Understanding the Design of Fear Appeals by Applying the Extended Parallel Process Model: A Qualitative Analysis of COVID-19 Public Service Announcements.

PURPOSE: Identify how early COVID-19 public health messages incorporated in the tenets of the extended parallel process model (EPPM). SETTING: YouTube videos developed by governmental departments, medical institutions, news organizations, and non-profit organizations in the United States were aggregated. METHOD: This qualitative study conducted a keyword search to identify public service announcements (PSAs). The sample was further refined after searching PSAs that contained fear appeals. A thematic analysis was performed by using the constant comparative method. SAMPLE: A total of forty-three videos was included in the final analysis. RESULT: Two themes emerged regarding messages aimed at arousing the perceived severity of threat. These themes include emphasizing the consequences of being infected and utilizing personal narratives. Perceived susceptibility of threat was aroused by emphasizing that some groups have higher risks than others. Two themes emerged around arousing perceived response efficacy: (1) the authority of professionals; and (2) altruism and personal responsibility. One way was identified to arouse perceived self-efficacy, which is informing the protective measures. CONCLUSION: Multiple strategies were used in PSAs about COVID-19 to arouse fear during the early stages of the pandemic. The utilization of self-efficacy was oversimplified, by not providing details about the rationale for the recommended behavior.

Comparing Message Appeals Employed in Efforts to Prevent E-cigarette Use Among Students in a US University.

College students tend to underestimate the risk associated with e-cigarette use while overestimating the prevalence of this behavior. The purpose of this study was to compare the perceived effectiveness of social norms messages to other theoretical appeals regarding the prevention of e-cigarette use. Researchers surveyed 586 college students who assessed five messages. Different appeals were featured in each message. A Rasch Rating Scale Model (RSM) was used to calibrate students' responses to seven items assessing each communication message. The results from the multiple regression models revealed that vape-users were less receptive to the messages than abstainers, and among vape users, males expressed lower message endorsement than females. Overall, the clinical appeal received the highest endorsement in Rasch calibrated logit unit measures, (M = 3.36 for abstainers and M = 2.41 for vape-users), whereas the social norms message was the least favored (M = 1.41 for abstainers and M = 0.22 for vape-users). Qualitative analyses revealed common themes of skepticism and a need for credible scientific information. Findings suggest college students prefer clinical evidence over normative information. An experimental design is needed to determine the extent to which messages influence behavior change.

Promoting HPV vaccination among Latinx: an application of the extended parallel processing model.

Vaccine hesitancy is a substantial barrier to increasing HPV vaccination rates among Latinx in the US who experience disproportional rates of HPV-related cancers. The current research tests the effectiveness of culturally-targeted, fear-appeal messages designed using the Extended Parallel Processing Model (EPPM). We compared differences among Latinx young adults and parents of adolescents of the effectiveness of messages that highlight HPV-related cancers, genital warts, or a control condition to promote online information seeking about the HPV vaccine-a known precursor to vaccination intention. Results found messages containing EPPM messaging elements produced significantly higher self-reported intention to seek information about HPV vaccines in comparison to a control message group. However, participants who received control messages had the highest percentage of hyperlink clicks to more information about HPV (a novel measure of information seeking). Findings suggest that fear appeals may be effective for promoting information seeking about HPV vaccination, which in turn could increase vaccine utilization, among Latinx participants. Clinical trial registration number (NCT05206669) retrospectively registered January 25, 2022.

An extended health belief model for COVID-19: understanding the media-based processes leading to social distancing and panic buying.

