Extended parallel process model

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The extended parallel process model (EPPM) is a fear appeal theory developed by communications scholar Kim Witte that illustrates how individuals react to fear-inducing messages. [1] Witte subsequently published an initial test of the model in Communication Monographs. [2]

Contents

The EPPM was developed by Witte as a response to the significant inconsistencies in fear appeal literature, serving as an extension of previous fear appeal models, hence the use of 'extended' in name 'EPPM'. The model is originally based on Leventhal's Parallel Process Model – a danger and fear control framework that studied how adaptive protective behaviour stemmed from attempts of danger control. [3] It also significantly draws from Roger's Protection motivation theory, which proposes two responses to fear-inducing stimuli: threat appraisal and coping appraisal.

The model's main theory is that when confronted with a fear-inducing stimulus, humans tend to engage in two simultaneous ways of message processing: a perceived efficacy appraisal (cognitive processing) and a perceived threat appraisal (emotional processing). Differences in message appraisal then lead to two behavioural outcomes, with individuals engaging in either a danger control process or a fear control process. In the case of the message being perceived as having no element of threat, individuals do not exhibit a response, and the message is ignored. The EPPM states that the danger control process leads to behavioural change, while the fear control process does not.

Witte's EPPM expands on previous fear appeal studies by explaining the reasons for failure in fear appeals and reincorporating fear as a central variable in the model. This is also the first fear appeal model that outlines the relationship between threat and efficacy in propositional forms.

The EPPM concludes that a fear control process leads to message rejection, while a danger control process leads to message acceptance, leading to adaptive behavioural changes.

Background

Witte's motivations for designing an updated fear appeal model was due to the declining role of fear in fear appeals. While initially, fear was the pinnacle of theoretical fear appeal literature, it was starting to be considered as a control variable in subsequent models. A lack of precision in the Parallel Process Model and empirical inconsistencies in the Protection Motivation Theory were also noted by Witte as reasons for formulating an extended parallel process model.

Two main components of large-scale public messaging that induce behavioural change are fear appeals and fear appraisals. Fear appeals are specifically designed to elicit fear and nudge individuals to adapt to the recommendations in the message. They find their use in public health campaigns and political adverts, and are designed to fit three main categories: message, behaviour, and the audience. [4]

Fear appraisals are the mental evaluations made in response to experiencing fear-inducing stimuli and are also known as threat appraisals. Fear appeal literature is primarily focused on understanding key fear appraisal processes in humans, with the intention of using it to drive social campaigns and behavioural interventions. [3]

Components

The EPPM uses persuasive fear-inducing messages to induce intended behavioural responses. Wittle details three main processes involved in fear appraisal: the fear appeal inputs, the message processing of the inputs, and the outputs, or action taken after evaluating the perceived threat.

Fear appeal inputs

Illustration of the Extended Parallel Process Model. Extended Parallel Process Model.png
Illustration of the Extended Parallel Process Model.

According to fear appeal studies, a fear appeal has two components: a component of threat and a component of efficacy. These two components are further divided into two categories each. The threat component is composed of severity and susceptibility, while the efficacy component is composed of response efficacy and self-efficacy.

These four key factors, as defined by the EPPM, predict the likely outcome of communications that involve a fear appeal.

Threat variables

Efficacy variables

The outcome of fear appeals is determined by an appraisal, that is, the evaluation of the message as either dangerous or indifferent.

Fear appraisal

Appraisal Theory states that an individual makes either an emotional or affective response to external stimuli. The EPPM outlines two primary appraisals an individual makes in response to a fear appeal: a threat appraisal, followed by an efficacy appraisal.

Low threat appraisal
When a threat appraisal is perceived to be low, i.e., there is a lack of imminent threat, the fear appeal is rejected immediately.
Moderate to High threat appraisal
When a threat appraisal is perceived as moderate or high, fear is induced, and individuals begin the efficacy appraisal.
Low efficacy appraisal
When the efficacy appraisal is perceived to be low, the message does not induce behavioural change.
Moderate to High efficacy appraisal
When the efficacy appraisal is perceived as moderate or high, the message induces a behavioural change.

After appraisals of the fear appeal, individuals then take action based on whether the threat is imminent or trivial.

Fear Appeal Outputs

The EPPM predicts three possible outputs after the fear appraisal is carried out:

Danger control
When an individual perceives that the severity and susceptibility are high (i.e., high threat appraisal) and also perceives that they are competent to take mitigating action (i.e., high efficacy appraisal), then they are likely to act to control the danger.
Fear control
The model predicts that if an individual perceives their ability to control risk as low, even if the severity and susceptibility are perceived as high, they are likely to take steps to control their fear instead. Fear control responses are defined as coping mechanisms that reduce fear and include denial, psychological reactance and defensive avoidance. These are maladaptive changes, or counterproductive behaviours. Fear controlling behaviour may involve the use of cognitive defence mechanisms such as "It will happen to me sooner or later", in order to manage the state of anxiety.
No Response
The severity or susceptibility of the danger is perceived as low, and the individual rejects the message. There is no behavioural change.

