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Summary UvA Communication Science: Health Communication Theory Block - all required literature
This summary includes all articles required during the theory block of health communication .
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UvA Communication Science – Persuasive CommunicationHealthCom 2022-2023
Summary Health Communication
Week 1 – Week 7
A meta-analysis of fear appeals: implications for effective public health campaigns.
Witte & Allen
Fear appeals motivate adaptive danger control actions (e.g., message acceptance) and maladaptive fear
control actions (e.g., defensive avoidance or reactance).
• Strong fear appeals and high-efficacy messages produce the greatest behavior change
• Strong fear appeals with low-efficacy messages produce the greatest levels of defensive
responses
Fear appeal theory
3 key independent variables:
1. Fear
( = a negatively valenced emotion, accompanied by a high level of arousal)
2. Perceived threat
Composed of 2 dimensions
1. Perceived susceptibility to the threat [the degree to which one feels at risk for
experiencing the threat]
2. Perceived severity of the threat [the magnitude of harm expected form the threat]
3. Perceived efficacy
Composed of 2 dimensions
1. Perceived self-efficacy [one’s beliefs about his ability to perform the recommended
response]
2. Perceived response efficacy [one’s beliefs about whether the recommended response
works in averting the threat]
Witte’s extended parallel process model (EPPM)
• Explains both successes and failures of fear appeals
According the EPPM, the evaluation of a fear appeal initiates two appraisals of the message, which
results in one of three outcomes.
1. First, individuals appraise the threat of an issue from a message.
2. The more individuals believe they are susceptible to a serious threat, the more motivated they
are to begin the second appraisal, which is an evaluation of the efficacy of the recommended
response.
If the threat is perceived as irrelevant or insignificant (i.e., low perceived threat), then there is no
motivation to process the message further, and people simply ignore the fear appeal.
When a threat is portrayed as and believed to be serious and relevant, individuals become scared.
• Their fear motivates people to take any action that will reduce their fear.
• Perceived efficacy (composed of self-efficacy and response efficacy) determines whether
o people will become motivated to control the danger of the threat, or
o control their fear about the threat.
• When people believe they can perform an effective recommended response against the threat
(i.e., high perceived self-efficacy and response efficacy), they are motivated to control the
danger and consciously think about ways to remove or lessen the threat.
When people doubt whether the recommended response works (i.e., low perceived response efficacy)
and/or whether they are able to do the recommended response (i.e., low perceived self-efficacy), they
are motivated to control their fear (because they believe it’s futile to control the danger) and focus on
eliminating their fear through denial, defensive avoidance, or reactance.
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,UvA Communication Science – Persuasive Communication
HealthCom 2022-2023
In sum, the EPPM suggests that perceived threat contributes to the extent of a response to a fear appeal
whereas perceived efficacy (or lack thereof) contributes to the nature of the response.
Appealing to fear: a meta-analysis of fear appeal effectiveness and theories
Tannenbaum et al.
Fear appeals = persuasive messages that attempt to arouse fear by emphasizing the potential danger
and harm that will befall individuals if they do not adopt the messages’ recommendations.
Depicted fear = the most central aspect of a fear appeal message is the amount of fear it is intended to
arouse in message recipients. Depicted fear is a source of motivation: exposure to depicted fear
increases motivation to adopt the message’s recommendations.
• Low depicted fear: less motivating and less effective than moderate levels of fear.
Linear model:
• High depicted fear is more effective than moderate depicted fear
Curvilinear model:
• High depicted fear elicits defensive avoidance (message recipients disengage from the
message, avoid further exposure to it, and/or derogate the message because it is too
frightening)
• Thus, high levels of depicted fear should be less effective than moderate levels of fear.
It is argued that fear appeals work only when accompanied with an efficacy message.
