A meta-analysis of fear appeals: implications for effective public health campaigns.

The fear appeal literature is examined in a comprehensive synthesis using meta-analytical techniques. The meta-analysis suggests that strong fear appeals produce high levels of perceived severity and susceptibility, and are more persuasive than low or weak fear appeals. The results also indicate that fear appeals motivate adaptive danger control actions such as message acceptance and maladaptive fear control actions such as defensive avoidance or reactance. It appears that strong fear appeals and high-efficacy messages produce the greatest behavior change, whereas strong fear appeals with low-efficacy messages produce the greatest levels of defensive responses. Future directions and practical implications are provided.     

Motivating women and men to take protective action against rape: examining direct and indirect persuasive fear appeals

This article examines the effectiveness of persuasive fear appeals in motivating women to enroll in self-defense classes to take protective action against rape. Witte's extended parallel process model is used as a framework to examine the relations between perceived invulnerability, perceived fear, and fear control processes. Because women may perceive invulnerability to rape, persuasive fear appeals targeted toward them may be ineffective in achieving attitude, intention, and behavioral change toward protecting themselves. One possible solution is to persuade men to talk with women about whom they care. Results indicated that women did not perceive invulnerability to rape, and although there was no differential impact between high- and low-threat messages, women did report positive intention and behaviors in response to direct fear appeals. Moreover, men reported positive intention and behaviors in response to indirect fear appeals.     

Uplifting Fear Appeals: Considering the Role of Hope in Fear-Based Persuasive Messages

Fear appeal research has focused, understandably, on fear as the primary emotion motivating attitude and behavior change. However, while the threat component of fear appeals associates with fear responses, a fear appeals’ efficacy component likely associates with a different emotional experience: hope. Drawing from appraisal theories of emotion in particular, this article theorizes about the role of hope in fear appeals, testing hypotheses with two existing data sets collected within the context of sun safety messages. In both studies, significant interactions between hope and self-efficacy emerged to predict behavioral intentions. Notable main effects for hope also emerged, though with less consistency. Further, these effects persisted despite controlling for the four cognitions typically considered central to fear appeal effectiveness. These results, consistent across two samples, support the claim that feelings of hope in response to fear appeals contribute to their persuasive success. Implications for developing a recursive model of fear appeal processing are discussed.     

AIDS prevention and college students: male and female responses to "fear-provoking" messages

This study was designed to examine the effects of fear appeals in AIDS prevention messages and to determine whether or not males and females differ in their response to these appeals. MANOVA results from a sample of 179 junior and senior business students at a mid-Atlantic urban university indicate that significant differences in message effects were associated with type of appeal, gender of the respondent, and the interaction between appeal and gender.     

AIDS Prevention and College Students

This study was designed to examine the effects of fear appeals in AIDS prevention messages and to determine whether or not males and females differ in their esponse to these appeals. MANOVA results from a sample of 179 junior and senior business students at a mid-Atlantic urban university indicate that significant differences in message effects were associated with type of appeal, gender of the respondent, and the interaction between appeal and gender.     

Examining HPV Threat-to-Efficacy Ratios in the Extended Parallel Process Model

The Extended Parallel Process Model (EPPM) posits that an effective fear appeal includes both threat and efficacy components; however, research has not addressed whether there is an optimal threat-to-efficacy ratio. It is possible that varying levels of threat and efficacy in a persuasive message could yield different effects on attitudes, beliefs, and behaviors. In a laboratory experiment, women (n?=?442) were exposed to human papilloma virus (HPV) prevention messages containing one of six threat-to-efficacy ratios and one of two message frames (messages emphasizing the connection between HPV and cervical cancer or HPV and genital warts). Multiple mediation analysis revealed that a 1-to-1 ratio of threat to efficacy was most effective at increasing prevention intentions, primarily because it caused more fear and risk susceptibility than other message ratios. Response efficacy significantly mediated the relationship between message framing and intentions, such that participants exposed to a genital warts message reported significantly higher intentions, and this association can be explained in part through response efficacy. Implications for future theoretical research as well as campaigns and intervention research are discussed.     

Using EPPM to Evaluate the Effectiveness of Fear Appeal Messages Across Different Media Outlets to Increase the Intention of Breast Self-Examination Among Chinese Women

ABSTRACT

The current study aims to examine the influence of fear appeal messages across different media outlets on Chinese women’s intention of breast self-examination using the Extended Parallel Processing Model (EPPM). A two-by-two-by-two factorial experiment is designed to examine the effect of threat and efficacy level of stimulus on different media outlets on behavioral intention. The sample includes 488 Chinese women who are between 25 and 50 years old. The results revealed that there were significant main effects of both threat and efficacy on the intention to performing breast self-examination. Moreover, the significant two-way interaction effect between threat and efficacy was detected, which indicated that Chinese women who received messages containing both high threat and high efficacy had the highest intention of breast self-examination. Besides, the results demonstrated that there was no significant difference in the effectiveness of fear appeal messages on between traditional and social media.     

