Threat appeals in health communication: messages that elicit fear and enhance perceived efficacy positively impact on young male drivers

Willingness to be vaccinated against COVID-19: the role of risk perception, trust in institutions, and affects

Introduction

Vaccination is one of the most effective ways to stop the COVID-19 pandemic and prevent severe disease. This study aims to ascertain the determinants of COVID-19 vaccination acceptance in the French population before the vaccine was introduced (France's second lockdown) and during the roll-out of the vaccination campaign (France's third lockdown). We focus on the following as determinants of willingness to be vaccinated: risk perception, affects related to the risk, and trust in political and health institutions.

Method

The study was conducted among two convenient samples including 591 and 474 participants. The results show that the timing of the crisis was important. While the intention to be vaccinated was relatively low before the vaccines were introduced, it became significantly higher when the vaccination campaign was deployed.

Results

The results show that risk perception and trust in health institutions are the most relevant predictors of intention to be vaccinated.

Discussion

Results are discussed in terms of the effectiveness of communication campaigns.

Health and Environmental Protective Behavioral Intentions for Reducing Harm from Water Pollutants

Understanding what motivates people to adopt protective behaviors is important in developing effective risk messaging. Motivations may vary depending on the nature of the risk and whether it poses a personal or impersonal threat. Water pollution creates both personal (human health) and impersonal (environmental) threats, yet few studies have examined people's motivations to protect both personal health and environmental health. Protection motivation theory (PMT) uses four key variables to predict what motivates individuals to protect themselves in relation to a perceived threat. Using data from an online survey (n = 621), we investigated the relationships between PMT variables related to health and environmental protective behavioral intentions related to toxic water pollutants among residents in Oregon, Idaho, and Washington, USA. Among PMT variables, high self-efficacy (belief in one's own capacity to carry out certain behaviors) significantly predicted both health and environmental protective behavioral intentions for water pollutants, while perceived severity of the threat was only significant in the environmental behavioral intentions model. Perceived vulnerability and response efficacy (belief that a specific behavior will effectively mitigate the threat) were significant in both models. Education level, political affiliation, and subjective knowledge of pollutants were significant predictors of environmental protective behavioral intentions, but not health protective behavioral intentions. The results of this study suggest that when communicating environmental risks of water pollution, highlighting self-efficacy in messaging is particularly important to promote protective environmental and personal health behavior.

Predicting COVID-19 vaccination intentions: the roles of threat appraisal, coping appraisal, subjective norms, and negative affect

BACKGROUND

As a new disease, communities possess little natural immunity to COVID-19 and vaccines are considered critical to preventing and reducing the incidence of severe illness. This study, inspired by Protection Motivation Theory (PMT), examines the relationship between citizens' threat appraisal, coping appraisal, subjective norms, negative affect, and their COVID-19 vaccination intentions.

METHODS

A sample of 340 citizens from two main cities in Mainland China, Xi'an and Wuxi, was used for data analysis. Structural Equation Modeling (SEM) was employed with latent and observed variables to test hypotheses. Data were analyzed using AMOS 24.0.

RESULTS

Several findings extend current understanding. Firstly, our proposed model explains 73% of the variance in vaccination intentions. Secondly, perceived severity only indirectly shapes COVID-19 vaccination intentions through negative affect. Thirdly, negative affect and response costs are negatively related to COVID-19 vaccination intentions. Finally, Perceived probability, subjective norms, response efficacy and self-efficacy are positively related to COVID-19 vaccination intentions; among them, self-efficacy contributes the most, followed by response efficacy and subjective norms, and lastly perceived probability.

CONCLUSION

Theoretically, this study increases current understanding about subjective norms and affective responses. We provoke a certain amount of thought about the role of affect response in relation to threat appraisal and vaccination intentions. Specifically, governments must be vigilant that citizens' negative affect, such as fear, may cause vaccine hesitation.

