indirectly
increased favorable attitudes through the mediation of transportation. That is, participants in
the study not only developed more favorable attitudes about Pap tests as a direct result of
more media multitasking during narrative viewing. They also developed such favorable
attitudes indirectly through the impact of media multitasking during narrative viewing on
their levels of being transported into the narrative viewing, which, in turn, helped them
develop more favorable attitudes towards Pap tests.

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Change in behavioral intentions. Unlike knowledge and attitudes, which were
influenced by media multitasking both directly and indirectly, change in behavioral intentions
and subjective knowledge were only indirectly affected by media multitasking through
narrative mechanisms as mediators. Media multitasking only resulted in stronger intentions to
receive Pap tests in the near future because it enhanced narrative transportation, narrative
engagement, identification, and enjoyment. The relative strength of transportation was the
strongest when all mediators on intents were included together in the same model. Although
the total effect of media multitasking during narrative viewing on change in intents was
nonsignificant, nonetheless, it seems that participants in the YouTube page group developed
stronger intentions to receive Pap tests in the near future only because their experiences of
narrative mechanisms were magnified by the real-time action of media multitasking.
Subjective knowledge. Finally, and perhaps most importantly, subjective knowledge
is the only outcome that is fully accounted for by each narrative mechanism examined in this
study. The mediation effect on subjective knowledge is significant in each single-
mediator model. On top of that, the total effect of media multitasking during narrative
viewing on subjective knowledge is significant across all models, unlike change in tents
(nonsignificant total effect). Given the strong correlation between media multitasking and
subjective knowledge, as well as the significant mediation paths, it is tempting to conclude
that narrative transportation, narrative engagement, identification, enjoyment, negative
emotion, and positive emotion each almost fully explained why greater media multitasking
during narrative viewing caused participants to think that they knew significantly more about
cervical cancer than others. It seems that the aforementioned narrative mechanisms are the
only explanation for the positive influence of media multitasking on subjective knowledge
within the scope of this study.

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Furthermore, the relative strengths of narrative engagement and enjoyment were the
strongest when all narrative mechanisms were included as mediators together in the same
mediation model on subjective knowledge. It is possible that participants in the YouTube
group engaged in more media multitasking during narrative viewing, which increased the all-
encompassing experience of narrative engagement, thereafter eliciting greater confidence
among viewers about the knowledge they acquired from narrative viewing. A previous
qualitative study (Barhdi et al., 2010) suggests that a higher level of media multitasking gives
media users a stronger sense of control and greater confidence about the
information/knowledge they may have acquired from media consumption. However, Barhdi
and his colleagues (2010) offer relatively little evidence on whether it is a general sense of
control or engagement with a specific media platform or involvement with particular content
that elicits such confidence. In alignment with Barhdi et al.’s study, empirical data from this
dissertation pinpoints narrative engagement (i.e., immersive absorption into the story content
conveyed in a media multitasking context) as one of the mental mechanisms that connects
media multitasking during narrative viewing to subjective knowledge. The findings can also
be understood from the other way around. The higher level of disengagement with media
usage (less media multitasking as indicated by the survey page group), the more mentally
detached from narrative experiences (lower engagement), then the more critical examination
or weaker (lower) subjective judgment of the knowledge viewers might have gained from
narrative viewing.
Enjoyment is another particularly important mediator. Participants in the YouTube
group reported they enjoyed watching Tamale Lesson more as compared to participants in the
survey page group. The higher the level of media multitasking during video viewing, the
more enjoyable experience of narrative viewing, and resulting in increased confidence about
the knowledge gained from narrative viewing. These data are consistent with the existing role

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of enjoyment in narrative research, as enjoyment can be considered a narrative mechanism in
itself (instead of only as a byproduct or outcome of transportation or identification). The
findings are also in line with existing multitasking research that suggests media multitasking
can help satisfy inner needs (such as the need for socialization) and thus bring media users a
certain level of gratification (Wang & Tchernev, 2014), which implies a positive association
between media multitasking and enjoyment.
The successful mediation on subjective knowledge and change in intents showed that
people are not directly affected by media multitasking during narrative viewing. Instead, they
seem to be only affected indirectly through the impact of media multitasking on a variety of
narrative experiences, which, in turn, increased their confidence in their knowledge about
Pap tests and their intentions to get a Pap test as encouraged by the narrative. Crucially, these
findings highlight the importance of integrating the underlying mechanisms of narrative
persuasion into the study of the effect of media multitasking on the final outcomes of
narrative persuasion.
Relative strengths of mediators. This dissertation assessed the relative strengths of
narrative mechanisms as mediators by entering all six mediators together in the same model.
When all mediators were entered together in the same model, narrative engagement
successfully mediated the influence of media multitasking on subjective knowledge and on
change in attitudes. Enjoyment successfully mediated the influence of media multitasking on
change in knowledge (negative) and on subjective knowledge. Narrative transportation
successfully mediated the influence of media multitasking on change in behavioral intentions.
Identification successfully mediated the influence of media multitasking on change in
knowledge. Positive emotion successfully mediated the influence of media multitasking on
change in knowledge. The results suggested that narrative engagement and enjoyment
were the strongest mediators, successfully mediating the influence of media multitasking

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on two persuasive outcomes, respectively. Narrative transportation, identification, and
positive emotion all successfully mediated the influence of media multitasking on one
persuasive outcome, respectively.
Methodological Contributions
It can be challenging to design accurate, comprehensive, and user-friendly methods
for capturing media multitasking in both action and past behaviors (David et al., 2014).
Reporting past behaviors of media multitasking can be challenging for most media users. The
simultaneous usage of multiple media is often underreported. For example, respondents may
forget that a TV or radio is playing in the background when filling out survey questionnaires
(Meng & McDonald, 2009). In a study of how residents in Munice, Indiana
1
used media
(Papper et al., 2004), it was found that “People spend almost a quarter of their media day
with two or more media, and much of that multiple use appears to go unnoticed by the people
who do it.” (p. 45). If media multitasking behaviors that take place while participants respond
to a survey (about media multitasking) can be easily forgotten or underreported, then how
accurately can we expect respondents’ recollections of their media multitasking behaviors in
the past days or weeks to be? This dissertation sought to address such methodological
challenges by incorporating several modified measures.
First, media multitasking during narrative viewing was manipulated in an online
experiment that resembled how viewers watch narrative content in daily life. Crucially, the
multitasking action was induced rather than forced. The manipulation was simple:
participants in the high action condition were directed away from the survey webpage to an
external video website (YouTube) to watch Tamale Lesson. It was expected that YouTube, or
the real-life World Wide Web in general, would directly expose video viewers to rich media
opportunities, and strongly entice viewers to engage in media multitasking when watching

1
The locations of a sociological study published in the book “Middletown” (1929).

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the video. Rather than being instructed to complete several media tasks at the same time (as
other multitasking studies have tended to do), participants in this study chose to practice
media multitasking during video viewing of their own volition. This is clearly a more organic
and spontaneous way of getting involved in media multitasking. As Wang and Tchernev
(2012) note, individuals often actively seek out media multitasking to fulfill intrinsic needs,
so the voluntary engagement with media multitasking explored in this dissertation may be
closely in aligned with the process wherein individuals decide to media multitask in
naturalistic settings. In this way, the results of the experiment conducted here can be
reasonably expected to provide a more accurate picture of how individuals multitask with
media in real life. In a sense, the induced experimental condition is similar to enabling
participants to “getting there,” which is the relatively active process of seeking information,
rather than putting participants in a condition of “being there,” which is the relatively passive
exposure to acquired media content. Moreover, previous studies have suggested that different
ways of acquiring information may affect the actual processing of content (Wise, Bolls,
Myers, & Sternadori, 2009). Similarly, creating an induced experimental environment in
which participants choose to actively engage in media multitasking during narrative viewing
is likely to differ from the required media multitasking condition used in some previous
studies.
Incorporating both behavioral data (media multitasking during narrative viewing) and
self-report data (prior frequency of non-media multitasking and frequency of media
multitasking) in the same study ensures a more comprehensive understanding of media
multitasking, because while each of these two types of data has its own limitations, they can
complement each other. Media multitasking during media consumption is believed to be
prevalent, such as during TV viewing (Voorveld & Viswanathan, 2014) and mobile phone
usage (David et al., 2014). It can be especially the case if media consumption takes place in

114
natural settings (Yeykellis et al., 2014). Creating an opportunity for participants to behave as
if they are in a natural setting may help us better understand the likelihood of viewers
choosing to engage in multitasking actions at the same time as watching a narrative video
when they are given the opportunity to choose in an academic study.
Using this data, it is reported that 21% of participants in the survey group and 40% of
participants in the YouTube group engaged in media multitasking when watching Tamale
Lesson video. On the one hand, this is consistent with previous findings and estimates about
the prevalence of media multitasking during media consumption. On the other hand, this
contrasts with the self-report data on prior habits of multitasking. More than 80% of
participants reported that they sometimes or always media multitasking when watching
videos on a computer, on a TV or on a phone. It seems that the ratio of actually media
multitasking is far lower than the self-reported frequencies/tendencies to media multitask in
the past. Of course, the manipulation check in this dissertation only asked participants if they
opened multiple windows or pages in Internet browsers during narrative viewing, which is
only one of the many activities of media multitasking. Nonetheless, the data seem to show a
discrepancy between frequencies of real-time media multitasking and multitasking in the past
as recalled by memory.
Another key modified measure was that the data on media multitasking during
narrative viewing were collected without a time limit. Thanks to the flexible nature of the
online experiment, no time limit was set for study participants. It has been an important
concern for multitasking researchers that the strict time pressure imposed by many
multitasking experimental studies (three seconds in Foerde et al., 2006; two minutes in Wang
& Tchernev, 2012) can differ too much from the comparatively unrestricted time window of
media multitasking in real life. Media multitasking may be more likely to naturally occur

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when time pressure (of completing tasks) is low (Wang & Tchernev, 2012). Addressing this
concern, the present study attempted to take a middle ground between methods of high time
pressure (experimental settings in a lab) and methods of low time pressure (keeping a diary
of daily media activities that may run days or even weeks). Participants in this study could
finish watching the online video with little time restraint, as the survey webpage would not
expire. They only needed to record the media activities that occurred during the viewing of
the narrative video, instead of weeklong activities. This dissertation reported that the high-
media-multitasking condition (29’20’’) spent longer time completing the online study
compared to the low-media-multitasking condition (16’40’’ on average). Interestingly, this
finding in fact is consistent with the manipulation and experiment design. Participants in the
YouTube group apparently spent more time on engaging with non-video related tasks,
whereas participants in the plain survey group spent less time completing activities other than
viewing the video.
Practical Contributions
Besides contributing to media multitasking research and the use of narrative
persuasion in health communication, this dissertation’s findings also have practical
implications for communication specialists, health campaign designers, and for everyday
behavior. Regarding media practices, based on the documented influence of media
multitasking on persuasive outcomes and narrative mechanisms, media practitioners and
researchers may take media multitasking into consideration when examining narrative impact
in a health context. They can focus on narrative viewers and variations within a narrative
structure, as well as defining features of the viewing context that includes media
multitasking.

