Parallel Process Model Research Articles

What drives the vaccination intention against COVID-19? Application of EPPM, TAM, and theories of risk assessment

ABSTRACT Vaccines are widely used to fight against COVID-19. However, COVID-19 vaccine hesitancy appears as some individuals are concerned with COVID-19 vaccines. This study investigates the vaccination intention against COVID-19 in China with the Extended Parallel Process Model (EPPM), Technology Acceptance Model (TAM), and theories of risk information assessment. Results showed that the formation mechanism of vaccination intention could be considered a psychological process, as subjective knowledge was a primary influence on correspondents’ weighting of both the potentially positive (usefulness) and negative effects (threat) of vaccination. This unequal consideration then resulted in different levels of fear arousal between subjects. Driven by usefulness/threat perception and fear, people conducted different decision strategies, so-called analytical assessment, and experiential assessment to make vaccination decision. In addition to the direct effects of experiential assessment on vaccination intention, two decision strategies and fear arousal also affected people’s vaccination intention through the mediation role of vaccination attitude. For policymakers and stakeholders, this study provides a knowledge base for confidence-building, and emotional guidance concerning against COVID-19 vaccination.

Communicating COVID-19 Risk on Instagram: A Content Analysis of Official Public Health Messaging During the First Year of the Pandemic

Early in the COVID-19 pandemic, social media platform Instagram surged in popularity as a source of health information. Both the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) leveraged Instagram accounts to publicly distribute COVID-related information. The current study investigated whether WHO and CDC messaging strategies on Instagram adhered to best practices defined by two theoretical frameworks: the extended parallel process model and crisis and emergency risk communication. We conducted a quantitative content analysis of COVID-related posts (n = 726) published between January–December 2020 to determine how both agencies (1) communicated the threat of the pandemic (e.g. susceptibility and severity of negative COVID-19 consequences); (2) appealed to self-, response, and collective efficacy; (3) incorporated cues to action (e.g. preventive behaviors, information seeking); and (4) leveraged credibility cues (e.g. scientific evidence, experts). Results showed threat information was limited, whereas efficacy appeals and cues to action were abundant. The CDC relied more heavily on depictions of self- and response efficacy, whereas the WHO appealed more frequently than the CDC to collective efficacy. Neither visually modeled behaviors nor leveraged scientific evidence or experts with great frequency. Implications for future research and official communication efforts via social media are discussed.

Applying the Extended Parallel Process Model to aquatic invasive species prevention behaviors in wading anglers

Applying the Extended Parallel Process Model to aquatic invasive species prevention behaviors in wading anglers

Data Analytics for Pandemic Management using MapReduce and Apriori Algorithm

Amidst the profound impact of the COVID-19 pandemic on global economies and healthcare systems, effective data analysis has become paramount. Our research paper, titled ”Data Analytics for Pandemic Management Using MapReduce and Apriori Algo- rithm,” presents a comprehensive framework to analyze pandemic data. We harness the power of the MapReduce and Apriori algorithms, with a parallel processing model achieving an average speedup of 50%. This approach involves data collection, pre- processing, and algorithmic application to extract valuable insights from pandemic-related data. Notably, our findings reveal a substantial 22.29% support rate for ”n95 masks,” indicating high demand. Additionally, we identify strong co-occurrence patterns, exemplified by the perfect support rate of 1.00 between ”n95 masks” and ”chloroquine,” highlighting their interconnectedness. Our framework goes beyond data analysis, enhancing personalized marketing, and optimizing inventory management for efficient resource allocation during crises. We also uncover robust associations, such as the 0.220 confidence in joint purchases of ”butyl rubber gloves” and ”surgical masks”.Hence, the research aligns seamlessly with the pressing need for effective pandemic data management and response strategies. By validating our approach through numerical insights, we aim to contribute to mitigating pandemic-related challenges and support global efforts to better prepare for and manage future health emergencies.

Toward Sustainable Cities and Communities: A Qualitative Study of Motorists’ Response to an Anti-drunk Driving Media Campaign in Southeast, Nigeria

The 17 Sustainable Development Goals (SDGs) are a worldwide partnership’s urgent call to action for all nations, developed or developing. While it is practically impossible to accommodate the entire goals in a single research paper, this study focused on Goals 3 and 11 through a qualitative evaluation of motorists’ response to an anti-drunk driving media campaign in Southeast, Nigeria. Using the Protection Motivation Theory and the Extended Parallel Process Model as the theoretical framework, this study investigated motorists’ exposure, knowledge, and compliance as well as factors (if any) that inhibit compliance to the campaign by adopting focus group discussions and an in-depth interview as the research methods. Findings revealed that the motorists were exposed and had knowledge of the campaign; however, these indices did not translate into total compliance on their part with the campaign messages. Therefore, for an effective response, the campaign needs to be evaluated in line with its messages, design/packaging, channels of delivery, and measures of enforcement to be adopted.

