Relative importance of “why” and “how” messages on medication behavior: Insights from construal level theory

Objective: This study assesses the impact of initial messaging strategies on medication behavior in newly diagnosed hypertension patients in a hypothetical context. Applying Construal Level Theory, this study evaluated which message type—low construal (focused on how, feasibility, and concrete) or high construal (focused on why, desirability, and abstract)—is more effective. Methods: An online quasi-experiment was performed with 1200 participants without hypertension aged 30–60. The participants were divided into two message groups, each receiving a hypothetical hypertension diagnosis during a health check-up and different medication messages tailored to construal levels. Results: Compared to “how” messages, “why” messages significantly improved message satisfaction (F_1,1192 = 10.36, p = 0.001, ηp² = 0.009, M (SE) = 5.25 (0.04) vs. 5.04 (0.04)) and adherence intentions (F_1,1192 = 7.54, p = 0.006, ηp² = 0.006, M (SE) = 4.83 (0.06) vs. 4.59 (0.06)). Conclusion: In the hypothetical scenario, patients newly diagnosed with hypertension were found to be more responsive to “why” messages and perceived a distant psychological distance to medication. Practice implications: To enhance adherence intentions and message satisfaction, healthcare professionals should emphasize the reasons and benefits of medication use for newly prescribed hypertension patients. Moreover, early-stage patient materials should prioritize “why” messages to improve adherence.