2. Fear Appeals
A popular form of health message is the fear appeal – to scare people into change
Fear appeals can be effective – only if:
properly designed
do more than just frighten
Fear is multidimensional
Pushing somebody to change their behaviour when they are not ready, invariably leads to resistance

3. Fear Appeals
Fear appeals create an impression of message effectiveness
Unfortunately audience judgments of perceived effectiveness of an advertisement has been shown NOT to be a reliable predictor of behaviour
To be effective, media campaign should be integrated with supportive activities
TAC Media Campaigns provides public education support to enforcement activities, legislative change and raises community awareness

4. The Deficit Model

5. Young People
Pre-existing beliefs, attitudes and prior behaviour acts as a screen for messages from the media and society
Prior knowledge and experiences determine the extent to which threat communications are accepted/discounted and subsequent strategies they engage in
Young people are in a critical stage of development – when they shift their key point of reference from family to peer group

6. Young People
Young people more likely to assess risks for opportunity for gains, compared to adults who tend to focus on opportunity for loss
Opportunity for gain – include peer approval, self-image, self-esteem
Need to understand
What belief do young people hold?
Who are their relevant referents?
What are the barriers to desired behaviour change?

7. Shock Tactics and Fear
Shock tactics are designed to lead to fear response and subsequent behaviour change
Shock tactics can evoke a range of affective responses including fear, anger, puzzlement, guilt, shame
It cannot be assumed that a threat appeal will evoke a fear response
Fear is multidimensional and complex
Inhibitory Fear – where the audience makes an effort to reduce the anxiety caused by the stimulus
Anticipatory Fear – related to the perceived likelihood of experience the threat, where the aim is the deal with the threat rather than avoid the anxiety

8. Shock Tactics Fear can evoke a range of cognitive responses:
Third Person Effect
Optimistic Bias
Maladaptive Coping Responses
Fatalism
Avoidance
Religious faith reliance
Inaccurate information beliefs
Denial

9. Protection Motivation Theory – Rogers (1983)
People motivated to take action to protect themselves from a health threat, according to:
Severity - Perceived severity of threat
Vulnerability - Perceived probability of its occurrence
Response Efficacy - Perceived efficacy of advocated response
Self Efficacy - Perceived self-efficacy to perform the response

10. Shock tactics – what works
Vulnerability – predictive of intention and behaviour
Response Efficacy – predictive of intention
Tay & Watson 2002:
Low/Moderate Fear & High Response Efficacy
High Fear & High Response Efficacy
High Fear & Low Response Efficacy

11. Communication Features of Shock Tactics
Frames – Tversky and Kahneman
Emotional Interest
Concreteness
Proximity
Delivery and wording appropriate to the target group

12. Shock Tactics and Young People
The health message must penetrate several levels of passive and active defenses
Threat based advertising while relevant and influential for some segments, may not be relevant and influential for the entire audience
Fear more effective with adults and with children or young people
Fear arousing messages more effective for the converted

13. Why Shock Tactics fail Fail to increase perception of vulnerability
Fail to promote high response efficacy – instead maladaptive actions occur
As fear appeals increase in strength, so do defensive responses

14. Shock Tactics – HIV / AIDS The Grim Reaper Campaign

15. Why not Grim Reaper II ?
Given the 2 distinct (heterogeneous) target groups – focus on the toxic side effects of antiviral treatments
To increase sense of vulnerability:
Risk of HIV transmission
HIV Transmission
Disease Progression
Increased viral load – antiviral therapy recommended
Antivirals associated with lipodystrophy/lipoatrophy prescribed
Lipodystrophy/lipoatrophy develops

16. Why not Grim Reaper II ? Confuses the debate about HIV transmission
Significant possibility of detrimental effects
Reduce QoL for people living with HIV
HIV positive individuals deferring, rejecting or poorly adhering to antiviral therapy
Increased disease progression among HIV positive
Increased communal viral pool
Increases in HIV transmission

17. Shock Tactics – Smoking Cessation QUIT Campaign 1998
Quit Victoria has conducted graphic smoking cessation campaigns for many years
Negative health effects of smoking well known and undisputable
Tools
Taxes on cigarettes
Regulations at point of sale
Advertising ban on cigarette promotion
Quit programs, Quitline,
pharmacological quitting aids
Anti-smoking mass media campaigns

18. Shock Tactics – Smoking Cessation QUIT Campaign 1998

19. Shock Tactics – Smoking Cessation QUIT Campaign 1998

20. Effective Shock Tactic Campaigns
NOT stand alone media campaigns!
Effective Shock Tactic Campaigns integrated into evidence-based behavioural programs in the community.
Drive Drive – Random breath testing, increase penalties and enforcement
Grim Reaper – Safe Sex Education, Free Needle Exchange programs
QUIT – Quitline, Quit programs in workplaces, advertising bans at point of sale, smoking restrictions
Stand-alone/One-off events or campaigns – do not work.

21. Things to Remember When Working with Young People
Whilst fear appeals may have a motivational role, prevention programs are more like to be effective if they focus on:
Building Decision Making Skills
General Coping Skills
Assertive Skills / Resist Peer Pressure
Self-Esteem/Self-efficacy
Encourage Conversations/Discussions
Similar Communicator & Credible

22. Things to Remember When Working with Young People
Provides New Facts
Disablement Rather Than Death / Short Term and Social (Peer) Effects
Personal Relevance
Avoid A Paternalistic Approach
Avoid A Didactic Approach
Avoid Single, One-off “Events”
Low-Moderate Fear & High Response Efficacy