Applications

The EPPM model is mainly used in social and behaviour change communication (SBCC). Practitioners design a general communications program, such as a campaign or an advert, and then test the effectiveness of the program through implementation. SBCC methods in healthcare, education, and marketing have employed the EPPM to induce behavioural change in patients and customers.

Multiple versions of the EPPM are employed in health campaigns. For example, EPPM-based campaigns have helped increase colorectal cancer screening participation among young adults [5] [6] and increased HPV vaccination interest among LatinX. [7]

Other usages of EPPM lie in shaping public perceptions, such as in political adverts, climate change messages, and pandemic responses. [8] [9]

Criticisms

While the EPPM has been effective in health campaigns and behavioural change interventions, there are limitations that have been pointed out through rigorous meta-analytical studies.

Reviews have highlighted the many applications of the EPPM model in its 20 years since initial publication [10] but significant theoretical questions on the operationalization of key constructs remain and not all of its hypotheses have received empirical support. [11]

Lucy Popova's 'The Extended Parallel Process Model: Illuminating the Gaps in Research', is an extensive review on the theoretical and empirical applications of the EPPM. [11] Popova discovered that the strong theoretical foundations has some inconsistencies in a few of its operational definitions. A systematic review of existing literature on EPPMs found that its propositions had no clear empirical support. The outcomes of fear appeals differ slightly from what the EPPM claims. This questions the practical validity of the EPPM.

See also

Related Research Articles

Behavior or behaviour is the range of actions and mannerisms made by individuals, organisms, systems or artificial entities in some environment. These systems can include other systems or organisms as well as the inanimate physical environment. It is the computed response of the system or organism to various stimuli or inputs, whether internal or external, conscious or subconscious, overt or covert, and voluntary or involuntary.

<span class="mw-page-title-main">Emotion</span> Conscious subjective experience of humans

Emotions are mental states brought on by neurophysiological changes, variously associated with thoughts, feelings, behavioral responses, and a degree of pleasure or displeasure. There is no scientific consensus on a definition. Emotions are often intertwined with mood, temperament, personality, disposition, or creativity.

<span class="mw-page-title-main">Fear</span> Basic emotion induced by a perceived threat

Fear is an intensely unpleasant emotion in response to perceiving or recognizing a danger or threat. Fear causes physiological changes that may produce behavioral reactions such as mounting an aggressive response or fleeing the threat. Fear in human beings may occur in response to a certain stimulus occurring in the present, or in anticipation or expectation of a future threat perceived as a risk to oneself. The fear response arises from the perception of danger leading to confrontation with or escape from/avoiding the threat, which in extreme cases of fear can be a freeze response.

<span class="mw-page-title-main">Attitude (psychology)</span> Concept linking cognitive processes to behavior

An attitude "is a summary evaluation of an object of thought. An attitude object can be anything a person discriminates or holds in mind." Attitudes include beliefs (cognition), emotional responses (affect) and behaviors. In the classical definition an attitude is persistent, while in more contemporary conceptualizations, attitudes may vary depending upon situations, context, or moods.

<span class="mw-page-title-main">Arousal</span> State of being awoken

Arousal is the physiological and psychological state of being awoken or of sense organs stimulated to a point of perception. It involves activation of the ascending reticular activating system (ARAS) in the brain, which mediates wakefulness, the autonomic nervous system, and the endocrine system, leading to increased heart rate and blood pressure and a condition of sensory alertness, desire, mobility, and reactivity.

Behavior change, in context of public health, refers to efforts put in place to change people's personal habits and attitudes, to prevent disease. Behavior change in public health can take place at several levels and is known as social and behavior change (SBC). More and more, efforts focus on prevention of disease to save healthcare care costs. This is particularly important in low and middle income countries, where supply side health interventions have come under increased scrutiny because of the cost.

<span class="mw-page-title-main">Theory of planned behavior</span> Theory that links behavior

The theory of planned behavior (TPB) is a psychological theory that links beliefs to behavior. The theory maintains that three core components, namely, attitude, subjective norms, and perceived behavioral control, together shape an individual's behavioral intentions. In turn, a tenet of TPB is that behavioral intention is the most proximal determinant of human social behavior.