Race, ethnicity, psychological factors, and COVID-19 vaccine hesitancy during the COVID-19 pandemic

We examined the associations between perceived risk, perceived severity, and fear of contracting COVID-19 and vaccine acceptance among different ethnic groups in San José, California. We surveyed 3,797 adults living in San José using a multi-stage, clustered sampling design in which we randomly selected census tracts in San José followed by households within each census tract. We estimated the odds ratio (ORs) for perceived risk, perceived general severity, fear of contracting COVID-19, and vaccine acceptance using regression models. Finally, we assessed the differential impacts of perceived risk, perceived severity, and fear of contracting the COVID-19 on vaccine acceptance by controlling for social-demographic variables. Hispanic/Latino respondents reported higher levels of perceived risk and lower fear of contracting COVID-19 than Asians. Hispanic/Latinos (odds ratio [OR] = 0.48, P < 0.05), Whites (OR = 0.61, P < 0.05), and African Americans (OR = 0.28, P < 0.05) were less likely to report intentions to be vaccinated than Asians. Finally, perceived risk and perceived personal severity were not associated with intentions to be vaccinated, while perceived general severity and fear of contracting COVID-19 were stronger predictors of vaccination intentions. The study highlights the importance of psychological factors in understanding vaccine acceptance across race/ethnicity groups.

Subjective evaluations of self and others' driving behaviors: A comparative study involving data from drivers in Japan, China, and Vietnam

INTRODUCTION

This study explored the influence of personal attributes on subjectively-reported aggressive driving behaviors, with an emphasis on the inter-influences between subjectively-reported aggressive driving behaviors between self and other individuals. To determine this, a survey was conducted comprising participants' socio-demographic data, information on their history with automotive accidents, and subjective scales to report on the driving behaviors between self and others. More specifically, a four-factor shortened version of the Manchester Driver Behavior Questionnaire was used to collect data on the aberrant driving behaviors of "self" and "others."

METHOD

Participants were recruited from three countries, namely, Japan (1,250 responses), China (1,250), and Vietnam (1,000). This study only considered the "aggressive violations' factor," which was referred to as self-aggressive driving behaviors (SADB) and others' aggressive driving behaviors (OADB). After collecting the data, univariate and bivariate multiple regression models were employed to better understand the response patterns from both scales.

RESULTS

This study found that accident experience had the strongest influence on the reporting of aggressive driving behaviors (followed by education level). However, variation in countries was also found between both the rate of engagement in aggressive driving behavior and its recognition. In this study, highly educated Japanese drivers tended to evaluate others as safe, whereas highly educated Chinese drivers tended to evaluate others as aggressive. This discrepancy can likely be attributed to cultural norms and values. Meanwhile, evaluations from Vietnamese drivers seemed to differ depending on whether they drove cars or bikes, with additional influences as a result of the driving frequency. Furthermore, this study found that it was most difficult to explain the driving behaviors on the "other" scale reported by Japanese drivers.

PRACTICAL APPLICATIONS

These findings can aid policymakers and planners to develop road safety measures that reflect the behaviors of drivers in their respective countries.

Impact of media trust and personal epidemic experience on epidemic prevention behaviors in the context of COVID-19: A cross-sectional study based on protection motivation theory

Objective

This study aimed to elucidate the impact of media trust on epidemic prevention motivation and behaviors based on the Protection Motivation Theory (PMT) and to evaluate the moderation effect of personal epidemic experience, which focused on the differences in two groups with or without epidemic experience.

Methods

The exogenous constructs and PMT model and scale were constructed through literature analysis, and a web-based questionnaire survey was conducted among 428 individuals aged above 18 years in China. Statistical analysis and hypothesis testing were performed in SPSS 26 and SmartPLS 3.

Results

Traditional media trust accounted for the largest weight in media trust (w = 0.492, p-value < 0.001), followed by social media (w = 0.463, p-value < 0.001), and interpersonal communication (w = 0.290, p-value < 0.001). Media trust was positively and significantly related to both threat appraisal (β = 0.210, p-value < 0.001) and coping appraisal (β = 0.260, p-value < 0.001). Threat appraisal (β = 0.105, p-value < 0.05) and coping appraisal (β = 0.545, p-value < 0.001) were positively and significantly related to epidemic prevention motivation, which positively and significantly related to epidemic prevention behaviors (β = 0.492, p-value < 0.001). The R² values of epidemic prevention motivation and behavior are 0.350 and 0.240, respectively, indicating an acceptable explanation. Multiple-group analysis revealed five significant differences in paths between the two groups, indicating personal epidemic experience acting as a slight moderator on these paths.

