Response efficacy: the key to minimizing rejection and maximizing acceptance of emotion-based anti-speeding messages

Embodying Temporality in Response Efficacy: How Coping Appraisal Promotes Preventive Behavioral Engagement During the Ongoing Pandemic

This study heightens the understanding of response efficacy as a determinant of engagement in preventive behavior during the ongoing COVID-19 pandemic. To achieve a more nuanced conceptualization of response efficacy, this study proposes and examines a time-based coping appraisal framework, drawing upon a part of the extended parallel process model (EPPM). The current study investigates how the temporality of coping response message features work in generating social distancing behavioral intentions and explicates the role of anticipated emotions in this motivational process. Results of the experimental study (N = 584) indicate that proximal future framed coping response message (vs. distant future message) led to greater response efficacy, which in turn led to greater anticipated guilt and pride, and by extension increased social distancing behavioral intentions. Mediation analyses also demonstrated the indirect effects of the temporality conditions (proximal future-oriented message vs. distant future-oriented message) on social distancing intentions through response efficacy, anticipated guilt, and anticipated pride. The theoretical and practical implications of this study are discussed.

The effect of fear and situational motivation on online information avoidance: The case of COVID-19

During the COVID-19 pandemic, a plethora of online sources for information and news dissemination have emerged. Extant research suggests that very quickly, individuals become disinterested and begin avoiding the information. In this study, we investigate how an individual's fear and situational motivation impact Online Information Avoidance. Using the self-determination theory and information avoidance theories, we argue that fear and external regulation are associated with increased Online Information Avoidance. We also argue that intrinsic motivation and identified regulation are associated with a decrease in Online Information Avoidance. Our findings suggest that fear, intrinsic motivation, and external regulation drive Online Information Avoidance, where intrinsic motivation is the most significant driver. We also found that identified regulation is a crucial inhibitor of Online Information Avoidance. While focusing on COVID-19, our study contributes to the broader information systems research literature and specifically to the information avoidance literature during a pandemic or a prolonged crisis. Our study's findings will be useful for governments, health organizations, and communities that utilize online platforms, forums, and related outlets to reach larger audiences for disseminating pertinent information and recommendations during a crisis.

Willingness to pay to enhance pandemic preparedness in Mauritius

OBJECTIVES

The objective of this study is to assess the determinants of willingness to pay to enhance pandemic preparedness in Mauritius.

STUDY DESIGN

A contingent valuation method is used to estimate willingness to pay to pay for enhancing pandemic preparedness using a sample of working people in Mauritius.

METHODS

A two-phase decision process analysis is carried out to model the willingness to pay to enhance pandemic preparedness. The first phase is to analyse the respondents' decision of whether or not to pay for enhancing pandemic preparedness using a Probit model. The second phase is to estimate the determinants of the amount of money respondents are willing to pay using a Tobit model.

RESULTS

Income earners are willing to pay an average of Rs. 1,900 (approximately USD 50) per annum to enhance pandemic preparedness. 'Perceived Response Efficacy', 'Awareness of the Need and Responsibility for Paying', 'Subjective Obligation to Pay' and the 'Theory of Planned Behaviour' are found to affect both stages of of the decision-making process. Knowledge on COVID-19 is found to have a positive impact on the decision to pay and health responsibility attitude is found to have a negative impact on the amount people are willing to pay.

CONCLUSIONS

On average, the government can potentially expect to mobilise an additional Rs. 1,047,470,000 (USD 27,565,000) from taxpayers to spend on enhancing pandemic preparedness in Mauritius. To increase willingness to pay for enhanced pandemic preparedness, the government can focus on improving knowledge on a pandemic, perceived response efficacy and awareness on need and responsibility of paying.

Effect of fear appeal mobile phone messaging on health behaviors of caregivers with children under-five in Ghana

Social and Behavior Change Communication is a vital strategy in the control of malaria. However, the effectiveness of fear appeal tactic as a preventive strategy remains uncertain. This study examined the influence of a fear appeal mobile phone-based intervention, guided by Witte's Extended Parallel Process model, on malaria prevention among caregivers with children under-five. We conducted a quasi-experimental study of a 12-month intervention using a sample of 324 caregivers from two rural districts, assigned to either an intervention or control group. The intervention group received fear appeal voice Short Message Service (SMS), once a week for twelve (12) months, while caregivers in the control group received none. The results showed that exposure to the messages was associated with an increased odds of positive attitude [adjusted Odds ratio (aOR) = 2.58; 95% CI 1.61-4.15] and behavioral changes (aOR = 2.03, 95% CI 1.29-3.19). The intervention group exhibited lower odds of defensive avoidance (aOR = 0.44, 95% CI 0.29-0.68) and message minimization (aOR = 0.51, 95% CI 0.33-0.78) compared with the control group. These findings highlight the importance of communicating health messages via mobile phones using fear appeal for improving the health behaviors of caregivers. This strategy, however, may not be useful for influencing the intention of caregivers to engage in positive health practices to protect their children from malaria.

Increasing Receptivity to COVID-19 Public Health Messages with Self-Affirmation and Self vs. Other Framing

There remains an urgent need for effective communication about the importance of widespread adherence to behavioral recommendations to control the COVID-19 pandemic that will also reduce resistance to such guidance. We examined two strategies for COVID-19 communication- (1) self-affirmation (reflecting on a personal value in order to boost self-integrity and reduce defensiveness to potentially threatening information); and (2) manipulating self/other message framing - and moderation of these strategies by COVID-19 risk. 600 participants (M_age = 32.55, 51% female) were recruited for an online study and, after assessment of risk factors for severe COVID-19 infection, were exposed to the experimental manipulations. Three classes of defensive responses were considered as outcomes of interest: reactance, attitudinal responses, and behavioral responses. We found that participants derogated the self-focused message more than the other-focused message. Further, other-focused messaging and/or self-affirmation were more likely to elicit positive responses among individuals at higher risk for COVID-19 complications. Our findings suggest having individuals affirm values prior to viewing COVID-19 messages, and framing messages in terms of the importance of protecting others, may be beneficial strategies for encouraging responsiveness - particularly if the targets of such messages are at risk of COVID-19 complications themselves.