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Health intervention and advertising campaign. A key takeaway from this
dissertation is that media multitasking might not always be detrimental to health interventions
and persuasive campaigns. The study argues that health researchers/educators may attempt to
design preventive health materials that take account of viewers’ strategic media multitasking
activities. The observed impact of media multitasking is important to consider when
designing health campaigns. A media multitasking experience may lead to stronger
engagement with a story and facilitate persuasive outcomes from a narrative video that aims
to increase health awareness of a certain topic. Indeed, some emerging industry practices are
already taking advantage of the potential benefits of media multitasking, and customizing
branding communication campaigns to incorporate and even encourage media multitasking in
the hope of achieving greater persuasion success. For example, the sporting goods brand
Reebok launched an interactive campaign that purposefully utilized multiple media within an
umbrella narrative in order to encourage viewer engagement. Viewers were encouraged to
solve a fictional mystery, and multiple media platforms were utilized to display mystery cues.
The interactive campaign successfully increased web traffic to the official Reebok website,
and enhanced viewers’ engagement with the brand by encouraging them to engage in
multiple media for the completion of several tasks (Bardhi et al., 2010).
Beyond persuasive campaigns, media multitasking can be properly designed and
purposefully included in health devices to achieve preventive health purposes. A technology
startup named Brain-Power designs software to transform wearable technology (e.g., Google
Glass) into “neuro-assistive devices” to address the challenges of autism. The software is
designed to teach life skills, language, and social interaction skis to autistic children. A child
wears the device can view several media contents on the screen: the physical reality includes
the person who smiles at him/her in real life and the virtual reality includes media contents
such as smiley faces, social skill scores, encouragements, and little stars (Figure 5.4. shows

117
the illustrative pictures). The child who wares the glasses is placed in a context of higher
media multitasking, but the multitasking aspect is purposefully designed to help the child
walk through the challenges of social interaction. Importantly, health educators and
practitioners may leverage the benefits of media multitasking, and customize devices,
toolsets, and campaigns to create a proper context that encourages well-designed media
multitasking.

[Insert Figure 5.4. here]

Limitations and Future Research
An area that could be improved in future studies is the means by which emotion is
measured. Due to the space/length restrictions of survey, the study only dealt with a limited
number of discrete emotions. Indeed, just five discrete emotions were selected to form the
emotion scale, which might be considered incomplete and unrepresentative of the full
spectrum of affective states. The relatively limited reliability of the positive emotion measure
(a = .69) may therefore threaten the interpretability of results associated with the measure and
can also partially explain why certain emotion-related hypotheses were found to be
nonsignificant in this study. Future research could use a more reliable and comprehensive
scale to measure emotion in media multitasking research, or better yet, track physiological
measures of emotion.
Another shortcoming of the study is that it did not ask participants to report the
content of media multitasking action during narrative viewing. If such data had been
collected, it would have been helpful for understanding whether the content of media
multitasking action is congruent or incongruent with the content of narrative video, which
may turn out to be another significant media multitasking variable influencing narrative

118
effects. This can be explained as the dimension of task relations, which refers to the extent to
which multiple tasks relate to one another, in Wang and Tchernev (2012)’s conceptualization
of multitasking as a multidimensional construct. For example, Angell and his colleagues
(2016) examined the impact of media multitasking on consumer memory for advertising
messages. They found that when primary activities (advertising viewing) and secondary
activities (media multitasking activities) were congruent with each other, participants
experienced a higher level of advertising recall and recognition compared to worse recall and
recognition in most other media multitasking situations.
A related area for improvement is that this dissertation didn’t measure the amount of
multitasking opportunities directly. Participants in the YouTube group were assumed to face
greater temptation and more convenient access to media multitasking opportunities because a
typical YouTube webpage does display various contents, such as banner advertisements,
recommended videos in the sidebar, and users’ viewing histories besides the chosen video. In
comparison, participants in the survey group were afforded with less media multitasking
opportunities because a typical survey page (on Qualtrics) is usually plain and absent of un-
related content. Although manipulation check confirmed that those in the YouTube group
indeed practiced more media multitasking during narrative viewing as opposed to those in the
survey group, it would be useful if additional measures can be taken to measure directly the
level of media multitasking opportunities on both webpages.
Therefore, if the content of media multitasking is recorded in future studies, it will be
helpful to learn about the synchronicity of media multitasking action, such that highly
synchronous social interactions (such as real-time online chatting) require more cognitive
resources for producing timely responses compared with less synchronous social interactions
(such as leaving an online message on SNS website) that do not require timely responses
(David et al., 2015; Wang & Tchernev 2012). Xu, Wang, and David (2016) found that

119
synchronous social interactions were positively associated with university students’
psychological well-being (understood as social success, normalcy, and self-control), yet
media multitasking during synchronous social interactions was still associated with decreases
in social success. Evaluating the synchronicity of media multitasking task will correspond to
the dimension on task outputs, which refers to the kind of behavioral response required by the
tasks, in Wang & Tchernev (2012)’s conceptualization. As such, future research should ask
participants to report the content/topic of their media multitasking actions especially when
they are given the opportunity to take tests in a natural or ecologically valid setting.
Resistance to persuasion is another useful theoretical construct that might be useful in
understanding the indirect effects of media multitasking on persuasive outcomes. Media
multitasking might improve viewers’ positive brand evaluations after watching TV
advertisements because people are less capable of resisting the persuasive message when
media multitasking as compared to non-multitasking (Segijn, Voorveld, & Smit, 2016).
Although media multitasking might suppress comprehension, it can also suppress
counterarguing, which in turn, might improve the effectiveness of persuasion (Jeong &
Yoori, 2015). Ideally, it would be helpful to measure counterarguing after narrative viewing
to see if a decrease in counterarguing emerges as another significant intermediary (or
mediator) between media multitasking impact and narrative persuasion. If counterarguing
were measured, it would be possible to examine whether media multitasking reduces
counterarguing and leads to stronger narrative effects. That is, counterarguing can be another
potential mediator of media multitasking’s impact on narrative persuasion. Unfortunately,
such data are not available in this study. As such, this study provides some evidence on the
positive effects between media multitasking and narrative persuasion, and shows that the
narrative processing mechanism (involving transportation, identification, and enjoyment)
may partially explain why such a positive effect exists. However, this study cannot rule out

120
counterarguing as another widely-accepted potential mechanism that may mediate and/or
explain the positive effects found in this study. Moreover, the relatively low completion rate
(29%) is already difficult to acquire given that this is a high involvement study. Adding
another set of measures about counterarguing would probably cause more exhaustion of
participants and lead to an even lower response and completion rates. Due to the resource
limitations of this study, and the primary focus on narrative persuasion and narrative
processing, counterarguing was thus not chosen as a focus, but it could certainly be included
in future research.
Another factor that might play an important role in determining the influences of
media multitasking is narrative versus nonnarrative. Recent studies found that media
multitasking occur less often when viewers consumed entertainment and advertising genres,
and to occur more often with the sports genre (Voorveld & Viswanathan, 2014). Similarly,
another study used ecological momentary assessment to explore individual and contextual
predictors of adolescents’ TV-multitasking behavior (Christensen, Bickham, Ross, & Rich,
2015). It found that young people were likely to pay more attention to TV and less attention
to multitasking if watching a drama, experiencing negative affect, or attending to other
people. Both studies show that media multitasking may vary across different genres of media
content and be less likely to occur during narrative viewing. It is possible that media
multitasking while consuming narrative genre might have a different impact on persuasive
outcomes and underlying mechanisms as compared to media multitasking while consuming
nonnarrative genre. Thus, future study should also examine the effects of media multitasking
on persuasion using both narrative and nonnarrative materials for comparison.
In line with earlier research investigating the use of narrative in health disparity
(Murphy et al., 2013; Rimal et al., 2013), the present study included only Mexican-American
women. Some studies on media multitasking suggest that ethnicity is related to media

121
multitasking tendencies. Kononova and Chiang (2015) examined predictors of media
multitasking tendency among media users in the U.S. and Taiwan. They found that American
participants reported higher levels of polychronicity and a higher frequency of media
multitasking in the past than Taiwanese participants. It is suspected that media multitasking
tendency may vary systematically across different ethnicity and cultural backgrounds. Future
studies can include an ethnically diversified sample for systematical comparison.
Finally, the sampling method, which relied on a nonprobability-based online panel,
might be considered problematic in terms of the extent to which the sample is representative
of the larger population, thus limiting the generalizability of the findings. Although this study
intentionally sought to recruit Mexican-American females aged between 25 and 45, data
obtained through online panels can be subject to some errors. For example, the sample was
slightly skewed toward young adults (65.5% of participants were between 25-34 years old).
Considering such limitations, any similar future studies should ensure that they are analyzing
higher-quality data with a larger and more demographically balanced sample.
Conclusion
Overall, this dissertation suggests that engaging in media multitasking while watching
a narrative film can actually make the narrative more persuasive, as well as making the
mental experience of narrative persuasion more intensified. The power of narrative
persuasion remains effective and strong even when viewers practice several media tasks
simultaneously. Importantly, this research shows that viewers are not only directly influenced
by the action of media multitasking. They are also indirectly affected by the effects of media
multitasking on change in knowledge, subjective knowledge, change in attitudes, and change
in behavioral intentions, through the mediation effects of transportation, engagement,
identification, enjoyment, negative emotion, and positive emotion. Crucially, the condition of
higher media multitasking during narrative viewing results in amplified experiences of

122
absorption into the narrative, leading to improved outcomes of persuasion.
This dissertation extends the existing work on narrative persuasion by determining the
influence of media multitasking during narrative viewing on the specific outcomes of
narrative persuasion, as well as its influence on the exact psychological mechanisms of
narrative persuasion. Furthermore, the relationship between narrative mechanisms and
persuasive outcomes was examined and compared among participants in a condition of
higher media multitasking during narrative viewing (YouTube group) and participants in a
condition of lower media multitasking during narrative viewing (survey group). Finally, and
perhaps most importantly, this research integrates narrative theory into the study of media
multitasking effects by demonstrating the mediation effects of narrative transportation,
narrative engagement, identification, enjoyment, negative emotion, and positive emotion that
lead media multitasking to increased knowledge, subjective knowledge, attitudinal, and
intentional change. Overall, this study provides a starting point to help untangle narrative
persuasion in a media multitasking context and to better understand the process by which
media multitasking influences persuasion.