Clicking Health Risk Messages on Social Media: Moderated Mediation Paths Through Perceived Threat,Perceived Efficacy,and Fear Arousal

ABSTRACT

This study drew on appraisal theory to examine how fear appeal messages and individual coping styles combined to drive users’ intention to click (ITC) health risk messages on social media. A 2 × 2 × 2 mixed-design experiment was conducted, with threat and efficacy as between subject factors and message as the within subject factor. The results suggested that: (1) threat and efficacy message influenced ITC via the mediating effect of perceived threat, and perceived efficacy; (2) fear arousal was positively related to intention to click; (3) blunting style used by the participant suppressed fear arousal’s ability to mobilize ITC; and (4) monitoring style had a positive main effect on ITC. Theoretical and practical implications are discussed.     

Subjective knowledge and fear appeal effectiveness: implications for message design

This research investigates the role of perceived health knowledge on the effectiveness of fear-based persuasive appeals. Undergraduates (N = 263) read a strong fear, weak fear, or efficacy-only message encouraging breast or testicular self-examination. As expected, results indicated that men high in subjective knowledge were less reactant and more persuaded by the efficacy-only message whereas those low in subjective knowledge did not evidence this pattern. Contrary to expectation, women high in subjective knowledge had comparable reactions to each of the 3 messages. Implications for fear appeal theory and message design are discussed.     

The Effects of Message Framing and Risk Perceptions for HPV Vaccine Campaigns: Focus on the Role of Regulatory Fit

This study investigates the effects of framing and risk perception, and their interaction effects on human papillomavirus (HPV) vaccination. Based on a 2 (message frames) × 2 (perceived risk) experimental design, the interaction effects reveal the effectiveness of loss- (vs. gain-) framed messages would be maximized for high (vs. low) perceived risk condition. Based on regulatory fit principles the synergy effects are shown in terms of attitudes toward advertising and HPV vaccination, HPV vaccination intention, and ad-promoted behavioral intention. The findings indicate right message appeals should be selected for the right target audiences in the setting of HPV vaccine promotions.     

Fear, threat, and perceptions of efficacy from frightening skin cancer messages.

Fear appeal messages were designed and tested to ascertain their effectiveness in promoting skin protective behaviors. Theoretically guided by the Extended Parallel Process Model, the fear appeal messages in this study conveyed the seriousness of exposed and unprotected skin for college students in the Southwestern United States, and recommended a series of behaviors that would protect individuals from serious sunburns. The results demonstrated that fear appeals are effective in promoting skin protective behaviors. Specifically, highly threatening fear appeal messages were most effective when combined with a strong efficacy message emphasizing the effectiveness of the recommended behaviors.     

Subjective Knowledge and Fear Appeal Effectiveness: Implications for Message Design

This research investigates the role of perceived health knowledge on the effectiveness of fear-based persuasive appeals. Undergraduates (N?=?263) read a strong fear, weak fear, or efficacy-only message encouraging breast or testicular self-examination. As expected, results indicated that men high in subjective knowledge were less reactant and more persuaded by the efficacy-only message whereas those low in subjective knowledge did not evidence this pattern. Contrary to expectation, women high in subjective knowledge had comparable reactions to each of the 3 messages. Implications for fear appeal theory and message design are discussed.     

Do Emotional Appeals in Public Service Advertisements Influence Adolescents’ Intention to Reduce Consumption of Sugar-Sweetened Beverages?

Mass media campaigns are a commonly used approach to reduce sugary drink consumption, which is linked to obesity in children and adolescents. The present study investigated the direct and mediated effects of emotional appeals in public service advertisements (PSAs) that aired between 2010 and 2012 on adolescents’ intention to reduce their sugar-sweetened beverage (SSB) consumption. An online randomized experiment was conducted with a national sample of adolescent respondents ages 13 to 17 years old (N = 805). Participants were randomly assigned to 1 of 4 conditions. Three experimental conditions represented PSAs with different emotional appeals: humor, fear, and nurturance, plus a fourth control condition. The outcome was adolescents’ intention to cut back on SSBs. The direct effect of fear appeals on intention was mediated through adolescents’ perception of the PSAs’ argument strength; perceived argument strength was also the key mediator for the indirect effects of humor and nurturance on intention. Several hypothesized mediators influenced by the appeals were not associated with intention. This is the first study to test the effect of persuasive emotional appeals used in SSB-related PSAs. The perceived strength of the PSAs’ arguments is important to consider in the communication of messages designed to reduce SSB consumption.     

