Communication Studies 394-0: Undergraduate Research Seminar

Section 24: Persuasion in Health Contexts

Spring 2021

READINGS FOR 12 APRIL

OUTLINE

 

3.  Some health-focused models of behavior

            3.1  Stage models of behavioral change

                        3.1.1 The transtheoretical model (“stages of change”)

                        3.1.2 Alternatives, issues, reviews, commentaries

            3.2  Protection motivation theory and the extended parallel process model

                        3.2.1 Protection motivation theory (PMT)

                                    3.2.1.1 PMT background

                                    3.2.1.2 PMT applications

                        3.2.2 Extended parallel process model (EPPM)

                        3.2.3 Content analyses based on PMT, EPPM, and related ideas

            3.3  Health belief model (HBM)

                        3.3.1 Overviews and reviews

                        3.3.2 Some HBM applications

            3.4  Health action process approach (HAPA)

                        3.4.1 Overviews and reviews

                        3.4.2 Some HAPA applications

 





3.1 Stage models of behavioral change

 

3.1.1 The transtheoretical model (“stages of change”)

 

            Prochaska, J. O., Redding, C. A., & Evers, K. E. (2002). The transtheoretical model and stages of change. In K. Glanz, B. K. Rimer, & F. M. Lewis (eds.), Health behavior and health education: Theory, research, and practice (3rd ed., pp. 99-120). San Francisco: Jossey-Bass.  [available here]

            Prochaska, J. O., Velicer, W. F., Rossi, J. S., Goldstein, M. G., Marcus, B. H., Rakowski, W., Fiore, C., Harlow, L. L., Redding, C. A., Rosenbloom, D., & Rossi, S. R. (1994). Stages of change and decisional balance for 12 problem behaviors. Health Psychology, 13, 39-46.

            Quinlan, K. B., & McCaul, K. D. (2000). Matched and mismatched interventions with young adult smokers: Testing a stage theory. Health Psychology, 19, 165-171.

 

For further reading:

            Prochaska, J. O., & DiClemente, C. C. (1984). The transtheoretical approach: Crossing traditional boundaries of therapy. Homewood, IL: Dow Jones-Irwin.

            Prochaska, J. O. (1994). Strong and weak principles for progressing from precontemplation to action on the basis of twelve problem behaviors. Health Psychology, 13, 47-51.

            Slater, M. D. (1999). Integrating application of media effects, persuasion, and behavior change theories to communication campaigns: A stages-of-change framework. Health Communication, 11, 335-354.

            Campbell, M. K., Reynolds, K. D., Havas, S., Curry, S., Bishop, D., Niklas, T., Palombo, R., Buller, D., Feldman, R., Topor, M., Johnson, M., Beresford, S. A. A., Motsinger, B. M., Morrill, C., & Heimendinger, J. (1999). Stages of change for increasing fruit and vegetable consumption among adults and young adults participating in the national 5-a-Day for Better Health community studies. Health Education and Behavior, 26, 513-534.

            Cho, H., & Salmon, C. T. (2006). Fear appeals for individuals in different stages of change: Intended and unintended effects and implications on public health campaigns. Health Communication, 20, 91-99.  doi:10.1207/s15327027hc2001_9

            Honda, K., & Gorin, S. S. (2006). A model of stage of change to recommend colonoscopy among urban primary care physicians. Health Psychology, 25, 65-73.

            DiNoia, J., & Prochaska, J. O. (2010). Dietary stages of change and decisional balance: A meta-analytic review. American Journal of Health Behavior, 34, 618–632. doi:10.5993/AJHB.34.5.11

            Milan, J. E. & White, A. A. (2010). Impact of a stage-tailored, web-based intervention on folic acid-containing multivitamin use by college women.  American Journal of Health Promotion, 24, 388-395. doi:10.4278/ajhp.071231143

