Improving the efficacy of appearance-based sun exposure interventions with the terror management health model

The terror management health model (TMHM) suggests that when thoughts of death are accessible people become increasingly motivated to bolster their self-esteem relative to their health, because doing so offers psychological protection against mortality concerns. Two studies examined sun protection intentions as a function of mortality reminders and an appearance-based intervention. In Study 1, participants given a sun protection message that primed mortality and shown a UV-filtered photo of their face reported greater intentions to use sun protection on their face, and took more sunscreen samples than participants shown a regular photo of their face. In Study 2, reminders of mortality increased participants’ intentions to use facial sun protection when the UV photo was specifically framed as revealing appearance consequences of tanning, compared to when the photo was framed as revealing health consequences or when no photo was shown. These findings extend the TMHM, and provide preliminary evidence that appearance-based tanning interventions have a greater influence on sun protection intentions under conditions that prime thoughts of death. We discuss implications of the findings, and highlight the need for additional research examining the applicability to long-term tanning behaviour.     

The Effects of Appraised Severity and Efficacy in Promoting Water Conservation: An Informational Analysis

To test Rogers' protection motivation theory and Fishbein's behavioral intention model, subjects observed one of four water conservation films which differed according to message severity (high/low) and efficacy of conserving (high/low). A questionnaire assessed the impact of the films on (1) the arguments (informational items) presented; (2) beliefs external to the films; (3) fear arousal; (4) Fishbein's mediating variables SN and A_act; (5) appraised severity and efficacy; and (6) behavioral intention to conserve water. High efficacy and low severity messages increased positive evaluative attitudes (A_act) toward conserving water. Although there was no effect for these manipulations on behavioral intention, the film groups, when compared with a control group which did not observe a fdm, showed significantly greater intentions to conserve water. These results are accounted for through an informational analysis of the beliefs affected by the films. This analysis provided evidence that feelings of citizen's duty to conserve water and concern about the water situation are closely related to behavioral intentions. This analysis did not support Fishbein's assertion of a dominant mediational role for SN and/or A_act in predicting behavioral intentions. The possible inclusion of a moral norm measure as a third component of Fishbein's model is discussed.     

The Effects of Source Credibility and Message Framing on Exercise Intentions,Behaviors, and Attitudes: An Integration of the Elaboration Likelihood Model and Prospect Theory1

This study examined the influence of source credibility and message framing on promoting physical exercise in university students. Participants were randomly assigned to reading a positively or negatively framed communication that was attributed to either a credible or a noncredible source. Exercise intentions and attitudes were measured immediately following the delivery of the communication and following a 2‐week delay. Exercise behavior was also measured following the delay. There were Source Frame interactions for the exercise intentions, exercise behaviors, and cognitive response/elaboration measures such that participants receiving a positively framed communication from a credible source elaborated more and reported more positive exercise intentions and behaviors than participants in the other conditions. The results of the present investigation indicate that it might be beneficial for health professionals to provide exercise‐related information stressing the benefits of participating in exercise, rather than the traditional fear appeals, to motivate clients to engage in regular physical exercise. Implications for future research are discussed.     

Vulnerability Beliefs, Symptom Experiences, and the Processing of Health Threat Information: A Self-Regulatory Perspective

This study used a self-regulation model of health behavior to explore the impact of risk perceptions and disease-risk symptoms on responses to health messages. Undergraduates with beliefs of high or low vulnerability to heart disease participated in a task that either did or did not induce disease-risk symptoms. Participants were then given a threatening or reassuring message about heart disease prevention, or no message. Participants with high-vulnerability beliefs reported higher exercise intentions only after the reassuring message, and then only in the absence of risk symptoms. However, their exercise rates were increased by both messages and by the symptoms. Participants with preexisting beliefs of low vulnerability reported higher risk perceptions after experiencing the symptoms; only the threat message enhanced their exercise rates.     

Protection Motivation Theory and Skin Cancer Risk: The Role of Individual Differences in Responses to Persuasive Appeals

Undergraduates who sunbathed were assessed on personality variables and then randomly assigned to read one of 4 essays (with photos) that manipulated threat and coping appraisal information about sunbathing, skin damage, and skin cancer symptoms and prevention. High threat-appraisal information was by far the most powerful predictor of intentions to take precautionary measures against skin cancer. Coping appraisal information was associated with reduced perceptions of hopelessness concerning skin cancer risk. Individual-difference variables (i.e., appearance concern, need for cognition, health locus of control) predicted maladaptive coping modes and, to a lesser extent, adaptive behavioral intentions. Results suggest that tailoring persuasive appeals to individuals may modestly improve preventive efforts, and that invoking perceived threat effectively motivates most people.     