Building on the health belief model (HBM), this research tests, over six months, how the exposure to COVID-related information in the media affects fear, which in turn conditions beliefs about the severity of the virus, susceptibility of getting the virus, and benefits of safety measures. These health beliefs ultimately lead to social distancing and panic buying. As a first contribution, we find that fear is not directly triggered by the objective severity of a crisis, but rather formed over time by the way individuals are exposed to media. Second, we show that fear affects behaviors through the components of the HBM which relate to the risks/benefits of a situation. Last, we find that critical thinking about media content amplifies the "adaptive" responses of our model (e.g., health beliefs, social distancing) and reduces its "maladaptive" responses (e.g., panic buying). Interestingly, we note that the beneficial effect of critical thinking about media content disappears as the level of fear increases over time. The implications of these findings for policymakers, media companies, and theory are further discussed. Supplementary Information: The online version contains supplementary material available at 10.1007/s11747-022-00865-8.

Are Fear Campaigns Effective for Increasing Adherence to COVID-Related Mitigation Measures?

BACKGROUND: Using fear to increase the uptake of preventative health behaviours is a longstanding practice, which could be useful in mitigating the spread of COVID-19. However, the impact of fear campaigns beyond behavioural outcomes has rarely been considered. It is possible that these threatening health messages could heighten health-related anxiety by inducing a tendency to interpret ambiguous stimuli in a threatening manner. This research aimed to evaluate the effects of fear-based articles about COVID-19, on intentions to adhere to mitigation measures and interpretation bias-a core maintenance factor in health anxiety. METHOD: Two pilot studies were conducted with the aim of validating our novel COVID-related measures and assessing engagement with the threat manipulation. Following this, 375 community members were recruited through social media for the main study. Participants were then randomly allocated to read an article about COVID which was manipulated on both threat and efficacy. After reading the article, participants then completed measures of interpretation bias and intentions to engage in COVID-19 mitigation measures. RESULTS: Although the threatening articles consistently produced greater COVID-related threat, they only generated a stronger interpretation bias in the first pilot study. Importantly, threat-based communications failed to enhance intentions to perform mitigation measures in any of the studies. Likewise, reading an article which bolstered self-efficacy did not increase intentions, compared to reading a low efficacy article. CONCLUSION: This research suggests that fear appeals are unlikely to increase intentions to perform COVID-related mitigation measures.

Fear of COVID-19 and Prevention Behaviors: Cross-Lagged Panel Analysis.

BACKGROUND: The ongoing COVID-19 pandemic has brought forth conversations about effective behavior change models for increasing prevention behavior, ranging from wearing masks in public to physical distancing. Among the considered behavior change techniques is the use of fear appeals, through which a negative possible outcome is emphasized to invoke fear, which in turn may promote prevention behaviors to counter the likelihood of the negative outcome. Although fear is hypothesized as health promoting in some theories of health behavior, little research has rigorously assessed the relationship. OBJECTIVE: In our exploratory analyses, we aim to examine the association, including directionality of the association between fear of COVID-19 and COVID-19 prevention behaviors across 2 time points during the early COVID-19 pandemic among a sample of US women. METHODS: The COPE study, a web-based survey of US women's COVID-19 experiences, was deployed in May-June 2020 (time 1) with follow-up in December 2020-January 2021 (time 2; n=200). Demographic characteristics as well as fear of COVID-19 and COVID-19 prevention behaviors (eg, staying home except for essential activities, physical distancing in public, and masking in public) were measured. Descriptive and bivariate analyses were used to characterize COVID-19 prevention behaviors and fear of COVID-19 among participants. Cross-lagged panel analysis, a type of structural equation modeling that assesses directionality of temporal associations, was used to understand relationships, if any, between variables of interest. RESULTS: We found cross-sectional associations between fear of COVID-19 and staying home and physical distancing, as well as temporal associations between fear at time 1 and time 2 and prevention behaviors at time 1 and time 2. However, results of the cross-lagged panel analysis indicated no cross-lagged temporal relationships between fear of COVID-19 and COVID-19 prevention behaviors 6 months apart. CONCLUSIONS: Fear of COVID-19 did not appear to predict COVID-19 prevention behaviors 6 months after initial measurements among the sample of women recruited for our study. Future research should rigorously test these associations longitudinally, and alternative methods of public health prevention promotion should be considered.