            Skaal, L., & Pengpid, S. (2012). The predictive validity and effects of using the transtheoretical model to increase the physical activity of healthcare workers in a public hospital in South Africa. Translational Behavioral Medicine, 2, 384-391.
            Friman, M., Huck, J., & Olsson, L. E. (2017). Transtheoretical model of change during travel behavior interventions: An integrative review. International Journal of Environmental Research and Public Health, 14, 581. doi:10.3390/ijerph14060581
            Kim, H. K., & Lee, T. K. (2017). Conditional effects of gain–loss-framed narratives among current smokers at different stages of change. Journal of Health Communication, 22, 990-998.  doi:10.1080/10810730.2017.1396629

 


3.1.2 Alternatives, issues, reviews, commentaries

 

            Weinstein, N. D., Rothman, A. J., & Sutton, S. R. (1998). Stage theories of health behavior: Conceptual and methodological issues. Health Psychology, 17, 290-299.

            Bridle, C., Riemsma, R. P., Pattenden, J., Sowden, A. J., Mather, L., Watt, I. S., & Walker, A. (2005). Systematic review of the effectiveness of health behavior interventions based on the transtheoretical model. Psychology and Health, 20, 283-301.

 

For further reading:

            Adams, J., & White, M. (2005). Why don’t stage-based activity promotion interventions work? Health Education Research, 20, 237-243.

            Brug, J., Conner, M., Harre, N., Kremers, S., McKellar, S., & Whitelaw, S. (2005). The transtheoretical model and stages of change: A critique: Observations by five commentators on the paper by Adams, J. and White, M. (2005) Why don’t stage-based activity promotion interventions work? Health Education Research, 20, 244-258.

            Povey, R., Conner, M., Sparks, P., James, R., & Shepherd, R. (1999). A critical examination of the application of the transtheoretical model’s stages of change to dietary behaviours. Health Education Research, 14, 641-652. 

            Rosen, C. S. (2000). Is the sequencing of change processes by stage consistent across health problems? A meta-analysis. Health Psychology, 19, 593-604.

            Marshall, S. J., & Biddle, S. J. H. (2001). The transtheoretical model of behavior change: A meta-analysis of applications to physical activity and exercise. Annals of Behavioral Medicine, 23, 229-246.

            Riemsma, R. P., Pattenden, J., Bridle, C. Sowden, A. J., Mather, L., Watt, I. S., & Walker, A. (2002). A systematic review of the effectiveness of interventions based on a stages-of-change approach to promote individual behaviour change. Health Technology Assessment, 6(24).

            Riemsma, R. P., Pattenden, J., Bridle, C., Sowden, A. J., Mather, L., Watt, I. S. & Walker, A. (2003). Systematic review of the effectiveness of stage based interventions to promote smoking cessation. BMJ, 326, 1175-1181.

            Herzog, T. A. (2008). Analyzing the transtheoretical model using the framework of Weinstein, Rothman, and Sutton (1998): The example of smoking cessation. Health Psychology, 27, 548-556. doi:10.1037/0278-6133.27.5.548

            Hall, K. L., & Rossi, J. S. (2008). Meta-analytic examination of the strong and weak principles across 48 health behaviors. Preventive Medicine, 46, 266-274. doi: 10.1016/j.ypmed.2007.11.006

            Armitage, C. J. (2009). Is there utility in the transtheoretical model? British Journal of Health Psychology, 14, 195-210. doi:10.1348/135910708X368991

            Cahill, K., Lancaster, T., & Green, N. (2010). Stage-based interventions for smoking cessation. Cochrane Database of Systematic Reviews, issue 11, article number CD004492. doi:10.1002/14651858.CD004492.pub4 

            Noar, S. M., & Van Stee, S. K. (2012). Designing messages for individuals in different stages of change. In H. Cho (Ed.), Health communication message design: Theory and practice (pp. 209-229). Los Angeles, CA: Sage.

            Sutton, S. (2015). Stage theories. In M. Conner & P. Norman (Eds.), Predicting and changing health behaviour: Research and practice with social cognition models (3rd ed., pp. 279-320). New York: McGraw-Hill.

            O’Keefe, D. J. (2016) Stage models. Chapter 7 (pp. 132-147) in: O’Keefe, D. J. (2016). Persuasion: Theory and research (3rd ed.). Los Angeles, CA: Sage Publications.

