THE EFFECTS OF NARRATIVE EXEMPLARS AND FEAR APPEALS ON PROMOTING ...

107 Pages·2013·0.82 MB·English

by  Cui Zhang

THE EFFECTS OF NARRATIVE EXEMPLARS AND FEAR APPEALS
ON PROMOTING PREVENTIVE SKIN CANCER BEHAVIORS

by

CUI ZHANG

SHUHUA ZHOU, COMMITTEE CHAIR
KIMBERLY BISSELL
JAMES LEEPER
YORGO PASADEOS
JOSEPH PHELPS

A DISSERTATION

Submitted in partial fulfillment of the requirements
for the degree of Doctor of Philosophy
in the College of Communication
and Information Sciences
in the Graduate School of
The University of Alabama

TUSCALOOSA, ALABAMA

2013
Copyright Cui Zhang 2013
ALL RIGHTS RESERVED
ABSTRACT
This dissertation investigated the effects of narrative exemplars and fear appeals on
individuals’ health-risk perception toward skin cancer, attitude toward the preventive
behavior, and coping responses, with need for cognition, self-efficacy and response efficacy
as moderators. This dissertation employed a 2 (message type: narrative exemplar vs. base-rate
information) × 2 (threat: high vs. low) factorial between-subject design. A total of 251
college students participated in the experiment. A high-threat message describing the severe
consequences of not protecting one’s skin and the high susceptibility to skin cancer both
directly and indirectly impacted individuals’ perceptions of skin cancer risk and their
intention to perform a coping response. Fear mediated the effects of threat information on
individuals’ health risk perception and intention for the coping responses. In addition, when
they read a high-threat message, high efficacy individuals believed that the recommendation
outlined in the messages produced the desired outcome and the threat could be averted,
therefore, they were more likely to accept the recommended behavior in the messages than
their lower counterparts. Moreover, need for cognition did not have an effect on the reported
transportation when processing narrative exemplars, although participants who read the
narrative exemplars reported higher transportation than those who read the base-rate
information messages. Theoretical and practical implications were discussed.
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DEDICATION
This dissertation is dedicated to those individuals who have supported and helped me in
everything I do: Baoli Zhang, Lidi Zhao, C.W. Meadows, Melanie Meadows, and Charles
Meadows III.

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LIST OF ABBREVIATIONS AND SYMBOLS

a Cronbach’s index of internal consistency

β Beta coefficients or standardized coefficients: the estimates resulting from an analysis
performed on variables that have been standardized so that they have variances of 1

df Degrees of freedom: number of values free to vary after certain restrictions have been
placed on the data

η2 Eta squared: the ratio of variance explained in the dependent variable by a predictor
while controlling for other predictors

F Fisher’s F ratio: A ration of two variances

M Mean: the sum of a set of measurements divided by the number of measurements in
the set

N Size of overall data set

p Probability associated with the occurrence under the null hypothesis of a value as
extreme as or more extreme than the observed value

r Pearson product-moment correlation

SD Standard deviation: a measure of dispersion in a sample or population

t Computed value of t test

< Less than

= Equal to
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ACKNOWLEDGEMENTS
A dissertation is a long journey filled with both times of joy and sorrow. I have been
considerably lucky because I have completed this journey with help and support of many
people. I would like to express my great appreciation to my dissertation Chair, Dr. Shuhua
Zhou, who has been both a role model and mentor; Dr. Kim Bissell, who has provided me
with very valuable advise on my data collection; Dr. James Leeper, who has been so
knowledgeable and patient about my statistical questions; Dr. Yorgo Pasadeos, who provided
valuable advice on my methodology and stimulus materials; and Dr. Joseph Phelps, who was
always rigorous and thought provoking in evaluating research. Their doors were always open
to me. My special thanks are extended to the faculty at the College of Communication and
Information Sciences at The University of Alabama.
In addition to those individuals who helped me succeed in this endeavor, I would also
like to acknowledge my time spent at the University of Alabama. The past few years were
very rewarding and I was honored to be associated with intelligent and enthusiastic peers who
I am certain will become future academic stars.
Last but not least, I would like to thank my parents and family in China, who are always
proud of me, and my family here in the United States, who have always loved and supported
me in both my academic and personal journey.
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CONTENTS

ABSTRACT................................................................................................ii
DEDICATION...........................................................................................iii
LIST OF ABBREVIATIONS AND SYMBOLS......................................iv
ACKNOWLEDGEMENTS.........................................................................v
LIST OF TABLES....................................................................................vii
LIST OF FIGURES.................................................................................viii
1. INTRODUCTION...................................................................................1
2. LITERATURE REVIEW........................................................................7
3. METHODOLOGY................................................................................45
4. RESULTS..............................................................................................54
5. CONCLUSIONS AND DISCUSSION.................................................63
REFERENCES..........................................................................................77
APPENDIX................................................................................................87

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LIST OF TABLES

2.1 Fear Appeal Models and Their Main Propositions..............................33
4.1 M and SD of Risk Perception, Attitude, and Behavioral Intention.....55
4.2 Means of Health Risk Perception and Behavioral Intention................60
4.3 Means of Transportation......................................................................62

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LIST OF FIGURES

4.1 Interaction of Threat Level and Efficacy.............................................61
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CHAPTER 1
INTRODUCTION
The Need for Effective Messages to Prevent Skin Cancer
Health campaign practitioners and researchers are well aware of the importance of
effective health messages designed to promote attitude and behavioral change among the
general population (Brinol & Petty, 2006). Understanding how characteristics of health
messages affect individuals’ health decision-making and behavior is crucial for developing
appropriate real-world applications (McQueen, Kreuter, Kalesan, & Alcaraz, 2011). Policy
makers and health organizations strive to develop effective health campaigns to promote
healthy lifestyles, raise awareness of health risks, and encourage the public to perform
self-examinations. Therefore, designing effective messages to increase public awareness of
health issues and threats is both critical and urgent to ensuring a healthy society.
Skin cancer is the most common form of cancer in the United States (Centers for
Disease Control and Prevention, 2011), and affects both females and males almost equally.
Data from a 2007 report indicated that among the 58,094 people who were diagnosed with
skin cancer, 33,041 were males and 25,053 were females. Moreover, more males (5,506) died
from skin cancer than females (2,955) in 2007. The diagnosed incident cases and mortality
rates of skin cancer have increased dramatically over the past decades (Lemal & Bulck, 2010).
In 2008, the incidence of skin cancer was 62,480 in the United States, with mortality at 8,420
(Riet, Ruiter, Werrij, & De Vries, H., 2010).
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