The role of message framing in promoting MMR vaccination: evidence of a loss-frame advantage

This study examined the effects of message framing on intentions to obtain the measles, mumps and rubella (MMR) vaccine for one's child and investigated whether Theory of Planned Behaviour (TPB) and perceived outcome efficacy variables mediate and/or moderate message framing effects. One hundred and forty women read either a loss-framed or gain-framed message and then completed measures assessing their intentions to obtain the MMR vaccine for their child, and TPB and outcome efficacy variables. Exposure to the loss frame increased intentions to obtain the MMR vaccine and influenced perceptions of outcome efficacy. This suggests that outcome efficacy, but not other TPB variables may mediate framing effects within the context of MMR vaccination. Message frame, in addition to TPB variables, significantly predicted unique variance in behavioural intentions. These findings are discussed within the context of Prospect Theory, perceived risk and prevention/detection behaviours.     

Enhancing the effects of a narrative message through experiential information processing: An experimental study

First-person narratives are becoming a popular means to communicate health risk information. Although studies show they can increase risk perception and motivate health behaviours compared to statistical messages, more research on the conditions in which they are particularly likely to have effects is needed. In this study, we tested a moderator related to how information is processed. Specifically, we hypothesised that thinking in terms of emotions and personal experiences – known as experiential information processing – would increase people’s responsiveness to a narrative. Female college students (N = 138) who reported indoor tanning were randomly assigned to read a first-person narrative message or a statistical message about the risks of skin cancer. Prior to reading the message, the women received instructions that would activate either experiential or rational information processing. Participants then reported their risk perceptions of skin cancer, worry about skin cancer and behaviour intentions related to skin cancer. Analyses showed that message type and information processing interacted to influence risk perceptions and worry. Consistent with hypotheses, participants reported the highest risk perception and worry when they used an experiential information system prior to reading the narrative message. There were no effects on behaviour intentions. Implications of these findings are discussed.     

Adolescents’ reasons for tanning and appearance motives: A preliminary study

We examined adolescents’ reasons for tanning and how these relate to appearance evaluation and orientation. Two hundred and sixty-four Canadian adolescents (age range 15–19 years) in grades 10, 11, and 12 completed a survey that included scales measuring their reasons for tanning, appearance evaluation, and appearance orientation. It was found that girls and boys differed on four of nine subscales measuring reasons for tanning. Girls believed more strongly than boys that tanning improved their general appearance and that friends influenced their decision to tan. Girls also expressed less concern than boys that tanning caused immediate skin damage or premature aging. The pattern of correlations between the reasons for tanning and appearance orientation was similar for girls and boys. For both, appearance reasons for tanning and sociocultural influences on tanning were positively associated with appearance orientation. Suggestions for future research with adolescents and a proposal for a guiding model are provided.     

Changing knowledge and attitudes about skin cancer risk factors in adolescents.

We examined knowledge, attitudes, and behaviors related to skin cancer, sun exposure, sunscreen use, and use of tanning booths in 903 female and 800 male adolescents. The effectiveness of a brief, school-based intervention designed to increase teens' knowledge and preventive attitudes about skin cancer was also evaluated. Females, older students, and those with high-risk skin types were most likely to use sunscreen and to take precautions. However, overall level of protection was low. Intentions to take precautions were associated with levels of perceived susceptibility to skin cancer, attitudes about the benefits of sun exposure, skin type, and sex. Beyond intentions, sunscreen use was associated with perceived susceptibility and skin type. The one-session, school-based intervention significantly increased knowledge and perceived susceptibility to skin cancer but not behavioral intentions.     

Issue Salience, Perceived Efficacy and Perceived Risk: A Study of the Origins of Anti-Nuclear War Activity

One hundred eleven college students participated in this two-session experiment designed to explore the origins of anti-nuclear war activism. In Session 1 participants completed questionnaires assessing a number of background characteristics and attitudes, the most important of which for this study's purpose was a measure of perceived political efficacy in the nuclear realm. One week later both the salience of the nuclear weapons issue and participants' sense of personalized risk were experimentally manipulated in a 2 × 2 × 2 (salience × risk × measured efficacy) design. Dependent measures were a behavioral intentions questionnaire and an actual opportunity to sign a petition which participants did not recognize as part of the experiment. High salience significantly increased both anti-nuclear war behavioral intentions and actual behavior as predicted. Individuals who felt highly efficacious were also significantly more likely to take action than others as predicted. A similar relation between efficacy and behavioral intentions was not found, although a salience by efficacy interaction was. Personalized risk influenced only behavioral intentions. Finally, the relative impact of these three variables and of other background and attitudinal variables measured in the first session was explored using regression techniques.     