            Noar, S. (2017). Transtheoretical model and stages of change in health and risk messaging. Oxford Research Encyclopedia of Communication. doi:10.1093/acrefore/9780190228613.013.324

 

            West, R. (2005). Time for a change: Putting the transtheoretical (stages of change) model to rest. Addiction, 100, 1036–1039.

            Herzog, T. A. (2005). When popularity outstrips the evidence: Comment on West (2005). Addiction, 100, 1040-1041.

            Etter, J.-F. (2005). Theoretical tools for the industrial era in smoking cessation counselling: A comment on West (2005). Addiction, 100, 1041-1042.

            Hodgins, D. C. (2005). Weighing the pros and cons of changing change models: A comment on West (2005). Addiction, 100, 1042-1043.

            Sutton, S. (2005). Another nail in the coffin of the transtheoretical model? A comment on West (2005). Addiction, 100, 1043-1046.

            DiClemente, C. C. (2005). A premature obituary for the transtheoretical model: A response to West (2005). Addiction, 100, 1046-1048.

            West, R. (2005). What does it take for a theory to be abandoned? The transtheoretical model of behaviour change as a test case. Addiction, 100, 1048-1050.

 

 


 

3.2  Protection motivation theory (PMT) and the extended parallel process model (EPPM)

 

3.2.1 Protection motivation theory (PMT)

 

3.2.1.1 PMT background

 

For further reading:

            O’Keefe, D. J. (2016). Message factors. In D. J. O’Keefe, Persuasion: Theory and research (3rd ed., pp. 214-251). Los Angeles, CA: Sage. (Chapter 11) (see specifically pp. 228-229)

            Floyd, D. L., Prentice-Dunn, S., & Rogers, R. W. (2000). A meta-analysis of research on protection motivation theory. Journal of Applied Social Psychology, 30, 407-429.

            Milne, S., Sheeran, P., & Orbell, S. (2000). Prediction and intervention in health-related behavior: A meta-analytic review of protection motivation theory. Journal of Applied Social Psychology, 30, 106-143.

            de Hoog, N., Stroebe, W., & de Wit, J. (2007). The impact of vulnerability to and severity of a health risk on processing and acceptance of fear-arousing communications: A meta-analysis. Review of General Psychology, 11, 258-285. doi:10.1037/1089-2680.11.3.258

            Norman, P., Boer, H., Seydel, E. R., & Mullan, B. (2015). Protection motivation theory. In M. Conner & P. Norman (Eds.), Predicting and changing health behaviour: Research and practice with social cognition models (3rd ed., pp. 70-106). New York: McGraw-Hill.

 

 

3.2.1.2 PMT applications

 

For further reading:

McClendon, B. T., & Prentice-Dunn, S. (2001). Reducing skin cancer risk: An intervention based on protection motivation theory. Journal of Health Psychology, 6, 321-328.

            Pechmann, C., Zhao, G., Goldberg, M. E., & Reibling, E. T. (2003). What to convey in antismoking advertisements for adolescents: The use of protection motivation theory to identify effective message themes. Journal of Marketing, 67(2), 1-18.

            McMath, B. F., & Prentice-Dunn, S. (2005). Protection motivation theory and skin cancer risk: The role of individual differences in responses to persuasive appeals. Journal of Applied Social Psychology, 35, 621-643.

            Fry, R. B., & Prentice-Dunn, S. (2006). Effects of a psychosocial intervention on breast self-examination attitudes and behaviors. Health Education Research, 21, 287–295.

            Lwin, M. O., Stanaland, A. J., & Chan, D. (2010). Using protection motivation theory to predict condom usage and assess HIV health communication efficacy in Singapore. Health Communication, 25, 69-79.