Two experimental studies on the differential effects of low and high treatability information on the inclination to engage in cancer prevention

Two 3(control versus LTI versus HTI) × 2(self-affirmation versus no self-affirmation)-experiments were conducted. The first study presented a news message on the treatability of bowel cancer (N = 717); the second study was about skin cancer (N = 342). The dependent variables were the intention to engage in preventive behaviors and message acceptance. The results showed that when participants were exposed to LTI, only when response efficacy was low, a self-affirmation procedure increased their intention to prevent cancer (experiment 1), and increased message acceptance (experiment 2). When participants were exposed to HTI, the self-affirmation procedure did not increase the intention, and even reduced message acceptance. The findings suggest that defensive processes were active in reaction to LTI, but not in reaction to HTI. Although publishing LTI and HTI information in the media serves legitimate goals, it may have positive but also negative unintended effects on preventive behaviors in the population.

Experimental Effects of Tweets Encouraging Social Distancing: Effects of Source, Emotional Appeal, and Political Ideology on Emotion, Threat, and Efficacy

CONTEXT

Public health officials and celebrities use social media to provide guidance to reduce the spread of COVID-19. Messages apply different promotional strategies to motivate behavior change, likely yielding divergent reactions from partisan audiences. The Extended Parallel Process Model (EPPM) suggests that perceived threat for a negative outcome should impact perceived need for the advocated health behavior, which should be more appealing to an audience if perceived it to be efficacious and feasible.

OBJECTIVE

This study examines the interactive effects of Tweet source, message emotional appeal, and audience political affiliation on US adults' perceptions of COVID-19 threat and social distancing efficacy during early months of the pandemic.

DESIGN AND SETTING

This online survey experiment applies the EPPM to assess US adults' reactions to tweets encouraging social distancing. The experiment tests 3 emotional appeals (fear, humor, and neutral) and 2 sources (Centers for Disease Control and Prevention [CDC] and celebrity) on adults' emotional reactions and perceptions of COVID-19 threat and social distancing efficacy.

PARTICIPANTS

The final sample included 415 US adults (242 Democrat and 173 Republican) recruited through Amazon's Mechanical Turk.

MAIN OUTCOME MEASURES

Outcome measures were adapted from the EPPM and include perceived susceptibility to and severity of COVID-19, and response efficacy and self-efficacy regarding social distancing. Each was measured through the survey on a 7-point response scale.

RESULTS

Humor and fear appeal messages evoked less fear and guilt responses than a neutral tweet from the CDC. Fear and guilt emotions predicted greater perceived threat, while hope and pride predicted efficacy constructs in relationships moderated by political ideology.

CONCLUSIONS

Public health messages targeting a bipartisan audience through social media may increase perceived threat by inducing fear of COVID-19 infection. EPPM theory suggests boosting efficacy is also critical to message acceptance and behavior change; thus, inducing feelings of hope and pride in addition to fear may be particularly effective.

Fear of disasters within the risk communication network of foreign students in Japan amid the COVID-19 pandemic crisis: A cohort design

The main objective of this study is to examine the role of risk communication during the COVID-19 crisis, which is often neglected in studies investigating the outbreak of the pandemic. The study is based on survey data from a group of international (non-Japanese) students in Japan and the theoretical foundation of fear appeal theory. The results, which are based on the panel data structure, show that individually, (1) the act of seeking out others to discuss risks in depth in the current pandemic context or (2) the observed adoption of advocated precautionary health behaviours is not necessarily a good indicator of mental management, but (3) the combined effect of (1) and (2) unexpectedly suggests a conciliatory effect on the fear of disasters. Moreover, this evidence-based finding (3) suggests that a reciprocal relationship exists between threat and efficacy in terms of mediating fear under the framework and theory of fear appeals, indirectly challenging the fear control response proposition of the extended parallel process model. Our empirical findings emphasize the role of risk discourse and information sharing combined with preventive health behaviours adopted within a community in the context of global health crises.

Pilot implementation of a user-driven, web-based application designed to improve sexual health knowledge and communication among young Zambians: a mixed method study (Preprint)

Background

Digital health interventions show promise in improving the uptake of HIV services among adolescents and young people aged 15 to 24 years in sub-Saharan Africa.

Objective

This study aimed to pilot-test a theory-based, empirically grounded web-based application designed to increase condom-related knowledge, sexual and reproductive health (SRH) communication, and healthier choices among young Zambians.

Methods

We conducted a pre-post quasi-experimental evaluation of the user-driven Be in the Know Zambia (BITKZ) web application using web-based surveys and in-depth interviews (IDIs) on the phone. We enrolled participants using social media advertisements. Our final analysis set comprised 46.04% (749/1627) of participants in the intervention group (which received the BITKZ link) and 53.96% (878/1627) of participants in the comparison group (no intervention). We collected survey data at study enrollment (baseline) and 5 weeks after the first enrollment in each group. Approximately 85% (637/749) of BITKZ users completed a user survey, of whom 9.3% (59/637) participated in IDIs. We calculated the time interfacing with BITKZ using the application log files. We conducted descriptive analyses to describe baseline characteristics and the user experience. At the endline, we assessed association using a t test and adjusted logistic regression for binary outcomes and ordinal regression for ordered outcomes, conditioning on age, sex, marital status, and employment status. We used adjusted average treatment effects (aATE) to assess the effects of BITKZ intervention. We conducted rapid matrix analyses of IDI transcripts in Microsoft Excel, sorting the data by theme, gender, and experience rating.

Results

Users rated BITKZ highly (excellent: 352/609, 57.8%; good: 218/609, 35.8%). At the endline, the intervention group had a higher level of knowledge related to condoms (adjusted odds ratio [aOR]: 1.35, 95% CI 1.06-1.69) and on wearing condoms correctly (aOR: 1.23, 95% CI 1.02-1.49). Those who had full-time employment had increased odds of knowing how to wear condoms correctly (aOR: 1.67, 95% CI 1.06-2.63) compared with those who reported being unemployed, as did men when compared with women (aOR: 1.92, 95% CI 1.59-2.31). Those in the intervention group were more likely to score higher for intention to test for sexually transmitted infections (STIs; aATE 0.21; P=.01) and HIV (aATE 0.32; P=.05), as well as for resisting peer pressure (aATE 2.64; P=.02). IDIs corroborated increased knowledge on correct condom use among men and female condoms among women, awareness of STIs and testing, and resistance to peer pressure. Interviewees provided examples of more open SRH communication with partners and peers and of considering, adopting, and influencing others to adopt healthier behaviors.