The Role of Self-Efficacy and Risk Perception in the Willingness to Respond to Weather Disasters Among Emergency Medicine Health Care Workers in Pakistan.

Optimizing health care workers' (HCWs) willingness to respond (WTR) is critical in low-and-middle-income countries (LMICs) for proper health system functioning during extreme weather events. Pakistan frequently experiences weather-related disasters, but limited evidence is available to examine HCW willingness. Our study examined the association between WTR and behavioral factors among emergency department HCWs. A cross-sectional survey was conducted from August to September 2022 among HCWs from 2 hospitals in Karachi, Pakistan. Non-probability purposive sampling was used to recruit participants. A survey tool was informed by Witte's Extended Parallel Process Model (EPPM). Multivariate logistic regression analyses were performed to examine the association between WTR and attitudes/beliefs as well as EPPM profiles. Twenty-nine percent of HCWs indicated a low WTR. HCWs using public transportation had a higher WTR. Perceived knowledge and skills, self-efficacy, and perceived impact of one's response showed positive associations with WTR if required. Perception that one's colleagues would report to work positively predicted WTR if asked. Consistent with the EPPM, HCWs with high efficacy and perceived threat were willing to respond to weather disasters. Our findings highlight the need of strengthening WTR by promoting self-efficacy and enhancing accurate risk perception as a response motivator, among emergency department HCWs in Pakistan.

Toward sustainable cities and communities: A qualitativestudy of motorists’ response to an anti-drunk driving mediacampaign in Southeast, Nigeria

The 17 sustainable development goals (SDGs) are a worldwide partnership’s urgent call to action for all nations, developed or developing. While it is practically impossible to accommodate the entire goals in a single research paper, this study focused on Goals 3 and 11 through a qualitative evaluation of motorists’ response to an anti-drunk driving media campaign in Southeast, Nigeria. Using the protection motivation theory and the Extended Parallel Process Model as the theoretical framework, this study investigated motorists’ exposure, knowledge, and compliance as well as factors (if any) that inhibit compliance to the campaign by adopting focus group discussions and an in-depth interview as the research methods. Findings revealed that the motorists were exposed and had knowledge of the campaign; however, these indices did not translate into total compliance on their part with the campaign messages. Therefore, for an effective response, the campaign needs to be evaluated in line with its messages, design/packaging, channels of delivery, and measures of enforcement to be adopted.

Behavioral response for condom use messages to prevent human immunodeficiency virus/acquired immune deficiency syndrome among Bahir Dar City High School students, North West Ethiopia, 2022: Application of the extended parallel process model

Objective: The human immunodeficiency virus has become one of the world’s most serious health and development challenges. Human immunodeficiency virus prevention has not received sufficient attention, and the prevalence of human behavioral virus infections among Ethiopian high school and preparatory students has also increased. The aim of this study was to assess behavioral responses to condom use messages to prevent human immune virus/acquired immune deficiency syndrome among Bahir Dar city high school and preparatory students using the extended parallel process model, Bahir Dar, Ethiopia, 2022. Methodology: This institution-based cross-sectional study was conducted from 15 November to 15 December 2022, in Bahir Dar city. The data were collected from 601 participants. A multi-stage sampling technique was used to select the study participants. Data were entered into Epi-Info version 7.2.5 and exported to SPSS version 26 for analysis. Descriptive statistics, percentages, and frequencies were calculated. Bivariable logistic regression was performed to identify variables candidates for multivariable logistic regression at p-values less than 0.25, and multivariable logistic regression was performed to identify factors associated with the outcome variable at p-values < 0.05. A 95% confidence interval and odds ratio were used for the interpretation of the association. Result: The response rate of the respondents was 94.9%. The behavioral response for condom use messages was affected by grade level adjusted odds ratio, 0.473, 95% CI (0.252–0.886), knowledge adjusted odds ratio, 2.627, 95% CI (1.788–3.859), attitude adjusted odds ratio, 3.19, 95% CI (2.145–4.744), efficacy adjusted odds ratio, 3.286, 95% CI (2.03–5.339), and threat adjusted odds ratio, 0.249, 95% CI (0.167–0.369). The behavioral response for condom use messages was associated with danger control. Conclusion: The danger control response is 60.9%. Grade level, knowledge, attitude, and perceived and threat efficacies were independent predictors of danger control. Therefore, messages must aim to enhance threat component perception with appropriate efficacy to control danger and developed using scientific health communication strategies to promote behavioral change.