Conclusion

Traditional media trust and social media trust were the important elements in COVID-19 prevention and control, and public health departments and governments should ensure the accuracy and reliability of information from traditional and social media. Simultaneously, the media should balance threat information and efficacy information in order to generate the public's prevention motivation and behaviors.

Effect of fear appeal mobile phone messaging on health behaviors of caregivers with children under-five in Ghana

Social and Behavior Change Communication is a vital strategy in the control of malaria. However, the effectiveness of fear appeal tactic as a preventive strategy remains uncertain. This study examined the influence of a fear appeal mobile phone-based intervention, guided by Witte's Extended Parallel Process model, on malaria prevention among caregivers with children under-five. We conducted a quasi-experimental study of a 12-month intervention using a sample of 324 caregivers from two rural districts, assigned to either an intervention or control group. The intervention group received fear appeal voice Short Message Service (SMS), once a week for twelve (12) months, while caregivers in the control group received none. The results showed that exposure to the messages was associated with an increased odds of positive attitude [adjusted Odds ratio (aOR) = 2.58; 95% CI 1.61-4.15] and behavioral changes (aOR = 2.03, 95% CI 1.29-3.19). The intervention group exhibited lower odds of defensive avoidance (aOR = 0.44, 95% CI 0.29-0.68) and message minimization (aOR = 0.51, 95% CI 0.33-0.78) compared with the control group. These findings highlight the importance of communicating health messages via mobile phones using fear appeal for improving the health behaviors of caregivers. This strategy, however, may not be useful for influencing the intention of caregivers to engage in positive health practices to protect their children from malaria.

The psychological and behavioural correlates of COVID-19 vaccine hesitancy and resistance in Ireland and the UK

Background

The successful control of the COVID-19 pandemic depends largely on the acceptance and uptake of a COVID-19 vaccine among the public. Thus, formative research aiming to understand and determine the causes of weak and/or positive vaccination intentions is vital in order to ensure the success of future and current vaccination programmes through the provision of effective, evidence-based health messaging.

Methods

A cross-sectional survey was completed by a sample of Irish (N = 500) and UK (N = 579) citizens using the online platform ‘Qualtrics’. Participants completed a questionnaire battery comprised of health, attitudes/beliefs, influences, and behavioural intention measures. Demographic information was also assessed.

Results

Results highlighted similar rates of vaccine intention among both samples; where a total of 76.8% Irish respondents, and 73.7% of UK respondents indicated that they intended to be immunized if the government advised them to take the COVID-19 vaccine. Overall, 23.2% of Irish respondents reported being vaccine hesitant or vaccine resistant, while a rate of 26.3% of UK respondents reported vaccine hesitancy or resistance. Univariate analysis highlighted that both gender and age played a significant role in vaccine intention, with women under age 30 reporting higher rate of vaccine hesitancy. Multivariate analysis revealed that significant correlates of vaccine acceptance included peer influence, GP influence, civic responsibility, perceived benefit, and positive vaccination attitudes. Those who reported vaccine resistance and hesitancy were more likely to have less positive vaccination attitudes and perceive higher vaccination risk.

Discussion

The current sociodemographic and psychological profiles of vaccine resistant and hesitant individuals provide a useful resource for informing health practitioners in the UK and Ireland with the means of enhancing pro-vaccine attitudes and promoting vaccination uptake. The current research shows indications of associations between distrust in the vaccine itself and vaccine hesitancy and resistance. Thus, to effectively design and deliver public health messages that ensures the success of vaccination uptake, it is likely that governments and public health officials will need to take actions to garner trust in the safety of the vaccine itself. Additionally, campaigns to decrease hesitancy and resistance in the COVID-19 vaccine may benefit in targeting altruism to increase willingness to get vaccinated against COVID-19.