123
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Table 3.1
Sample Characteristics, n = 478

N %
Age
25 to 34 years 313 65.5%
35 to 45 years 165 34.5%
Gender
Female 478 100%
Ethnicity
Hispanic 478 100%
5

Education
A college education or higher 385 80.5%
Less than a college degree 93 19.5%

Household income
Less than $30K per annum 141 29.5%
Between $30K and $100K per annum 286 59.8%
Greater than $100K per annum 51 10.7%
Have some sort of health insurance 406 84.9%
Have been diagnosed of cervical cancer
0
0%
Owner of a computer/laptop, TV and a smart phone 478 100%

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Table 4.1
Bivariate Correlations among Main Variables with Means and Standard Deviations Reported, n = 478
1 2 3 4 5 6 7 8 9 10 11
1 Group - - - - - - - - - - -
2 Change in
Knowledge
.164** - - - - - - - - - -
3 Subjective
Knowledge
.099* .020 - - - - - - - - -
4 Change in
Attitudes
.090* .179** .110* - - - - - - - -
5 Change in
Intents
-.010 .046 .051 .070 - - - - - - -

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6Transportation .119** .140** .299** .045 .187** - - - - - -
7 Engagement .175** .155** .336** .212** .086 .529** - - - - -
8 Identification .092* .116* .241** -.010 .119** .621** .195** - - - -
9 Enjoyment .108* .039 .306** -.005 .126** .717** .305** .749** - - -
10 Negative
Emotion
-.115* -.117* -.131** -.131** .038 -.114* -.355** .119** .082 - -
11 Positive
Emotion
.186** .177** .181** .044 .033 .434** .166** .500** .540** .040 -
Mean - .51 30.40 1.93 1.01 25.42 51.40 4.35 72.87 10.53 9.81
SD - 1.12 5.71 6.32 4.81 8.20 11.86 .47 26.31 6.60 4.81
Notes. Transportation 1 is the scale used to measure narrative transportation. Transportation 2 is the scale used to measure narrative
engagement. Pearson correlation is reported. * means p ≤ .05, ** p ≤ .01

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Table 4.2
Frequency of non-media multitasking in the past, n = 478 (1 = strongly disagree, 7 =
strongly agree)

Mean SD
I am more efficient when I am multitasking. 4.95 1.632
I try to multitask whenever possible. 5.24 1.677
I enjoy multitasking. 5.08 1.750
I am in a state of flow when multitasking. 4.96 1.733
I multitask out of habit. 5.17 1.727
Before multitasking I deliberately think about specific tasks
that I can do concurrently.
4.93 1.867
I lose track of time when multitasking.

4.72 1.814
I can do more through multitasking.

5.17 1.670
When I am on a computer or using my mobile phone, I am
always drawn to do more than one thing at a time.
4.97 1.845
I am distracted when I have to focus on only one task. 3.68 2.036
I find it difficult to do more than one task at a time. 2.98 1.998
I am bored when I am not multitasking. 3.70 1.982
I find it entertaining and enjoyable when multitasking. 4.69 1.784

165
I find it distracting to engage in different activities
concurrently.
3.28 1.971

166
Table 4.3
Frequency of Media Multitasking in the Past, n = 478
Seldom or Never Sometimes or Always
Frequency Percentage Frequency Percentage
Media multitasking while
consuming video content on
a computer in your daily life
51 10.7% 427 89.3%
Media multitasking while
consuming video content on
a TV in your daily life
63 13.2% 415 86.8%
Media multitasking while
consuming video content on
a phone in your daily life
80 16.7% 398 83.3%

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Table 4.4
Change in Knowledge, Attitudes, and Behavioral Intentions, and Subjective knowledge by
Multitasking Groups

Low Media
Multitasking during
narrative viewing
High Media
Multitasking during
narrative viewing
N = 239 N = 239
Change in Knowledge*** 0. 33 (.99) 0.70 (1.22)
Subjective Knowledge* 29.84 (5.45) 30.97 (5.92)
Change in Attitudes* 1.36 (6.28) 2.49 (6.31)
Behavioral Intentions 1.05 (4.82) .96 (4.81)
Notes. Standard deviations are in parentheses. * means p < .05, ** means p < .01, *** means
p =.0005.

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Table 4.5
Transportation, Engagement, Identification, Enjoyment, and Emotion by Multitasking
Groups

Low Media
Multitasking during
narrative viewing
High Media
Multitasking during
narrative viewing
N = 239 N = 239
Narrative Transportation** 24.44 (7.74) 26.39 (8.54)
Narrative Engagement*** 49.33(11.81) 53.47(11.56)
Identification* 82.32 (32.99) 87.64 (30.86)
Enjoyment* 70.03 (26.40) 75.70 (25.96)
Negative Emotion* 11.29 (6.91) 9.78 (6.20)
Positive Emotion*** 8.92(4.63) 10.70(4.83)
NoteS. Standard deviations are in parentheses. * means p < .05, ** means p < .01, *** means
p = .0005.

169
Table 4.6
Regression of Change in Knowledge, Attitudes, and Behavioral Intentions, and Subjective
Knowledge on Transportation, Engagement, Identification, Enjoyment, and Emotion in
YouTube Group, n = 239
Change in
Knowledge
Subjective
Knowledge
Change in
Attitudes
Change in
Behavioral
Intentions
Transportation -.002 -.076 -.098 .188**
Engagement .022** .132** .101* .048
Identification .758* 1.568 -.203 1.171
Enjoyment -.018** .067** .002 -.037
Negative Emotion -.013 -.127* -.049 .066
Positive Emotion .060** -.052 .085 -.009
R
2
0.12*** 0.21*** 0.03 0.11***
Note: Standardized beta coefficients from regression models. * means p <.05, ** means p <
.01, ***means p=.0005

170
Table 4.7
Regression of Change in Knowledge, Attitudes, and Behavioral Intentions, and Subjective
Knowledge on Transportation, Engagement, Identification, Enjoyment, and Emotion in
Survey Group, n = 239
Change in
Knowledge
Subjective
Knowledge
Change in
Attitudes
Change in
Behavioral
Intentions
Transportation .032* .038 -.002 .687
Engagement -.005 .116** .144** -.033
Identification .178 .083 .015 .317
Enjoyment -.008* .019 -.030 .025
Negative Emotion -.011 .001 -.041 .030
Positive Emotion .019 .064 .096 -.159*
R
2
.05
(p = .066)
0.124*** 0.08** 0.03
Note: Standardized beta coefficients from regression models. * means p <.05, ** means p <
.01, ***means p=.0005

171
Table 4.8
Summary of Difference of Narrative Impact between Survey Group and YouTube Group
Change in
knowledge
Subjective
knowledge
Change in
attitudes
Change in
intentions

Transportation ✗ ✗ ✗ ✓ YouTube
✓ ✗ ✗ ✗ Survey
Engagement ✓ ✓ ✓ ✗ YouTube
✗ ✓ ✓ ✗ Survey
Identification ✓ ✗ ✗ ✗ YouTube
✗ ✗ ✗ ✗ Survey
Enjoyment ✓ − ✓ ✗ ✗ YouTube
✓ − ✗ ✗ ✗ Survey
Negative
Emotion
✗ ✓ − ✗ ✗ YouTube
✗ ✗ ✗ ✗ Survey
Positive
Emotion
✓ ✗ ✗ ✗ YouTube
✗ ✗ ✗ ✓ − Survey
Model
Significance
✓ ✓ ✗ ✓ YouTube
✗ marginal ✓ ✓ ✗ Survey
Note: ✓ means significant relationship in the group condition. ✗ eans significant
relationshnship in the group condition

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Table 5.1
Mediation Effects of Media Multitasking During Viewing on Change in Knowledge, Attitudes,
and Behavioral Intentions, and Subjective Knowledge via Transportation, Engagement,
Identification, Enjoyment, and Emotion as Intermediaries
Change in Knowledge
Total Effect Direct Effect Mediation Effect
Narrative Transportation .3682* .3355* .0327*
Narrative Engagement .3682* .3170* .0512*
Identification .3682* .3473* .0209*
Enjoyment .3682* .3630* .0052
Negative Emotion .3682* .3425* .0257*
Positive Emotion .3682* .3050* .0632*
All mediators .3682* .2546* .1136*
Transportation .0272
Engagement .0326
Identification .0313*
Enjoyment -.0659*
Negative Emotion .0170
Positive Emotion .0715*
Subjective Knowledge
Total Effect Direct Effect Mediation Effect
Narrative Transportation 1.1255* .7306 .3949*
Narrative Engagement 1.1255* .4687 .6569*
Identification 1.1255* .8803 .2452*
Enjoyment 1.1255* .7583 .3673*

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Negative Emotion 1.1255* .9671 .1584*
Positive Emotion 1.1255* .7682 .3573*
All Mediators 1.1255* .2426 .8829*
Transportation -.0431
Engagement .4974*
Identification .0607
Enjoyment .2531*
Negative Emotion .0887
Positive Emotion .0262
Change in Attitudes
Total Effect Direct Effect Mediation Effect
Narrative Transportation 1.1339* 1.0818 .0521
Narrative Engagement 1.1339* .6876 .4463*
Identification 1.1339* 1.1554* -.0215
Enjoyment 1.1339* 1.1546* -.0207
Negative Emotion 1.1339* .9578 .1761*
Positive Emotion 1.1339* 1.0683 .0656
All Mediators 1.1339* .5937 .5402*
Transportation -.1175
Engagement .5170*
Identification .0127
Enjoyment -.0849
Negative Emotion .0717
Positive Emotion .1413
Change in Behavioral Intentions

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Total Effect Direct Effect Mediation Effect
Narrative Transportation -.0921 -.3099 .2178*
Narrative Engagement -.0921 -.2449 .1528*
Identification -.0921 -.1985 .1064*
Enjoyment -.0921 -.2250 .1329*
Negative Emotion -.0921 -.0503 -.0417
Positive Emotion -.0921 -.1559 .0638
All Mediators -.0921 -.1701 .0781
Transportation .2529*
Engagement .0147
Identification .0169
Enjoyment -.0200
Negative Emotion -.0734
Positive Emotion -.1131
Notes. Standardized beta coefficients from regression models. Independent variable was
media multitasking during narrative viewing.