An extension of the extended parallel process model to promote heart-healthy exercise behavior: An experimental study.

Background: The prevalence of heart disease has increased and is a leading cause of death in the U.S. Despite the importance of physical activity, only one-third of adults in the United States meet the amount of physical activity recommended by the Centers for Disease Control and Prevention (CDC). The purpose of this study was to extend the extended parallel process model (EPPM) by adding a 'barrier' (a construct from Health Belief Model) and exploring the roles of threat, efficacy, and barrier on participants' self-efficacy, attitudes, and intentions toward exercise. Methods: A between-subject experimental design was conducted online in 2018 in the U.S. A total of 446 participants were recruited from the Amazon Mechanical Turk age 18 or above. The participants were first provided with stimuli messages about physical activity behaviors. Then participants' responses to self-efficacy, intention, and attitudes toward exercise were assessed. Results: The results found an interaction between efficacy and barrier to participants' attitudes toward exercise [F(1,435)=4.35, P=0.038, η2 part=0.01]. The results also showed that there was a statistically significant effect of barriers on participants' self-efficacy regarding exercise behavior [F(1,442)=4.21, P=0.04, η2 part=0.009]. However, three-way interactions of threat, efficacy, and barrier were not found in attitudes or intentions to exercise. Conclusion: The findings suggested that addressing an individual's perceived barrier regarding a health behavior may lead to an increase in self-confidence ensuing in higher physical activity. Future studies should further explore how addressing barriers may influence other health behaviors to design unique and effective health messages.

Behavioral responses for facemask use messages to prevent COVID-19 among residents of Bahir Dar City, Ethiopia: an application of extended parallel process model

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic causes major morbidity and mortality in the world. Timely behavioral response assessment of the community is important to shape the next effective interventions and risk communication strategies to adopt preventive behavior. Hence, this study aimed to assess behavioral responses for facemask-use messages to prevent COVID-19 and its predictors among residents of Bahir Dar City, Ethiopia, 2021 by using the Extended Parallel Process Model. MethodsA community-based cross-sectional study was conducted with the guide of the Extended Parallel Process Model in Bahir Dar city from March 9 to April 9, 2021. A multistage sampling technique was used, and data was collected through a face-to-face interviewer-administered questionnaire using Epicollect5. Descriptive statistics and Binary logistic regression were computed using SPSS V.25. Variable with P < 0.25 in the bivariable analysis was a candidate for multivariable analysis to control confounding effect. In multivariable analysis, variables with P < 0.05 were considered statistically significant and the result was presented using an adjusted odd ratio (AOR) with a 95% confidence interval (CI).ResultsA total of 616 participants with a response rate of 97.1% were included. Of the total participants, 229(37.2%) were in the danger control response. The behavioral response was affected by Occupational status [AOR (95%CI) 3.53(1.67–7.46)], the number of people living together [AOR (95%CI) 2.62(1.28–5.39)], self-control [AOR (95%CI) 1.14(1.05–1.25)], a friend for the preferred source of information [AOR (95%CI) 5.18(3.22–8.33)] and printed materials for the preferred channel [AOR (95%CI) 2.14(1.35–3.43)].ConclusionAbove one-third of the participants were in the danger control response. Occupational status, number of people living together, self-control, a friend for the preferred source of information, and printed materials for the preferred channel were independent predictors of resident behavioral response to the use of facemasks. Policymakers should consider students and people who live alone. Message developers should use a friendly person to transmit messages and should prepare printed materials. Activities and strategies should also focus on self-control and perceived efficacy without ignoring the perceived threat.

