Interventions to prevent skin cancer: Experimental evaluation of informational and fear appeals

Abstract

Reports experimental and correlational analyses of intentional sunbathing in 82 female and 54 male suntanned adults at high-risk of skin cancer. Random assignment to high or low information conditions allowed evaluation of a widely-distributed American Cancer Society pamphlet. A crossed manipulation assigned subjects to a cancer fear/no fear condition. Personality variables served as correlational predictors of sunbathing attitudes, intentions, and information-seeking behaviors; skin cancer knowledge served as both a predictor and a dependent variable. Skin cancer knowledge, but not fear, emerged as a significant predictor of attitudes, intentions, and behaviors; and simple provision of information affected relevant knowledge. Contrary to the limits often encountered with health behaviors, specific cancer education appears to be somewhat effective in this domain, though indirectly. High risk-taking personalities were less likely to have or seek relevant information, suggesting the need to take into account individual predispositions and routes of knowledge acquisition when designing interventions.     

Scary warnings and rational precautions: A review of the psychology of fear appeals

Abstract

Research into the effects of fear-arousal on precautionary motivation and action is reviewed. Current models do not adequately distinguish between emotional (i.e., fear arousal) and cognitive (i.e., threat perception) responses to fear appeals and, in general, are not well supported. Evidence suggesting that (i) coping appraisals are more powerful predictors of precautionary action than threat perception and that (ii) fear control processes may interfere with precautionary motivation, recommends cautious and limited use of fear appeals in health promotion. It seems likely that fear arousal is less important in motivating precautionary action than perceptions of action effectiveness and self-efficacy. Moreover, perceived personal relevance may be critical to the emotional and cognitive impact of threat information. Available findings are summarised in the form of a process model that highlights the potential complexity of fear arousal effects. Sequential measurement of fear arousal, other than by self-report, is recommended in studies seeking to clarify these effects.     

Finding theory‐ and evidence‐based alternatives to fear appeals: Intervention Mapping

Fear arousal—vividly showing people the negative health consequences of life‐endangering behaviors—is popular as a method to raise awareness of risk behaviors and to change them into health‐promoting behaviors. However, most data suggest that, under conditions of low efficacy, the resulting reaction will be defensive. Instead of applying fear appeals, health promoters should identify effective alternatives to fear arousal by carefully developing theory‐ and evidence‐based programs. The Intervention Mapping (IM) protocol helps program planners to optimize chances for effectiveness. IM describes the intervention development process in six steps: (1) assessing the problem and community capacities, (2) specifying program objectives, (3) selecting theory‐based intervention methods and practical applications, (4) designing and organizing the program, (5) planning, adoption, and implementation, and (6) developing an evaluation plan. Authors who used IM indicated that it helped in bringing the development of interventions to a higher level.     

Protection motivation and self-efficacy: A revised theory of fear appeals and attitude change

The effects of fear appeals on persuasion were investigated in a factorial experiment that was designed to test a combined model of protection motivation theory and self-efficacy theory. As predicted, the probability of a threat's occurrence and the effectiveness of a coping response both had positive main effects on intentions to adopt a recommended preventive health behavior. More importantly, the findings provided support for self-efficacy expectancy as a fourth component of protection motivation theory: Self-efficacy had a direct influence on intentions and interacted with two other variables of protection motivation theory. The interaction effect was interpreted in terms of two new decision-making strategies that people use when confronted with a fear appeal: a precaution strategy and a hyperdefensiveness strategy. In addition, the results replicated previous findings on the relationship between self-efficacy expectancy and outcome expectancy. A model incorporating protection motivation theory and self-efficacy theory is presented as a possible general model of attitude change.     

The role of vivid information in fear appeals and attitude change

Fear-arousing persuasive communications frequently incorporate so many types of information that the results can be difficult to interpret. R. Nisbett and L. Ross' (1980, Human inference: Strategies and shortcomings of social judgment, Englewood Cliffs, NJ: Prentice-Hall) analysis of informational vividness offers an attractive conceptual framework that identifies and predicts the effects of several types of information that have been confounded with other variables in fear appeal studies. Thus, the first purpose of this factorial experiment was to investigate the persuasive impact of three types of vivid information frequently used in fear appeals: emotional interest, concreteness, and proximity. It was predicted that vivid information would be more persuasive than pallid information. The results disclosed that emotionally interesting information was highly effective in changing intentions to seek protection from the depicted health threat. Also, the impact of information of high emotional interest and greater temporal and spatial proximity was enhanced with the passage of time, but information of low emotional interest and proximity diminished over time. Additional findings indicated that concrete, specific information was memorable and affected beliefs. The data rejected the hypothesis that memorial availability mediated the effects of vivid information. Implications for designing and strengthening fear appeals were discussed.     