Attitudes are associated beliefs and behaviors towards some object. They are not stable, and because of the communication and behavior of other people, are subject to change by social influences, as well as by the individual's motivation to maintain cognitive consistency when cognitive dissonance occurs—when two attitudes or attitude and behavior conflict. Attitudes and attitude objects are functions of affective and cognitive components. It has been suggested that the inter-structural composition of an associative network can be altered by the activation of a single node. Thus, by activating an affective or emotional node, attitude change may be possible, though affective and cognitive components tend to be intertwined.

In psychology, self-efficacy is an individual's belief in their capacity to act in the ways necessary to reach specific goals. The concept was originally proposed by the psychologist Albert Bandura.

In psychology, reactance is an unpleasant motivational reaction to offers, persons, rules, or regulations that threaten or eliminate specific behavioral freedoms. Reactance occurs when an individual feels that an agent is attempting to limit one's choice of response and/or range of alternatives.

Social cognitive theory (SCT), used in psychology, education, and communication, holds that portions of an individual's knowledge acquisition can be directly related to observing others within the context of social interactions, experiences, and outside media influences. This theory was advanced by Albert Bandura as an extension of his social learning theory. The theory states that when people observe a model performing a behavior and the consequences of that behavior, they remember the sequence of events and use this information to guide subsequent behaviors. Observing a model can also prompt the viewer to engage in behavior they already learned. Depending on whether people are rewarded or punished for their behavior and the outcome of the behavior, the observer may choose to replicate behavior modeled. Media provides models for a vast array of people in many different environmental settings.

Behavioural change theories are attempts to explain why human behaviours change. These theories cite environmental, personal, and behavioural characteristics as the major factors in behavioural determination. In recent years, there has been increased interest in the application of these theories in the areas of health, education, criminology, energy and international development with the hope that understanding behavioural change will improve the services offered in these areas. Some scholars have recently introduced a distinction between models of behavior and theories of change. Whereas models of behavior are more diagnostic and geared towards understanding the psychological factors that explain or predict a specific behavior, theories of change are more process-oriented and generally aimed at changing a given behavior. Thus, from this perspective, understanding and changing behavior are two separate but complementary lines of scientific investigation.

Appraisal theory is the theory in psychology that emotions are extracted from our evaluations of events that cause specific reactions in different people. Essentially, our appraisal of a situation causes an emotional, or affective, response that is going to be based on that appraisal. An example of this is going on a first date. If the date is perceived as positive, one might feel happiness, joy, giddiness, excitement, and/or anticipation, because they have appraised this event as one that could have positive long-term effects, i.e. starting a new relationship, engagement, or even marriage. On the other hand, if the date is perceived negatively, then our emotions, as a result, might include dejection, sadness, emptiness, or fear. Reasoning and understanding of one's emotional reaction becomes important for future appraisals as well. The important aspect of the appraisal theory is that it accounts for individual variability in emotional reactions to the same event.

<span class="mw-page-title-main">Health belief model</span> Psychological model

The health belief model (HBM) is a social psychological health behavior change model developed to explain and predict health-related behaviors, particularly in regard to the uptake of health services. The HBM was developed in the 1950s by social psychologists at the U.S. Public Health Service and remains one of the best known and most widely used theories in health behavior research. The HBM suggests that people's beliefs about health problems, perceived benefits of action and barriers to action, and self-efficacy explain engagement in health-promoting behavior. A stimulus, or cue to action, must also be present in order to trigger the health-promoting behavior.

Fear appeal is a term used in psychology, sociology and marketing. It generally describes a strategy for motivating people to take a particular action, endorse a particular policy, or buy a particular product, by arousing fear. A well-known example in television advertising was a commercial employing the musical jingle: "Never pick up a stranger, pick up Prestone anti-freeze." This was accompanied by images of shadowy strangers (hitchhikers) who would presumably do one harm if picked up. The commercial's main appeal was not to the positive features of Prestone anti-freeze, but to the fear of what a "strange" brand might do.

Protection motivation theory (PMT) was originally created to help understand individual human responses to fear appeals. Protection motivation theory proposes that people protect themselves based on two factors: threat appraisal and coping appraisal. Threat appraisal assesses the severity of the situation and examines how serious the situation is, while coping appraisal is how one responds to the situation. Threat appraisal consists of the perceived severity of a threatening event and the perceived probability of the occurrence, or vulnerability. Coping appraisal consists of perceived response efficacy, or an individual's expectation that carrying out the recommended action will remove the threat, and perceived self efficacy, or the belief in one's ability to execute the recommended courses of action successfully.