Appealing to Individual Fears or Social Norms: How Can the Public Be Persuaded to Accept COVID-19 Vaccination through Risk Communication?

In the context of the COVID-19 pandemic, improving the public's understanding of the increased efficacy and safety of the COVID-19 vaccines through scientific risk communication campaigns, promoting the public's acceptance and willingness to receive COVID-19 vaccines, and forming collective actions at the social level will deeply impact on the effect of COVID-19 prevention in various countries, which is also a key factor that governments need to address urgently. Previous research on risk communication has mostly focused on microscopic perspectives of how to stimulate individual self-protection behaviors by awakening threat and efficacy perceptions; however, a lack of observation of social collective actions means there is a risk of failure regarding COVID-19 epidemic reduction and prevention. In this regard, this study was based on the issue of vaccination in the context of the COVID-19 epidemic through a highly regulated and controlled research experiment in China (n = 165), which was designed to examine the impact of two risk communication frameworks, appealing to individual fears and appealing to social norms, on the public's acceptance and recommendations of COVID-19 vaccines, thus outlining the path of action from individual protection to collective epidemic prevention. Both the "fear appeals" framework and the "social norms" framework were found to have a positive effect on the Chinese public's vaccination acceptance. Specifically, social norms information may increase vaccination acceptance by enhancing the public's perceptions of social responsibility, while fear appeals information may reduce their perceptions of threat and social pressure to get the vaccine. Female and highly educated groups were more likely to refuse to recommend vaccination after reading the risk communication information. These results can be a useful supplement to the theory and practice of risk communication.

An empirical comparison of the Extended Parallel Process Model with the Terror Management Health Model.

The Extended Parallel Process Model posits that fear-appeal messages are processed only when message recipients perceive a critical level of threat. The more recent Terror Management Health Model suggests that, in addition to level of perceived threat, the nature of the threat also influences how target audiences process fear appeals. Specifically, fear appeals that utilize the threat of death as a consequence trigger both conscious and nonconscious responses that influence message recipients' health-related decisions. Accounting for the influence of consciousness of death helps explain maladaptive responses that extant theory has been unable to explain. Results from an experiment indicate that, when the level of perceived fear was the same across participants, the Extended Parallel Process Model successfully predicted persuasive outcomes for fear appeals that utilized the threat of arrest or serious injury as a consequence of noncompliance. However, for fear appeals that utilized the threat of death as a consequence of noncompliance, as predicted by the Terror Management Health Model, ego involvement in the health-related behavior predicted persuasive outcomes more accurately than the dual fear control and danger control processes. These findings suggest that incorporating consciousness of death and ego involvement can avoid conceptual problems with the level-of-fear construct, provide a meaningful way to predict fear-appeal responses across target audiences, and explain maladaptive responses that have eluded the explanations of extant fear-appeal theories.

In this research, we compared two psychological models that explain how people respond to fear-based health promotion campaigns. The well-established Extended Parallel Process Model predicts that when faced with a fear-arousing message, audiences evaluate their self-efficacy in performing the recommended action, as well as the efficacy of the proposed action. Next, the efficacy appraisal is weighed against the perceived level of fear and the relevance of the threat to one's personal situation to determine a response to the threat. The more recently developed Terror Management Health Model states that fear of death is a special case. When faced with a fear-arousing message that utilizes threat of death as a consequence, audiences can cling to worldviews that grant them self-esteem. As such, defensiveness evoked by the fear of death is not in response to the level of perceived threat, but the qualitative nature of the threat. This worldview defense can create undesirable responses to fear appeals containing the fear of death. Results from a laboratory experiment indicate that the established model explains audience behavior for health-related messages that utilize threats with nonfatal consequences but the Terror Management Health Model is better suited to predicting behavior for messages that utilize threat of death as a consequence.

The Role of Agency and Threat Immediacy in Interactive Digital Narrative Fear Appeals for the Prevention of Excessive Alcohol Use: Randomized Controlled Trial.