Conclusions

Despite the high baseline awareness of SRH among Zambian adolescents and young people with internet access, BITKZ provided modest gains in condom-related knowledge, resistance to peer pressure, and intention to test for STIs and HIV.

Protection Motivation and Food Waste Reduction Strategies

“Ugly food” refers to agricultural products that are discarded because their appearance is not attractive, even though their nutritional content is unaffected. In this study, protection motivation theory (PMT) was applied to analyze whether an individual’s awareness of food waste problems affects their “ugly food” purchase intention. Hence, the relationships between awareness of food waste problems, threat appraisal (severity and vulnerability), coping appraisal (response efficacy and self-efficacy), and ugly food purchase intention were analyzed. Additionally, a moderating effect analysis was conducted per consumer age. Descriptive statistical analysis, frequency, and SPSS reliability analysis were used, including confirmatory factor analysis, structural equation modeling, and multi-group analysis of the Amos program. For the final analysis, 361 samples were used. Results showed that awareness of food waste problems positively affected severity and vulnerability, response efficacy, and self-efficacy. Moreover, severity positively affected ugly food purchase intention and vulnerability did not. Response and self-efficacy positively affected ugly food purchase intention. In the moderating effect analysis per consumer age, the difference between severity and ugly food purchase intention and vulnerability and ugly food purchase intention was significant. This study has various academic and practical implications, and presents several strategies to reduce food waste to contribute to a sustainable future environment. It is also the first study linking the food waste problem, PMT, and ugly food purchase behavior.

Targeting Smartphone Use While Driving: Drivers’ Reactions to Different Types of Safety Messages

Only a few previous studies analyzed the effectiveness of road safety messages targeting smartphone use while driving and only several of them used messages from an ongoing road safety campaign. Thus, contributing to the field, this study aimed at testing the effectiveness of two types of social messages (threat appeal and threat appeal together with safe behavior role modelling) targeting smartphone use while driving. Ninety-three drivers were randomly assigned to two experimental (n1 = 26; n2 = 37) and one control (n = 29) groups. Each experimental group was presented with one 30 s length video message to reduce or stop smartphone use while driving. Messages differed in terms of threat appeal and modelling of safe behavior. The control group was presented with a 30 s length video clip showing neutral driving related content. The results revealed that threat appeals (alone or together with a safe role model) resulted in less positive emotions when compared to the control group’s reported emotional reactions. The message with threat appeal only also resulted in more negative emotions compared to the control group. With regards to behavioral intentions, road safety messages used in this study had minor effectiveness: the threat appeal message reduced the intentions to use smartphones while driving, only when previous behavior has been controlled. In sum, messages targeting smartphone use while driving were effective at least to some extent in changing drivers’ emotions and intentions not to be involved in targeted behavior, but the effect was minor and threat appeal only showed higher effectiveness.

Fear appeals to promote better health behaviors: an investigation of potential mediators

Background: Fear appeals are widely used in health communication, despite conflicting views on their effectiveness. Unresolved issues include possible mediation mechanisms and the effect of defensive reactions aimed at controlling a perceived danger.

Methods: The present study compared the impact of three versions of an existing online course on how to prevent noncommunicable diseases. Participants, recruited in South America via a crowdsourcing platform, were divided randomly between three versions of the course – ‘threat only’/‘threat plus coping information’/‘coping information plus threat’ (reverse order). We then asked them to complete a questionnaire measuring perceived efficacy, perceived threat, defensive reactions, and intention to change unhealthy behaviors.

Results: Using a serial parallel mediation model to test the course's impact on our dependent variables did not reveal any significant differences between the three versions. Perceived efficacy was positively associated with intention to change behavior, as well as with lower suppression, lower reappraisal, and greater denial. Suppression was the only defensive reaction to be associated with intention to change behavior: greater suppression was linked to less intention to change.

Conclusions: Our results open interesting perspectives for research into defensive reactions.

Keeping Safe on Australian Roads: Overview of Key Determinants of Risky Driving, Passenger Injury, and Fatalities for Indigenous Populations

Social and cultural barriers associated with inequitable access to driver licensing and associated road safety education, as well as socioeconomic issues that preclude ongoing vehicle maintenance and registration, result in unsafe in-car behaviours such as passenger overcrowding. This in turn is associated with improper seatbelt usage, noncompliance with child restraint mandates, and driver distraction. For example, in Australia, where seatbelt use is mandatory, Indigenous road users are three times less likely to wear seatbelts than non-Indigenous road users. This is associated with a disproportionately high fatality rate for Indigenous drivers and passengers; 21% of Indigenous motor-vehicle occupants killed on Australian roads were not wearing a seatbelt at the time of impact. In addition, inequitable access to driver licensing instruction due to financial and cultural barriers results in Indigenous learner drivers having limited access to qualified mentors and instructors. A consequent lack of road safety instruction results in a normalising of risky driving behaviours, perpetuated through successive generations of drivers. Moreover, culturally biased driver instruction manuals, which are contextualised within an English written-language learning framework, fail to accommodate the learning needs of Indigenous peoples who may encounter difficulties with English literacy. This results in difficulty understanding the fundamental road rules, which in turn makes it difficult for young drivers to develop and sustain safe in-car behaviours. This paper considers the literature regarding road safety for Indigenous road users and critically evaluates strategies and policies that have been advanced to protect Indigenous drivers. Novel solutions to increasing road safety rule compliance are proposed, particularly in relation to passenger safety, which are uniquely embedded within Indigenous ways of knowing, being, and doing. Safe driving practices have crucial health and social implications for Indigenous communities by allowing more Indigenous people to participate in work and education opportunities, access healthcare, maintain cultural commitments, and engage with families and friends, qualities which are essential for ongoing health and wellbeing.

Information Sources, Risk Perception, and Efficacy Appraisal's Prediction of Engagement in Protective Behaviors Against COVID-19 in China: Repeated Cross-sectional Survey

Background

As the COVID-19 pandemic has become a major public health threat worldwide, it is critical to understand what factors affect individual engagement in protective actions. Because of its authoritarian political system and state-owned media system, how Chinese individuals engaged in protective actions against COVID-19 might be different compared to other countries.

Objective

The purpose of this study is to examine how the source of information about COVID-19, Chinese individuals’ risk perception of COVID-19 (ie, perceived severity and perceived susceptibility), and their efficacy appraisal in controlling COVID-19 (ie, response efficacy and self-efficacy) affected their engagement in protective actions. Additionally, this study aims to investigate whether there is any difference in these relationships throughout the duration of this pandemic.

