Investigating the Effects of Threatening Language, Message Framing, and Reactance in Opt-Out Organ Donation Campaigns

Jordan Miller, Lesley McGregor, Sinéad Currie, Ronan E O’Carroll

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)
4 Downloads (Pure)


Under opt-out organ donation policies, individuals are automatically considered to have agreed to donate their organs in the absence of a recorded opt-out decision. Growing evidence suggests that the language used within organ donation campaigns influences donor intentions and decision-making.

As awareness campaigns to promote opt-out consent in the UK are ongoing, the objectives of this study were to investigate the effect of language and message framing used in opt-out organ donation campaigns on donor intentions and psychological reactance.

Individuals from Scotland and England (N = 1,350) completed this online experiment. Participants were randomized to view one of four messages, designed in the format of a newspaper article, which described the upcoming opt-out system. This followed a 2 × 2 design whereby the degree of threatening language (high threat vs. low threat) and message framing (loss vs. gain) of the newspaper article was experimentally manipulated. Measures of intention (pre-exposure and postexposure) and postmessage reactance (threat to freedom and anger and counter-arguing) were obtained.

A mixed analysis of variance revealed a significant Group × Time interaction on donor intentions; post hoc analysis revealed that intentions significantly decreased for individuals exposed to the High threat × Loss frame article but significantly increased for those exposed to the High threat × Gain frame article.

In campaigns to promote opt-out legislation, high-threat language combined with loss-frame messages should be avoided. If high-threat language is used, gain-frame messaging that highlights the benefits of organ donation should also be incorporated.
Original languageEnglish
Pages (from-to)50-63
Number of pages13
JournalAnnals of Behavioral Medicine
Issue number1
Early online date3 May 2021
Publication statusPublished - 1 Jan 2022

Bibliographical note

This study was funded by a PhD studentship awarded to Jordan Miller from the University of Stirling.


  • Organ donation
  • Opt-out consent
  • Message framing
  • Threat to freedom
  • Reactance


Dive into the research topics of 'Investigating the Effects of Threatening Language, Message Framing, and Reactance in Opt-Out Organ Donation Campaigns'. Together they form a unique fingerprint.

Cite this