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Project 1: Persuading people to have safer sex: the design of effective fear appeals

Who & When
General Background
Research Questions
Theoretical Embedding
Research Methodology
Work Plan
Expected Outcomes


Who & When

Project co-ordinator Prof C Jansen (Nijmegen University)
Researcher: Ms Dineke Ehlers
Supervision: Prof C Jansen (Nijmegen University)
Prof H Hoeken (Nijmegen University)
Prof P H Swanepoel (Unisa, Pretoria)
Starting date: January 2003
Date of completion: December 2006


up General background

An important goal of most health campaigns is to persuade people to change their health behaviour by adopting recommended responses. In order to achieve this goal, campaign materials often present target groups with the negative consequences that may arise as a result of not performing the recommended behaviour. Thus health campaign texts often contain a fear appeal to convince people that current behaviour (for instance unsafe sex) carries great danger for the participant. Threats of negative consequences are used to instill fear in the recipient of the message, who will show one of two reactions:
  • controlling the fear (an undesired reaction, because it implies tuning out of the message or showing reactance) or

  • controlling the danger (the desired reaction) by performing the propagated behaviour (for instance practising safer sex).
An important aim of this project is to identify what constitutes an effective fear appeal in South African health campaign texts. To that end, it tries to identify fear-arousing agents in culturally divergent target groups. It is presumed that culturally divergent target groups may differ with respect to:
  • what they fear,

  • whether they believe that the propagated behaviour will block negative consequences,

  • their perceived ability to perform the behaviour



up Research questions

The main research questions are the following:

  • Which text characteristics lead to intense feelings of severity, susceptibility, response efficacy and self-efficacy?

  • Given the cultural orientation of a specific target group, how are cultural differences accommodated in texts with regard to feelings of severity, susceptibility, response efficacy and self-efficacy?

  • How are the various dimensions of fear appeals currently used in South African health communication on HIV/AIDS meant for youths aged 14-16?

  • Do fear appeal texts on HIV/AIDS meant for the age group 14-16 have different effects on culturally diverse target groups in South Africa?

  • What implications do these answers have for the design of effective HIV/AIDS campaign texts in South Africa?

  • How does one design effective high-threat, high-efficacy messages for South African target groups?


up Theoretical embedding

The theoretical framework followed is the Extended Parallel Process Model (EPPM) of Witte (1992a, 1992b, 1994, 1998). This model focuses on the use of fear appeals in health communication texts, taking into account possible cultural differences (see also Murray-Johnson et al. 2001). The model is an expansion of previous fear appeal theoretical approaches by Janis (1967), Leventhal (1970,1971) and Rogers (1975, 1983). The Health Belief Model (HBM) (Janz & Becker 1984) is also closely related to these fear appeal theories. Fear appeal models can be thought of as experimental variants or explanatory (as compared to descriptive) versions of the HBM. The EPPM not only constitutes a theoretical framework, but goes on to indicate how the model can be used in the design of effective health messages, for instance HIV/AIDS prevention messages.


up Research methodology

Witte's EPPM will be empirically tested in the South African context of written HIV/AIDS campaign texts. The target population are South African urbanised female youths between the ages of 14-16. Permission will be sought from South African education authorities to conduct research in high school classes, grade 9-11. At least two culturally diverse groups will be selected.

Qualitative research (e.g. focus group interviews, utilising a number of participatory methodologies) will be conducted to ascertain which text features lead to heightened feelings of personal susceptibility and self-efficacy. Text features used, will include source, choice of verbal and visual content and presentation techniques.

Based on the outcomes of the qualitative research an experiment will be designed in which text features believed to lead to high threat and high self-efficacy will be manipulated to test the validity of the assumptions on how to create effective texts using fear appeals in South African HIV/AIDS campaign texts for the chosen target groups. 2 x 2 experimental designs will be used. The results of the quantitative research will be translated into guidelines for the writing of effective HIV/AIDS campaign texts for female youths aged 14-16 in South Africa.



up Work plan

January 2003 to December 2006 for completion of PhD, divided in the following phases:

Phase 1: January 2003 - December 2003
  • Review of literature on persuasion, fear appeals, document design principles for risk communication, and the role of cultural differences in persuasive communication within the South African context

  • Qualitative research among culturally diverse target groups, e.g. focus group interviews)
Phase 2: January 2004 - December 2004
  • Corpus analysis of existing South African HIV/AIDS campaign texts focussing on the use of fear appeals
Phase 3: January 2005 - December 2005
  • Experimental research using manipulated texts in culturally divergent South African populations, followed by quantitative and qualitative evaluation of the effectiveness of different fear appeals in manipulated texts
Phase 4: January 2006 - December 2006
  • Writing and revision of dissertation

  • One article on the interim research results in 2004.


up Expected outcomes

Expected main findings:
  • An overview of the current literature on the effectiveness of fear appeals in cultural divergent groups

  • Insight in the role of perceived threat and efficacy in determining safe sex behaviour among female adolescents in South Africa

  • Guidelines for the development of culture-sensitive persuasive texts using fear appeals in the context of health education and HIV/AIDS prevention campaigns in South Africa
Expected packaged results:
  • PhD thesis

  • Research article on interim research results

  • Workshop contributions