COVID-19 Protective Behaviors of Iranian Healthcare Workers: A Psychological Theoretical Design Analysis

Background: This study aimed to investigate COVID-19 protective behaviors of Iranian healthcare workers (HCWs) using an extended parallel process model (EPPM). Methods: This cross-sectional study was conducted online on a convenience sample of 418 Iranian HCWs in 2020. Data were gathered using a standardized electronic questionnaire published on the Porsline website, designed based on the EPPM, to assess the relationships between different constructs of EPPM and COVID-19 protective behaviors. For data analysis, statistical tests, such as descriptive tests, independent t-test, ANOVA, Pearson's correlation test, and multiple regression analysis, were performed in SPSS version 18. Results: Most participants (40.4%) were in the age group of 30-40 years, and most were female (70.6%). Significant associations were found between COVID-19 protective behaviors and EPPM constructs of perceived self-efficacy (r = 0.373, P = 0.000), perceived response efficacy (r = 0.120, P = 0.014), and intention (r = 0.462, P = 0.000). Perceived self-efficacy (P = 0.000, beta = 0.398) and behavioral intention (P = 0.000; Beta = 0.283) were predictors of protective behaviors. Also, 34.4% of the HCWs were involved in the danger control process. Conclusions: Only one-third of the HCWs contributed to the process of COVID-19 danger control. The HCWs' motivation for protection against COVID-19 depended on their perception of self-efficacy and their perceived efficacy of COVID-19 preventive behaviors. The present results can be used to design and implement training programs to improve the protective behaviors of HCWs.

Co-development of an evidence-based personalised smoking cessation intervention for use in a lung cancer screening context

BackgroundOptimising smoking cessation services within a low radiation-dose computed tomography (LDCT) lung cancer screening programme has the potential to improve cost-effectiveness and overall efficacy of the programme. However, evidence on the optimal design and integration of cessation services is limited. We co-developed a personalised cessation and relapse prevention intervention incorporating medical imaging collected during lung cancer screening. The intervention is designed to initiate and support quit attempts among smokers attending screening as part of the Yorkshire Enhanced Stop Smoking study (YESS: ISRCTN63825779). Patients and public were involved in the development of an intervention designed to meet the needs of the target population.MethodsAn iterative co-development approach was used. Eight members of the public with a history of smoking completed an online survey to inform the visual presentation of risk information in subsequent focus groups for acceptability testing. Three focus groups (n = 13) were conducted in deprived areas of Yorkshire and South Wales with members of the public who were current smokers or recent quitters (within the last year). Exemplar images of the heart and lungs acquired by LDCT, absolute and relative lung cancer risk, and lung age were shown. Data were analysed thematically, and discussed in stakeholder workshops. Draft versions of the intervention were developed, underpinned by the Extended Parallel Processing Model to increase self-efficacy and response-efficacy. The intervention was further refined in a second stakeholder workshop with a patient panel.ResultsIndividual LDCT scan images of the lungs and heart, in conjunction with artistic impressions to facilitate interpretation, were considered by public participants to be most impactful in prompting cessation. Public participants thought it important to have a trained practitioner guiding them through the intervention and emphasising the short-term benefits of quitting. Presentation of absolute and relative risk of lung cancer and lung age were considered highly demotivating due to reinforcement of fatalistic beliefs.ConclusionAn acceptable personalised intervention booklet utilising LDCT scan images has been developed for delivery by a trained smoking cessation practitioner. Our findings highlight the benefit of co-development during intervention development and the need for further evaluation of effectiveness.

Intention of health experts to counter health misinformation in social media: Effects of perceived threat to online users, correction efficacy, and self-affirmation.

Our study analyzes the intention of Chinese health experts (health professionals and medical students) to correct health misinformation in social media. In an experimental 2 × 2 × 2 between-subjects factorial design (n = 415), we manipulated the experts' perception of the threat that health misinformation poses for online users, their self-efficacy with respect to correcting misinformation, and their self-affirmation. To select the potential influence factors, we draw on self-affirmation theory and the extended parallel process model. Results of our experiment revealed that correction intention increases if experts perceive the threat for online users as severe, believe that they are capable of countering the impact of misinformation, and have a high motivation to maintain a positive self-image of caring for others. We discuss the consequences of our findings for motivating experts to help reduce the adverse effects of health misinformation in social media.