            Bassett, S. F., & Prapavessis, H. (2011). A test of an adherence-enhancing adjunct to physiotherapy steeped in the protection motivation theory. Physiotherapy Theory and Practice, 27, 360-372. doi:10.3109/09593985.2010.507238

            Glendon, A. I., & Walker, B. L. (2013). Can anti-speeding messages based on protection motivation theory influence reported speeding intentions? Accident Analysis and Prevention, 57, 67-79. doi:10.1016/j.aap.2013.04.004

            Lin, T. T. C., & Bautista, J. R. (2016). Predicting intention to take protective measures during haze: The roles of efficacy, threat, media trust, and affective attitude. Journal of Health Communication, 21, 790-799. doi:10.1080/10810730.2016.1157657
            Cathcart, R. L., & Glendon, A.I. (2016). Judged effectiveness of threat and coping appraisal anti-speeding messages. Accident Analysis and Prevention, 96, 237-248. doi:10.1016/j.aap.2016.08.005
            Lindell, M. K., Mumpower, J. L., Huang, S. K., Wu, H. C., Samuelson, C. D., & Wei, H.L. (2017). Perceptions of protective actions for a water contamination emergency. Journal of Risk Research, 20, 887-908. doi:10.1080/13669877.2015.1121906

            Camerini, A., Diviani, N., Fadda, M., & Schulz, P. J. (2019). Using protection motivation theory to predict intention to adhere to official MMR vaccination recommendations in Switzerland. SSM Population Health, 7, 100321. doi:10.1016/j.ssmph.2018.11.005

 


3.2.2 Extended parallel process model (EPPM)

 

For further reading:

            Witte, K. (1992). Putting the fear back into fear appeals: The extended parallel process model. Communication Monographs, 59, 329-349.

            Witte, K. (1998). Fear as motivator, fear as inhibitor: Using the extended parallel process model to explain fear appeal successes and failures. In P. A. Andersen & L. K. Guerrero (Eds.), Handbook of communication and emotion: Research, theory, applications, and contexts (pp. 423-450). San Diego, CA: Academic Press.

            Witte, K., Berkowitz, J. M., Cameron, K. A., & McKeon, J. K. (1998). Preventing the spread of genital warts: Using fear appeals to promote self-protective behaviors. Health Education and Behavior, 25, 571-585.

            Witte, K., Meyer, G., & Martell, D. (2001). Effective health risk messages: A step-by-step guide. Thousand Oaks, CA: Sage.

            McKay, D. L., Berkowitz, J. M., Blumberg, J. B., & Goldberg, J. P. (2004). Communicating cardiovascular disease risk due to elevated homocysteine levels: Using the EPPM to develop print materials. Health Education and Behavior, 31, 355-371.

            Cheah, W. H. (2006). Issue involvement, message appeal and gonorrhea: Risk perceptions in the US, England, Malaysia and Singapore. Asian Journal of Communication, 16, 293-314.

            Maloney, E. K., Lapinski, M. K., & Witte, K. (2011). Fear appeals and persuasion: A review and update of the extended parallel process model. Social and Personality Psychology Compass, 5, 206-219.  doi:10.1111/j.1751-9004.2011.00341.x

            Basil, M., & Witte, K. (2012). Health risk message design using the extended parallel process model. In H. Cho (Ed.), Health communication message design: Theory and practice (pp. 41-58). Los Angeles, CA: Sage.

            Popova, L. (2012). The extended parallel process model: Illuminating the gaps in research. Health Education and Behavior, 39, 455-473. doi:10.1177/1090198111418108

            Hatchell, A. C., Bassett-Gunter, R. L., Clarke, M., Kimura, S., & Latimer-Cheung, A. E. (2013). Messages for men: The efficacy of EPPM-based messages targeting men's physical activity. Health Psychology, 32, 24-32. doi:10.1037/a0030108

            Shen, L., & Dillard, J. P. (2014). Threat, fear, and persuasion: Review and critique of questions about functional form. Review of Communication Research, 2, 94-114. doi:10.12840/issn.2255-4165.2014.02.01.004 

            Ruiter, R. A. C., Kessels, L. T. E., Peters, G.-J. Y., & Kok, G. (2014). Sixty years of fear appeal research: Current state of the evidence. International Journal of Psychology, 49, 63-70. doi:10.1002/ijop.12042 

            Shi, J., & Smith, S. W. (2016). The effects of fear appeal message repetition on perceived threat, perceived efficacy, and behavioral intention in the extended parallel process model. Health Communication, 31, 275-286.   doi:10.1080/10410236.2014.948145