175

Figure 1.1. Images for illustrative purposes about the Multi-link Screen feature of 2014
Samsung Smart Hub TV

176

Figure 1.2. An image for illustrative purpose about the mixed reality display released by Real
Fiction in 2018

177

Figure2.1. Hypothesized direct effects of media multitasking during narrative viewing on
persuasive outcomes

178

Figure 2.2. Hypothesized relationships between narrative mechanisms and persuasive
outcomes in a context of higher media multitasking during narrative viewing

179

Figure2.3. Hypothesized indirect effects of media multitasking during viewing on persuasive
outcomes in single-mediator models

180

Figure2.4. Hypothesized indirect effects of media multitasking during narrative viewing on
persuasive outcomes in six-mediator models

181

Figure 2.5. Screenshots of two experimental conditions: survey group (lower media
multitasking during narrative viewing) and YouTube group (higher media multitasking during
narrative viewing)

182

Figure 4.1. Indirect effects of media multitasking during narrative viewing on change in
knowledge in single-mediator models

183

Figure 4.2. Indirect effects of media multitasking during narrative viewing on change in
knowledge in six-mediator models

184

Figure 4.3. Indirect effects of media multitasking during narrative viewing on subjective
knowledge in single-mediator models

185

Figure 4.4. Indirect effects of media multitasking during narrative viewing on subjective
knowledge in six-mediator models

186

Figure 4.5. Indirect effects of media multitasking during narrative viewing on change in
attitudes in single-mediator models

187

Figure 4.6. Indirect effects of media multitasking during narrative viewing on change in
attitudes in six-mediator models

188

Figure 4.7. Indirect effects of media multitasking during narrative viewing on change in
behavioral intentions in single-mediator models

189

Figure 4.8. Indirect effects of media multitasking during narrative viewing on change in
behavioral intentions in six-mediator models

190

Figure 5.1. Results of the direct influence of media multitasking during narrative viewing on
persuasive outcomes and narrative mechanisms

191

Figure5.2. Results of the relationship between narrative mechanisms and persuasive
outcomes in the YouTube group

192

Figure5.3. Results of the relationship between narrative mechanisms and persuasive
outcomes in the survey group

193

Figure5.4. Images for illustrative purposes about the wearable technology with software
developed for children with autism by Brain Power

194
APPENDIX A: QUESTIONNAIRE (SURVEY GROUP)
University of Southern California

Annenberg School for Communication and Journalism University of Southern California
3502 Watt Way Los Angeles, CA 90089-0281

INFORMATION SHEET FOR NON-MEDICAL RESEARCH
HEALTH NARRATIVE PERSUASION AND MEDIA BEHAVIOR

You are invited to participate in a research study conducted by Jin Huang, Doctoral
Candidate, under the supervision of Professor Sheila Murphy, Ph.D. at the University of
Southern California, because you are a Spanish-speaking female aged between 25 - 45, and
have no prior diagnosis of cervical cancer. This study is funded by USC Annenberg. Your
participation is voluntary. You should read the information below, and ask questions about
anything you do not understand, before deciding whether to participate. Please take as much
time as you need to read the consent form. You may also decide to discuss participation with
your family or friends. You can keep this form for your records.

PURPOSE OF THE STUDY
The present research proposes to study people’s attitudes, knowledge, and behavior change
after watching videos with health-related storylines. Meanwhile, the study investigates how
people’s media behavior influences their acceptance of health messages conveyed through
videos.

STUDY PROCEDURES

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If you agree to participate, you will be asked to complete two online surveys and watch an
online video about cervical cancer prevention. The video runs for about 12:15 minutes; the
surveys will take about 12 minutes to complete. The survey questions are about your
knowledge, attitudes and behavioral intention about pap test; your media usage habits. You
can take the study wherever you have access to a computer. You do not have to answer any
question(s) you don’t want to. You will be asked to complete the survey via Qualtrics, an
online survey platform.

POTENTIAL BENEFITS TO PARTICIPANTS AND/OR TO SOCIETY
You may not directly benefit from your participation in this study; however, you may learn
about information related to cervical cancer prevention. It is hoped that researchers will learn
about how to broaden people’s awareness about cervical cancer prevention.

PAYMENT/COMPENSATION FOR PARTICIPATION
You will be eligible for points for participating in this study. You will be compensated
through the survey panel you belong to.

CONFIDENTIALITY
We will keep your records for this study confidential as far as permitted by law. However, if
we are required to do so by law, we will disclose confidential information about you. The
members of the research team, and the University of Southern California’s Human Subjects
Protection Program (HSPP) may access the data. The HSPP reviews and monitors research
studies to protect the rights and welfare of research subjects. Since this study is conducted on
Qualtrics, it adheres to Qualtrics’ Privacy Policy. To understand the privacy and
confidentiality limitations associated with using Qualtrics, we strongly advise you to

196
familiarize yourself with Qualtrics’ privacy code (https://www.qualtrics.com/privacy-
statement/) In light of privacy concerns, we tried to create a study design that reduces any
potential privacy risks to participants. The data will be stored in the researchers’ secure
computer or laptop. Only the principal investigator and faculty advisor will have access to the
data. All data will be stripped of identifying information. The data will be coded into numeric
value and your personal information won’t be identifiable. Key to the codes will be destroyed
upon completion of the research. The remaining data will be kept for future research use; if
you do not want your data to be used in future research studies, you should not participate in
this study. When the results of the research are published or discussed in conferences, no
identifiable information will be used.

PARTICIPATION AND WITHDRAWAL
Your participation is voluntary. Your refusal to participate will involve no penalty or loss of
benefits to which you are otherwise entitled. You may withdraw your consent at any time and
discontinue participation without penalty. You are not waiving any legal claims, rights or
remedies because of your participation in this research study.

INVESTIGATOR’S CONTACT INFORMATION If you have any questions or concerns
about the research, please feel free to contact Jin Huang, via phone at 213-3994359 or email
at huangjin@usc.edu; or the Faculty Advisor, Sheila Murphy, via phone at 213-740-0945 or
email at smurphy@usc.edu.

RIGHTS OF RESEARCH PARTICIPANT – IRB CONTACT INFORMATION
If you have questions, concerns, or complaints about your rights as a research participant or
the research in general and are unable to contact the research team, or if you want to talk to

197
someone independent of the research team, please contact the University Park Institutional
Review Board (UPIRB), 3720 South Flower Street #301, Los Angeles, CA 90089-0702,
(213) 821-5272 or upirb@usc.edu

198
Q1
. Yes, I'm ready to take the survey! (1)
. No, I prefer not to take the survey. (2)
If No, I prefer not to take the survey is Selected, Then Skip To End of Block

Q2 How old are you?
1. 25-34 (1)
2. 35-45 (2)
3. else (3)
If else Is Selected, Then Skip To End of Block

Q3 What is your ethnicity?
1. Hispanic (1)
2. else (2)
If else Is Selected, Then Skip To End of Block

Q4 Have you been diagnosed with cervical cancer?
1. Yes (1)
2. No (2)
If Yes Is Selected, Then Skip To End of Block

Q5 Are you an owner, and experienced with, a computer/laptop, tv and smart phone?
1. Yes (1)
2. No (2)
If No Is Selected, Then Skip To End of Block

199

Q6 On a scale from 1 to 10, where 1 means strongly disagree and 10 means strongly agree,
please indicate how much you agree with each of the following statements.
1. ______ I don't know what pap tests are. (7)
2. ______ Pap tests are embarrassing. (1)
3. ______ Pap tests are physically painful. (2)
4. ______ Pap tests are important. (3)
5. ______ Pap tests are expensive. (4)
6. ______ Pap tests are time consuming. (5)
7. ______ Pap tests are scary. (6)

Q7 On a scale from 1 to 10, where 1 means strongly disagree and 10 means strongly agree,
please indicate how much you agree with each of the following statements.
1. ______ I will get a Pap test within the next 2 years. (1)
2. ______ I will return for follow-up treatment, of an abnormal Pap test result if
necessary. (2)
3. ______ If I had a 13 year old daughter, I would have her vaccinated against HPV. (3)
4. ______ The HPV vaccine has also been approved for males. If I had a 13-year-old
son, I would have my son vaccinated against HPV. (4)

Q8 Do some clinics offer pap tests for little or no cost?
1. Yes (1)
2. No (2)

Q9 Does a woman need a pap test if she is not sexually active?

200
1. Yes (1)
2. No (2)

Q10 How treatable is cervical cancer if it is caught early? Is it...?
1. almost always treatable (1)
2. mostly untreatable (2)

Q11 How is HPV transmitted?

Q12 What, if anything, can prevent females from contracting the Human Papilloma Virus?
Please select all that apply.
1. vaccines (1)
2. abstinence (2)
3. condoms (3)
4. none of the above (4)

Q13 What is the youngest age the HPV vaccine is recommended for?

Q14 How many shots of the vaccine does it take before it is completely effective?
1. 1 (1)
2. 2 (2)
3. 3 (3)
4. 4 (4)

201
Q15 Now I'd like you to imagine 10 randomly selected women in the United States. By the
time they turn 50, how many of them will have HPV (not the vaccine, the virus)?
1. 8 (1)
2. 5 (2)
3. 3 (3)
4. 2 (4)

Q16 Timing
1. First Click (1)
2. Last Click (2)
3. Page Submit (3)
4. Click Count (4)

Q17 We would like you to view this 12:15 min video narrative.