Understanding cancer genetic risk assessment motivations in a remote tailored risk communication and navigation intervention randomized controlled trial

ABSTRACT Background National guidelines recommend cancer genetic risk assessment (CGRA) (i.e. genetic counseling prior to genetic testing) for women at increased risk for hereditary breast and ovarian cancer (HBOC). Less than one-half of eligible women obtain CGRA, leaving thousands of women and their family members without access to potentially life-saving cancer prevention interventions. Purpose The Genetic Risk Assessment for Cancer Education and Empowerment Project (GRACE) addressed this translational gap, testing the efficacy of a tailored counseling and navigation (TCN) intervention vs. a targeted print brochure vs. usual care on CGRA intentions. Selected behavioral variables were theorized to mediate CGRA intentions. Methods Breast and ovarian cancer survivors meeting criteria for guideline-based CGRA were recruited from three state cancer registries (N = 654), completed a baseline survey, and were randomized. TCN and targeted print arms received the brochure; TCN also participated in a tailored, telephone-based decision coaching and navigation session grounded in the Extended Parallel Process Model and Ottawa Decision Support Framework. Participants completed a one-month assessment. Logistic regression was used to compare the rate of CGRA intentions. CGRA intentions and theorized mediator scores (continuous level variables) were calculated using mixed model analysis. Results CGRA intentions increased for TCN (53.2%) vs. targeted print (26.7%) (OR = 3.129; 95% CI: 2.028, 4.827, p < .0001) and TCN vs. usual care (23.1%) (OR = 3.778, CI: 2.422, 5.894, p < .0001). Perceived risk (p = 0.023) and self-efficacy (p = 0.035) mediated CGRA intentions in TCN. Conclusions Improvements in CGRA intentions and theorized mediators support the use of a tailored communication intervention among women at increased HBOC risk. (Clinicaltrials.gov: NCT03326713.) Trial registration: ClinicalTrials.gov identifier: NCT03326713.

Design and evaluation of two educational media in the form of animation and games to promote the cutaneous leishmaniasis prevention behaviors in adolescent female

BackgroundCutaneous leishmaniasis (CL) has social and psychological effects on different groups, especially adolescents and young girls in 98 countries of the world, in addition to the economic burden. Therefore, it is necessary to apply effective methods for CL prevention. In this study, educational messages were designed based on Extended Parallel Process Model in both forms of animation and game, whose effect on the cutaneous leishmaniasis prevention behaviors was evaluated in adolescent female students. MethodsThis experimental study was carried out from January to September 2021 on 275 adolescent female students in Isfahan province, Iran. Cluster sampling method was used, and then the students were randomly divided into three groups, namely animation education, game education, and control groups. The educational intervention was performed with two new media in the form of animation and games. The data collected before and two months after the education through a valid and reliable researcher-made questionnaire were analyzed in SPSS24 software using statistical tests of ANOVA, Chi-square, paired t and analysis of covariance (ANCOVA).ResultsThe mean age of the participants was 14.07 ± 0.94. The mean scores of behavior in the animation group (60.60 ± 23.00), the game group (61.70 ± 22.05), and the control group (66.13 ± 24.62) were not significantly different prior to the education. However, after the education, there was a significant difference between the animation (80.66 ± 17.62) and game groups (82.58 ± 19.07) and the control group (69.79 ± 23.29) (P < 0.001). The mean scores of model constructs following the intervention (susceptibility, severity, response efficacy, and perceived self-efficacy) significantly increased in the animation and game groups compared to that in the control group (P < 0.05).ConclusionThe results showed that if educational programs contain a combination of threat and efficiency messages, CL-preventive behaviors in adolescents increase. Providing similar educational content with both game and animation methods indicated that both methods had an almost same effect. Although animation production is more costly, it has the advantage of being used in periods and for other adolescents.

Relative deprivation patterns in social and geographical references for health trajectories in China: Investigations of gender and urban-rural disparities

ObjectiveA pervasive link between relative deprivation and health has been well-documented. However, prior studies suffered from inadequate relative deprivation measures that fail to define appropriate reference groups to which individuals compare themselves, and few provided longitudinal evidence. This study explores latent relative deprivation patterns based on multiple social and geographic reference groups, examining their impacts on health trajectories and variations by gender and urban-rural areas. MethodsUsing three waves (2013, 2015, & 2018) of the China Health and Retirement Longitudinal Study (n = 6035), we conducted latent class analysis (LCA) to identify the baseline latent relative deprivation patterns among five social and geographic reference groups (relatives, schoolmates, colleagues, neighbors, and other people in the city or county). The LCA results were linked to the latent growth curve parallel process modeling (PPM) to investigate the impacts of deprivation patterns on dual health trajectories (depressive symptoms and self-rated health), and the results were stratified to explore gender and urban-rural differences. ResultsThe LCA revealed a relatively deprived group (36.39%) and a non-deprived group (63.61%). The PPM results indicated that the relatively deprived group showed a higher initial level of depressive symptoms and a lower initial level of self-rated health than the non-deprived group. However, the relatively deprived group showed a slower growth rate in depressive symptoms than the non-deprived group. These findings were particularly evident among women and rural residents. ConclusionsFindings emphasize the negative impact of relative deprivation on health. Furthermore, there is a complex interplay in these effects intertwined with gender and locality. Policies aimed at promoting mental health should not only consider relatively deprived groups, but also non-deprived women and rural residents who are at higher risk for later-life depression.

