The document summarizes several studies on health promotion through fear appeals and behavior change. It discusses factors that influence the effectiveness of fear-arousing health messages, such as the level of fear used. Studies found that high-fear messages were more effective at changing attitudes about smoking than low-fear messages, when paired with a solution. However, fear appeals that are too strong may reduce message effectiveness. Additional models and techniques for health promotion in schools, worksites, and communities are also outlined.

1. Health Promotion
RASHA SAKR

2. Health Promotion
 Methods for Promoting health
 Fear Arousal
 Roberts and Russell (2002) noted that there are certain factors that affect whether a
person will be scared enough to follow the advice and change their behaviour:
 The unpleasantness of the fear-arousing message
 The probability that the consequences of the behaviour will occur to the person if they
don’t follow the advice.
 The perceived effectiveness of the message.

3. JANIS AND FESHBACH
 (1953) investigated the consequences of fear appeals on emotions and
behaviour with 200 high school student. They found that the overall
effectiveness of a message is likely to be reduce by the use of appeals
that are too strong ; therefore, the level of fear needs to be tailored to
the audience.

4.  LEVENTHAL ET AL (1967) wanted to see whether high-fear or low-fear communication had an
effect, with the initial variable being whether the subjects were presented with a detailed
presentation. The study was conducted in France with teenagers, who completed a questionnaire
about their attitudes around smoking and desire to quit to be assigned to one of the two groups:
 Moderate fear
 High fear – these reported of feelings more vulnerable to lung-cancer and a higher desire to quit.
 It was concluded that a high-fear appeal is much more effective in changing people’s attitudes and
intentions regarding smoking because they are pairing the fear with a solution (quitting).
 Strengths:
 Useful – this research is useful to health campaigns because it suggests that people need to be
given a powerful message in order for behaviours or attitudes to change.
 High control – the research was carried out in a laboratory, therefore the situation was highly
controlled, meaning that extraneous variables were less likely to have affected the results. This
makes the experiment more reliable.
 Realism – actual smokers were used, therefore their attitudes towards smoking were real and
genuine. This makes the study have higher internal validity.
 in a certain way to please the experimenters.

5.  Sample- teenagers were used for the study, meaning that the results
cannot be generalised to other age groups. Also, between 13-19 people
are more likely to be vulnerable to other people’s opinions and
recommendations ; thus, that might be why they wanted to quit so ‘easily’.
 Cultural bias – the research was conducted in France, meaning that the
findings cannot be generalised to other countries or cultures.
 Demand characteristics – It is impossible to establish and guarantee that
the behaviour changed because no follow-up experiment was carried out.
Therefore, there is the possibility that participants answered in a certain
way to please the experimenters.

6. YLC :Yale Model of Communication
 According to The Yale Model of Communication, the key to changing
behaviour is by focusing on the
 communicator,
 the communication
 the audience.
 This is in line with the Yerkes Dodson Law of Arousal, which suggests that
up to a medium level of arousal, there is a positive correlation between
increasing levels of arousal and the increasing level of performance
exhibited by the participant.

7. Promoting health in schools, worksites and
communities

8. Leventhal’s Health Belief Model (1967)
 suggests that individuals are more likely to change their behaviours if they believe
that failure to do so will lead to serious, negative health consequences, as
demonstrated by Leventhal with the idea that cigarette smokers are more likely to
give up smoking if they’ve been exposed to images of a diseased lung.
 information so that they can make informed choices about their health. For
example, using 176 patients who’d recently suffered from a heart attack and then
completed Anxiety and Depression Scale questionnaires, the largest
improvement in health was seen in patients who were most anxious and had the
largest propensity for depression.
 Therefore, this suggests that stress is essential towards motivating patients to
change their lifestyle and recovery.

9. Tapper et al (2003
 According to Tapper et al (2003), the three techniques which can be used
to change children’s attitudes towards food are taste exposure,
modeling, and then the consequent rewards (positive reinforcement).
 Through the design of an intervention in schools (lasting 16 days), to
increase the number of healthy-food choices which children make, the
researchers found that reading the Food Dudes letters aloud to the
children, as well as making them aware of the potential rewards given if
they make healthy choices, increases the likelihood that children will view
healthy eating in a positive light and so will be more willing to make
permanent changes in their diet.

10. Work
 Fox et al. (1987) – Token Economy in open-pit mines
 The study investigated the effectiveness of token economy and operant
conditioning on reducing lost-time injuries in workers at two open-pit
mines. It used positive reinforcement in the form of stamps for not being
involved in accidents and respecting safety guidelines. Similarly, the
stamps were taken away if the workers or others in their group got injured,
if there was equipment damage or for failing to report accidents. The
stamps could be later exchanged for goods.
 The results show a great reduction in accidents, fewer days lost due to
injury and a decrease in expenditure on damage recovery. These effects
were maintained over the course of several years.

11. Communities
 Farquhar et al. (1985) – Five City Project
 The aim of the project was to reduce cardiovascular diseases by means of
community health education in 5 cities: Salinas, Monterey, Modesto, San
Luis Obispo and Santa Maria. Approximatively 122.800 individuals
participated in the experimental group and 197.500 in the control one;
their age ranged from 12 to 74 years. Information was provided through
means of radio, newspapers, books and pamphlets over the course of 6
years. Measures were taken about the participants’ height, weight, blood
pressure, heart rate, sodium in urine and a fitness test. A decrease in
cholesterol and heart rate was found as well as a significant decline in
saturated fat intake in females. From the surveys collected it was
concluded that the knowledge about coronary heart disease problems
improved.

12. INDIVIDUAL FACTORS AFFECTING
HEALTH BELIEFS
 Weinstein (1980) – Unrealistic Optimism
 Unrealistic optimism can be described as the popular belief that people
think they are invulnerable – they expect others to be victims of misfortune
and not themselves.

The 6 hypotheses of the experiment were that:

13. 1.People believe that negative events are less likely to happen to them than to others and
oppositely with positive events.
2. The more negative or positive an event is, the more likely people are to believe that their
chances are above or under average.
3. The greater the perceived probability of events, the stronger the tendency for people to believe
that their own chances are greater than average.
4. Previous personal experience increases the likelihood people will believe their chances are
greater than the average.
5. The greater the perceived controllability of an event, the stronger the tendency for people to
believe that their own chances are greater than average.
6. If a stereotype exists of individuals for whom a particular event may happen, the more likely
people are to believe their chances are less than average.