            Roberto, A. J., van Raalte, L. J., Liu, Y., & Posteher, K. A. (2018). The role of perceived threat and efficacy in motivating behavior change in sport and physical activity communication contexts. In B. Jackson, J. Dimmock, & J. Compton (Eds.), Persuasion and communication in sport, exercise, and physical activity (pp. 55-72). New York, NY: Routledge.
            Quick, B. L., LaVoie, N. R., Reynolds-Tylus, T., Martinez-Gonzalez, A., & Skurka, C. (2018). Examining mechanisms underlying fear-control in the extended parallel process model. Health Communication, 33, 379-391. doi:10.1080/10410236.2016.1266738


3.2.3  Content analyses based on PMT, EPPM, and related ideas

 

For further reading:

            Smith, S. L. (1997). The effective use of fear appeals in persuasive immunization: An analysis of national immunization intervention messages. Journal of Applied Communication Research, 25, 264-292.

            Kline, K. N., & Mattson, M. (2000). Breast self-examination pamphlets: A content analysis grounded in fear appeal research. Health Communication, 12, 1-21.

            Abraham, C., Krahe, B., Dominic, R., & Fritsche, I. (2002). Do health promotion messages target cognitive and behavioural correlates of condom use? A content analysis of safer sex promotion leaflets in two countries. British Journal of Health Psychology, 7, 227-246.

            Gordon, J. (2003). Risk communication and foodborne illness: Message sponsorship and attempts to stimulate perceptions of risk. Risk Analysis, 23, 1287-1296.

            Abraham, C., Southby, L., Quandte, S., Krahé, B., & van der Sluijs, W. (2007). What’s in a leaflet? Identifying research-based persuasive messages in European alcohol-education leaflets. Psychology and Health, 22, 31-60.

            Cismaru, M., Deshpande, S., Thurmeier, R., Lavack, A. M., & Agrey, N. (2010). Preventing fetal alcohol spectrum disorders: The role of protection motivation theory. Health Marketing Quarterly, 27(1), 66-85.

            Cismaru, M. (2014). Using the extended parallel process model to understand texting while driving and guide communication campaigns against it. Social Marketing Quarterly, 20, 66-82. doi:10.1177/1524500413517893
            Jiang, S., & Beaudoin, C. E. (2016). Smoking prevention in China: A content analysis of an anti-smoking social media campaign. Journal of Health Communication, 21, 755-764. doi:10.1080/10810730.2016.1157653 

            Elliott, L. R., White, M. P., Taylor, A. H., & Abraham, C. (2018). How do brochures encourage walking in natural environments in the UK? A content analysis. Health Promotion International, 33, 299-310. doi:10.1093/heapro/daw083

 


 

 

3.3  Health belief model (HBM)

 

3.3.1 Overviews and reviews

 

For further reading:

            Rosenstock, I. M. (1974). Historical origins of the health belief model. Health Education Monographs, 2, 328-335.

            Carpenter, C. J. (2010). A meta-analysis of the effectiveness of health belief model variables in predicting behavior. Health Communication, 25, 661-669. doi:10.1080/10410236.2010.521906

            Jones, C. J., Smith, H., & Llewellyn, C. (2014). Evaluating the effectiveness of health belief model interventions in improving adherence: A systematic review. Health Psychology Review, 8, 253-269. doi:10.1080/17437199.2013.802623

            Skinner, C. S., Tiro, J., & Champion, V. L. (2015). The health belief model. In K. Glanz, B. K. Rimer, & K. Viswanath (Eds.), Health behavior: Theory, research, and practice (pp. 75-94). Jossey-Bass.

            Abraham, C., & Sheeran, P. (2015). The health belief model. In M. Conner & P. Norman (Eds.), Predicting and changing health behaviour: Research and practice with social cognition models (3rd ed., pp. 30-69). McGraw-Hill.

            Paek, H.-J. (2016). Health belief model. In D. K. Kim & J. W. Dearing (Eds.), Health communication research measures (pp. 25-32). New York: Peter Lang.

 

 

3.3.2 Some HBM applications

 

For further reading:

            Hyman, R. B., Baker, S., Ephraim, R., Moadel, A., & Philip. J. (1994). Health belief model variables as predictors of screening mammography utilization. Journal of Behavioral Medicine, 17, 391-406.