A behavior change method, or behavior change technique, is a theory-based method for changing one or several determinants of behavior such as a person's attitude or self-efficacy. Such behavior change methods are used in behavior change interventions. Although of course attempts to influence people's attitude and other psychological determinants were much older, especially the definition developed in the late nineties yielded useful insights, in particular four important benefits:

  1. It developed a generic, abstract vocabulary that facilitated discussion of the active ingredients of an intervention
  2. It emphasized the distinction between behavior change methods and practical applications of these methods
  3. It included the concept of 'parameters for effectiveness', important conditions for effectiveness often neglected
  4. It drew attention to the fact that behavior change methods influence specific determinants.

A health campaign is a type of media campaign which attempts to promote public health by making new health interventions available. The organizers of a health campaign frequently use education along with an opportunity to participate further, such as when a vaccination campaign seeks both to educate the public about a vaccine and provide the vaccine to people who want it. When a health campaign has international relevance it may be called a global health campaign.

Kim Witte is a communications scholar with an emphasis on the area of fear appeals called “scare tactics”. In 2015 Witte is a professor who teaches graduate courses at Michigan State University.

<span class="mw-page-title-main">Fear pattern</span> Advertising technique

In advertising, a fear pattern is a sequence of fear arousal and fear reduction that is felt by the viewing audience when exposed to an advertisement, which attempts to threaten the audience by presenting a negative physical, psychological or social consequence that is likely to occur if they engage in a particular behaviour. Fear appeals are commonly used in social marketing campaigns. These are sometimes called “threat appeals”, however the label “fear appeals” is justified if the appeal can be shown to arouse fear.

References

  1. Witte K (December 1992). "Putting the fear back into fear appeals: The extended parallel process model". Communication Monographs. 59 (4): 329–349. doi:10.1080/03637759209376276.
  2. Witte K (June 1994). "Fear control and danger control: A test of the extended parallel process model (EPPM)". Communication Monographs. 61 (2): 113–134. doi:10.1080/03637759409376328.
  3. 1 2 Leventhal H (June 1971). "Fear appeals and persuasion: the differentiation of a motivational construct". American Journal of Public Health. 61 (6): 1208–1224. doi:10.2105/AJPH.61.6.1208. PMC   1529874 . PMID   4110702.
  4. Tannenbaum MB, Hepler J, Zimmerman RS, Saul L, Jacobs S, Wilson K, Albarracín D (November 2015). "Appealing to fear: A meta-analysis of fear appeal effectiveness and theories". Psychological Bulletin. 141 (6): 1178–1204. doi:10.1037/a0039729. PMC   5789790 . PMID   26501228.
  5. Birmingham WC, Hung M, Boonyasiriwat W, Kohlmann W, Walters ST, Burt RW, et al. (October 2015). "Effectiveness of the extended parallel process model in promoting colorectal cancer screening". Psycho-Oncology. 24 (10): 1265–1278. doi:10.1002/pon.3899. PMC   7161702 . PMID   26194469.
  6. Pengchit W, Walters ST, Simmons RG, Kohlmann W, Burt RW, Schwartz MD, Kinney AY (November 2011). "Motivation-based intervention to promote colonoscopy screening: an integration of a fear management model and motivational interviewing". Journal of Health Psychology. 16 (8): 1187–1197. doi:10.1177/1359105311402408. PMC   3162074 . PMID   21464114.
  7. Reno, Jenna E.; Dempsey, Amanda F. (2022-02-18). "Promoting HPV vaccination among Latinx: an application of the extended parallel processing model". Journal of Behavioral Medicine. 46 (1–2): 324–334. doi:10.1007/s10865-022-00293-7. ISSN   1573-3521. S2CID   246905792.
  8. von Gottberg C, Krumm S, Porzsolt F, Kilian R (January 2016). "The analysis of factors affecting municipal employees' willingness to report to work during an influenza pandemic by means of the extended parallel process model (EPPM)". BMC Public Health. 16 (1): 26. doi: 10.1186/s12889-015-2663-8 . PMC   4711035 . PMID   26757713.
  9. Roser-Renouf C, Maibach EW, Leiserowitz A, Zhao X (July 2014). "The genesis of climate change activism: from key beliefs to political action". Climatic Change. 125 (2): 163–178. doi: 10.1007/s10584-014-1173-5 . ISSN   0165-0009.
  10. Maloney EK, Lapinski MK, Witte K (April 2011). "Fear Appeals and Persuasion: A Review and Update of the Extended Parallel Process Model: Fear Appeals and Persuasion". Social and Personality Psychology Compass. 5 (4): 206–219. doi:10.1111/j.1751-9004.2011.00341.x.
  11. 1 2 Popova L (August 2012). "The extended parallel process model: illuminating the gaps in research". Health Education & Behavior. 39 (4): 455–473. doi:10.1177/1090198111418108. PMID   22002250. S2CID   22928121.