Q18 On a scale from 1 to 10, where 1 means not at all and 10 means extremely, to what
extent did the film make you feel...

Amused (1)
1 Not at all (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)

202
7 (7)
8 (8)
9 (9)
10 Extremely (10)

Depressed (2)
1 Not at all (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 (7)
8 (8)
9 (9)
10 Extremely (10)

Impatient (3)
1 Not at all (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 (7)

203
8 (8)
9 (9)
10 Extremely (10)

Nervous (4)
1 Not at all (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 (7)
8 (8)
9 (9)
10 Extremely (10)

Relaxed (5)
1 Not at all (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 (7)
8 (8)

204
9 (9)
10 Extremely (10)

Q19 Did you open more than one web page or window on your browser when watching the
video?
1. Yes (1)
2. No (2)

Q20 Did you engage in other media activities when watching the video? Please select all that
apply. Check none if you didn't engage in any other activity.
1. surf the web (1)
2. online video (2)
3. social media (3)
4. tv (4)
5. texting/instant messaging (5)
6. phone call (6)
7. music (7)
8. other computer applications (e.g., word, excel) (8)
9. email (9)
10. play with my phone in general (10)
11. None (11)

Q21 On a scale from 1 to 10, where 1 means strongly disagree and 10 means strongly agree,
please indicate how much you agree with each of the following statements.
1. ______ It was fun for me to watch this narrative. (1)

205
2. ______ I had a good time watching this narrative. (2)
3. ______ The narrative was entertaining. (3)
4. ______ I found this narrative to be very meaningful. (4)
5. ______ I was moved by this narrative. (5)
6. ______ The narrative was thought provoking. (6)
7. ______ This narrative will stick with me for a long time. (7)
8. ______ I know I will never forget this narrative. (8)
9. ______ The narrative left me with a lasting impression. (9)
10. ______ I was at the edge of my seat while watching this narrative. (10)
11. ______ This was a heart-pounding kind of narrative. (11)
12. ______ The narrative was suspenseful. (12)

Q22 On a scale from 1 to 10, where 1 means not at all and 10 means a great deal, please
indicate what you think of Lupita, the eldest daughter who was on the phone with her
boyfriend.
1. ______ How much did you like Lupita, the eldest daughter who was on the phone
with her boyfriend? (1)
2. ______ How similar are you to Lupita, the eldest daughter who was on the phone with
her boyfriend? (2)
3. ______ How much do you feel like you know LUPITA? (3)
4. ______ How much would you like to be LUPITA? (4)

Q23 On a scale from 1 to 10, where 1 means not at all and 10 means a great deal, please
indicate what you think of Petra, the mother’s friend.

206
How much did you like Petra, the mother’s friend? (1)
1 Not at all (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 (7)
8 (8)
9 (9)
10 A great deal (10)

How similar are you to Petra, the mother’s friend? (2)
1 Not at all (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 (7)
8 (8)
9 (9)
10 A great deal (10)

How much do you feel like you know PETRA? (3)

207
1 Not at all (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 (7)
8 (8)
9 (9)
10 A great deal (10)

How much would you like to be PETRA? (4)
1 Not at all (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 (7)
8 (8)
9 (9)
10 A great deal (10)

208

Q24 On a scale from 1 to 10, where 1 means strongly disagree and 10 means strongly agree,
please indicate how much you agree with each of the following statements.

After I finished watching the narrative, I found it easy to put it out of my mind. (1)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 (7)
8 (8)
9 (9)
10 Strongly agree (10)

I could picture myself in the scenes shown in the narrative. (2)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 (7)
8 (8)

209
9 (9)
10 Strongly agree (10)

I found my mind wandering while watching the narrative. (3)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 (7)
8 (8)
9 (9)
10 Strongly agree (10)

I found myself thinking of ways the narrative could have turned out differently. (4)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 (7)
8 (8)
9 (9)

210
10 Strongly agree (10)

Please select option "4" for this line (13)

I wanted to learn how the narrative ended. (5)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 (7)
8 (8)
9 (9)
10 Strongly agree (10)

I was mentally involved in the narrative while watching it. (6)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 (7)
8 (8)

211
9 (9)
10 Strongly agree (10)

The events in the narrative are relevant to my everyday life. (7)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 (7)
8 (8)
9 (9)
10 Strongly agree (10)

The events in the narrative have changed my life. (8)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 (7)
8 (8)
9 (9)

212
10 Strongly agree (10)

While I was watching the narrative, activity going on in the room around me was on my
mind. (9)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 (7)
8 (8)
9 (9)
10 Strongly agree (10)

While I was watching the narrative, I could easily picture the events in it taking place. (10)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 (7)
8 (8)
9 (9)

213
10 Strongly agree (10)

While viewing the narrative, I felt as if I was part of the action. (11)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 (7)
8 (8)
9 (9)
10 Strongly agree (10)

While viewing the narrative, I forgot myself and was fully absorbed. (12)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 (7)
8 (8)
9 (9)
10 Strongly agree (10)

214

If Please select option "4" for this line Is Not Selected, Then Skip To End of Block

Q25 On a scale from 1 to 10, where 1 means strongly disagree and 10 means strongly agree,
please indicate how much you agree with each of the following statements.
1. ______ At points, I had a hard time making sense of what was going on in the
narrative. (1)
2. ______ My understanding of the characters is unclear. (2)
3. ______ I had a hard time recognizing the thread of the narrative. (3)
4. ______ I found my mind wandering while the narrative was on. (4)
5. ______ While the narrative was on I found myself thinking about other things. (5)
6. ______ I had a hard time keeping my mind on the narrative. (6)
7. ______ During the narrative, my body was in the room, but my mind was inside the
world created by the story. (7)
8. ______ The narrative created a new world, and then that world suddenly disappeared
when the program ended. (8)
9. ______ At times during the narrative, the story world was closer to me than the real
world. (9)
10. ______ The narrative affected me emotionally. (10)
11. ______ During the narrative, when a main character succeeded, I felt happy, and
when they suffered in some way, I felt sad. (11)
12. ______ I felt sorry for some of the characters in the narrative. (12)

Q26 In your daily life, how often do you engage in the following groups of activities
concurrently?

215
TV, texting/instant messaging (IM), social media (1)
1 Always (1)
2 Most of the time (2)
3 About half the time (3)
4 Sometimes (4)
5 Never (5)

TV, social media, surf the Web (2)
1 Always (1)
2 Most of the time (2)
3 About half the time (3)
4 Sometimes (4)
5 Never (5)

TV, texting/IM, surf the Web (3)
1 Always (1)
2 Most of the time (2)
3 About half the time (3)
4 Sometimes (4)
5 Never (5)

Q27 Please check how often you engage in another media activity when consuming video
content on a computer in your daily life.

Computer-based video (e.g., watch YouTube videos or TV episodes on a computer)

216
Print media (1)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Television (2)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Computer-based video (on a 2nd set) (3)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Music (4)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Video/computer games (5)

217
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Mobile phone usage in general (6)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Telephone and mobile phone voice calls (7)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

texting/instant messaging (IM) (8)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Email (9)
1 Always (1)

218
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Social media (12)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Web surfing (10)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Other computer-based applications (e.g., word, excel, photoshop) (11)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Q28 In your daily life, how often do you engage in the following groups of activities
concurrently?

219
phone-based video, texting/instant messaging (IM), social media (1)
1 Always (1)
2 Most of the time (2)
3 About half the time (3)
4 Sometimes (4)
5 Never (5)

phone-based video, texting/IM, surf the Web (2)
1 Always (1)
2 Most of the time (2)
3 About half the time (3)
4 Sometimes (4)
5 Never (5)

phone-based video, social media, surf the Web (3)
1 Always (1)
2 Most of the time (2)
3 About half the time (3)
4 Sometimes (4)
5 Never (5)

Q29 On a scale from 1 to 10, where 1 means not at all and 10 means a great deal, please
indicate what you think of Connie, the middle daughter who goes to the clinic at the end.

How much did you like Connie, the middle daughter who goes to the clinic at the end? (1)

220
1 Not at all (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 (7)
8 (8)
9 (9)
10 A great deal (10)

How similar are you to Connie, the middle daughter who goes to the clinic at the end? (2)
1 Not at all (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 (7)
8 (8)
9 (9)
10 A great deal (10)

How much do you feel like you know CONNIE? (3)
1 Not at all (1)

221
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 (7)
8 (8)
9 (9)
10 A great deal (10)

How much would you like to be CONNIE? (4)
1 Not at all (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 (7)
8 (8)
9 (9)
10 A great deal (10)

Q30 On a scale from 1 to 10, where 1 means not at all and 10 means a great deal, please
indicate what you think of Blanca, the mother.
1. ______ How much did you like Blanca, the mother? (1)

222
2. ______ How similar are you to Blanca, the mother? (2)
3. ______ How much do you feel like you know BLANCA? (3)
4. ______ How much would you like to be BLANCA? (4)

Q31 In your daily life, how often do you engage in the following groups of activities
concurrently?
computer-based video, texting/Instant messaging (IM), social media (1)
1 Always (1)
2 Most of the time (2)
3 About half the time (3)
4 Sometimes (4)
5 Never (5)

computer-based video, texting/IM, surf the Web (2)
1 Always (1)
2 Most of the time (2)
3 About half the time (3)
4 Sometimes (4)
5 Never (5)

computer-based video, social media, surf the Web (3)
1 Always (1)
2 Most of the time (2)
3 About half the time (3)
4 Sometimes (4)

223
5 Never (5)

Q32 Please check how often you engage in another media activity when consuming video
content on a television in your daily life.

