Fear appeals to promote better health behaviors: an investigation of potential mediators

Background: Fear appeals are widely used in health communication, despite conflicting views on their effectiveness. Unresolved issues include possible mediation mechanisms and the effect of defensive reactions aimed at controlling a perceived danger. Methods: The present study compared the impact of three versions of an existing online course on how to prevent noncommunicable diseases. Participants, recruited in South America via a crowdsourcing platform, were divided randomly between three versions of the course – ‘threat only’/‘threat plus coping information’/‘coping information plus threat’ (reverse order). We then asked them to complete a questionnaire measuring perceived efficacy, perceived threat, defensive reactions, and intention to change unhealthy behaviors. Results: Using a serial parallel mediation model to test the course's impact on our dependent variables did not reveal any significant differences between the three versions. Perceived efficacy was positively associated with intention to change behavior, as well as with lower suppression, lower reappraisal, and greater denial. Suppression was the only defensive reaction to be associated with intention to change behavior: greater suppression was linked to less intention to change. Conclusions: Our results open interesting perspectives for research into defensive reactions.