BACKGROUND: Serious games for the training of prevention behaviors have been widely recognized as potentially valuable tools for adolescents and young adults across a variety of risk behaviors. However, the role of agency as a distinguishing factor from traditional health interventions has seldom been isolated and grounded in the persuasive health communication theory. Fear appeals have different effects on intentions to perform prevention behaviors depending on the immediacy of the consequences. Looking into how to increase self-efficacy beliefs for health behavior with distant consequences is the first step toward improving game-based interventions for adverse health outcomes. OBJECTIVE: This study aimed to investigate the effect of agency on self-efficacy and the intention to drink less alcohol in an interactive digital narrative fear appeal. Furthermore, the communicated immediacy of threat outcomes was evaluated as a potential moderator of the effect of agency on self-efficacy. METHODS: A web-based experimental study was conducted with university students (N=178). The participants were presented with a fear appeal outlining the consequences of excessive alcohol use in a fully automated web-based interactive narrative. Participants either had perceived control over the outcome of the narrative scenario (high agency) or no control over the outcome (low agency). The threat was either framed as a short-term (high immediacy) or long-term (low immediacy) negative health outcome resulting from the execution of the risk behavior (drinking too much alcohol). RESULTS: A total of 123 valid cases were analyzed. Self-efficacy and intention to limit alcohol intake were not influenced by the agency manipulation. Self-efficacy was shown to be a significant predictor of behavioral intention. The immediacy of the threat did not moderate the relationship between agency and self-efficacy. CONCLUSIONS: Although agency manipulation was successful, we could not find evidence of an effect of agency or threat immediacy on self-efficacy. The implications for different operationalizations of different agency concepts, as well as the malleability of self-efficacy beliefs for long-term threats, are discussed. The use of repeated versus single interventions and different threat types (eg, health and social threats) should be tested empirically to establish a way forward for diversifying intervention approaches. TRIAL REGISTRATION: ClinicalTrials.gov NCT05321238; https://www.clinicaltrials.gov/ct2/show/NCT05321238.

Response Efficacy and Self-Efficacy Mediated the Relationship between Perceived Threat and Psychic Anxiety among College Students in the Early Stage of the COVID-19 Pandemic.

Applying Fear Appeals Theory and Social Learning Theory, this study aims to explore the impact of perceived threat on psychic anxiety among college students in the early stage of the COVID-19 pandemic and the mediating roles of response efficacy and self-efficacy. An empirical study was conducted using an online cross-sectional survey in the early stage of the COVID-19 pandemic in February 2020. A random sampling method was applied to administer questionnaires to 646 Chinese college students. The results showed that: (1) the perceived threat of the COVID-19 pandemic, including perceived susceptibility and severity, was positively correlated with psychic anxiety; (2) self-efficacy mediated the effect of both perceived susceptibility and severity on psychic anxiety, while the response efficacy only mediated the effect of perceived susceptibility on psychic anxiety; and (3) response efficacy and self-efficacy played a serial mediating role on the relationship between perceived susceptibility and psychic anxiety. This study elucidates the relationship between perceived threat and psychic anxiety from the perspective of cognitive appraisal of threat, showing the role positive efficacy appraisal played in reducing psychic anxiety, which could be induced by the perceived threat of major public health emergencies such as COVID-19 pandemic.

Change of risk behaviour in young people - the effectiveness of the trauma prevention programme P.A.R.T.Y. considering the effect of fear appeals and cognitive processes.

