Fear Appeals
Persuasive Health Message
Framework
Kim Witte, The Persuasive
Health Message Framework

Framework = Combine parts of successful
theories into a single framework. A
framework differs from a theory in that it
does not attempt to explain human
behavior, it simply outlines what one
should do to develop the most effective
and persuasive campaigns.
PHM

combines elements from:
– theory of reasoned action (Fishbein & Azjen,
1975)
– elaboration likelihood model (Petty &
Cacioppo, 1986)
– protection motivation theory (Rogers, 1983)
PHM elements

Threat message
– Perceived risk
 Audience must feel susceptible to threat
– Perceived severeity
 Audience must perceive threat as severe (BUT, must not
overpower efficacy or will create backlash of fear, defense)

Efficacy message
– Self-efficacy
 Self-confidence in one’s own ability to carry out behavior
– Response-effiacy
 Belief in the recommended response’s effectiveness
Message Cues

peripheral cues (credibility/attractiveness of
source)
– peripheral processing happens when people are
uninvolved with the topic or message; used to catch
attention

central cues (arguments in content)
– central processing occurs when topic is relevant and
seen as important; used after attention is gotten

message variables (source and appeal)
– most message variables tend to be processed
peripherally
Targeting to Audience

Audience profile –
– it is important that message fit audience’s demographic,
psychographic, cultural beliefs and values, etc.

Salient beliefs
– beliefs about the threat and efficacy of recommended response

Salient referents
– beliefs about what is important to others, what others believe
about the threat, and how important those others’ views are to
the target individual

Culture and environment preferences
– demographic, psychographics; potential logistical barriers; media
channel preferences; etc.
Theory of Reasoned Action

Fishbein & Azjen:
– to change behavior you must change
underlying salient beliefs, identify which
salient beliefs counter the recommended
behavior, and determine and address salient
referents/social norms – then design
message.
Using PHM

Three-step process:
1. Determine information about threat and
efficacy
2. Develop audience profile
3. Construct persuasive message
Step 1

Determining info about threat and efficacy
– determine salient beliefs and salient referents
– specify behavioral goal (recommended response)
– clearly identify target audience (original research or lit
review, see tables 8.1-2; see Appendix for sample
survey for salient beliefs).
– Barriers to self-efficacy are especially important to
determine and must be addressed in the message.
Step 2

Audience profile is developed –
– assess audience cultural and environmental
information to develop cues
– use census records, survey research,
interviews
– channel, message and source preferences
must be identified.
Step 3

Persuasive message is constructed –
– must fit with salient beliefs, salient referents
and specific audience (transient
components)
– can try to reinforce existing beliefs, change
beliefs, or introduce new beliefs
– reinforcement is easiest

frame recommendation within audience’s current
belief system.
Prior Research

Campaign to promote specific safety
behaviors among farmers
– Salient beliefs:
 Injuries are common and severe, but susceptibility
is low (farmers don’t feel at personal risk).
 Believe that safety measures are effective, and feel
self-efficacy for doing safety measures, but don’t
necessarily use them.
 High perceived severity
 Low perceived risk (susceptibility)
Farmers’ campaign (cont’d)

Preferred channel:
– Manufacturer’s safety manual

Preferred source:
– Equipment company

Message concept:
– Perceived susceptibility needs to be changed.
Other beliefs should be reinforced. Need to
target specific behaviors.