Promoting Safe Driving Behaviors: The Influence of Message Framing and Issue Involvement

This study examined the influence of framing and issue involvement on the intentions of participants to perform safe driving behaviors. It was hypothesized that when participants were involved with the issue, gain messages would increase intentions to perform safe driving behaviors more than would loss messages. To examine this hypothesis, participants were classified as either being high or low in involvement, and then were required to read either a gain or a loss message promoting a particular safe-driving behavior. After reading the message, the participants' agreement with the message, cognitive and affective responses to the message, and intentions to perform the behavior were recorded. The results supported the hypothesis.     

Antenatal predictors and use of coping strategies in labour

Abstract

One aim of antenatal preparation is developing coping strategies for use (luring labour. However, the existing literature suggests that attendance at classes is not associated with lower pain or distress, possibly because receiving training cannot be assumed to be associated with subsequent practice.

This study aimed to assess whether attenders at classes actually used their taught strategies in their labours, whether use was associated with psychological benefits and whether antenatal measures could predict subsequent use. Concepts from the theories of planned behaviour and self efficacy were used to attempt to predict use of three types of coping strategy.

Use was high for breathing strategies but poor for relaxation and posture. Proportion of use of breathing and relaxation showed weak associations with lower fear. Whilst intentions did act as significant predictors for use of posture and relaxation only small proportions of the variance were accounted for and other antenatal measures showed little predictive capacity.

Reasons why women in labour may fail to take behavioural consequences from their antenatal beliefs are considered. Predicting health-related behaviours where maintenance rather than just initiation is involved may require greater consideration of intra-situational and emotional factors. Modifications of antenatal preparation to facilitate use of strategies are discussed.     

The Correlates of Antinuclear Activism: Attitudes, Subjective Norms, and Efficacy

Ajzen's (1988) theory of planned behavior was modified and used to examine antinuclear behavior. Subjects completed a questionnaire measuring their antinuclear attitudes, their perceptions of support for taking antinuclear action, and their perceptions of efficacy in this arena. Then, an antinuclear behavioral intentions questionnaire was presented, as well as several opportunities to engage in various antinuclear actions. Regression analyses indicated that Ajzen's model was supported to the extent that attitude emerged as a significant predictor of antinuclear intentions and behaviors. Subjective norms and efficacy were not significant predictors of either intentions or behaviors. Models incorporating behavior-specific attitude measures accounted for more variance than did models using more general attitude measures toward nuclear war/weapons.     

Effects of Social Norms Information and Self-Affirmation on Sugar-Sweetened Beverage Consumption Intentions and Behaviors

The separate and combined efficacy of a social norms and a self-affirmation intervention to motivate decreased sugar-sweetened beverage (SSB) consumption was examined in 2 experiments. College students were randomly assigned to receive information about SSB consumption risks, norms, both, or neither. In addition, participants performed either a self-affirmation or control task. Self-affirmation only weakly affected SSB consumption intentions and behaviors. However, participants in Experiment 2 who received risks information, norms information, or both reported greater SSB reduction intentions than did those who received no information. Two weeks later, those who received both types of information reported more frequent behavior change preparations, and it appears this effect may have been partially mediated by the changes in intentions to reduce SSB consumption.     

Protection Motivation Theory and Adolescents' Perceptions of Exercise1

Coping strategies endorsed by adolescents in dealing with a potential threat to their health were assessed in a study which investigated components of protection motivation theory. Year 9 and 10 high school students were presented with information about cardiovascular disease risk and the role of exercise in maintaining cardiorespiratory fitness. Three components specified by the theory were manipulated: response efficacy (effectiveness of exercise in preventing cardiovascular disease), response costs (costs associated with taking up a regular program of exercise) and self-efficacy (belief in ability to carry out a program of exercise) in a 2 × 2 × 2 factorial design with two levels (high vs. low) of each variable. It was hypothesized that such information would affect participants' perceptions of response efficacy, response costs, self-efficacy, and their selection of coping strategies. Six dependent variables were investigated: two adaptive coping strategies (behavioral intention to exercise, rational problem solving) and four maladaptive strategies (avoidance, wishful thinking, hopelessness, arid fatalism). Manipulation checks found significant differences between the high and low conditions of each independent variable. Adaptive strategies were strongly endorsed, whereas endorsement of the maladaptive strategies ranged from minimal to complete disagreement. Participants in the high self-efficacy condition indicated stronger intentions to exercise. Students in the low response efficacy condition demonstrated more endorsement of hopelessness and fatalism than did students in the high response efficacy condition. When exercising status was included as a fourth independent variable, it was found that active adolescents endorsed the adaptive coping strategies more strongly than did inactive adolescents. The cognitive coping strategies adopted by adolescents when dealing with perceived threats to their health may be influenced by information on the efficacy of relevant behavior, by perceptions of their ability to perform such behavior, and by their actual involvement with the behavior of concern.     