BACKGROUND: The purpose of the present study was to examine the effectiveness of the injury awareness and prevention programme P.A.R.T.Y. (Prevent Alcohol and Risk-Related Trauma in Youth) in Germany. On a designated P.A R.T.Y. day, school classes spend a day in a trauma hospital experiencing the various wards through which a seriously injured person goes. A further goal of the study was to reveal indications of the programme's mechanism of action by testing theory-based impact models of fear appeals and cognitive beliefs. METHODS: In a quasi-experimental longitudinal study with three measurement times the participants of 19 P.A.R.T.Y. days (n = 330), as well as pupils who did not attend the programme (n = 244), were interviewed with a standardised questionnaire. They reported risk behaviour, feelings of threat and cognitive beliefs about road traffic. The data were analysed using a meta-analytical approach to estimate an average effect size across the different P.A.R.T.Y. days. Path models were used to identify possible mechanisms of action. RESULTS: For most of the parameters, small positive effects could be proven immediately after the P.A.R.T.Y. INTERVENTION: However, after four to 5 months only one statistically significant effect was found. Using path analytical models, important predictors for behavioural changes (e.g. self-efficacy) could be identified. But for these predictors no or only short-term effects were observed in the meta-analysis. CONCLUSIONS: Fear appeals as used primarily in the P.A.R.T.Y. programme appear to cause behavioural changes only to a limited extent and only in the short-term, especially if the strengthening of psychosocial resources is not given sufficient consideration. The participants must also cognitively process the experiences in the hospital. Accordingly, consideration should be given to how the P.A.R.T.Y. program could be adapted to complement the fear appeal with cognitive components.

Social Facilitation in Fear Appeals Creates Positive Affect but Inhibits Healthy Eating Intentions.

The social facilitation of eating plays a significant role in influencing individuals' eating decisions. However, how social eating cues are processed in health promotion messages is unclear. This study examined individuals' food craving in response to social cues in images (Experiment 1) and emotional experiences, perceived threat, perceived efficacy, behavioral intentions, and motivational coactivation elicited by social eating cues in obesity prevention fear appeals (Experiment 2). Results suggested that the presence of a group of people eating in an image facilitated food craving for the presented foods. Moreover, fear appeals that presented obesity and its consequences with more social eating cues, versus individual eating cues, generated greater positive emotional responses, perceived threat severity, response and self-efficacy, and motivational coactivation indicating more attention and threat vigilance. However, these cues also generated fewer self-reported intentions to change unhealthy eating behaviors. Implications and suggestions for future research are discussed.

Fear Appeals in Anti-Knife Carrying Campaigns: Successful or Counter-Productive?

In the UK, knife crime continues to be a persistent and worrying concern. Media campaigns are often used by police and anti-knife crime organisations in an attempt to discourage young people from picking up a weapon. Many focus on the potentially devastating consequences associated with carrying a weapon, with the aim of provoking fear and thus a deterrent effect. In this paper, we present the findings from two experimental studies exploring the effects of exposure to fear-based knife crime media campaigns on young people's intentions to engage in knife-carrying behaviour. Utilising a terror management theory perspective, in both studies we found that exposure to knife-related campaign imagery increased mortality salience, but there was no effect of campaign condition on willingness to carry a knife or on perceived benefits of knife-carrying. Although knife-related self-esteem/cultural worldviews predicted attitudes towards knife-carrying, such views did not moderate the effect of exposure to knife-related campaign imagery, and there was no effect of priming participants' to consider the value of behaving responsibly. Implications and suggestions for future research are discussed.

Fear of disasters within the risk communication network of foreign students in Japan amid the COVID-19 pandemic crisis: A cohort design.

The main objective of this study is to examine the role of risk communication during the COVID-19 crisis, which is often neglected in studies investigating the outbreak of the pandemic. The study is based on survey data from a group of international (non-Japanese) students in Japan and the theoretical foundation of fear appeal theory. The results, which are based on the panel data structure, show that individually, (1) the act of seeking out others to discuss risks in depth in the current pandemic context or (2) the observed adoption of advocated precautionary health behaviours is not necessarily a good indicator of mental management, but (3) the combined effect of (1) and (2) unexpectedly suggests a conciliatory effect on the fear of disasters. Moreover, this evidence-based finding (3) suggests that a reciprocal relationship exists between threat and efficacy in terms of mediating fear under the framework and theory of fear appeals, indirectly challenging the fear control response proposition of the extended parallel process model. Our empirical findings emphasize the role of risk discourse and information sharing combined with preventive health behaviours adopted within a community in the context of global health crises.