Methods

A six-wave repeated cross-sectional survey (N=1942) was conducted in six major cities in China between February 7 and April 23, 2020. Participants’ reliance on expert versus inexpert sources for information about COVID-19, their perceived severity of and susceptibility to COVID-19, their response efficacy and self-efficacy, and their engagement in protective actions (staying at home, wearing a face mask, and washing hands) were measured. Demographic variables (sex, age, income, education, and city of residence), knowledge of COVID-19, and self-rated health condition were controlled.

Results

Reliance on expert sources did not become the major factor that motivated these actions until wave 3, and the negative effect of inexpert sources on these actions was limited to wave 2. Perceived severity encouraged some protective behaviors but its effect varied depending on the specific behavior. In addition, perceived severity exhibited a stronger effect on these behaviors compared to perceived susceptibility. The positive effect of response efficacy was only significant at waves 1 and 2, and limited to certain behaviors.

Conclusions

Chinese individuals’ engagement in protective behaviors might not entirely be their autonomous decision but a result of compliance with executive orders. After the early outbreak, expert sources started to facilitate protective behaviors, suggesting that it might take time to develop trust in these sources. The facilitating effect of perceived severity lasted throughout the duration of the pandemic, but that of response efficacy was limited to the early stage.

An Investigation of Cognitive Processing of Fear Appeal Messages Promoting HPV Vaccination: Predictors and Outcomes of Magnitude and Valence of Cognitive Responses

An improvement in HPV vaccination rates is one of the primary goals of public health organizations. Toward this end, fear appeal communication is commonly used in health interventions, warning individuals of threats of HPV infection and promoting vaccination. However, little is known about how threat-related emotions, such as fear and anxiety, influence the cognitive processing of vaccination information and how this processing is associated with vaccination intention. To address this void, this study tests a model drawing upon functional emotion theories and dual-process models of persuasion. Results from an experimental study showed that fear and anxiety, which arose from exposure to threat information, triggered motivation to process HPV protection-related information, which in turn, was positively associated with depth of HPV vaccination information processing. Subsequently, greater depth of processing led to a greater number of positive cognitive responses when participants were presented with information with a high (vs. low), level of response efficacy. Finally, greater positivity of cognitive responses predicted greater intention to obtain HPV vaccination. Collectively, our findings provide a theory-based explanation about how the sequential provision and processing of threat and efficacy information in fear appeals contribute to the promotion of HPV vaccination. Implications for designing fear appeal messages are discussed.

Perceptions of Active Shooter Prevention and Preparation Strategies in Pennsylvania: Links to Self-Protective Behavior

In this study, I document how members of the public perceive active shooter risk in their communities and their perceptions of the effectiveness of common efforts to prevent and respond to active shooters. I further investigate how news media exposure shapes these perceptions. I applied Protection Motivation Theory (PMT) to explore how perceptions and news media exposure might shape self-protective actions taken by individuals and their households. Data were obtained in 2019 from a cross-sectional, state-representative sample of 668 Pennsylvania adults who completed a web survey. Those who perceived higher community active shooter risk and those who felt community prevention and preparation efforts were effective were more likely to take self-protective steps themselves. Increased news exposure through apps, social media, family and friends was associated with increased perceived risk and effectiveness of prevention and preparation strategies. These results suggest that self-selected news and news through personal ties are linked to active shooter perceptions while other news mediums, like television or radio broadcasts, are not. News exposure was largely unrelated to self-protection. Those who felt community efforts were effective in prevention or preparation, however, were more likely to take self-protective actions. This finding indicates that community efforts may be more influential than news media in directing personal behavior.

Gender differences in the effectiveness of public education messages aimed at smartphone use among young drivers

Objective: The main aim of this survey study was to evaluate the relative persuasiveness of three newly developed and piloted public education messages aimed at monitoring/reading social interactive technology on a smartphone among young male and female drivers. In accordance with the Step Approach to Message Design and Testing, the messages were evaluated on a number of outcome measures and also explored the influence of self-reported involvement in the target behavior.Methods: Participants (N = 152; 105 F) were aged 17 to 25 years (M_age = 20.14 years, SD = 2.35) and were randomly allocated to either an intervention (one of the three messages) or control (no message) condition. The messages in the intervention group were assessed on acceptance (i.e., behavioral intention and message effectiveness), rejection, and the third person effect (TPE) differential score (i.e., the message is perceived to be more effective for others than for themselves).Results: Hierarchical regression analyses found that, compared to males, females reported: a) lower intention to monitor/read social interactive technology on a smartphone while driving, b) lower rejection; and, c) lower TPE likelihood, irrespective of message.Conclusions: These findings suggest that young male drivers and young female drivers require different message content to be effective and support the importance of including multiple outcome measures to explain the messages' persuasive effects.

Rank-ordering anti-speeding messages

PURPOSE

Further explore the utility of protection motivation theory (PMT) in developing effective roadside anti-speeding messages.

METHOD

Via an electronic link, 81 participants holding a current Australian driver's license rated all possible pairs of 18 PMT-derived anti-speeding messages in terms of their perceived effectiveness in reducing speed for themselves, and for drivers in general.

RESULTS

While some messages revealed third-person effects (perceived as being more relevant to drivers-in-general than to self-as-driver), others showed reverse third-person effects (perceived as being more relevant to self-as-driver than to drivers-in-general). Compared with messages based on coping appraisal components, those derived from threat appraisal PMT components (perceived severity, counter-rewards, vulnerability) were rated as being more effective, both for participants themselves as driver, and for drivers-in-general. Compared with females, males reported threat appraisal messages as being more effective for reducing speed in themselves (reverse third-person effect). Aggregate scores for the 18 messages derived from this ipsative methodology correlated modestly with those from a normative study using similarly-worded items.

DISCUSSION

As jurisdictions globally recognize speeding as a major road safety issue, effective anti-speeding campaigns are essential. Findings added to current knowledge of PMT's efficacy as a basis for generating effective anti-speeding messages and indicated areas for future research and application.