Print media (1)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Television (on a 2nd set) (2)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Computer-based video (3)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Music (4)
1 Always (1)

224
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Video/computer games (5)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Mobile phone usage in general (6)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Telephone and mobile phone voice calls (7)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

texting/instant messaging (IM) (8)
1 Always (1)
2 Sometimes (2)

225
3 Seldom (3)
4 Never (4)

Email (9)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Social media (12)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Web surfing (10)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Other computer-based applications (e.g., word, excel, photoshop) (11)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)

226
4 Never (4)

Q33 On a scale from 1 to 10, where 1 means strongly disagree and 10 means strongly agree,
please indicate how much you agree with each of the following statements.
1. ______ I don't know what pap tests are. (7)
2. ______ Pap tests are embarrassing. (1)
3. ______ Pap tests are physically painful. (2)
4. ______ Pap tests are important. (3)
5. ______ Pap tests are expensive. (4)
6. ______ Pap tests are time consuming. (5)
7. ______ Pap tests are scary. (6)

Q34 On a scale from 1 to 10, where 1 means strongly disagree and 10 means strongly agree,
please indicate how much you agree with each of the following statements.
1. ______ I will get a Pap test within the next 2 years. (1)
2. ______ I will return for follow-up treatment, of an abnormal Pap test result if
necessary. (2)
3. ______ If I had a 13 year old daughter, I would have her vaccinated against HPV. (3)
4. ______ The HPV vaccine has also been approved for males. If I had a 13-year-old
son, I would have my son vaccinated against HPV. (4)

Q35 Please check how often you engage in another media activity when consuming video
content on a mobile phone in your daily life (e.g., watch YouTube videos or TV clips on a
smart phone).

227
Print media (1)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Television (2)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Computer-based video (3)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Music (4)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Video/computer games (5)

228
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Mobile phone usage in general (6)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Telephone and mobile phone voice calls (7)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

texting/instant messaging (IM) (8)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Email (9)
1 Always (1)

229
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Social media (12)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Web surfing (10)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Other computer-based applications (e.g., word, excel, photoshop) (11)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Q36 In your daily life, how often do you engage in the following groups of activities
concurrently?

230
TV, computer-based video (1)
1 Always (1)
2 Most of the time (2)
3 About half the time (3)
4 Sometimes (4)
5 Never (5)

TV, phone-based video (2)
1 Always (1)
2 Most of the time (2)
3 About half the time (3)
4 Sometimes (4)
5 Never (5)

computer-based video, phone-based video (3)
1 Always (1)
2 Most of the time (2)
3 About half the time (3)
4 Sometimes (4)
5 Never (5)

Q37 Which of the following statements best describes how much you know about pap tests?
1. A lot less than other women (1)
2. Somewhat less than other women (2)
3. Slightly less than other women (3)

231
4. About the same as other women (4)
5. Slightly more than other women (5)
6. Somewhat more than other women (6)
7. A lot more than other women (7)

Q38 Which of the following statements best describes your confidence in using pap tests
information?
1. A lot less than other women (1)
2. Somewhat less than other women (2)
3. Slightly less than other women (3)
4. About the same as other women (4)
5. Slightly more than other women (5)
6. Somewhat more than other women (6)
7. A lot more than other women (7)

Q39 On a scale from 1 to 7, where 1 is disagree and 7 is agree, please indicate how much you
agree with each of the following statements.
1. ______ I feel confident about my ability to comprehend pap tests information on
media. (1)
2. ______ I know a lot about pap tests. (2)
3. ______ I am knowledgeable about pap tests. (3)

Q40 On a scale from 1 to 7, where 1 means strongly disagree and 7 means strongly agree,
please indicate how much you agree with each of the following statements.

232
I am more efficient when I am multitasking. (1)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 Strongly agree (7)

I try to multitask whenever possible. (2)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 Strongly agree (7)

I enjoy multitasking. (3)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)

233
7 Strongly agree (7)

I am in a state of flow when multitasking. (4)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 Strongly agree (7)

I multitask out of habit. (5)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 Strongly agree (7)

Before multitasking I deliberately think about specific tasks that I can do concurrently. (6)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)

234
5 (5)
6 (6)
7 Strongly agree (7)

I lose track of time when multitasking. (7)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 Strongly agree (7)

I can do more through multitasking. (8)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 Strongly agree (7)

Please select option "6" for this line (15)

235
When I am on a computer or using my mobile phone, I am always drawn to do more than one
thing at a time. (9)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 Strongly agree (7)

I am distracted when I have to focus on only one task. (10)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 Strongly agree (7)

I find it difficult to do more than one task at a time. (11)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)

236
6 (6)
7 Strongly agree (7)

I am bored when I am not multitasking. (12)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 Strongly agree (7)

I find it entertaining and enjoyable when multitasking. (13)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 Strongly agree (7)

I find it distracting to engage in different activities concurrently. (14)
1 Strongly disagree (1)
2 (2)
3 (3)

237
4 (4)
5 (5)
6 (6)
7 Strongly agree (7)

Q41 Do some clinics offer pap tests for little or no cost?
1. Yes (1)
2. No (2)

Q42 Does a woman need a pap test if she is not sexually active?
1. Yes (1)
2. No (2)

Q43 How treatable is cervical cancer if it is caught early? Is it...?
1. almost always treatable (1)
2. mostly untreatable (2)

Q44 How is HPV transmitted?

Q45 What, if anything, can prevent females from contracting the Human Papilloma Virus?
Please select all that apply.
1. vaccines (1)
2. abstinence (2)
3. condoms (3)
4. none of the above (4)

238

Q46 What is the youngest age the HPV vaccine is recommended for?

Q47 How many shots of the vaccine does it take before it is completely effective?
1. 1 (1)
2. 2 (2)
3. 3 (3)
4. 4 (4)

Q48 Now I'd like you to imagine 10 randomly selected women in the United States. By the
time they turn 50, how many of them will have HPV (not the vaccine, the virus)?
1. 8 (1)
2. 5 (2)
3. 3 (3)
4. 2 (4)

Q49 What is your education level?
1. college or higher (1)
2. else (2)

Q50 Do you have any health insurance plan?
1. Yes (1)
2. No (2)

Q51 What is your household income?

239
1. less than $30k per annum (1)
2. between $30k and $100k per annum (2)
3. greater than $100k per annum (3)

240

APPENDIX B: QUESTIONNAIRE (YOUTUBE GROUP)
University of Southern California

Annenberg School for Communication and Journalism University of Southern California
3502 Watt Way Los Angeles, CA 90089-0281

INFORMATION SHEET FOR NON-MEDICAL RESEARCH
HEALTH NARRATIVE PERSUASION AND MEDIA BEHAVIOR

You are invited to participate in a research study conducted by Jin Huang, Doctoral
Candidate, under the supervision of Professor Sheila Murphy, Ph.D. at the University of
Southern California, because you are a Spanish-speaking female aged between 25 - 45, and
have no prior diagnosis of cervical cancer. This study is funded by USC Annenberg. Your
participation is voluntary. You should read the information below, and ask questions about
anything you do not understand, before deciding whether to participate. Please take as much
time as you need to read the consent form. You may also decide to discuss participation with
your family or friends. You can keep this form for your records.

PURPOSE OF THE STUDY
The present research proposes to study people’s attitudes, knowledge, and behavior change
after watching videos with health-related storylines. Meanwhile, the study investigates how
people’s media behavior influences their acceptance of health messages conveyed through
videos.

241
STUDY PROCEDURES
If you agree to participate, you will be asked to complete two online surveys and watch an
online video about cervical cancer prevention. The video runs for about 12:15 minutes; the
surveys will take about 12 minutes to complete. The survey questions are about your
knowledge, attitudes and behavioral intention about pap test; your media usage habits. You
can take the study wherever you have access to a computer. You do not have to answer any
question(s) you don’t want to. You will be asked to complete the survey via Qualtrics, an
online survey platform.

POTENTIAL BENEFITS TO PARTICIPANTS AND/OR TO SOCIETY
You may not directly benefit from your participation in this study; however, you may learn
about information related to cervical cancer prevention. It is hoped that researchers will learn
about how to broaden people’s awareness about cervical cancer prevention.

PAYMENT/COMPENSATION FOR PARTICIPATION
You will be eligible for points for participating in this study. You will be compensated
through the survey panel you belong to.

CONFIDENTIALITY
We will keep your records for this study confidential as far as permitted by law. However, if
we are required to do so by law, we will disclose confidential information about you. The
members of the research team, and the University of Southern California’s Human Subjects
Protection Program (HSPP) may access the data. The HSPP reviews and monitors research
studies to protect the rights and welfare of research subjects. Since this study is conducted on
Qualtrics, it adheres to Qualtrics’ Privacy Policy. To understand the privacy and

242
confidentiality limitations associated with using Qualtrics, we strongly advise you to
familiarize yourself with Qualtrics’ privacy code (https://www.qualtrics.com/privacy-
statement/) In light of privacy concerns, we tried to create a study design that reduces any
potential privacy risks to participants. The data will be stored in the researchers’ secure
computer or laptop. Only the principal investigator and faculty advisor will have access to the
data. All data will be stripped of identifying information. The data will be coded into numeric
value and your personal information won’t be identifiable. Key to the codes will be destroyed
upon completion of the research. The remaining data will be kept for future research use; if
you do not want your data to be used in future research studies, you should not participate in
this study. When the results of the research are published or discussed in conferences, no
identifiable information will be used.

PARTICIPATION AND WITHDRAWAL
Your participation is voluntary. Your refusal to participate will involve no penalty or loss of
benefits to which you are otherwise entitled. You may withdraw your consent at any time and
discontinue participation without penalty. You are not waiving any legal claims, rights or
remedies because of your participation in this research study.

INVESTIGATOR’S CONTACT INFORMATION If you have any questions or concerns
about the research, please feel free to contact Jin Huang, via phone at 213-3994359 or email
at huangjin@usc.edu; or the Faculty Advisor, Sheila Murphy, via phone at 213-740-0945 or
email at smurphy@usc.edu.

