Health Promotion (DP IB Psychology)

Fear arousal as a health promotion method

• Health promotion is the process of helping people to exert control over their health behaviours in order to improve their health

• Fear arousal often uses vivid imagery to raise awareness of risky health behaviour e.g.  pictures of damaged lungs on cigarette packets.

• Fear arousal has to strike a balance: if the messages are too anxiety-provoking, behaviour becomes defensive and people then avoid the message or even engage more in the activity (Brown & Smith, 2007).

• However, low fear appeals are also ignored as they do not produce the motivation to change

• A change in health behaviours in response to fear arousal is more likely if the individual concerned has a high level of self-efficacy and feels capable of changing their behaviour (see self-efficacy as a health promotion tool, below)

Fear arousal messages have most recently been used on cigarette packets

Evaluation of fear arousal

Strengths

• Fear arousal has been shown to be effective in reducing smoking and also in one-off interventions, such as health screenings (Tannenbaum et al., 2015)

• Fear arousal works particularly well when combined with a message emphasising individuals’ self-efficacy and control over their own health

Limitations

• Fear arousal is less effective in long-term health changes, such as dieting or exercise to improve cardio-vascular health

• Fear arousal ignores the role of sociocultural factors on health, such as peer pressure and social and cultural norms, which could reduce its effectiveness

Social cognitive theory in health promotion

• Social cognitive theory places behaviour within social contexts: the individual is affected by their environment and may learn behaviours from role models e.g. a boy is inspired to join the school football team from observing his older brother play in a team

• Observational learning must involve attention, retention, self-efficacy and motivation (see the revision note on SCT as part of the Sociocultural Approach)

• A change in health behaviour is more likely if the individual concerned has a high level of self-efficacy and feels capable of changing their behaviour (Witte and Allen, 2000)

• Self-efficacy is a key concept of social cognitive theory, demonstrating that someone has to feel capable of carrying out an observed behaviour i.e. they believe that they can be successful in achieving it

• Social cognitive theory has been applied successfully to increase the self-efficacy and to change the health behaviours of people managing long-term health challenges, such as diabetes (Smith et al., 2020)

Evaluation of social cognitive theory in health promotion

Strengths

• Social cognitive theory, and especially the concept of self-efficacy, provide an explanation for why some people do not respond to fear arousal messages (motivation is a key component of behaviour change)

• Social cognitive theory has been applied to help people manage their health conditions at home, also increasing their feeling of self-efficacy as they maintain some independence

Limitations

• Social cognitive theory disregards the role of physical addiction, which can undermine self-efficacy and lead to a continuation of unhealthy behaviours

• The theory also cannot account for individual differences in outcome expectations, as changes in some addictive behaviours, for example, can result in losing friends and thus bring resistance to change

Research which investigates health promotion

• Quist-Paulsen et al. (2003) found that an anti-smoking programme based on fear arousal and relapse prevention was effective for patients with heart disease

• Lowe et al. (2004) found that social cognitive theory could be used successfully to promote healthy eating in British school children

Both Quist-Paulsen et al. (2003) and Lowe et al. (2004) are available as ‘Two Key Studies of Health Promotion’ – just navigate to the next section of the Health Promotions topic.