WITH A BRIGHT ENOUGH HUE

Given the unique vulnerabilities of children during disasters, and the low rates of disaster preparedness in the United States, this content analysis examines the nature of federal preparedness materials specifically crafted for children. Three websites were analyzed: Let's Get Ready, FEMA for Kids, and ReadyKids. Borrowing from risk and health communication literature examining effectiveness of fear appeals, and using the Extended Parallel Process Model as a framework, content was examined for perceived threat, perceived efficacy, and possible behavioral outcomes. Results indicated heavy use of fictional characters and activities, some persuasive messages to parents, and an overall lack of messages connoting urgency. Being “prepared” was explicitly defined, with each site mentioning specific supplies. Consequences were highlighted on the FEMA site only, using fear appeals to emphasize severity and susceptibility, which may unintentionally trigger fear control responses in children rather than preparedness behavior. Shortcomings of the websites and suggestions for improvements are also discussed.     

Hand hygiene posters: selling the message

This literature review was undertaken to determine the established theory and research that might be utilized to inform the construction of persuasive messages on hand hygiene posters. It discusses the principles of message framing and the use of fear appeals. Current theory suggests that the most effective messages for health promotion behaviours should be framed in terms of gains rather than losses for the individual. However, as clinical hand hygiene is largely for the benefit of others (i.e. patients), messages should also invoke a sense of personal responsibility and appeal to altruistic behaviour. The use of repeated minimal fear appeals have their place. Posters that simply convey training messages are not effective persuaders.     

Communicating ALS to the public: The message effectiveness of social-media-based health campaign

Celebrity endorsement has been proved to be a very powerful tool in health campaigns. This study examined how celebrity–issue matchup presented in utilitarian and hedonic appeals influences attitude toward the video, perceived issue severity, and behavioral intentions in the context of ALS communication. The findings showed that celebrity–issue matchup condition outperformed nonmatchup condition in generating positive attitude and behavioral intentions. The results also indicated that utilitarian appeal with matchup condition triggered significantly greater behavioral intention than that with nonmatchup condition. However, no difference was found in hedonic appeal between matchup and nonmatchup conditions. Theoretical and practical implications are also discussed.     

The Influence of Statistical versus Exemplar Appeals on Indian Adults’ Health Intentions: An Investigation of Direct Effects and Intervening Persuasion Processes

In two separate investigations, we examined the persuasive effectiveness of statistical versus exemplar appeals on Indian adults’ smoking cessation and mammography screening intentions. To more comprehensively address persuasion processes, we explored whether message response and perceived message effectiveness functioned as antecedents to persuasive effects. Results showed that statistical appeals led to higher levels of health intentions than exemplar appeals. In addition, findings from both studies indicated that statistical appeals stimulated more attention and were perceived as more effective than anecdotal accounts. Among male smokers, statistical appeals also generated greater cognitive processing than exemplar appeals. Subsequent mediation analyses revealed that message response and perceived message effectiveness fully carried the influence of appeal format on health intentions. Given these findings, future public health initiatives conducted among similar populations should design messages that include substantive factual information while ensuring that this content is perceived as credible and valuable.     

Clash of the Primary Motivations: Motivated Processing of Emotionally Experienced Content in Fear Appeals About Obesity Prevention

This study examined individuals’ physiological and cognitive responses to different types of emotionally experienced content located in obesity prevention fear appeals. Results suggested that experienced valence impacted individuals’ attention and memory as a function of experienced arousal level. Local content that created coactive highly arousing experiences received the most attention, though visual recognition suggested these messages were more difficult to encode. Local content that created negative moderately arousing experiences was best encoded. Global message evaluation data suggest that moderately arousing messages with a change in experienced valence may prove to be most effective, as they ensure attention and good memory while keeping high self-reported interest, and a high level of perceived severity of obesity. Implications and suggestions for future research are discussed.     

Targeting Smokers With Empathy Appeal Antismoking Public Service Announcements: A Field Experiment

A field experiment study (N = 189) was conducted to investigate the effectiveness of empathy appeal antismoking messages and their potential advantage over fear appeal messages. Data from 12 antismoking public service announcements showed that (a) smokers resist antismoking messages and (b) overall empathy appeal was equally effective as fear appeal messages. There was also evidence for moderators. First, empathy messages were more effective to women than to men. Second, fear appeal messages were more effective to occasional smokers than were empathy messages. Third, empathy messages were more effective to regular smokers than were fear appeal messages. Implications for audience segmentation and message targeting in public health antismoking efforts are discussed.     

Non Castigat Ridendo Mores: Evaluating the Effectiveness of Humor Appeal in Printed Advertisements for HIV/AIDS Prevention in Italy

This article investigates the effects of different emotional appeals in HIV/AIDS prevention campaigns using printed advertisements. More specifically, it examines the effectiveness of humor appeal compared with shock and fear appeals. The authors experimentally test the level of attention drawn and the spontaneous recall arising when young Italian adults are shown different HIV/AIDS prevention campaigns. Findings show that humor appeals are less effective than fear and shock appeals, evidencing the failures in HIV/AIDS prevention campaigns in Italy, a country where the former communication strategy has been used in substantive ways. The results also indicate the higher effectiveness of fear appeals (over shock and humor) in printed HIV/AIDS advertising campaigns. The implications of these results for further studies and for improving the design, implementation, and evaluation of HIV/AIDS campaign efforts are also discussed.