Summary that includes all material for the exam of Health Communication. The summary is built up through the structure of the articles, supplemented by the most important parts from the micro lectures and reading questions.
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Health Communication UvA | 1
Summary Health Communication
Theory block I / part A
Master: Persuasive Communication
Overview literature
Week 1: Affective appeals
- Witte, K., & Allen, M. (2000)
- Tannenbaum, et al. (2015)
- Kok, G. J. (2016)
- Brown, S. L., & West, C. (2014)
Week 2: Designing persuasive health messages
- Fishbein, M., & Cappella, J. N. (2006)
- Jordan, A., Taylor Piotrowski, J., Bleakley, A., & Mallya, G. (2012)
- De Bruijn, G.-J., Nguyen, M. H., Rhodes, R. E., & van Osch, L. (2017)
- Ajzen, I. (n.d.). [PDF file 3X]
Week 3: Reflective versus impulsive processes
- Rothman, A. J., Sheeran, P., & Wood, W. (2009)
- Papies, E. K., & Hamstra, P. (2010)
- McGowan, et al. (2013)
Week 4: Social influences
- Prentice, D. (2008)
- Stok, F. M., de Ridder, D. T. D., de Vet, E., & de Wit, J. B. F. (2012)
- Mollen, S., Rimal, R.N., Ruiter, R.A.C., Kok, G. (2013)
, Health Communication UvA | 2
Week 1: Affective appeals
Witte, K., & Allen, M. (2000). A meta-analysis of fear appeals: Implications for effective
public health campaigns. Health Education & Behavior, 27(5), 591-615. [ONLY READ
PAGES 591-595]
Emotions in persuasive messages
Differences between moods and emotions:
● Mood: less intense, long lasting, positive or negative.
● Emotions: short-lived and immediate.
○ Have adaptive functions;
○ Arise in response to an event that is personally relevant;
○ Motivates us to take action.
When can emotions influence persuasion?
● Within the receiver, prior to the message (having good news before processing a
persuasive message);
● Through prior contextual information (funny or sad TV show);
● Through the message itself.
➔ E.g., in health communication: shame, sadness, guilt, fear, disgust.
The effect of fear appeals
Affective appeals use a functional approach using emotion and persuasion. Fear appeal is a
message that has the goal to arouse fear in order to motivate attitude and behavior change.
General fear appeal process:
Message Fear appeal
↓
Perceived susceptibility and severity Cognition
↓
(Fear emotion)
↓
Behavior change Conation
, Health Communication UvA | 3
The purpose of this article is to provide a comprehensive review and update of the fear appeal
research, because health researchers and practitioners continue to contend that fear appeals
backfire.
● Early reviews tended to be critical essays that identified conceptual, operational, and
methodological issues, which might account for the disparate results in the literature.
● Later reviews applied quantitative methods to analyze the fear appeal literature, as in
the meta-analyses of Boster and Mongeau, Sutton, and Mongeau.
Fear (= emotion) and threat (= cognition) are conceptually distinct, but they are intricately
and reciprocally related ➔ the higher the perceived threat, the greater the fear experienced.
Three key independent variables:
1) Fear: a negatively valenced emotion, accompanied by a high level of arousal.
2) Perceived threat:
○ Perceived susceptibility to the threat: the degree to which one feels at risk
for experiencing the threat.
○ Perceived severity of the threat: the magnitude of harm expected from the
threat.
3) Perceived efficacy:
○ Perceived self-efficacy: one’s beliefs about his or her ability to perform the
recommended response.
○ Perceived response efficacy: one’s beliefs about whether the recommended
response works in averting the threat.
➔ Last two variables were identified by Rogers.
The outcomes studied in fear appeals appear to fall into two general classes:
1) Outcomes related to acceptance of the message’s recommendations.
○ I.e., attitudes, intentions, behaviors in line with the recommendations.
2) Outcomes related to rejection of the message.
○ I.e., defensive avoidance, reactance, denial.
Fear appeal theories can be classified into three major groups (according to Dillard):
, Health Communication UvA | 4
1) Drive theories: the level of fear arousal produced by a fear appeal acts as a drive to
motivate actions.
○ It was argued that fear could have both facilitating (e.g., motivate appropriate
self-protective responses) and interfering (e.g., avoidance) effects.
● Fear as a facilitating attribute: Fear ➔ negative conditioning ➔
motivation to change ➔ but too much fear can lead to skewed effect.
○ Drive theories suggested an inverted U-shaped relationship between fear and
attitude change in which a moderate amount of fear arousal was thought to
produce the most attitude change.
○ Rejected because: This class of theories was rejected during the early 1970s
due to a lack of support for the inverted U-shaped model.
2) Parallel response models: suggests that fear appeals produce two separate and
potentially interdependent processes:
○ Danger control processes: efforts to control the threat/danger.
○ Fear control processes: efforts to control one’s fear about the threat/danger.
3) Subjective expected utility (SEU) models: attempted to assess in a logical manner
what made a fear appeal effective.
Models that predict behavior change through fear appeals
1) Fear-as-acquired drive/the drive approach (e.g., Janis)
○ Drive is seen as a motivator to change attitudes and behavior.
○ Fear will function as a motivator.
○ This can have facilitating effects or
interfering effects:
● Facilitating effects: fear ➔
negative condition ➔
motivational drive to change
the condition.
● Interfering effects: Too much
fear ➔ too negative condition
➔ avoidance effects.
, Health Communication UvA | 5
○ Rejected because the model’s central hypothesis, that acceptance of the
message occurs when fear is reduced, was not supported.
○ ➔ Attention then turned to explaining emotional versus cognitive responses to
fear appeals.
2) Parallel response models (e.g., Leventhal)
○ Fear can lead to two parallel processes
and responses:
● Danger control: cognitive
response:
■ How to avoid the
threat?
● Fear control: affective response:
■ How to reduce feelings of fear?
○ Rejected because Leventhal failed to explicitly state when danger control and
fear control processes would be initiated and the model was subsequently
criticized as lacking specificity and being untestable.
○ ➔ The model did change current thinking about fear appeals and separated
emotional from cognitive processes.
Difference between PRM and EPPM:
● PRM has no role for efficacy (the extent to which people think they can accelerate the
behavior) yet.
● PRM does not include a stepwise appraisal.
3) Protection Motivation Theory (e.g., Rogers)
○ Based on (cognitive) subjective expected utility.
● What (utility) will I (subjective) get when (not) performing (expected).
○ So, mainly focus on danger control (which is cognitive).
● PMT has only a small role for emotion. Fear was given a tangential
role in Rogers’s work (it was thought to be related to perceptions of
severity only).
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