RIGHTS OF RESEARCH PARTICIPANT – IRB CONTACT INFORMATION

243
If you have questions, concerns, or complaints about your rights as a research participant or
the research in general and are unable to contact the research team, or if you want to talk to
someone independent of the research team, please contact the University Park Institutional
Review Board (UPIRB), 3720 South Flower Street #301, Los Angeles, CA 90089-0702,
(213) 821-5272 or upirb@usc.edu

244
Q1
. Yes, I'm ready to take the survey! (1)
. No, I prefer not to take the survey. (2)
If No, I prefer not to take the survey is Selected, Then Skip To End of Block

Q2 How old are you?
4. 25-34 (1)
5. 35-45 (2)
6. else (3)
If else Is Selected, Then Skip To End of Block

Q3 What is your ethnicity?
3. Hispanic (1)
4. else (2)
If else Is Selected, Then Skip To End of Block

Q4 Have you been diagnosed with cervical cancer?
3. Yes (1)
4. No (2)
If Yes Is Selected, Then Skip To End of Block

Q5 Are you an owner, and experienced with, a computer/laptop, tv and smart phone?
3. Yes (1)
4. No (2)
If No Is Selected, Then Skip To End of Block

245

Q6 On a scale from 1 to 10, where 1 means strongly disagree and 10 means strongly agree,
please indicate how much you agree with each of the following statements.
8. ______ I don't know what pap tests are. (7)
9. ______ Pap tests are embarrassing. (1)
10. ______ Pap tests are physically painful. (2)
11. ______ Pap tests are important. (3)
12. ______ Pap tests are expensive. (4)
13. ______ Pap tests are time consuming. (5)
14. ______ Pap tests are scary. (6)

Q7 On a scale from 1 to 10, where 1 means strongly disagree and 10 means strongly agree,
please indicate how much you agree with each of the following statements.
5. ______ I will get a Pap test within the next 2 years. (1)
6. ______ I will return for follow-up treatment, of an abnormal Pap test result if
necessary. (2)
7. ______ If I had a 13 year old daughter, I would have her vaccinated against HPV. (3)
8. ______ The HPV vaccine has also been approved for males. If I had a 13-year-old
son, I would have my son vaccinated against HPV. (4)

Q8 Do some clinics offer pap tests for little or no cost?
3. Yes (1)
4. No (2)

Q9 Does a woman need a pap test if she is not sexually active?

246
3. Yes (1)
4. No (2)

Q10 How treatable is cervical cancer if it is caught early? Is it...?
3. almost always treatable (1)
4. mostly untreatable (2)

Q11 How is HPV transmitted?

Q12 What, if anything, can prevent females from contracting the Human Papilloma Virus?
Please select all that apply.
5. vaccines (1)
6. abstinence (2)
7. condoms (3)
8. none of the above (4)

Q13 What is the youngest age the HPV vaccine is recommended for?

Q14 How many shots of the vaccine does it take before it is completely effective?
5. 1 (1)
6. 2 (2)
7. 3 (3)
8. 4 (4)

247
Q15 Now I'd like you to imagine 10 randomly selected women in the United States. By the
time they turn 50, how many of them will have HPV (not the vaccine, the virus)?
5. 8 (1)
6. 5 (2)
7. 3 (3)
8. 2 (4)

Q16 Timing
5. First Click (1)
6. Last Click (2)
7. Page Submit (3)
8. Click Count (4)

Q17 We would like you to view a 12:15 min Youtube video. Please right click on the link
and choose open link in new tab or new window: https://youtu.be/Lyhv9KmLroc . After
viewing, please return to this survey page.

Q18 On a scale from 1 to 10, where 1 means not at all and 10 means extremely, to what
extent did the film make you feel...

Amused (1)
1 Not at all (1)
2 (2)
3 (3)
4 (4)

248
5 (5)
6 (6)
7 (7)
8 (8)
9 (9)
10 Extremely (10)

Depressed (2)
1 Not at all (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 (7)
8 (8)
9 (9)
10 Extremely (10)

Impatient (3)
1 Not at all (1)
2 (2)
3 (3)
4 (4)
5 (5)

249
6 (6)
7 (7)
8 (8)
9 (9)
10 Extremely (10)

Nervous (4)
1 Not at all (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 (7)
8 (8)
9 (9)
10 Extremely (10)

Relaxed (5)
1 Not at all (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)

250
7 (7)
8 (8)
9 (9)
10 Extremely (10)

Q19 Did you open more than one web page or window on your browser when watching the
video?
3. Yes (1)
4. No (2)

Q20 Did you engage in other media activities when watching the video? Please select all that
apply. Check none if you didn't engage in any other activity.
12. surf the web (1)
13. online video (2)
14. social media (3)
15. tv (4)
16. texting/instant messaging (5)
17. phone call (6)
18. music (7)
19. other computer applications (e.g., word, excel) (8)
20. email (9)
21. play with my phone in general (10)
22. None (11)

251
Q21 On a scale from 1 to 10, where 1 means strongly disagree and 10 means strongly agree,
please indicate how much you agree with each of the following statements.
13. ______ It was fun for me to watch this narrative. (1)
14. ______ I had a good time watching this narrative. (2)
15. ______ The narrative was entertaining. (3)
16. ______ I found this narrative to be very meaningful. (4)
17. ______ I was moved by this narrative. (5)
18. ______ The narrative was thought provoking. (6)
19. ______ This narrative will stick with me for a long time. (7)
20. ______ I know I will never forget this narrative. (8)
21. ______ The narrative left me with a lasting impression. (9)
22. ______ I was at the edge of my seat while watching this narrative. (10)
23. ______ This was a heart-pounding kind of narrative. (11)
24. ______ The narrative was suspenseful. (12)

Q22 On a scale from 1 to 10, where 1 means not at all and 10 means a great deal, please
indicate what you think of Lupita, the eldest daughter who was on the phone with her
boyfriend.
5. ______ How much did you like Lupita, the eldest daughter who was on the phone
with her boyfriend? (1)
6. ______ How similar are you to Lupita, the eldest daughter who was on the phone with
her boyfriend? (2)
7. ______ How much do you feel like you know LUPITA? (3)
8. ______ How much would you like to be LUPITA? (4)

252
Q23 On a scale from 1 to 10, where 1 means not at all and 10 means a great deal, please
indicate what you think of Petra, the mother’s friend.

How much did you like Petra, the mother’s friend? (1)
1 Not at all (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 (7)
8 (8)
9 (9)
10 A great deal (10)

How similar are you to Petra, the mother’s friend? (2)
1 Not at all (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 (7)
8 (8)
9 (9)

253
10 A great deal (10)

How much do you feel like you know PETRA? (3)
1 Not at all (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 (7)
8 (8)
9 (9)
10 A great deal (10)

How much would you like to be PETRA? (4)
1 Not at all (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 (7)
8 (8)
9 (9)
10 A great deal (10)

254

Q24 On a scale from 1 to 10, where 1 means strongly disagree and 10 means strongly agree,
please indicate how much you agree with each of the following statements.

After I finished watching the narrative, I found it easy to put it out of my mind. (1)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 (7)
8 (8)
9 (9)
10 Strongly agree (10)

I could picture myself in the scenes shown in the narrative. (2)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)

255
6 (6)
7 (7)
8 (8)
9 (9)
10 Strongly agree (10)

I found my mind wandering while watching the narrative. (3)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 (7)
8 (8)
9 (9)
10 Strongly agree (10)

I found myself thinking of ways the narrative could have turned out differently. (4)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)

256
7 (7)
8 (8)
9 (9)
10 Strongly agree (10)

Please select option "4" for this line (13)

I wanted to learn how the narrative ended. (5)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 (7)
8 (8)
9 (9)
10 Strongly agree (10)

I was mentally involved in the narrative while watching it. (6)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)

257
6 (6)
7 (7)
8 (8)
9 (9)
10 Strongly agree (10)

The events in the narrative are relevant to my everyday life. (7)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 (7)
8 (8)
9 (9)
10 Strongly agree (10)

The events in the narrative have changed my life. (8)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)

258
7 (7)
8 (8)
9 (9)
10 Strongly agree (10)

While I was watching the narrative, activity going on in the room around me was on my
mind. (9)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 (7)
8 (8)
9 (9)
10 Strongly agree (10)

While I was watching the narrative, I could easily picture the events in it taking place. (10)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)

259
7 (7)
8 (8)
9 (9)
10 Strongly agree (10)

While viewing the narrative, I felt as if I was part of the action. (11)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 (7)
8 (8)
9 (9)
10 Strongly agree (10)

While viewing the narrative, I forgot myself and was fully absorbed. (12)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 (7)

260
8 (8)
9 (9)
10 Strongly agree (10)

If Please select option "4" for this line Is Not Selected, Then Skip To End of Block

Q25 On a scale from 1 to 10, where 1 means strongly disagree and 10 means strongly agree,
please indicate how much you agree with each of the following statements.
13. ______ At points, I had a hard time making sense of what was going on in the
narrative. (1)
14. ______ My understanding of the characters is unclear. (2)
15. ______ I had a hard time recognizing the thread of the narrative. (3)
16. ______ I found my mind wandering while the narrative was on. (4)
17. ______ While the narrative was on I found myself thinking about other things. (5)
18. ______ I had a hard time keeping my mind on the narrative. (6)
19. ______ During the narrative, my body was in the room, but my mind was inside the
world created by the story. (7)
20. ______ The narrative created a new world, and then that world suddenly disappeared
when the program ended. (8)
21. ______ At times during the narrative, the story world was closer to me than the real
world. (9)
22. ______ The narrative affected me emotionally. (10)
23. ______ During the narrative, when a main character succeeded, I felt happy, and
when they suffered in some way, I felt sad. (11)
24. ______ I felt sorry for some of the characters in the narrative. (12)

261

Q26 In your daily life, how often do you engage in the following groups of activities
concurrently?
TV, texting/instant messaging (IM), social media (1)
1 Always (1)
2 Most of the time (2)
3 About half the time (3)
4 Sometimes (4)
5 Never (5)

TV, social media, surf the Web (2)
1 Always (1)
2 Most of the time (2)
3 About half the time (3)
4 Sometimes (4)
5 Never (5)

TV, texting/IM, surf the Web (3)
1 Always (1)
2 Most of the time (2)
3 About half the time (3)
4 Sometimes (4)
5 Never (5)

262
Q27 Please check how often you engage in another media activity when consuming video
content on a computer in your daily life.

Computer-based video (e.g., watch YouTube videos or TV episodes on a computer)
Print media (1)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Television (2)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Computer-based video (on a 2nd set) (3)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Music (4)
1 Always (1)
2 Sometimes (2)

263
3 Seldom (3)
4 Never (4)

Video/computer games (5)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Mobile phone usage in general (6)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Telephone and mobile phone voice calls (7)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

texting/instant messaging (IM) (8)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)

264
4 Never (4)

Email (9)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Social media (12)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Web surfing (10)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Other computer-based applications (e.g., word, excel, photoshop) (11)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

265

Q28 In your daily life, how often do you engage in the following groups of activities
concurrently?

phone-based video, texting/instant messaging (IM), social media (1)
1 Always (1)
2 Most of the time (2)
3 About half the time (3)
4 Sometimes (4)
5 Never (5)

phone-based video, texting/IM, surf the Web (2)
1 Always (1)
2 Most of the time (2)
3 About half the time (3)
4 Sometimes (4)
5 Never (5)

phone-based video, social media, surf the Web (3)
1 Always (1)
2 Most of the time (2)
3 About half the time (3)
4 Sometimes (4)
5 Never (5)

266
Q29 On a scale from 1 to 10, where 1 means not at all and 10 means a great deal, please
indicate what you think of Connie, the middle daughter who goes to the clinic at the end.