Targeting Smartphone Use While Driving: Drivers’ Reactions to Different Types of Safety Messages

Only a few previous studies analyzed the effectiveness of road safety messages targeting smartphone use while driving and only several of them used messages from an ongoing road safety campaign. Thus, contributing to the field, this study aimed at testing the effectiveness of two types of social messages (threat appeal and threat appeal together with safe behavior role modelling) targeting smartphone use while driving. Ninety-three drivers were randomly assigned to two experimental (n1 = 26; n2 = 37) and one control (n = 29) groups. Each experimental group was presented with one 30 s length video message to reduce or stop smartphone use while driving. Messages differed in terms of threat appeal and modelling of safe behavior. The control group was presented with a 30 s length video clip showing neutral driving related content. The results revealed that threat appeals (alone or together with a safe role model) resulted in less positive emotions when compared to the control group’s reported emotional reactions. The message with threat appeal only also resulted in more negative emotions compared to the control group. With regards to behavioral intentions, road safety messages used in this study had minor effectiveness: the threat appeal message reduced the intentions to use smartphones while driving, only when previous behavior has been controlled. In sum, messages targeting smartphone use while driving were effective at least to some extent in changing drivers’ emotions and intentions not to be involved in targeted behavior, but the effect was minor and threat appeal only showed higher effectiveness.

Distancing Adherence and Negative Emotions among the Israeli Elderly Population during the COVID-19 Pandemic

Social distancing was found to prevent COVID-19 contagion. Therefore, understanding the factors associated with the public’s adherence is important. Acknowledging the importance of emotional wellbeing regarding older people’s health, and understanding their emotional state during the pandemic, are crucial. This study assessed factors associated with older people’s adherence to social distancing and their emotional status. A cross-sectional online survey was conducted among 1822 respondents above the age of 60. Distancing adherence, negative emotion, trust, social support, threat perception, attitudes, and subjective norms were assessed, and a path analysis was performed. Adherence was positively associated with attitudes (β = 0.10; p < 0.001), and with subjective norms (β = 0.19; p < 0.001). Negative emotions were positively associated with threat perception (β = 0.33; p < 0.001), and negatively associated with social support (β = −0.13; p < 0.001) and subjective norms (β = −0.10; p < 0.001). Attitudes mediated the relationship of threat perception (95% CI = 0.009, 0.034), trust (95% CI = 0.008, 0.029), and social support (95% CI = 0.006, 0.023) with distancing adherence. Subjective norms mediated the relationship between threat perception (95% CI = 0.014, 0.034), trust (95% CI = 0.026, 0.055), and social support (95% CI = 0.002, 0.048) with distancing adherence. Subjective norms mediated the relationship between threat perception (95% CI = −0.022, −0.006), trust (95% CI = −0.034, −0.010), and social support (95% CI = −0.029, −0.009) with negative emotions. When promoting social distancing adherence, subjective norms and attitudes must be considered, as they play a role in promoting adherence and negative-emotion regulation.

Public sentiments towards the use of Wolbachia-Aedes technology in Singapore

Background

Wolbachia technology is a novel vector control approach that can reduce mosquito populations and the risk of mosquito-borne diseases, which has recently gained popularity amongst countries. In 2016, Singapore embarked on a multi-phased field study named Project Wolbachia – Singapore, to evaluate the use of Wolbachia technology as an Aedes aegypti mosquito population suppression tool to fight dengue. Due to the novelty of this technology in Singapore, this study aims to understand the public’s acceptance and sentiments towards the use of Wolbachia technology.

Methods

Several public sentiment survey approaches – including online, face-to-face in the streets, as well as door-to-door household surveys – were conducted.

Results

The surveys conducted prior to the first field releases and implementation of the project revealed high support for the use of Wolbachia technology in Singapore. A household perception survey conducted in the interim of the first project phase was encouraging, with the majority of the respondents being aware of the project and having no concerns with the release of male Wolbachia-carrying Aedes aegypti (Wolbachia-Aedes) mosquitoes in their neighbourhood.