Threat appeals reduce impulsive decision making associated with texting while driving: A behavioral economic approach

The primary purpose of the present study was to examine the effectiveness of threat appeals in influencing impulsive decision making associated with texting while driving. The participants in the treatment group were exposed to a threatening message about the danger of texting while driving, whereas those in the control group were exposed to a non-threatening message. Following the exposure to either message, the participants completed a delay-discounting task that assessed the degree of impulsive decision making in a hypothetical texting-while-driving scenario. A comparison between the groups revealed that the threat appeals reduced the degree of impulsive decision making associated with texting while driving. In addition, the threat appeals led to greater anticipated regret from texting while driving, less favorable attitudes toward texting while driving, and decreased intentions to text while driving in the future in the treatment group. These results suggest that video-based threat appeals are promising intervention strategies for the public health challenge of texting while driving. Implications from the behavioral economic perspective are discussed.

Examining Mechanisms Underlying Fear-Control in the Extended Parallel Process Model

This investigation sought to advance the extended parallel process model in important ways by testing associations among the strengths of efficacy and threat appeals with fear as well as two outcomes of fear-control processing, psychological reactance and message minimization. Within the context of print ads admonishing against noise-induced hearing loss (NIHL) and the fictitious Trepidosis virus, partial support was found for the additive model with no support for the multiplicative model. High efficacy appeals mitigated freedom threat perceptions across both contexts. Fear was positively associated with both freedom threat perceptions within the NIHL context and favorable attitudes for both NIHL and Trepidosis virus contexts. In line with psychological reactance theory, a freedom threat was positively associated with psychological reactance. Reactance, in turn, was positively associated with message minimization. The models supported reactance preceding message minimization across both message contexts. Both the theoretical and practical implications are discussed with an emphasis on future research opportunities within the fear-appeal literature.

Evaluating public education messages aimed at monitoring and responding to social interactive technology on smartphones among young drivers

Young drivers are more likely than any other age group to access social interactive technology (e.g., Facebook, E-mail) on a smartphone while driving. The current study formed part of a larger investigation and was guided by The Step Approach to Message Design and Testing (SatMDT) to evaluate the relative effectiveness of three different public education messages aimed at reducing smartphone use among young drivers. The messages were each adapted to the specific behaviours of monitoring/reading and responding to social interactive technology on smartphones. Participants (n=288; 199F, 89M) were drivers aged 17-25 years who resided in the Australian state of Queensland. Message acceptance (i.e., intention and effectiveness) and message rejection were both assessed using a self-report survey. Multivariate analyses found that, overall, the messages targeting monitoring/reading behaviour were considered more effective than those targeting responding behaviour. The message that challenged the underlying motivation that believing you are a good driver makes it easier to monitor/read social interactive technology while driving was considered particularly effective by young male drivers.

Insights into targeting young male drivers with anti-speeding advertising: An application of the Step approach to Message Design and Testing (SatMDT)

In Australia, young drivers aged 17-25 years comprise 13% of the population yet account for 22% of all road deaths with young males over-represented in such trauma. Speeding represents a major contributing factor and advertising campaigns have long focused on promoting anti-speeding messages in the effort to reduce drivers' speeds. Positioned within a larger program of research aimed at developing, piloting, and evaluating a range of theoretically-informed anti-speeding messages, the current study reports results relating to the final phase of the research, the evaluation. Six messages were devised in accordance with the guiding framework, the Step approach to Message Design and Testing ([SatMDT]; Lewis et al., 2016) and based on the findings emerging from earlier qualitative and quantitative studies within the program of research. N=938 licensed drivers (n=455 males, 48%) aged 17-62 years completed an online survey. To ensure a controlled test of the persuasiveness of the message content, the messages were presented in an audio-based format and thus were devoid of potential confounds, such as images. The messages sought to address a particular belief (i.e., behavioural, normative, control) and to focus either on emphasising the positive aspects which make speeding less likely or challenging the negative aspects which make speeding more likely. Thus, key to this evaluation was to test the persuasiveness of the message content in terms of the particular belief and focus it was addressing. Participants were randomly assigned to either the Control condition (i.e., no exposure to a message) or the Intervention condition (i.e., exposed to one of the six messages presented as an audio-recorded message within the survey). Persuasiveness was assessed via a range of outcome measures including both direct (i.e., third-person perceptions, message rejection) as well as indirect measures (i.e., intentions, willingness to speed). Age, gender, and message type were independent variables (IVs), together with issue involvement as a covariate (or IV) in the study's analyses. Overall, positive persuasive effects, and a relative absence of any negative, dissuasive effects, were found for two messages, Glass Cars and The Lift. These messages addressed the same salient belief, control beliefs, with the former emphasising the factors which discourage speeding and the latter message challenging those factors which encourage speeding. The implications of the findings are discussed in terms of the insights they offer for the key content of future anti-speeding messages.

The effects of anti-speeding advertisements on the simulated driving behaviour of young drivers

Recent examinations of road safety communications, including anti-speeding advertisements, have considered the differential effects of positive and negative emotional appeals on driver behaviour. However, empirical evaluations of anti-speeding messages have largely relied on measures of viewers' reported intentions to comply with speed limits and the self-reported driving behaviour of viewers post-exposure, which might not be indicative of the direct effects that these messages have on real-world driving behaviour. The current research constitutes a first empirical evaluation of different real-world anti-speeding advertisements, as measured by their effects on young drivers' speeding behaviour, using a driving simulator. Licensed drivers (N=116) aged 17-25 years completed driving measures prior to, immediately following, and 7-10days after viewing one of four social marketing advertisements. Results indicated that young drivers' average driving speeds were modestly reduced immediately after they viewed an anti-speeding advertisement that depicted social consequences for speeding and employed a positive emotional appeal when compared to an emotion-matched control advertisement; however, this effect was not found for the anti-speeding advertisement depicting a crash. Interestingly, the results based on reported intentions to reduce speeding predicted the opposite pattern of results. However, there was no evidence that the immediate changes to speeding were maintained 7-10days later, and prompts during Phase 2 did not appear to have an effect. The implications of these findings for road safety advertisements targeting young drivers are discussed.

The Step approach to Message Design and Testing (SatMDT): A conceptual framework to guide the development and evaluation of persuasive health messages

This paper provides an important and timely overview of a conceptual framework designed to assist with the development of message content, as well as the evaluation, of persuasive health messages. While an earlier version of this framework was presented in a prior publication by the authors in 2009, important refinements to the framework have seen it evolve in recent years, warranting the need for an updated review. This paper outlines the Step approach to Message Design and Testing (or SatMDT) in accordance with the theoretical evidence which underpins, as well as empirical evidence which demonstrates the relevance and feasibility of, each of the framework's steps. The development and testing of the framework have thus far been based exclusively within the road safety advertising context; however, the view expressed herein is that the framework may have broader appeal and application to the health persuasion context.

