{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T15:40:16Z","timestamp":1787240416628,"version":"build-2736575974"},"reference-count":48,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T00:00:00Z","timestamp":1773619200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"\n Background<\/jats:title>\n Physical inactivity poses serious health risks. Message framing is a strategy to encourage healthy behaviors, but its effectiveness in promoting physical activity (PA) is unclear, creating challenges for professionals in choosing optimal strategies.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To compare the effects of gain-framed versus loss-framed messages on PA attitudes, intentions, and behaviors among inactive adults.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Seven electronic databases were searched from inception to December 15, 2024. Randomized controlled trials examining gain- versus loss-framed messages targeting physically inactive adults were included. Independent reviewers selected the studies, extracted the data, and performed the risk of bias. Standardized mean differences (SMDs) and 95% confidence intervals (CIs) werepooled using random-effects models. Heterogeneity was assessed using\n I<\/jats:italic>\n 2<\/jats:sup>\n and Q statistics. Subgroup and sensitivity analyses were conducted to explore heterogeneity sources and assess result stability.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Ten RCTs involving 1,355 participants were included. Three articles tested the gain-loss framing effect through PA attitudes, and eight studies each tested message framing through PA intentions and behaviors. There were no statistically significant differences between gain-framed and loss-framed messages in promoting PA attitudes [SMD:\u22120.60, 95%CI: (-2.09, 0.90),\n P<\/jats:italic>\n = 0.44], intentions [SMD: 0.10, 95%CI: (-0.12, 0.33),\n P<\/jats:italic>\n = 0.37] and behaviors [SMD: 0.15, 95%CI: (-0.04, 0.34),\n P<\/jats:italic>\n = 0.13]. Subgroup analyses suggested that gain-framed messages may have a potential advantage in promoting PA behaviors among general populations [SMD: 0.39, 95%CI: (0.03, 0.55),\n P<\/jats:italic>\n = 0.03] and young adults [SMD: 0.38, 95%CI: (013, 0.63),\n P<\/jats:italic>\n = 0.003].\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Current evidence does not demonstrate a clear overall advantage of gain- over loss-framed messages in promoting PA among inactive adults. However, gain-framed messages may be more promising for general and young populations. Further high-quality trials with standardized methodologies and longer follow-up periods are needed to clarify their effectiveness.<\/jats:p>\n <\/jats:sec>\n \n Systematic review registration<\/jats:title>\n \n https:\/\/www.crd.york.ac.uk\/prospero\/display_record.php?ID=CRD42023482474<\/jats:ext-link>\n , identifier CRD42023482474.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1782478","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T06:40:30Z","timestamp":1773643230000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["The effects of gain-loss framed message on physical activity attitudes, intentions, and behaviors in physically inactive adults: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"14","author":[{"given":"Yueying","family":"Jiang","sequence":"first","affiliation":[{"name":"Department of Nursing, The Second Affiliated Hospital of Zhejiang University School of Medicine","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Nursing, The Second Affiliated Hospital of Zhejiang University School of Medicine","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qunyan","family":"Xu","sequence":"additional","affiliation":[{"name":"Adjunct Research Academic, Clinical and Health Sciences, University of South Australia","place":["Adelaide, SA, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panpan","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Nursing, The Second Affiliated Hospital of Zhejiang University School of Medicine","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueqing","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Nursing, The Second Affiliated Hospital of Zhejiang University School of Medicine","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunyu","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Nursing, The Second Affiliated Hospital of Zhejiang University School of Medicine","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Nursing, The Second Affiliated Hospital of Zhejiang University School of Medicine","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Shao","sequence":"additional","affiliation":[{"name":"School of Nursing, Zhejiang University School of Medicine, Zhejiang University","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leiwen","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Nursing, The Second Affiliated Hospital of Zhejiang University School of Medicine","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,16]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1123\/jpah.2022-0266","article-title":"Associations between physical activity vital sign in patients and health care utilization in a health care system, 2018\u20132020","volume":"20","author":"Lin","year":"2022","journal-title":"J Phys Act Health"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e1077","DOI":"10.1016\/S2214-109X(18)30357-7","article-title":"Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1\u00b79 million participants","volume":"6","author":"Guthold","year":"2018","journal-title":"Lancet Glob Health"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1451","DOI":"10.1136\/bjsports-2020-102955","article-title":"World Health Organization 2020 guidelines on physical activity and sedentary behaviour","volume":"54","author":"Bull","year":"2020","journal-title":"Br J Sports Med"},{"key":"B4","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1200\/JCO.22.00171","article-title":"Physical activity in stage III colon cancer: CALGB\/SWOG 80702 (Alliance)","volume":"41","author":"Brown","year":"2023","journal-title":"J Clin Oncol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1499","DOI":"10.1093\/eurheartj\/ehab087","article-title":"The physical activity paradox in cardiovascular disease and all-cause mortality: the contemporary Copenhagen general population study with 104 046 adults","volume":"42","author":"Holtermann","year":"2021","journal-title":"Eur Heart J"},{"key":"B6","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1186\/s12966-020-00954-3","article-title":"Get the message? 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