Message Derogation and Self‐Distancing Denial: Situational and Dispositional Influences on the Use of Denial to Protect Against a Threatening Message1

Five types of denial to protect against the implications of a personal health threat message (cardiovascular disease or CVD) were examined. Undergraduates (N = 150) were randomly assigned to levels of threat and difficulty, read the message, and completed measures of objective risk for CVD, optimistic denial threat orientation, measures of 1 type of message‐oriented denial (message derogation) and 4 types of self‐oriented denial, and intentions to engage in protective action. High threat and difficulty both provoked message derogation, but low threat led to more self‐oriented denial. Individual differences were evident: Those higher in optimistic denial used more self‐oriented denial and had lower intention to engage in protective actions. Self‐oriented denial mediated the relationship between optimistic denial and behavioral intentions.     

Using message framing to promote acceptance of the human papillomavirus vaccine.

OBJECTIVE: Use of message framing for encouraging vaccination, an increasingly common preventive health behavior, has received little empirical investigation. The authors examined the relative effectiveness of gain-versus loss-framed messages in promoting acceptance of a vaccine against human papillomavirus (HPV)-a virus responsible for virtually all cases of cervical cancer. DESIGN: Undergraduate women (N = 121) were randomly assigned to read a booklet describing the benefits of receiving (gain-framed message) or the costs of not receiving (loss-framed message) a prophylactic HPV vaccine. After reading the booklet, participants indicated their intent to obtain the HPV vaccine. MAIN OUTCOME MEASURE: A 5-item composite representing intentions to obtain the HPV vaccine. RESULTS: The effect of message framing on HPV vaccine acceptance was moderated by risky sexual behavior and approach avoidance motivation. A loss-framed message led to greater HPV vaccination intentions than a gain framed message but only among participants who had multiple sexual partners and participants who infrequently used condoms. The loss-frame advantage was also observed among participants high in avoidance motivation. CONCLUSION: Findings highlight characteristics of the message recipient that may affect the success of framed messages promoting vaccine acceptance. This study has practical implications for the development of health communications promoting vaccination.     

Stable vs unstable weight history, body-image, and weight concern in women of average body weight

The focus of this study was the effect of unstable weight history on current body-image among women. Participants were 45 college women of average weight (median age = 23 yr.); 15 had stable weight histories, 15 had past lowest weights 15% or more below current weight, and 15 had past highest weights 15% or more above current weight. The women were assessed on perceptual and attitudinal measures of body-image and a self-report measure of preoccupation with weight. In comparison to women with stable weight histories, those with unstable weight histories indicated greater dissatisfaction with the shape and size of their bodies, expressed more negative body attitudes, and reported increased concern about weight. Women with high weight histories overestimated their frontal body-size and expressed greater dissatisfaction with frontal size than women with low weight histories, but the two groups did not differ significantly on any of the other dependent measures. Possible explanations for increased body-image disturbance and weight concern among women with unstable weight histories are presented.     

Feelings of vulnerability in response to threatening messages: Effects of self-affirmation

We examined effects of self-affirmation on feelings of vulnerability and behavioral intentions following exposure to personally threatening messages varying in message strength. In Experiment 1, female alcohol consumers read a strong message linking alcohol to breast cancer risk. Self-affirmed participants exhibited higher feelings of vulnerability concerning consumption levels and personal risk. In Experiment 2, female caffeine consumers read a weak or strong message linking caffeine to breast disease. Self-affirmed participants reported greater feelings of vulnerability to breast disease and greater intentions to reduce caffeine consumption (relative to control participants) only when reading the strong message. Effects on intentions were mediated by effects on feelings of vulnerability. These studies show that feelings of vulnerability can mediate effects of self-affirmation on intentions to change behavior under threat, although only in the presence of strong messages.     

The Influence of Attentional Style and Risk Perceptions on Intentions to Undergo Prophylactic Oophorectomy Among First-Degree Relatives

This study examined the predictors of women's intentions to undergo prophylactic oophorectomy. Eighty female first-degree relatives (FDRs) of ovarian cancer patients completed a measure of attentional style upon enrollment into a Family Risk Assessment Program. Following participation, measures of cancer risk perceptions, perceived benefits and costs of surgery, and intentions to undergo preventive surgery were obtained. Hierarchical regression analyses indicated that a high monitoring attentional style, as well as greater perceived risk of ovarian cancer and greater perceived benefits of the procedure, was associated with greater intentions to undergo prophylactic oophorectomy. In addition, a significant interaction between attentional style and perceived risk revealed that high monitors who felt at increased risk for ovarian cancer were less inclined to undergo surgery, whereas low monitors who perceived themselves to be at increased risk were more inclined to undergo surgery. The implications of the results for the design of counseling interventions are discussed.