Predictor factors of preventive behaviors based on Extended Parallel Process Model (EPPM) in residents of Bushehr province in 2021

Predictor factors of preventive behaviors based on Extended Parallel Process Model (EPPM) in residents of Bushehr province in 2021

Tax risk assessment, financial constraints and tax compliance: A bibliometric analysis

Taxation is a fundamental source of revenue for governments. However, globally tax revenue performance has continuously been poor. This has been attributed largely to poor tax compliance behaviour. Theoretical arguments from Pecking Order Theory (POT) and the Extended Parallel Process Model (EPPM) suggest that financial constraints and tax risk assessment could explain the dynamics of tax compliance. Motivated by these grounds, this paper seeks to explore the extent to which prior research efforts have been directed toward tax risk assessment, financial constraints and tax compliance. This paper employs bibliometric analytical procedures to interrogate the existing empirical literature from 1981 to 2022. This paper uses the Scopus database to conduct the bibliometric analysis using “bibliometrix” package. It was evident through the analyses that emerging studies have explored these variables: tax risk assessment, financial constraints and tax compliance. However, joint search criteria were introduced; it was found that the empirical literature has largely not considered the interconnectedness of these variables. When two variables mapping search criteria were used, it was observed that apart from financial constraints and tax compliance, these variables have virtually not been investigated. Given these empirical gaps coupled with the theoretical justification of the connectedness of these variables, it is recommended that future studies should extend the literature to contribute to filling the gap. Evidence of such analyses could also shape tax policy and practice and therefore government and tax authorities should sponsor studies in this area.

The efficacy and feasibility of the Arizona attorney general's school‐based cyber‐safety promotion and cyberbullying prevention intervention among middle school adolescents in Oman

AbstractThis study aimed to evaluate the short‐term effects of the social networking safety promotion and cyberbullying prevention presentation of the Arizona attorney general's guided by the extended parallel process model (EPPM). A quasi‐experimental (a pre‐posttest) was used with two groups with random assignment to intervention. A total of 389 adolescents in seventh, eighth, and ninth grades at two public middle schools in Muscat city were involved in the study procedures and randomly divided into two groups (the experimental group (n = 186) and the waiting list group (n = 203). The risk behavior diagnostic scale, behavioral intention and attitudes scale, coping strategies with cyberbullying scale, and self‐protection behavior intentions were used. Five separate presentations (each presentation was 60 min, one presentation per week) were introduced to the adolescents in the experimental group. The results supported the efficacy of the intervention in changing adolescents' attitudes and behavioral intentions against cyberbullying and promoting their security and safety during their use of social networks. Also, the intervention has a significant effect on the four EPPM components (susceptibility, severity, self‐efficacy, and self‐efficacy responses) and the participants learned coping skills to deal with potential cyberbullying incidents).

Message Presentation Is of Importance as Well: The Asymmetric Effects of Numeric and Verbal Presentation of Fear Appeal Messages in Promoting Waste Sorting

ABSTRACT This study aimed to investigate the effectiveness of fear appeal messages to promote public engagement with municipal solid waste (MSW) sorting in China using the extended parallel process model (EPPM). By adding information format to the EPPM as guided by the construal-level theory, the study examined whether the interaction effects of threat and efficacy on behavioral intention varied in terms of verbal and numeric information format. The 2 × 2 × 2 factorial experiment revealed a significant main effect for efficacy. The threat, albeit having no significant main effect itself, moderated the effect of efficacy on behavioral intention. Moreover, the significant three-way interaction effect of threat, efficacy, and information format suggested that individuals who received low-threat and high-efficacy messages in numeric format had the highest intention to perform MSW sorting. Findings from this study imply that how messages are presented is of just as much importance as what to communicate to the public when designing environmental campaigns.