Abstract
Fear arousal is widely used in persuasive campaigns and behavioral change interventions. Yet, experimental evidence argues against the use of threatening health information. The authors reviewed the current state of empirical evidence on the effectiveness of fear appeals. Following a brief overview of the use of fear arousal in health education practice and the structure of effective fear appeals according to two main theoretical frameworks-protection motivation theory and the extended parallel process model-the findings of six meta-analytic studies in the effectiveness of fear appeals are summarized. It is concluded that coping information aimed at increasing perceptions of response effectiveness and especially self-efficacy is more important in promoting protective action than presenting threatening health information aimed at increasing risk perceptions and fear arousal. Alternative behavior change methods than fear appeals should be considered.
Highlights
SCIENTIFIC EVIDENCEDiscussion programs on radio and television featured people who quit smoking sometime after the introduction of the health warnings—while ignoring the fact that many of these people would relapse (e.g., Zhou et al, 2009)
Fear arousal is widely used in persuasive campaigns and behavioral change interventions
Similar examples can be found in other health domains, such as the Australian Grim Reaper campaigns in the mid-1980s to warn of the fatal effects of human immunodeficiency virus infection/acquired immunodeficiency syndrome (HIV/AIDS), the US “this is your brain on drugs” campaign to prevent substance use and numerous traffic safety campaigns showing the bloody consequences of traffic accidents often involving young people
Summary
Discussion programs on radio and television featured people who quit smoking sometime after the introduction of the health warnings—while ignoring the fact that many of these people would relapse (e.g., Zhou et al, 2009) Among those involved in intervention design there is a strong belief in the persuasive efficacy of threatening health messages (see Peters, Ruiter, & Kok, 2014). Of the 22 experiments, 18 compared different formats of threatening health messages among each other (e.g., graphic + textual warning vs only textual warning) and not against a control condition with no or neutral information about the risk behavior From these studies, it is impossible to make statements about the effectiveness of threatening information. The difficulty to experimentally test policy measures is not a license to claim causal effects (see Ruiter & Kok, 2005, 2006)
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