Reprint of "Persuasive appeals in road safety communication campaigns: Theoretical frameworks and practical implications from the analysis of a decade of road safety campaign materials"

Communication campaigns are employed as an important tool to promote road safety practices. Researchers maintain road safety communication campaigns are more effective when their persuasive appeals, which are central to their communicative strategy, are based on explicit theoretical frameworks. This study's main objectives were to develop a detailed categorization of persuasive appeals used in road safety communication campaigns that differentiate between appeals that appear to be similar but differ conceptually, and to indicate the advantages, limitations and ethical issues associated with each type, drawing on behavior change theories. Materials from over 300 campaigns were obtained from 41 countries, mainly using road safety organizations' websites. Drawing on the literature, five types of main approaches were identified, and the analysis yielded a more detailed categorizations of appeals within these general categories. The analysis points to advantages, limitations, ethical issues and challenges in using different types of appeals. The discussion summarizes challenges in designing persuasive-appeals for road safety communication campaigns.

Young drivers' engagement with social interactive technology on their smartphone: Critical beliefs to target in public education messages

The current study forms part of a larger study based on the Step Approach to Message Design and Testing (SatMDT), a new and innovative framework designed to guide the development and evaluation of health communication messages, including road safety messages. This four step framework is based on several theories, including the Theory of Planned Behaviour. The current study followed steps one and two of the SatMDT framework and utilised a quantitative survey to validate salient beliefs (behavioural, normative, and control) about initiating, monitoring/reading, and responding to social interactive technology on smartphones by N=114 (88F, 26M) young drivers aged 17-25 years. These beliefs had been elicited in a prior in-depth qualitative study. A subsequent critical beliefs analysis identified seven beliefs as potential targets for public education messages, including, 'slow-moving traffic' (control belief - facilitator) for both monitoring/reading and responding behaviours; 'feeling at ease that you had received an expected communication' (behavioural belief -advantage) for monitoring/reading behaviour; and 'friends/peers more likely to approve' (normative belief) for responding behaviour. Potential message content targeting these seven critical beliefs is discussed in accordance with the SatMDT.

Threat appeals in health communication: messages that elicit fear and enhance perceived efficacy positively impact on young male drivers

Background

Health communications often present graphic, threat-based representations of the potential consequences of health-risk behaviours. These ‘threat appeals’ feature prominently in public health campaigns, but their use is controversial, with studies investigating their efficacy reporting inconsistent, and often negative, findings. This research examined the impact of a threat-based road safety advertisement on the driving behaviour of young male drivers.

Methods

To address limitations of previous research, we first identified a road safety advertisement that objectively and subjectively elicited fear using physiological and subjective measures. Study 1 (n = 62) examined the effect of this advertisement, combined with a manipulation designed to increase perceived efficacy, on speed choice. Study 2 (n = 81) investigated whether a state emotion, anger, impacts on the effectiveness of the advertisement in changing four distinct driving behaviours. Both studies examined short-term effects only.

Results

Study 1 findings indicated that a high threat message, when combined with high perceived efficacy, can lead to a decrease in speed choice. Study 2 results suggested that increased levels of state anger may counteract the potential value of combining fear-arousing threats and efficacy-building messages.

Conclusions

Findings suggest that threat-based road safety communications that target affective (fear) and cognitive (perceived efficacy) mechanisms can positively affect driving behaviours. State emotions, such as anger, may negatively impact on the effectiveness of the message. Taken together, these findings provide additional support for the use of efficacy-building messages in threat-based communications, but highlight the need for further research into the complex array of affective influences on driving.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-016-3227-2) contains supplementary material, which is available to authorized users.

Young drivers' responses to anti-speeding advertisements: Comparison of self-report and objective measures of persuasive processing and outcomes

OBJECTIVE

Self-report measures are typically used to assess the effectiveness of road safety advertisements. However, psychophysiological measures of persuasive processing (i.e., skin conductance response [SCR]) and objective driving measures of persuasive outcomes (i.e., in-vehicle Global Positioning System [GPS] devices) may provide further insights into the effectiveness of these advertisements. This study aimed to explore the persuasive processing and outcomes of 2 anti-speeding advertisements by incorporating both self-report and objective measures of speeding behavior. In addition, this study aimed to compare the findings derived from these different measurement approaches.

METHODS

Young drivers (N = 20, M age = 21.01 years) viewed either a positive or negative emotion-based anti-speeding television advertisement. While viewing the advertisement, SCR activity was measured to assess ad-evoked arousal responses. The RoadScout GPS device was then installed in participants' vehicles for 1 week to measure on-road speed-related driving behavior. Self-report measures assessed persuasive processing (emotional and arousal responses) and actual driving behavior.

RESULTS

There was general correspondence between the self-report measures of arousal and the SCR and between the self-report measure of actual driving behavior and the objective driving data (as assessed via the GPS devices).

CONCLUSIONS

This study provides insights into how psychophysiological and GPS devices could be used as objective measures in conjunction with self-report measures to further understand the persuasive processes and outcomes of emotion-based anti-speeding advertisements.

The Importance of Efficacy: Using the Extended Parallel Process Model to Examine Factors Related to Preschool-Age Children Enrolled in Medicaid Receiving Preventive Dental Visits

Early preventive dental visits are vital to the oral health of children. Yet many children, especially preschool-age children enrolled in Medicaid, do not receive early visits. This study attempts to uncover factors that can be used to encourage parents to seek preventive dental care for preschool-age children enrolled in Medicaid. The extended parallel process model was used as a theoretical framework for this research. This model suggests that people will act if the perceived threat (severity and susceptibility) is high enough and if efficacy levels (self-efficacy and response efficacy) are likewise high. Following Witte's method of categorizing people's perceptions and emotions into one of four categories based on levels of threat and efficacy, this article describes four groups (high threat/high efficacy, high threat/low efficacy, low threat/high efficacy, and low threat/low efficacy) of parents and how they compare to each other. Using logistic regression to model if a child had a preventive visit, results indicate that parents with low threat/high efficacy and parents with high threat/high efficacy had approximately 2.5 times the odds of having a child with a preventive oral health visit compared to parents with low threat/low efficacy, when controlling for perceived oral health status, health literacy, and child's age. The importance of efficacy needs to be incorporated in interventions aimed at increasing preventive dental visits for young children.