Conclusions

The study reveal high support for the use of Wolbachia technology in Singapore and also provided invaluable insights that were used in the development of a public communications and engagement framework model, which thus helped to guide these elements in the subsequent phases and expansion of the project.

Emotional responses to prosocial messages increase willingness to self-isolate during the COVID-19 pandemic

The COVID-19 pandemic may be one of the greatest modern societal challenges that requires widespread collective action and cooperation. While a handful of actions can help reduce pathogen transmission, one critical behavior is to self-isolate. Public health messages often use persuasive language to change attitudes and behaviors, which can evoke a wide range of negative and positive emotional responses. In a U.S. representative sample (N = 955), we presented two messages that leveraged either threatening or prosocial persuasive language, and measured self-reported emotional reactions and willingness to self-isolate. Although emotional responses to the interventions were highly heterogeneous, personality traits known to be linked with distinct emotional experiences (extraversion and neuroticism) explained significant variance in the arousal response. While results show that both types of appeals increased willingness to self-isolate (Cohen's d = 0.41), compared to the threat message, the efficacy of the prosocial message was more dependent on the magnitude of the evoked emotional response on both arousal and valence dimensions. Together, these results imply that prosocial appeals have the potential to be associated with greater compliance if they evoke highly positive emotional responses.

Considering Emotion in COVID-19 Vaccine Communication: Addressing Vaccine Hesitancy and Fostering Vaccine Confidence

Long-term control of the COVID-19 pandemic hinges in part on the development and uptake of a preventive vaccine. In addition to a segment of population that refuses vaccines, the novelty of the disease and concerns over safety and efficacy of the vaccine have a sizable proportion of the U.S. indicating reluctance to getting vaccinated against COVID-19. Among various efforts to address vaccine hesitancy and foster vaccine confidence, evidence-based communication strategies are critical. There are opportunities to consider the role of emotion in communication efforts. In this commentary, we highlight several ways negative as well as positive emotions may be considered and leveraged. Examples include attending to negative emotions such as fear and anxiety, raising awareness of emotional manipulations by anti-vaccine disinformation efforts, and activating positive emotions such as altruism and hope as part of vaccine education endeavors.

An Integrative Review on Teen Distracted Driving for Model Program Development

Distracted driving, especially driver inattention, is associated with high levels of crash-related fatalities and injury. Teen novice drivers are one of the groups most likely to drive distracted and to suffer its consequences. Teens have a higher risk of engaging in texting or secondary tasks, e.g., eating while driving. Distracted driving interventions to date aim to improve teen and societal safety, but few have achieved effectiveness. A need exists for effective evidence-based distracted driving interventions. We used an integrative review to identify rigorous evidence, and inform the development of a teen distracted driving educational intervention. This five-step review included: identifying the research problem; collecting literature; evaluating literature; synthesizing data; and presenting results. We searched 6 databases, identifying 185 articles. Following three rounds of inclusion screening (title, abstract, and full-text), captured according to a PRISMA flow chart, 17 studies met inclusion. We categorized these studies, conducted in the U.S., as five intervention types that used approaches including presentations, videos or instructional programs, education or training programs, driving simulator training, in-vehicle monitoring or feedback, and integrated programs. Study designs included randomized controlled trials pre-post, quasi-experimental, and experimental designs with prospective longitudinal cohorts. The studies were heterogeneous in design, intervention and outcome. However, three core themes emerged across studies: i.e., hazard awareness, hazard mitigation and attention maintenance are primary critically necessary skills to prevent distracted driving; engaging a parent or adult as a partner in the intervention process from classroom to car contributed to the effectiveness of the intervention; and leveraging technology in training enhanced the effectiveness of the intervention. Study limitations pertained to a focus on short-term effects; sampling distributions that did not account for gender, age, race, and/or ethnicity; types of interventions; and bias. The limitations affect the generalizability of included study findings and, potentially, the review findings, as they may not apply to populations or contexts outside those synopsized. Strengths included our team's expertise in conducting evidence-based reviews, support of a health science librarian, and use of international review guidelines. As an outcome, we are applying findings of the integrated review to develop a computer-based training addressing teen distracted driving.