The development of an instrument to measure teachers' use of fear appeals in the GCSE classroom

Background Previous work has suggested that teachers of General Certificate of Secondary Education classes may use fear appeals as a motivational device but these may have unwanted consequences by increasing examination‐related anxiety in students. Aim To facilitate future work in this area, an instrument was developed to measure teachers' use of fear appeals in the course of normal classroom instruction. Samples Students in their final 2 years of compulsory schooling in England: 192 in Study 1 and 133 in Study 2. Method A construct validity approach was used in the development of this instrument. Study 1 reports the development and piloting of this measure. Study 2 reports refinement of this measure and relations with other constructs. Results A three‐factor structure provided a reasonable model fit and all factors demonstrated acceptable reliability. Factors 1 and 2 described the perceived frequency of fear appeals made in relation to educational/occupational consequences and the third factor described the perceived threat of fear appeals. Conclusion This instrument has demonstrated sufficient convergent and discriminant validity and reliability to be used in subsequent research, although the validation process should continue and it is hoped that the instrument will be adapted for use in other contexts.     

The impact of fear appeals on processing and acceptance of action recommendations

A stage model of processing of fear-arousing communications was tested in an experiment that examined the impact of vulnerability to a severe health risk, the quality of the arguments supporting a protective action recommendation, and the source to which the recommendation was attributed, on processing and acceptance of the recommendation. Argument quality influenced attitudes toward the recommendation (but not intention to act), and this effect was mediated by negative thoughts about the recommendation. Vulnerability influenced intention to act (but not attitudes), and this effect was mediated by perceived threat and positive thoughts about the recommendation. The pattern of findings suggests that although vulnerability to a severe health risk induces biased processing of the recommendation, biased processing is restricted to intentions and does not compromise the evaluation of the recommendation. The theoretical and practical implications of these findings are discussed.     

Running and responding reinforced by the opportunity to run: effect of reinforcer duration.

The present study investigated the effect of reinforcer duration on running and on responding reinforced by the opportunity to run. Eleven male Wistar rats responded on levers for the opportunity to run in a running wheel. Opportunities to run were programmed to occur on a tandem fixed-ratio 1 variable-interval 30-s reinforcement schedule. Reinforcer duration varied across conditions from 30 to 120 s. As reinforcer duration increased, the rates of running and lever pressing declined, and latency to lever press increased. The increase in latency to respond was consistent with findings that unconditioned inhibitory aftereffects of reinforcement increase with reinforcer magnitude. The decrease in local lever-pressing rates, however, was inconsistent with the view that response strength increases with the duration of the reinforcer. Response rate varied inversely, not directly, with reinforcer duration. Furthermore, within-session data challenge satiation, fatigue, and response deprivation as determinants of the observed changes in running and responding. In sum, the results point to the need for further research with nonappetitive forms of reinforcement.     

Teachers use of fear appeals and timing reminders prior to high-stakes examinations: pressure from above,below, and within

Teachers often communicate to students the consequences of success and failure (fear appeals) and the timing (timing reminders) of forthcoming examinations. Prior research has examined how fear appeals and teaching reminders are evaluated by students and how they relate to educational outcomes such as engagement. Few studies have addressed the use of these behaviours from a teacher’s perspective. We examined teacher use of consequence and timing reminders, used prior to examinations, and its relation to perceived accountability pressure, teacher self-efficacy, perceived importance of tested outcomes, and the belief that students would interpret such messages as threatening. Data were collected from 854 English primary and secondary school teachers. Results showed that fear appeals and timing reminders were used more frequently when teachers believed that tested outcomes were important, when they had lower self-efficacy to engage students, and when they believed that students would interpret messages as threatening. Timing reminders, but not fear appeals, were used more frequently when perceived accountability pressure was greater. These findings help to understand why teachers are using such behaviours. In this study it was pressures from above, below, and within.     

