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

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          Abstract

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

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          Most cited references37

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          Diffusion of Innovations.

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            Threatening communication: a critical re-analysis and a revised meta-analytic test of fear appeal theory

            Despite decades of research, consensus regarding the dynamics of fear appeals remains elusive. A meta-analysis was conducted that was designed to resolve this controversy. Publications that were included in previous meta-analyses were re-analysed, and a number of additional publications were located. The inclusion criteria were full factorial orthogonal manipulations of threat and efficacy, and measurement of behaviour as an outcome. Fixed and random effects models were used to compute mean effect size estimates. Meta-analysis of the six studies that satisfied the inclusion criteria clearly showed a significant interaction between threat and efficacy, such that threat only had an effect under high efficacy (d = 0.31), and efficacy only had an effect under high threat (d = 0.71). Inconsistency in results regarding the effectiveness of threatening communication can likely be attributed to flawed methodology. Proper tests of fear appeal theory yielded the theoretically hypothesised interaction effect. Threatening communication should exclusively be used when pilot studies indicate that an intervention successfully enhances efficacy.
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              Sixty years of fear appeal research: current state of the evidence.

              Fear arousal is widely used in persuasive campaigns and behavioral change interventions. Yet, experimental evidence argues against the use of threatening health information. The authors reviewed the current state of empirical evidence on the effectiveness of fear appeals. Following a brief overview of the use of fear arousal in health education practice and the structure of effective fear appeals according to two main theoretical frameworks-protection motivation theory and the extended parallel process model-the findings of six meta-analytic studies in the effectiveness of fear appeals are summarized. It is concluded that coping information aimed at increasing perceptions of response effectiveness and especially self-efficacy is more important in promoting protective action than presenting threatening health information aimed at increasing risk perceptions and fear arousal. Alternative behavior change methods than fear appeals should be considered.
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                Author and article information

                Journal
                Int J Psychol
                Int J Psychol
                ijop
                International Journal of Psychology
                John Wiley & Sons, Ltd (Oxford, UK )
                0020-7594
                1464-066X
                April 2014
                02 October 2013
                : 49
                : 2
                : 98-107
                Affiliations
                [1 ]School of Psychology and Neuroscience, Maastricht University Maastricht, The Netherlands
                [2 ]School of Public Health, University of Texas Houston, TX, USA
                Author notes
                Correspondence should be addressed to Gerjo Kok, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands. (E-mail: g.kok@ 123456maastrichtuniversity.nl ).
                Article
                10.1002/ijop.12001
                4255304
                24811880
                780094b7-fdc8-4019-9edf-dd97509eb004
                © 2013 The Authors. International Journal of Psychology published by John Wiley © Sons Ltd on behalf of International Union of Psychological Science

                This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

                History
                : 18 October 2011
                : 25 November 2012
                Categories
                Special Section Articles

                fear appeals,intervention mapping,program planning,health promotion

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