Fear Appeals In Health Promotion Interventions

Emotive Images and Perceived Threat May Encourage Behavior Change

Nov 2, 2009

A persuasive form of communication, fear appeals are used in health promotion interventions to shock people into changing behaviors.

Graphic images of twisted metal, scenes of slow and painful rehabilitation, images of blackened lungs or missing limbs evoke strong feelings in human beings, including fear and anxiety.

Health promotion practitioners may choose to use such images to motivate positive behavior change. The use of fear appeals is controversial and has a mixed history of success.

Psychological Learning Principles

It is known from the field of psychology that fear can be used to elicit a response. The theories of reinforcement and punishment described by B.F. Skinner, show that fear of an unpleasant outcome. For example, a mild electric shock can stop a subject (animal or human) from partaking in a particular behaviour. The negative stimuli causes the subject to suppress the behavior (Mazur, 2006, Learning & Behavior).

Using punishment-based practices in learning may lead to problems of increased anxiety, suppression of behaviors beyond the target behavior (e.g. freezing) and potential for aggression towards punishers (Mazur, 2006). In the field of health promotion, inappropriate use of fear may lead to an increase in the unhealthy behaviors as subjects look for ways to reduce anxiety that was induced by the fearful images or experience (Soames, 1988).

How Fear Appeals Work - Extended Parallel Process Model

Witte’s Extended Parallel Process Model is an attempt to explain how fear appeals work to modify a person’s behaviour. The Extended Parallel Process Model states that an individual’s response to a fear appeal will be based initially on a decision to the threat posted by the health problem. Two questions will be answered: "Is this serious?" and "What is the probability of it happening to me?"

Witte's theory holds that if a person decides that the behavior referred to in the fear appeal is not a serious threat to their personal health, the fear appeal will be ignored. However, if an individual feels that there is a serious threat to their personal health, the individual may be motivated to act provided that two important criteria are met:

Fear Appeals Work Best When Alternative Behaviours are Suggested

It is important that alternative behaviors are identified and encouraged during the use of a fear appeal. Reinforcing alternate behaviors or Differential Reinforcement Other (DRO) is recognised in psychology as a behavior modification strategy based on operant conditioning.

In practice DRO requires that a therapist identifies both a problem behavior and an alternate behavior. In effect the therapist ignores the problem behavior by not providing any form of reinforcement (if, for example, the therapist does not chastise or mention the problem behavior to the subject), however reinforcement (like praise or use of a toy) is provided for the alternate behavior. The aim of DRO is to eliminate the problem behavior through only providing feedback to the subject on the alternate behavior. (Mazur, 2006)

Fear Appeals in Action - Welsh Police Use Fear to Reduce Texting While Driving

In 2009, Gwent Police in Wales used fear in a campaign to encourage people to avoid text messaging while driving. The short film depicts the catastrophic results of one girl’s decision to text while driving – a multi-vehicle crash in which four people were killed. As of November 2009 it was too early to evaluate whether the Gwent Police campaign was successful.

Encouraging behavior modification is at the heart of all health promotion programs. Fear appeals can be used to successfully modify behavior provided that an alternate behavior is identified, recommended and shown. The Extended Parallel Process Model explains the success of fear appeals through individual determinations relating to the seriousness of the health issue, the personal probability of being affected and personal capability to change.

The copyright of the article Fear Appeals In Health Promotion Interventions in Behavioural Therapy is owned by Tracey Lloyd. Permission to republish Fear Appeals In Health Promotion Interventions in print or online must be granted by the author in writing.