Appealing to fear: A meta-analysis of fear appeal effectiveness and theories

Fear appeals are a polarizing issue, with proponents confident in their efficacy and opponents confident that they backfire. We present the results of a comprehensive meta-analysis investigating fear appeals' effectiveness for influencing attitudes, intentions, and behaviors. We tested predictions from a large number of theories, the majority of which have never been tested meta-analytically until now. Studies were included if they contained a treatment group exposed to a fear appeal, a valid comparison group, a manipulation of depicted fear, a measure of attitudes, intentions, or behaviors concerning the targeted risk or recommended solution, and adequate statistics to calculate effect sizes. The meta-analysis included 127 articles (9% unpublished) yielding 248 independent samples (NTotal = 27,372) collected from diverse populations. Results showed a positive effect of fear appeals on attitudes, intentions, and behaviors, with the average effect on a composite index being random-effects d = 0.29. Moderation analyses based on prominent fear appeal theories showed that the effectiveness of fear appeals increased when the message included efficacy statements, depicted high susceptibility and severity, recommended one-time only (vs. repeated) behaviors, and targeted audiences that included a larger percentage of female message recipients. Overall, we conclude that (a) fear appeals are effective at positively influencing attitude, intentions, and behaviors; (b) there are very few circumstances under which they are not effective; and (c) there are no identified circumstances under which they backfire and lead to undesirable outcomes.

Persuasive appeals in road safety communication campaigns: Theoretical frameworks and practical implications from the analysis of a decade of road safety campaign materials

Communication campaigns are employed as an important tool to promote road safety practices. Researchers maintain road safety communication campaigns are more effective when their persuasive appeals, which are central to their communicative strategy, are based on explicit theoretical frameworks. This study's main objectives were to develop a detailed categorization of persuasive appeals used in road safety communication campaigns that differentiate between appeals that appear to be similar but differ conceptually, and to indicate the advantages, limitations and ethical issues associated with each type, drawing on behavior change theories. Materials from over 300 campaigns were obtained from 41 countries, mainly using road safety organizations' websites. Drawing on the literature, five types of main approaches were identified, and the analysis yielded a more detailed categorizations of appeals within these general categories. The analysis points to advantages, limitations, ethical issues and challenges in using different types of appeals. The discussion summarizes challenges in designing persuasive-appeals for road safety communication campaigns.

Fear and Psychological Reactance

Abstract. Psychological reactance and related defensive processes have been long cited as an explanation for failure of fear appeal messages. The overwhelming majority of studies on fear and reactance have only examined the intensity of fear from a between-individuals perspective, in which individuals who have higher peak fear are predicted to experience stronger levels of psychological reactance. Recent development in the fear appeal research suggests an alternative perspective: Psychological reactance is activated when fear is aroused but not reduced within each individual; on the other hand, psychological reactance is mitigated or inhibited when fear is aroused and then reduced. Empirical data from a quasi-experimental study using graphic tobacco warning labels are used to test and compare the two approaches to studying the relationship between fear and psychological reactance. Implications for psychological reactance and fear appeal are discussed.

Modifying behaviour to reduce over-speeding in work-related drivers: an objective approach

The goal of this study was to utilise an objective measurement tool, via an on-board Diagnostic tool (OBDII), to explore the effectiveness of a behaviour modification intervention designed to reduce over-speed violations in a group of work-related drivers. It was predicted that over-speed violations would be decreased following participation in a behaviour modification intervention where drivers received weekly feedback on their speeding performance and goal setting exercises. The final analysis included the on-road behaviour of 16 drivers, all of whom completed each stage of the intervention programme. As predicted, over-speed violations significantly decreased from pre-test to post-test, after controlling for kilometres driven. These findings offer practical guidance for industry in developing interventions designed to improve work-related driving behaviour.

The impact of threat appeals on fear arousal and driver behavior: a meta-analysis of experimental research 1990-2011

The existing empirical research exploring the impact of threat appeals on driver behavior has reported inconsistent findings. In an effort to provide an up-to-date synthesis of the experimental findings, meta-analytic techniques were employed to examine the impact of threat-based messages on fear arousal and on lab-based indices of driving behavior. Experimental studies (k = 13, N = 3044), conducted between 1990 and 2011, were included in the analyses. The aims of the current analysis were (a) to examine whether or not the experimental manipulations had a significant impact on evoked fear, (b) to examine the impact of threat appeals on three distinct indices of driving, and (c) to identify moderators and mediators of the relationship between fear and driving outcomes. Large effects emerged for the level of fear evoked, with experimental groups reporting increased fear arousal in comparison to control groups (r = .64, n = 619, p<.01). The effect of threat appeals on driving outcomes, however, was not significant (r = .03, p = .17). This analysis of the experimental literature indicates that threat appeals can lead to increased fear arousal, but do not appear to have the desired impact on driving behavior. We discuss these findings in the context of threat-based road safety campaigns and future directions for experimental research in this area.

Individual differences in drivers' cognitive processing of road safety messages

Using Gray and McNaughton's (2000) revised reinforcement sensitivity theory (r-RST), we examined the influence of personality on processing of words presented in gain-framed and loss-framed anti-speeding messages and how the processing biases associated with personality influenced message acceptance. The r-RST predicts that the nervous system regulates personality and that behaviour is dependent upon the activation of the behavioural activation system (BAS), activated by reward cues and the fight-flight-freeze system (FFFS), activated by punishment cues. According to r-RST, individuals differ in the sensitivities of their BAS and FFFS (i.e., weak to strong), which in turn leads to stable patterns of behaviour in the presence of rewards and punishments, respectively. It was hypothesised that individual differences in personality (i.e., strength of the BAS and the FFFS) would influence the degree of both message processing (as measured by reaction time to previously viewed message words) and message acceptance (measured three ways by perceived message effectiveness, behavioural intentions, and attitudes). Specifically, it was anticipated that, individuals with a stronger BAS would process the words presented in the gain-frame messages faster than those with a weaker BAS and individuals with a stronger FFFS would process the words presented in the loss-frame messages faster than those with a weaker FFFS. Further, it was expected that greater processing (faster reaction times) would be associated with greater acceptance for that message. Driver licence holding students (N=108) were recruited to view one of four anti-speeding messages (i.e., social gain-frame, social loss-frame, physical gain-frame, and physical loss-frame). A computerised lexical decision task assessed participants' subsequent reaction times to message words, as an indicator of the extent of processing of the previously viewed message. Self-report measures assessed personality and the three message acceptance measures. As predicted, the degree of initial processing of the content of the social gain-framed message mediated the relationship between the reward sensitive trait and message effectiveness. Initial processing of the physical loss-framed message partially mediated the relationship between the punishment sensitive trait and both message effectiveness and behavioural intention ratings. These results show that reward sensitivity and punishment sensitivity traits influence cognitive processing of gain-framed and loss-framed message content, respectively, and subsequently, message effectiveness and behavioural intention ratings. Specifically, a range of road safety messages (i.e., gain-frame and loss-frame messages) could be designed which align with the processing biases associated with personality and which would target those individuals who are sensitive to rewards and those who are sensitive to punishments.