How much did you like Connie, the middle daughter who goes to the clinic at the end? (1)
1 Not at all (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 (7)
8 (8)
9 (9)
10 A great deal (10)

How similar are you to Connie, the middle daughter who goes to the clinic at the end? (2)
1 Not at all (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 (7)
8 (8)
9 (9)

267
10 A great deal (10)

How much do you feel like you know CONNIE? (3)
1 Not at all (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 (7)
8 (8)
9 (9)
10 A great deal (10)

How much would you like to be CONNIE? (4)
1 Not at all (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 (7)
8 (8)
9 (9)
10 A great deal (10)

268

Q30 On a scale from 1 to 10, where 1 means not at all and 10 means a great deal, please
indicate what you think of Blanca, the mother.
5. ______ How much did you like Blanca, the mother? (1)
6. ______ How similar are you to Blanca, the mother? (2)
7. ______ How much do you feel like you know BLANCA? (3)
8. ______ How much would you like to be BLANCA? (4)

Q31 In your daily life, how often do you engage in the following groups of activities
concurrently?
computer-based video, texting/Instant messaging (IM), social media (1)
1 Always (1)
2 Most of the time (2)
3 About half the time (3)
4 Sometimes (4)
5 Never (5)

computer-based video, texting/IM, surf the Web (2)
1 Always (1)
2 Most of the time (2)
3 About half the time (3)
4 Sometimes (4)
5 Never (5)

computer-based video, social media, surf the Web (3)

269
1 Always (1)
2 Most of the time (2)
3 About half the time (3)
4 Sometimes (4)
5 Never (5)

Q32 Please check how often you engage in another media activity when consuming video
content on a television in your daily life.

Print media (1)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Television (on a 2nd set) (2)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Computer-based video (3)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)

270
4 Never (4)

Music (4)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Video/computer games (5)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Mobile phone usage in general (6)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Telephone and mobile phone voice calls (7)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

271

texting/instant messaging (IM) (8)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Email (9)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Social media (12)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Web surfing (10)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

272
Other computer-based applications (e.g., word, excel, photoshop) (11)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Q33 On a scale from 1 to 10, where 1 means strongly disagree and 10 means strongly agree,
please indicate how much you agree with each of the following statements.
8. ______ I don't know what pap tests are. (7)
9. ______ Pap tests are embarrassing. (1)
10. ______ Pap tests are physically painful. (2)
11. ______ Pap tests are important. (3)
12. ______ Pap tests are expensive. (4)
13. ______ Pap tests are time consuming. (5)
14. ______ Pap tests are scary. (6)

Q34 On a scale from 1 to 10, where 1 means strongly disagree and 10 means strongly agree,
please indicate how much you agree with each of the following statements.
5. ______ I will get a Pap test within the next 2 years. (1)
6. ______ I will return for follow-up treatment, of an abnormal Pap test result if
necessary. (2)
7. ______ If I had a 13 year old daughter, I would have her vaccinated against HPV. (3)
8. ______ The HPV vaccine has also been approved for males. If I had a 13-year-old
son, I would have my son vaccinated against HPV. (4)

273
Q35 Please check how often you engage in another media activity when consuming video
content on a mobile phone in your daily life (e.g., watch YouTube videos or TV clips on a
smart phone).

Print media (1)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Television (2)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Computer-based video (3)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Music (4)
1 Always (1)
2 Sometimes (2)

274
3 Seldom (3)
4 Never (4)

Video/computer games (5)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Mobile phone usage in general (6)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Telephone and mobile phone voice calls (7)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

texting/instant messaging (IM) (8)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)

275
4 Never (4)

Email (9)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Social media (12)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Web surfing (10)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

Other computer-based applications (e.g., word, excel, photoshop) (11)
1 Always (1)
2 Sometimes (2)
3 Seldom (3)
4 Never (4)

276

Q36 In your daily life, how often do you engage in the following groups of activities
concurrently?

TV, computer-based video (1)
1 Always (1)
2 Most of the time (2)
3 About half the time (3)
4 Sometimes (4)
5 Never (5)

TV, phone-based video (2)
1 Always (1)
2 Most of the time (2)
3 About half the time (3)
4 Sometimes (4)
5 Never (5)

computer-based video, phone-based video (3)
1 Always (1)
2 Most of the time (2)
3 About half the time (3)
4 Sometimes (4)
5 Never (5)

277
Q37 Which of the following statements best describes how much you know about pap tests?
8. A lot less than other women (1)
9. Somewhat less than other women (2)
10. Slightly less than other women (3)
11. About the same as other women (4)
12. Slightly more than other women (5)
13. Somewhat more than other women (6)
14. A lot more than other women (7)

Q38 Which of the following statements best describes your confidence in using pap tests
information?
8. A lot less than other women (1)
9. Somewhat less than other women (2)
10. Slightly less than other women (3)
11. About the same as other women (4)
12. Slightly more than other women (5)
13. Somewhat more than other women (6)
14. A lot more than other women (7)

Q39 On a scale from 1 to 7, where 1 is disagree and 7 is agree, please indicate how much you
agree with each of the following statements.
4. ______ I feel confident about my ability to comprehend pap tests information on
media. (1)
5. ______ I know a lot about pap tests. (2)
6. ______ I am knowledgeable about pap tests. (3)

278

Q40 On a scale from 1 to 7, where 1 means strongly disagree and 7 means strongly agree,
please indicate how much you agree with each of the following statements.

I am more efficient when I am multitasking. (1)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 Strongly agree (7)

I try to multitask whenever possible. (2)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 Strongly agree (7)

I enjoy multitasking. (3)
1 Strongly disagree (1)
2 (2)

279
3 (3)
4 (4)
5 (5)
6 (6)
7 Strongly agree (7)

I am in a state of flow when multitasking. (4)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 Strongly agree (7)

I multitask out of habit. (5)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 Strongly agree (7)

Before multitasking I deliberately think about specific tasks that I can do concurrently. (6)

280
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 Strongly agree (7)

I lose track of time when multitasking. (7)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 Strongly agree (7)

I can do more through multitasking. (8)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 Strongly agree (7)

281

Please select option "6" for this line (15)

When I am on a computer or using my mobile phone, I am always drawn to do more than one
thing at a time. (9)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 Strongly agree (7)

I am distracted when I have to focus on only one task. (10)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 Strongly agree (7)

I find it difficult to do more than one task at a time. (11)
1 Strongly disagree (1)
2 (2)

282
3 (3)
4 (4)
5 (5)
6 (6)
7 Strongly agree (7)

I am bored when I am not multitasking. (12)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 Strongly agree (7)

I find it entertaining and enjoyable when multitasking. (13)
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 Strongly agree (7)

I find it distracting to engage in different activities concurrently. (14)

283
1 Strongly disagree (1)
2 (2)
3 (3)
4 (4)
5 (5)
6 (6)
7 Strongly agree (7)

Q41 Do some clinics offer pap tests for little or no cost?
3. Yes (1)
4. No (2)

Q42 Does a woman need a pap test if she is not sexually active?
3. Yes (1)
4. No (2)

Q43 How treatable is cervical cancer if it is caught early? Is it...?
3. almost always treatable (1)
4. mostly untreatable (2)

Q44 How is HPV transmitted?

Q45 What, if anything, can prevent females from contracting the Human Papilloma Virus?
Please select all that apply.
5. vaccines (1)

284
6. abstinence (2)
7. condoms (3)
8. none of the above (4)

Q46 What is the youngest age the HPV vaccine is recommended for?

Q47 How many shots of the vaccine does it take before it is completely effective?
5. 1 (1)
6. 2 (2)
7. 3 (3)
8. 4 (4)

Q48 Now I'd like you to imagine 10 randomly selected women in the United States. By the
time they turn 50, how many of them will have HPV (not the vaccine, the virus)?
5. 8 (1)
6. 5 (2)
7. 3 (3)
8. 2 (4)

Q49 What is your education level?
3. college or higher (1)
4. else (2)

Q50 Do you have any health insurance plan?
3. Yes (1)

285
4. No (2)

Q51 What is your household income?
4. less than $30k per annum (1)
5. between $30k and $100k per annum (2)
6. greater than $100k per annum (3)

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Asset Metadata

Creator Huang, Jin (author)

Core Title How media multitasking during narrative viewing affects persuasion: the mediating roles of transportation, engagement, identification, enjoyment, and emotion

School Annenberg School for Communication

Degree Doctor of Philosophy

Degree Program Communication

Publication Date 02/22/2018

Defense Date 01/16/2018

Publisher University of Southern California (original), University of Southern California. Libraries (digital)

Tag experiment,health communication,media multitasking,narrative persuasion,OAI-PMH Harvest

Language English

Contributor Electronically uploaded by the author (provenance)

Advisor Murphy, Sheila Teresa (committee chair), Baezconde-Garbanati, Lourdes (committee member), Cody, Michael (committee member)

Creator Email huangjin@usc.edu,jinhuang922@gmail.com

Permanent Link (DOI) https://doi.org/10.25549/usctheses-c40-478752

Unique identifier UC11266843

Identifier etd-HuangJin-6055.pdf (filename),usctheses-c40-478752 (legacy record id)

Legacy Identifier etd-HuangJin-6055.pdf

Dmrecord 478752

Document Type Dissertation

Rights Huang, Jin

Type texts

Source University of Southern California (contributing entity), University of Southern California Dissertations and Theses (collection)

Access Conditions The author retains rights to his/her dissertation, thesis or other graduate work according to U.S. copyright law. Electronic access is being provided by the USC Libraries in agreement with the a...

Repository Name University of Southern California Digital Library

Repository Location USC Digital Library, University of Southern California, University Park Campus MC 2810, 3434 South Grand Avenue, 2nd Floor, Los Angeles, California 90089-2810, USA