The affective-persuasive turn in digital communication is dominated by rapid, emotionally charged messaging across multiple digital platforms [1]. Affect plays an imperative role in designing content that captures people’s attention; elicits people’s emotions; fosters engagement; and, ultimately, persuades people to change their behavior [1,2]. Persuasion theory proposes that the content of a message shapes its emotional tone, which influences how deeply the audience processes the information [3]. Within this framework, message content refers to what the message communicates and includes, among other things, emotional appeals, framing, narrative elements, and the way in which the arguments are presented [3].

However, the literature lacks a comprehensive overview of how messages targeted at adolescents affect influence health decision-making and behavior within the field of health communication. The role of affect in judgment, decision-making, and behavior [4] is not sufficiently explored in research on public health communication [5]. The gap between theory and empirical application highlights the need for research that connects conceptual models, empirical studies, and real-world health communication practices.

Adolescents are notably receptive to emotionally charged health messages [5]. Adolescence represents a key developmental period marked by emotional, cognitive, and social changes. During this period, extensive remodeling of the brain’s dopaminergic system occurs, leading to increased risk-taking and reward-seeking behaviors, particularly in the presence of peers [6]. These behaviors are largely driven by changes in the brain’s socioemotional system, which matures earlier than the cognitive control system responsible for self-regulation [6]. This heightened emotional sensitivity is further amplified by the pervasive influence of social media and digital communication in adolescents’ daily lives. Digital interactions on social media can intensify affective polarization [7] and significantly impact adolescents’ emotional well-being—both positively and negatively [8,9]. Moreover, existing studies rarely take account of the rapidly changing digital environments in which adolescents operate, raising concerns about the relevance of findings predating the social media era.

Increased sensitivity to emotional cues in communication, combined with massive exposure to digital information and the fact that the contingencies for health decision-making are different for adolescents than for their older counterparts and the population at large, highlights the need for better insight into the role of affect in health communication targeted at adolescents. Despite its importance, there is a lack of reviews synthesizing evidence on the role of affect in health message content targeted at adolescents. Existing systematic reviews have primarily focused on messages on specific health issues targeted at adolescents and young adults, such as messaging strategies for preventing and ceasing e-cigarette use [10], mental health awareness campaigns [11], vaccine coverage and timeliness [12], and the promotion of healthy lifestyle behaviors [13]. Systematic reviews have also examined the emotional impact of social media and digital technology [9,14]. Thus, much of the research reviewed is issue specific and lacks integration across health domains.

A generic and broader literature synthesis examining systematically how affective message content—originating from both formal (eg, public health campaigns) and informal (eg, social media) sources—is linked to communication outcomes remains lacking. Such evidence includes a wide variation in methodological designs and outcomes and crosses boundaries among public health, health communication, emotion science, and health decision-making, among others. The lack of a common framework limits comparability across studies and makes it difficult to conduct meta-analyses and assess which strategies are most effective in different contexts. However, the scoping review methodology is particularly useful in this matter to synthesize evidence in a systematic manner and identify knowledge gaps and the scope of a body of literature with different methodologies [15].

This scoping review aims to fill these current knowledge gaps related to lack of literature reviews on the use and outcomes of affective message content in health communication targeted at adolescents by systematically mapping empirical studies. This review is guided by the following research questions: what empirical literature exists regarding health message content targeted at adolescent emotions, and what are the associated communication outcomes?

This study is a scoping review, supporting a systematic approach to data identification, extraction, and synthesis [16]. We will conduct our review following guidance for systematic scoping reviews in health care [16] and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist (Checklist 1) [17].

As of May 2025, the search has yielded a total of 2218 hits, of which 784 (35.3%) were from Embase, 942 (42.5%) were from MEDLINE, and 492 (22.2%) were from PsycInfo. In addition, 29 literature reviews were screened for studies sampling adolescents or young people, which resulted in 111 hits. Removing duplicates resulted in 1856 unique hits, as displayed in the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flow diagram (Figure 2 [23]). An updated search will be conducted in February 2026 to ensure inclusion of recent publications, and Scopus will be added to the database list to strengthen interdisciplinary coverage.

This review presents a synthesis of the evidence on the role of affect in health messaging toward adolescents. Through applying systematic scoping review methodology, this study will qualitatively synthesize the outcomes of the identified empirical studies using health message content targeted at adolescents’ emotions, the associated communication outcomes, and identified research gaps.

Although this review applies a descriptive synthesis, interpretation of findings will be informed by persuasion theory, which emphasizes how message factors such as emotional appeals, framing, and narratives shape both affective responses and cognitive processing depth [3]. Persuasion theory suggests that affective cues can activate heuristic or peripheral processing routes, influencing attitudes and behavioral intentions even when systematic evaluation is limited. We aim to contextualize how affective message content may lead to positive or negative outcomes among adolescents and discuss the ethical implications of using persuasive messages with this age group, whose heightened emotional sensitivity and developmental characteristics make them particularly responsive to affect-driven communication strategies.

This scoping review will provide insights into how adolescents behave, form judgments, and make decisions in response to affective health message content and highlight the communication outcomes of these studies. We anticipate finding a knowledge gap pertaining to real behavioral outcomes (actions) and that most of the literature measures intention to behave or awareness as the communication outcome.

We will discuss the strengths and limitations of the methods used in the included studies and draw attention to identified ethical challenges of communication targeted at adolescents. The scoping review findings will be discussed in comparison with previous literature on emotion and decision-making [4], health decision-making [5], health communication targeted at adolescents [10-13], and digital communication [9,14], highlighting the novel insights from this review. To conclude, we will outline policy recommendations regarding considerations that are important when designing health message content targeted at adolescents. Additionally, the review will conclude by outlining the research gaps in, for example, emotion science and communication studies and offering recommendations for future studies and campaigns in selecting theory and communication strategies.

The strength of this scoping review is the systematic application of rigorous research methodology, which strives for transparency and methodological rigor in all phases of the review process. A limitation of this scoping review is the exclusion of gray literature in the search strategy, which may bias findings toward academic and Western contexts in which peer-reviewed publications are more common. A major limitation of this review is the unclear conceptual validity of affect in message content. We address this limitation by using predefined operationalized terms, which may provide transparency regarding the study selection strategy applied and strengthen the theoretical generalization of our findings to other contexts.