A prospective study of relationships between propositions about risk and driver speeding

Risk propositions are specific and modifiable hypotheses that people hold about the outcomes of risk-taking behavior. According to fuzzy trace theory (FTT), risk propositions arise from the subjective and idiosyncratic interpretations that people make about the meaning of risk information, and form the primary basis of decision-making. A community sample of 255 drivers was interviewed at baseline (T1), 6 weeks after baseline (T2) and 14 weeks after baseline (T3). We tested whether propositions about speeding-related risk at time 1 (T1) would predict speeding at time 3 (T3), controlling perceptions of speeding-related danger and other speeding-related variables (the perceived possibility of being caught and the enjoyment and excitement to be gained from speeding) measured at time 2 (T2). We also tested whether relationships between T1 propositions and T3 speeding would be mediated by T2 perceptions of danger. T1 propositions predicted T3 speeding independently of the control variables, and we also found evidence consistent with mediation by T2 danger. In line with FTT, risk propositions were not scaleable as a single dimension, but generally predicted speeding as independent entities. Taken together these findings support the view that drivers perceive speeding risk as a series of potentially modifiable propositions which may have item-specific influences on speeding behavior.

Community beliefs about intentional injury and responsibility for prevention

Community beliefs related to intentional injury inflicted by others were examined in a population-based telephone survey (n = 1032) in Queensland, Australia. Young adults 18 to 24 years old were nominated as the most likely to be intentionally injured. It was found that 89.1% of respondents nominating this group believed that the injury incidents occur in alcohol environments. Though respondents from this age group also identified 18- to 24-year-olds as most likely to be intentionally injured, this was at a significantly lower level when compared with parents or 25- to 64-year-olds respondents. Responsibility for preventing injuries was placed on proprietors of licensed premises, schools, and parents/family of the victim for alcohol, school, and home environments, respectively. Beliefs were aligned with prevalence data on intentional injury, demonstrating a high level of awareness in the community about likely victims and situations where intentional injuries occur. Interventions could target families of young adults to capitalize on high levels of awareness about young adult vulnerability.

"Teaching them a lesson?" A qualitative exploration of underlying motivations for driver aggression

Aggressive driving is increasingly a concern for drivers in highly motorised countries. However, the role of driver intent in this behaviour is problematic and there is little research on driver cognitions in relation to aggressive driving incidents. In addition, while drivers who admit to behaving aggressively on the road also frequently report being recipients of similar behaviours, little is known about the relationship between perpetration and victimisation or about how road incidents escalate into the more serious events that feature in capture media attention. The current study used qualitative interviews to explore driver cognitions and underlying motivations for aggressive behaviours on the road. A total of 30 drivers aged 18-49 years were interviewed about their experiences with aggressive driving. A key theme identified in responses was driver aggression as an attempt to manage or modify the behaviour of other road users. Two subthemes were identified and appeared related to separate motivations for aggressive responses: 'teaching them a lesson' referred to situations where respondents intended to convey criticism or disapproval, usually of unintended behaviours by the other driver, and thus encourage self-correction; and 'justified retaliation' which referred to situations where respondents perceived deliberate intent on the part of the other driver and responded aggressively in return. Mildly aggressive driver behaviour appears to be common. Moreover such behaviour has a sufficiently negative impact on other drivers that it may be worth addressing because of its potential for triggering retaliation in kind or escalation of aggression, thus compromising safety.

The extended parallel process model: illuminating the gaps in research

This article examines constructs, propositions, and assumptions of the extended parallel process model (EPPM). Review of the EPPM literature reveals that its theoretical concepts are thoroughly developed, but the theory lacks consistency in operational definitions of some of its constructs. Out of the 12 propositions of the EPPM, a few have not been tested explicitly and not a single one received unequivocal empirical support. This article proposes alternative operationalization for some of the constructs and examines some assumptions of this theory, such as additive relationship between the constructs, the role of time and issue of thresholds, and disregard for the existing state of the audience. Finally, the role of the EPPM as a potential foundation for a general theory of negative emotional appeals is addressed.

The social context of motorcycle riding and the key determinants influencing rider behavior: a qualitative investigation

OBJECTIVE

Given the increasing popularity of motorcycle riding and heightened risk of injury or death associated with being a rider, this study explored rider behavior as a determinant of rider safety and, in particular, key beliefs and motivations that influence such behavior. To enhance the effectiveness of future education and training interventions, it is important to understand riders' own views about what influences how they ride. Specifically, this study sought to identify key determinants of riders' behaviors in relation to the social context of riding, including social and identity-related influences relating to the group (group norms and group identity) as well as the self (moral/personal norm and self-identity).

METHOD

Qualitative research was undertaken via group discussions with motorcycle riders (n = 41).

RESULTS

The findings revealed that those in the group with which one rides represent an important source of social influence. Also, the motorcyclist (group) identity was associated with a range of beliefs, expectations, and behaviors considered to be normative. Exploration of the construct of personal norm revealed that riders were most cognizant of the "wrong things to do" when riding; among those issues raised was the importance of protective clothing (albeit for the protection of others and, in particular, pillion passengers). Finally, self-identity as a motorcyclist appeared to be important to a rider's self-concept and was likely to influence on-road behavior.

CONCLUSION

Overall, the insight provided by the current study may facilitate the development of interventions including rider training as well as public education and mass media messages. The findings suggest that these interventions should incorporate factors associated with the social nature of riding in order to best align it with some of the key beliefs and motivations underpinning riders' on-road behaviors.