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Messaging and scare tactics
Objectives
Examine the efficacy of fear appeals
Assess the theoretical underpinnings
Discuss the context of when to use fear appeals
Analyze various messages
Promote effective provider/patient communication
Disclosure
Some images may be offensive/graphic
Discuss controversial issues
Sexual health
Drug use
Varying opinions
Are “scare tactics” effective?
Risk Communication
Risk communication used to be viewed primarily as the dissemination of information to the public about health risks and events, such as outbreaks of disease and instructions on how to change behavior to mitigate those risks (WHO, 2021)
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Example
One key to a good message is to make it memorable
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Perspective
Think about the messages from the perspective of:
Psychologist
Practitioner
Researcher
Different disciplines
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What would a coalition member say about scare tactics?
Lay persons tend to think scare tactics are effective and are eager to use them.
They are intuitively appealing
They appear to work in the short-term!
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What would a health educator say about scare tactics?
What happens when scare tactics are over exaggerated?
Stigma
e.g., STD prevention during WWII. Maximized stigma while minimizing explicit information. Didn’t work.
Or… HIV prevention? Diabetes?
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What would a social or commercial marketer say about scare tactics?
Do people buy products when they are turned off?
Are you motivated to take action when you feel bad about yourself?
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Protection Motivation Theory (PMT)
Rogers (1975) Protection Motivation Theory
an extension of the Health Belief Model.
A later revision of Protection Motivation Theory (Rogers, 1983) extended the theory to a more general theory of persuasive communication
Emphasis on the cognitive processes mediating behavioral change.
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Protection Motivation Theory
Threat
Severity
Threat
Vulnerability
Response
Efficacy
Self-Efficacy
Coping
Appraisal
Threat
Appraisal
Protection
Motivation
Attitude/
Behavior
Change
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Protection Motivation Theory
Rogers (1985) also suggested a role of
a fifth component:
FEAR (e.g., an emotional response), in response to education or information.
The PMT describes severity, susceptibility, and fear as relating to THREAT APPRAISAL
The PMT describes response effectiveness and self-efficacy as relating to COPING APPRAISAL
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Protection Motivation Theory
According to the PMT, there are two sources of information:
environmental (e.g., verbal persuasion, observational learning)
intrapersonal (e.g., past experience).
This information influences the five components of the PMT, eliciting:
adaptive coping response (e.g., healthy behavioral intention)
maladaptive coping response (e.g., avoidance, denial).
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If applied to dietary change, the PMT would make the following predictions: information about the role of a high fat diet in coronary heart disease would increase fear; increase the individual’s perceptions of how serious coronary heart disease was (perceived severity); and increase their belief that they were likely to have a heart attack (perceived susceptibility). If the individual also felt confident that they could change their behavior (self-efficacy) and that this change would have beneficial consequences (response effectiveness), they would report high intentions to change their behavior (behavioral intentions).
Protection Motivation Theory
A message with too strong of a threat appeal may compromise efficacy.
Sense of learned helplessness.
e.g., everything causes cancer
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Extended Parallel Processing Model
Witte, 1994
EPPM Sometimes referred to as: Fear or threat management theory
Focuses on emotional response and its effect on motivation and behavior
Can be used to segment an audience
Social marketing
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Extended Parallel Processing Model
Describes the interaction between emotion & rationality
Emotion
Perceived threat
Rationality
Perceived efficacy
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Extended Parallel Processing Model
| EPPM | Low Threat | High Threat |
| Low Efficacy | No Action | Moderate Action |
| High Efficacy | Moderate Action | High Action |
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Loss vs. Gain Framed Messages
Consider how you “frame” the message… fear vs. opportunity.
May be less risk or fewer unintended consequences associated with gain framed messages.
Short term gains tend to motivate better than long-term losses.
Loss vs. Gain Framed Message
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Whether when designing health communication campaigns or working with patients, practitioners may inadvertently mislead and harm patients with the words they use.
Avoid using frightening metaphors, jargon, or technical language.
Main points
| Words that Harm | Words that Heal |
| Your life is hanging on by a thread. | You have an illness which requires immediate medical attention. These are the treatment options we have…. |
| You have Sick Heart Syndrome. | Occasionally, your heart slows down, and I believe that this explains your symptoms. |
| Ejection fractions of 50%. | Your heart is pumping well. |
| If you continue smoking this heart attack will be just one of many to come. | Your risk for experiencing another heart attack decreases considerably if you quit smoking. |
Carefully Choose Words
People may already be scared, scaring them with additional fear-based messages is not necessary or helpful
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Caution
Use discretion when communicating risk
Beneficence / nonmaleficence
Maximize good
Do no harm
Lots of strategies available to influence behavior change
But do scare tactics work?
It depends.
Target audience / demographics /psychographics
More effective in all-female samples and in East Asian countries (less in Western countries)
Behavior
More effective on one-time-only behaviors (e.g., screenings) vs. repeated behaviors (e.g., dieting)
More effective on detection behaviors (e.g., screenings) vs. prevention/promotion behaviors (e.g., vaccines)
Tannenbaum, 2013
To be effective, messages must promote self-efficacy and response-efficacy to counter-act the threat.
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