            Lajunen, T., & Rasanen, M. (2004). Can social psychological models be used to promote bicycle helmet use among teenagers? A comparison of the health belief model, theory of planned behavior, and the locus of control. Journal of Safety Research, 35, 115-123.

            Buglar, M. E., White, K. M., & Robinson, N. G. (2010). The role of self-efficacy in dental patients' brushing and flossing: Testing an extended health belief model. Patient Education and Counseling, 78, 269-272. doi:10.1016/j.pec.2009.06.014

            Gerend, M. A., & Shepherd, J. E. (2012). Predicting human papillomavirus vaccine uptake in young adult women: Comparing the health belief model and theory of planned behavior. Annals of Behavioral Medicine, 44, 171-180. doi:10.1007/s12160-012-9366-5

            Yang, Z. J. (2015). Predicting young adults’ intentions to get the H1N1 vaccine: An integrated model. Journal of Health Communication, 20, 69-79. doi:10.1080/10810730.2014.904023

            Rahmati-Najarkolaei, F., Rahnama, P., Fesharaki, M. G., & Behnood, V. (2016). Predictors of oral health behaviors in female students: An application of the health belief model. Iranian Red Crescent Medical Journal, 18 (11), article no. e24747. doi:10.5812/ircmj.24747

            Fall, E., Izaute, M., & Chakroun-Baggioni, N. (2018). How can the health belief model and self-determination theory predict both influenza vaccination and vaccination intention? A longitudinal study among university students. Psychology and Health, 33, 746-764. doi:10.1080/08870446.2017.1401623

 

 


 

3.4  Health action process approach (HAPA)

 

3.4.1 Overviews and reviews

 

For further reading:

            Sutton, S. (2005). Stage theories of health behaviour. In M. Conner & P. Norman (Eds.), Predicting health behaviour: Research and practice with social cognition models (2nd ed., pp. 223-275). Maidenhead, UK: Open University Press.

            Schwarzer, R. (2008). Modeling health behavior change: How to predict and modify the adoption and maintenance of health behaviors. Applied Psychology: An International Review, 57(1), 1–29. https://doi.org/10.1111/j.1464-0597.2007.00325.x 

            Schwarzer, R. & Luszczynska, A. (2008). How to overcome health-compromising behaviors: The health action process approach. European Psychologist, 13, 141-151.

 

 

3.4.2 Some HAPA applications

 

For further reading:

            Schüz, B., Sniehotta, F. F., & Schwarzer, R. (2007). Stage-specific effects of an action control intervention on dental flossing. Health Education Research, 22, 332-341. doi:10.1093/her/cyl084

            Scholz, U., Keller, R., & Perren, S. (2009). Predicting behavioral intentions and physical exercise: A test of the health action process approach at the intrapersonal level. Health Psychology, 28, 702-708.

            Teng, Y., & Mak, W. W. S. (2011). The role of planning and self-efficacy in condom use among men who have sex with men: An application of the health action process approach model. Health Psychology, 30, 119–128. doi:10.1037/a0022023

            Zhang, Y., & Cooke, R. (2012). Using a combined motivational and volitional intervention to promote exercise and healthy dietary behaviour among undergraduates. Diabetes Research and Clinical Practice, 95, 215–223. doi:10.1016/j.diabres.2011.10.006

            Reyes Fernández, B., Knoll, N., Hamilton, K., & Schwarzer, R. (2016). Social-cognitive antecedents of hand washing: Action control bridges the planning-behavior gap. Psychology and Health, 31, 993-1004.  doi:10.1080/08870446.2016.1174236

            Lin, C.-Y., Scheerman, J. F. M., Yaseri, M., Pakpour, A. H., & Webb, T. L. (2017). A cluster randomised controlled trial of an intervention based on the Health Action Process Approach for increasing fruit and vegetable consumption in Iranian adolescents. Psychology and Health, 32, 1449-1468. doi:10.1080/08870446.2017.1341516

 

 

Daniel J. O'Keefe home page
Daniel J. O'Keefe email