Teachers use of fear appeals: Association with student and teacher mental health.

BACKGROUND: Fear appeals are discourses commonly used by teachers to motivate students especially when academic outcomes are paramount. Fear appeals have been associated with better and worse academic performance by the student recipients, with some evidence that fear appeals are detrimental for students who are anxious and have lower self-efficacy. Little is known about the factors that drive teachers' use of fear appeals beyond a desire to increase motivation to excel. AIMS: This study examined the relationship between the use of fear appeals, psychological distress, and self-efficacy in both teachers and students. SAMPLE: Participants were 377 students (81% female, age range 15 to 18, M = 16.68, SD = 0.49) and 96 teachers (73% female, Mean years teaching = 18.04, SD = 12.39). METHODS: Participants completed surveys mid-way through the first school term of their final year of high school. Student surveys examined student anxiety, depression, stress, self-efficacy, and experience of teacher fear appeals. Teacher surveys examined teacher anxiety, depression, stress, emotional burnout, self-efficacy, years of teaching, and use of fear appeals. RESULTS: Teachers use of fear appeals was associated with student distress which was heightened for students with lower academic self-efficacy. Similarly, teachers' use of fear appeals was associated with higher anxiety and lower self-efficacy in teachers themselves. CONCLUSIONS: Therefore, the use and consequence of fear appeals is strongly linked to both student and teacher self-efficacy and distress. Given the detrimental impacts of fear appeals on academic performance in vulnerable students, more research is needed on the consequences of fear appeals.

Information Seeking and Risk Reduction Intentions in Response to Environmental Threat Messages: The Role of Message Processing.

Communicating complex information about environmental health risks in a single message is impossible. Thus, message designers hope that risk messages encourage people to think more about the message and risks, look for more information, and ultimately make behavior changes. The presentation of information about environmental risks using threat appeals is a common message design strategy thought to increase message engagement and influence attitudes, information seeking, and risk reduction behaviors. We compared lower threat messages, which did not include explicit statements about susceptibility and severity of a risk, to higher threat messages, which did. We combined predictions from the extended parallel process model with dual-process theories of persuasion to examine whether people respond to these types of messages differently. In an online experiment, participants (N = 892) were randomly assigned to a message condition (higher or lower threat) and topic condition (arsenic, bisphenol A, or volatile organic compounds). Overall, participants exposed to higher threat messages (regardless of risk topic) reported experiencing higher levels of fear. Higher levels of fear were associated with more positive thoughts about the message (in alignment with the message advocacy) and fewer negative thoughts about the message (against the message advocacy), both of which influenced message attitudes. Finally, message attitudes were associated with increased information seeking and intentions to engage in risk reduction behaviors.

Fear appeal effectiveness in antismoking campaigns: do anger and smoking matter?

Although fear appeals are widely used in health campaigns, empirical studies have produced conflicting results regarding their effectiveness. To understand the impact of fear appeal in health campaigns, this study investigates the relationship between fear, anger, and smoking status in the context of an antismoking campaign. Using a survey of 829 people in South Korea, this study tests the three-way interactive model with the PROCESS macro. Results indicate that the effect of fear on attitudes toward the campaign depends on the level of anger, and show that the impact of 'anger-adjusted' additional fear appears only among nonsmokers. Implications for antismoking advertising strategies are discussed.

A psychophysiological approach to fear appeals. Autonomic, subjective and behavioral responses to health promotion messages / Un enfoque psicofisiológico de los mensajes de miedo. Respuestas autónomas, subjetivas y conductuales a los mensajes de promoción de la salud

