Designing fear appeal messages to increase cervical cancer screening : lessons learned about models and measurement
Wilson, Katherine Mallender
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The Extended Parallel Process Model (EPPM) guides health communicators in the management of fear through balancing threat and efficacy in fear appeal message design. Cervical cancer is highly preventable cancer with routine Pap tests. Black women 40 and older seem to receive Pap tests less often than other groups of women in the United States. One reason cited is fear. Fear reduction through appropriate message design could increase the use of the Pap tests. The EPPM had not been used for message design outside of college populations, nor for managing fear generated by a cancer topic. The purpose of this research was to explore the relationships between constructs of the EPPM and selected demographic characteristics, and to validate intended message characteristics. Three studies were conducted over four months with a total of 172 Black women 40 years old and older living in the southeastern U.S. Each participant received one of four manipulated messages or a control message and completed a 35-item questionnaire. Messages were written in accordance with the EPPM with a threat component followed by an efficacy component. Responses were collected twice from each participant, once after reading the each component. Consistent with the EPPM, individual differences did not influence message processing of threat. Educational attainment, however, was central to initial comprehension of message and to the selection of format and number of response categories used in the instrument. Further, some evidence suggests that fear and threat may be reduced within the message while reading it, implying that estimates derived after reading the full message is read may underestimate the level of threat and fear initially generated. This would, according to the EPPM, in turn affect the design of the efficacy component of a fear appeal message. Lastly, threat appeared to be generated in the efficacy component of the message, an occurrence that is unaccounted for by the EPPM. Future research should focus on standardizing the process and tools for testing fear appeals outside a college population, as well as provide insight to the process of the feedback loop of the EPPM.