Effective health risk messages : a step-by-step guide PDF
Preview Effective health risk messages : a step-by-step guide
HEALTHRISK MESSAGES Kim Witte Gary Meyer. Dennis Martell HE ALT MESSAGES A Step-by-Step Guide Sage Publications International Educational and Professional Publisher Thousand Oaks ■ London ■ New Delhi Copyright © 2001 by Sage Publications, Inc. All rights reserved. No part of this book may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the publisher. For inform a tion : ^w Sage Publications, Inc. 2455 Teller Road Thousand Oaks, California 91320 E-mail: [email protected] Sage Publications Ltd. 6 Bonhill Street London EC2A 4PU United Kingdom Sage Publications India Pvt. Ltd. M-32 Market Greater Kailash I New Delhi 110 048 India Printed in the United States of America Library of Congress Cataloging-in-Publication Data Witte, Kim. Effective health risk messages: A step-by-step guide / Kim Witte, Gary Meyer, Dennis P. Martell. p. cm. ISBN 0-7619-1508-7 (cloth: alk. paper) ISBN 0-7619-1509-5 (pbk.: alk. paper)) I. Health promotion. 2. Health attitudes 3. Threat (Psychology) 4. Perception. 5. Health risk assessment. I. Meyer, Gary. II. Martell, Dennis P. III. Title. RA427.W67 2000 613—dc21 00-012404 01 02 03 04 05 10 9 7 6 5 4 3 2 1 Acquiring Editor: Margaret H. Seawell Production Editor: Claudia A. Hoffman Editorial Assistant: Candice Crosetti Typesetter/Designer: Janelle LeMaster Indexer: Molly Hall Cover Designer: Michelle Lee Contents Preface for Instructors and Practitioners vii Acknowledgments viii 1. What Are Health Risk Messages? 1 Health Risk Messages Defined 2 What's a Theory? 3 The Components of a Fear Appeal 4 Explicit versus Implicit Messages 6 The Use of Culturally Based Colloquialisms 7 Types of Threats 9 Summary 9 2. History of Health Risk Messages: Fear Appeal Theories from 1953 to 1991 11 Fear-as-Acquired Drive Model 12 The Parallel Process Model 14 Protection Motivation Theory 15 Summary 19 Definitions 19 3. Putting It All Together: The Extended Parallel Process Model 23 The Overall Model 24 The Depiction of the Model 29 Comparisons with Other Models 29 Research on the EPPM 31 4. Useful Concepts from Other Theories 33 The Health Belief Model 33 The Theory of Reasoned Action 36 Social-Cognitive Theory 40 Elaboration Likelihood Model 42 Stages of Change Model 42 Social Marketing 45 Summary 47 5. Starting Out the Right Way: Formative Research 49 Setting Goals and Objectives: The Campaign Plan 50 Formative Research 52 The Persuasive Health Message (PHM) Framework 52 Putting Transients and Constants Together 57 Gathering Information for the Persuasive Health Message Framework 58 Categorizing Audience Beliefs: A Chart to Guide Message Development 64 Conclusion 66 6. The Risk Behavior Diagnosis Scale 67 The Origin of the RBD Scale 67 Theoretical Basis for Expanding the EPPM 68 The RBD Scale 70 Tailored Health Risk Messages 72 Some Additional Guidelines 75 Conclusion 76 7. Out of the Tower and Into the Field 77 Using the RBD at a Campus Health Clinic: Background 78 Conclusion 93 8. Data Collection 95 Types of Evaluation 95 Gathering Data for the Evaluation 100 Data Collection Methods 101 Reliability and Validity 10 5 Sample Size 106 Summary 107 9. Data Analysis 109 Analyzing Data 109 Conclusion 120 10. Getting the Message Out 123 A Plan of Action 125 Message Dissemination Issues 127 Specific Channels 130 Summary 133 Conclusion 133 Appendix 135 Glossary 147 Worksheets 151 References 199 Suggested Readings 207 Index 211 About the Authors 215 Preface for Instructors and Practitioners We designed this book for Instructors with the express purpose of providing students (and practitioners) with practical, theoretically based hands-on experience in designing and evaluating a health risk campaign. The book has 10 chapters to accommodate both quarter and semester systems, as- suming you go through a chapter a week. It can work as a stand-alone text or as a supple- mental workbook to a more traditional text. The worksheets take students step-by-step through the formative, message development, and outcome phases of a health commu- nication campaign. Pilot tests of the worksheets indicate that students retain the mate- rial and rate classes using these worksheets as among the best they've ever taken. For Practitioners, we wanted to create a resource that clearly, plainly, and concretely explained how to go about conducting a theoretically based formative and outcome evaluation, as well as how to develop theoretically based messages. The worksheets and examples used in the book can be used with your clients or target audience members. This step-by-step guide was written as a resource guidebook, as well as to provide you with ready-to-use materials for your own health communication efforts. Enjoy and Good Luck! VII Acknowledgments Thanks to Kimo Ah Yun (University of Washington), Anthony J. Roberto (Michi- gan State University), Dorothy Tan-Wilhelm (National Institute of Occupa- tional Safety and Health), Susan E.Tate (University of Virginia), Mark P. Fulop (San Diego State University), Claire A. Stiles (Eckerd College), and Meagan Grant (Marquette University), for providing feedback on earlier drafts of the manu- script. Drs. Janet Lillie, Judith Berkowitz, Kenzie Cameron, Maria Lapinski, Lisa Murray-Johnson, and Wen-Ying Liu are gratefully acknowledged for their role in the re- search that helped form many of the ideas here. Most of all, thanks to our respective soul mates (Thorn, Anne, and Colleen) for their support of this project. VIII 1 What Are Health Risk Messages? W e remember the first time we saw a crashed car—the kind with blood- stains on the seat and pieces of hair embedded in the broken windshield. It was parked in front of a grocery store to "remind" teenagers to avoid drinking and driving. We would peer into it, trying to imagine what those last few moments of life were like for the occupants. Did they feel the crash? How long were they alive with their heads through the windshield ? What were their last moments like? We would read the vignettes about the victims 7 lives and what led to their deaths—usually binge drinking and then racing their cars at 80 mph down 35 mph roads. When their deaths became all too real, all too vivid, we began our morbid humor, trying to find ways to cope with the horror of it all. Later that night, we'd tell ghost sto- ries about the dead teens and how they now haunted the junk food sections of that very grocery store. The goal of these types of displays is to convince people to avoid drinking and driv- ing. But why not simply tell people "don't drink and drive"? Why not just give them the facts? Are such graphic displays of the consequences of drinking and driving needed? Do we really need to scare people into doing something? Many academics and health educators say yes. They firmly believe that logical and reasoned messages fall on deaf ears. They believe you have to hook people emotionally and get them aroused before they will listen and act. Because individuals make so many decisions based on their emotions, instead of logic, it is useful to look into the research on how emotional, persuasive messages work. Most health risk messages are "fear appeals, " or persuasive messages that arouse fear to gain compliance. For example, most health risk messages try to persuade by suggesting that you'll get hurt, get a disease, or even die if you don't follow some recommended be- havior. More than 45 years of research on fear appeals forms the basis for this book and provides a rich resource of information about what does and does not work in health risk messages. In this book, we explain exactly what a fear appeal is, how it's used, vari- ous theoretical perspectives, and give you the nuts-and-bolts knowledge on developing an effective health risk message.
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