A study was designed in order to analyze the effects of fear appeals on psychophysiological, subjective and behavioral responses on the target audience. Three messages on breast cancer, promoting regular mammography screening, elaborated in a similar way to those used by health promotion programs, were presented to ninety-eight women aged 49-50. Messages were of equal length, format and structure but varied in specific clues which distinguished their character (Threat, Surprise, and Standard/control). Psychophysiological reactions (heart rate and frequency of non- specific skin conductance responses) were recorded continuously during message exposure. Self-report measures and personality traits (STAI and EPQ-A) were obtained after viewing the stimulus. There were significant responses to the messages for all psychophysiological measures. The pattern of psychophysiological response, independent of the eliciting message, was significantly related to cancer preventive/detection behavior.(AU)

Se diseñó un estudio para analizar los efectos que tienen las apelaciones al miedo sobre las respuestas psicofisiológicas, subjetivas y conductuales en la población diana. Para ello, se presentaron, a 98 mujeres de 49-50 años de edad, tres mensajes sobre el cáncer de mama promoviendo la realización de mamografía regularmente. Los mensajes fueron elaborados de manera similar a los utilizados por los programas de promoción de la salud. Los tres tenían la misma longitud, formato y estructura, pero variaban en determinadas claves que diferenciaban su carácter (Amenaza, Sorpresa y Estándar/control). Durante la exposición a estos mensajes, se registraron, de manera continua, las respuestas psicofisiológicas (frecuencia cardíaca y frecuencia de respuestas electrodérmicas inespecíficas). Después de ver los estímulos, se tomaron medidas de autoinforme y de personalidad (STAI y EPQ-A). Se encontraron respuestas significativas a los mensajes para todas las medidas psicofisiológicas. Independientemente del mensaje presentado, el patrón de respuesta psicofisiológica se relacionó significativamente con la conducta preventiva de detección del cáncer.(AU)

Using COVID-19 Symbols in Anti-Smoking Fear Appeal Advertisements for Encouraging Smoking Cessation among Israeli Smokers.

The current study aims to reveal whether using COVID-19 as the threatening message in anti-smoking ads will influence smokers differently than other threat appeals. All ads that were chosen for this study were created by the Israel Cancer Association/the Israeli Ministry of Health. Since the coronavirus has proven to have far-reaching effects on the human respiratory system, it is directly connected to smoking. The present study included semi-structured in-depth interviews with experts, a pre-test (n = 106) and an online questionnaire including 721 participants (adults aged 18-30 versus 55+). The findings indicated that when using the COVID-19 symbol as the threatening message in an anti-smoking ad for the older participants, smoking cessation intentions were higher than when using a cigarette simulating a 'gunpoint' threat (p < 0.08). Additionally, when using the COVID-19 symbol, there was a positive relation between participants' age and smoking cessation intentions. The average smoking cessation intention for the participants from the older age group (M = 3.05, SD = 1.07) was higher than the average for the participants from the young age group (M = 2.80, SD = 1.13). Finally, when using impotence (for men) and pregnancy risks (for women) as the threatening message in the ads for young respondents, smoking cessation intentions were higher than when using COVID-19 (p < 0.05). The results may help decision-makers and public health officials in choosing the marketing communication suited for conveying messages aimed to encourage people to reduce/quit smoking.

Testing Messages on Facebook to Promote Use of an HPV Educational Web-Intervention.

In the US, the human papillomavirus (HPV) vaccine remains underutilized leading to disparities in HPV-related diseases. Latinx have some of the highest rates of cancer caused by HPV. In a previous study, we developed a tailored-messaging based online educational intervention (CHICOS) that was found to increase HPV vaccination intention among Latinx participants. The current research uses Facebook Advertising to test the comparative effectiveness of messages designed using the Extended Parallel Processing Model (EPPM) to promote the use of CHICOS among Latinx young adults and parents of adolescents. We also looked at differences in the effectiveness of messages that highlighted HPV-related cancers, genital warts, or a control condition as well as differences in Spanish vs. English messages. Results found Latinx young adults and parents, were more likely to click on Facebook Advertisements containing messages in Spanish and those that mention cancer risks pertinent to this population compared to those in English or messages that discuss genital warts. Thus, findings suggest that Facebook Advertising has the potential to be a useful tool for motivating information seeking online about HPV vaccination.