An efficacy message is a statement that assures the message recipients that:
• They can perform the fear appeal’s recommended actions (self-efficacy) and/or
• Performing the recommended actions will result in desirable consequences (response efficacy)
Two forms of the efficacy statements hypothesis
• Strong hypothesis: fear appeals without efficacy statements will produce negative effects (i.e.,
will backfire)
• Weak hypothesis: fear appeals without efficacy statements will produce weaker (i.e., less
positive, or null) effects relative to fear appeals with efficacy statements
Depicted susceptibility and severity
• The effectiveness of fear appeals also depends on their levels of depicted susceptibility and
severity.
High depicted susceptibility:
• Emphasizes the message recipient’s personal risk for negative consequences
o E.g., “One of fourteen women is destined to develop breast cancer during her life, so
every woman may get breast cancer. You also run that risk.”
• Describes negative consequences of not taking action.
o “Breast cancer is a serious disease of which many women die, contrary to, for
example, cancer of the uterus, where 90% to 95% recover”
Low depicted susceptibility:
• The message does not personalize risk
• Portrays manageable consequences
o “If breast cancer is detected at an early stage it can be cured in a number of cases,
contrary to, for example, lung cancer where 90% die of it”
According to this model, high depicted severity (but not susceptibility) should improve attitudes,
whereas high depicted susceptibility (but not severity) should improve intentions and behaviors.
Consequently, only the combination of high-depicted susceptibility and severity should improve
attitudes, intentions, and behaviors.
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, UvA Communication Science – Persuasive Communication
HealthCom 2022-2023
The recommended behavior
One time vs. repeated behaviors:
• Persuasive messages should be more successful when they recommend one-time behaviors
(e.g., getting vaccinated) compared with behaviors that must be repeated over an extended
period of time (e.g., exercising).
Detection vs. prevention/promotion behaviors:
• Based on prospect theory: fear appeals should be more effective when recommending
detection behaviors relative to prevention/promotion behaviors
o Detection behaviors are enacted to obtain information about potential risk factors or
existing health issues (e.g., being screened for cancer), and thus engaging in a
detection behavior increases risk for incurring a loss (e.g., acquiring the unwanted and
undesirable information that one has cancer).
o Prevention/promotion behaviors are enacted to obtain desirable outcomes (e.g.,
exercising to lose weight or avoid weight gain), and thus, engaging in
prevention/promotion behaviors does not increase risk for incurring a loss (e.g.,
exercising will only bring one closer to the desired outcome of losing weight or
avoiding weight gain, so there is no potential for loss by engaging in exercise).
• Fear appeals are loss-framed messages because they emphasize negative consequences, and
loss-framed information makes people more willing than usual to take risks
• Fear appeals should be particularly effective for detection behaviors: the loss-framed nature of
the message should make people more willing than usual to take on the risk of the detection
behavior.
The audience
Gender and culture:
• Prevention-focused populations should be more persuaded by fear appeals relative to
promotion-focused populations.
• Women tend to be more prevention focused than men, and members of collectivist groups
tend to be more prevention focused than members of individualist ones.
o Fear appeals should be particularly effective for female (vs. male) and collectivist (vs.
individualist) audiences.
Results
Message content: efficacy statements.
• The results clearly support the weak efficacy hypothesis and disconfirm the strong efficacy
hypothesis.
• Thus, fear appeals are effective with or without efficacy statements, but the inclusion of
efficacy statements is associated with increased effectiveness.
Message content: depicted susceptibility and severity:
• The 2nd hypothesis is that fear appeals high in depicted susceptibility (but not severity) will
positively influence intentions and behaviors but will not influence attitudes.
o Hypothesis was supported.
• The 3rd hypothesis is that fear appeals with high depicted severity and high depicted
susceptibility will positively influence attitudes, intentions, and behaviors.
o Hypothesis was supported.
Concludingly: Fear appeals generally had positive effects on attitudes, intentions, and behaviors when
they were high in depicted severity and/or susceptibility.
Recommended behavior: one-time vs. repeated behaviors
• Fear appeals recommending one-time behaviors were more effective than fear appeals
recommending repeated behaviors (which were also effective).
Audience: gender
• Fear appeals are more effective for audiences with a larger percentage of female message
recipients than male message recipients.
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