The magnitude effect: Temporal discount rates and restaurant tips

Decision makers show a larger subjective temporal discount rate for small magnitudes than for large ones. That is, they demand a larger percent increase in value to compensate for a delay when they are waiting for a small amount of money than for a large amount. Prelec and Loewenstein (1991; see also Loewenstein & Prelec, 1992) proposed an increasing proportional sensitivity account of this magnitude effect. This account surmises that the magnitude effect stems from the utility function for money and is consequently not unique to intertemporal choice. One study tested this prediction by demonstrating the magnitude effect in two domains: intertemporal choice and tipping for restaurant meals, haircuts, and taxi rides. In intertemporal choice, subjects showed a larger discount rate for smaller monetary amounts. They also tipped a larger percentage on small bills than on large bills. Thus, both domains showed the magnitude effect; however, the size of the effect was not well correlated between domains.     

Effects of threatening and reassuring components of fear appeals on physiological and verbal measures of emotion and attitudes

Physiological processes are integral components of (a) many conceptualizations of emotion, (b) the emotion of fear, and (c) the fear-as-acquired-drive model of attitude change. Nevertheless, few studies of fear and persuasion have simultaneously measured self-reports of fear and autonomic activity. The present factorial experiment manipulated high versus low fear and high versus low reassurance and monitored self-reports and cardiovascular and electrodermal activity. The results disclosed that heart rate (HR) and skin conductance (SC) were highly correlated (r = .70). Although the multiple correlation among HR, SC, and a self-report measure of fear was a modest .44 (p < .05), additional evidence suggested that self-reports were the most sensitive measure of the construct of fear. The fear-film manipulation, which is typical of many fear-arousing communications, had identical effects upon the autonomic and self-report measures of fear. These data support the construct validity of the self-report measure of fear and increase our confidence that “fear” has been aroused in previous studies of fear and persuasion. Neither the fear-film manipulation nor the autonomic components of fear were associated with attitude change. The reassurance variable facilitated attitude change. Overall, the findings emphasized the importance of cognitive mediational processes rather than an emotional state of fear.     

The perceived value of maths and academic self-efficacy in the appraisal of fear appeals used prior to a high-stakes test as threatening or challenging

Previous work has examined how messages communicated to students prior to high-stakes exams, that emphasise the importance of avoiding failure for subsequent life trajectory, may be appraised as threatening. In two studies, we extended this work to examine how students may also appraise such messages as challenging or disregard them as being of little relevance. In study one we piloted a questionnaire with students studying for their school leaving qualification in maths. Threat appraisals were correlated with low academic self-efficacy, high attainment value and low intrinsic value. Challenge appraisals were correlated with high academic self-efficacy, and high intrinsic, extrinsic and attainment value. In study two, we manipulated attainment value and academic self-efficacy in a series of vignettes. High value and high academic self-efficacy lead to challenge appraisals, high value but low academic self-efficacy lead to threat appraisals and low value lead to a disregarding of messages. These findings show that the relevance of messages is judged on attainment value in a primary appraisal and as a challenge or threat in a subsequent appraisal, based on the expectation of success or failure. These findings also highlight how the effectiveness of such messages may differ depending on student characteristics.     

Theoretical mechanisms underlying the trial-spacing effect in Pavlovian fear conditioning.

Contemporary explanations of the trial-spacing effect (TSE) were evaluated. Experiment 1 revealed, in rats given tone-footshock trials with 15-, 60-, or 900-s intertrial intervals (ITIs), a direct relationship between freezing to the tone and ITI (the TSE) but an inverted U-shaped relationship between freezing to the training context and ITI. In Experiment 2, footshock preexposure eliminated the TSE that otherwise occurs across 15- to 60-s ITIs but had no effect on the TSE that occurs across 60- to 900-s ITIs. In Experiments 3 and 4, neither (a) increasing posttraining exposure to the training context in rats trained with 60-s ITIs nor (b) reducing between-trial exposure to this context in rats trained with 900-s ITIs influenced freezing to the tone. These findings suggest that the TSE obtained in this research is due to more than 1 mechanism: 1 responsible for the TSE that occurs with ITIs less than approximately 60 s and another responsible for the TSE that occurs with ITIs greater than this. Although the perceptual-defensive-recuperative model may correctly describe the former mechanism, none of the theories tested seems to correctly describe the latter.