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)
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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
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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):
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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.
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○ 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).