Threat appeals reduce impulsive decision making associated with texting while driving: A behavioral economic approach

The primary purpose of the present study was to examine the effectiveness of threat appeals in influencing impulsive decision making associated with texting while driving. The participants in the treatment group were exposed to a threatening message about the danger of texting while driving, whereas those in the control group were exposed to a non-threatening message. Following the exposure to either message, the participants completed a delay-discounting task that assessed the degree of impulsive decision making in a hypothetical texting-while-driving scenario. A comparison between the groups revealed that the threat appeals reduced the degree of impulsive decision making associated with texting while driving. In addition, the threat appeals led to greater anticipated regret from texting while driving, less favorable attitudes toward texting while driving, and decreased intentions to text while driving in the future in the treatment group. These results suggest that video-based threat appeals are promising intervention strategies for the public health challenge of texting while driving. Implications from the behavioral economic perspective are discussed.

Adolescents' perspectives on distracted driving legislation

PURPOSE

Distracted driving is a growing global epidemic, with adolescent drivers reporting frequent engagement in distracted driving behaviors. Public health initiatives and legislative efforts designed to decrease the prevalence of these unwanted driving behaviors have demonstrated small, but significant reductions in crash risk. Non-compliance is a known problem among drivers of all ages, but may be especially problematic for novice, adolescent drivers. Using a construct from the Health Belief Model, the relations between demographic factors, perceived threat to safety, and peer influences were investigated with adolescents' support for three types of distracted driving legislation regarding: (a) reading or sending text messages/emails while driving; (b) hand-held cell phone use while driving; and (c) using non-driving-related-in-vehicle (NDIV) technology while driving. Investigating adolescents' perceptions provides an opportunity to understand distracted driving enforcement and legislation.

METHODS

Three hundred and seventy-nine adolescents aged 15-19 (M = 16.12, SD = 0.56) were recruited from public high schools. Demographics, perceptions, and support regarding distracted driving were assessed using self-report surveys. Statistical analyses included bivariate correlations and adjusted odds ratios to investigate influences of adolescent support for distracted driving legislation.

RESULTS

Female adolescents were at 2 times greater odds of supporting a law against texting/emailing while driving compared to male adolescents. Greater perceived threat to safety was associated with all three types of distracted driving legislation (aOR = 1.10, 1.33). Minimal association was found with peer influences.

CONCLUSIONS

Perceived threat to safety and gender were associated with legislative support in adolescents. Practical application: Interventions and public health campaigns that incorporate elements related to perceived threat may be more successful with female adolescent drivers than male adolescents. Future experimental research will help to determine what factors affect adolescents' perspectives on distracted driving to promote compliance with related legislation.

Comparison of self-report and objective measures of driving behavior and road safety: A systematic review

INTRODUCTION

This research systematically reviewed the existing literature in regards to studies which have used both self-report and objective measures of driving behavior. The objective of the current review was to evaluate disparities or similarities between self-report and objective measures of driving behavior.

METHODS

Searches were undertaken in the following electronic databases, PsycINFO, PubMed, and Scopus, for peer-reviewed full-text articles that (1) focused on road safety, and (2) compared both subjective and objective measures of driving performance or driver safety. A total of 22,728 articles were identified, with 19 articles, comprising 20 studies, included as part of the review.

RESULTS

The research reported herein suggested that for some behaviors (e.g., driving in stressful situations) there were similarities between self-report and objective measures while for other behaviors (e.g., sleepiness and vigilance states) there were differences between these measurement techniques. In addition, findings from some studies suggested that in-vehicle devices may be a valid measurement tool to assess driving exposure in older drivers.

CONCLUSIONS

Further research is needed to examine the correspondence between self-report and objective measures of driving behavior. In particular, there is a need to increase the number of studies which compare "like with like" as it is difficult to draw comparisons when there are variations in measurement tools used.

PRACTICAL APPLICATIONS

Incorporating a range of objective and self-report measurements tools in research would help to ensure that the methods used offer the most reliable measures of assessing on-road behaviors.