Effectiveness of Health Promotion Programmes (DP IB Psychology)

The effectiveness of fear appeals as part of health promotion programmes

• Health promotion programmes often rely on fear arousal as part of their efforts to change people’s health behaviour

• This strategy aligns with the general aim of health promotion, which is to enable people to exert control over and improve their health (WHO, 1986)

• The effectiveness of fear appeals is affected by a number of factors, including:

  • the level of self-efficacy of an individual

  • the level of positive outcome expectations 

  • the level of perceived susceptibility to a disease

  • the tone of the message (not too fear-provoking, but not too weak)

  • the level of social support the individual has for the health behaviour change

• Most of the above are out of the direct control of health psychologists

• Health promotion programmes should not rely solely on fear arousal - they have to address a range of factors which may impede an individual’s attempts to become (and to stay) healthy

Fear appeals are very common in anti-smoking campaigns

Evaluation of fear appeals as part of health promotion programmes

Strengths

• Fear appeals have been shown to be particularly effective when a person has received a doctor’s warning about their susceptibility to a disease

• Fear appeals are also most effective with females when the appeals include efficacy messages and emphasise susceptibility (Tannenbaum, 2015)

Limitations

• Health promotion programmes often use social media or television to get their fear appeals out, but it is unlikely that sampled participants can accurately self-report how much of the campaign they have seen/heard, leading to lower validity of the findings

• It is difficult to measure the effectiveness of fear appeals over a long period of time to identify if the effectiveness is simply short-term or long-lasting

The effectiveness of taxing sweetened drinks as a health promotion programme

• In 2016 the WHO published a report calling on countries to introduce taxes and subsidies for food to encourage responsible and healthy eating habits

• The WHO recommends people to consume no more than 25g of added sugars per day

• Most foods have natural sugars in them; ‘added sugars’ are sugars or syrups that are mixed into nearly all processed foods to improve flavour

• Sweetened soft drinks are the number one source of added sugars in Americans’ diets, contributing to tooth decay, obesity and type 2 diabetes  (Johnson et al, 2009).

• By 2023, 108 countries had introduced a sweetened soft drinks tax (WHO, 2023)

• Since 2016, research has pointed towards a levelling off or even a drop in the amount of added sugar being consumed globally 

• At the beginning of 2014, Mexico introduced a tax on sweetened soft drinks 

• The results, from a study conducted by the Mexican Public Health Institute, showed:

  • on average there was a 6% decline in the amount (ml) of taxed sweetened drinks bought during 2014 and the downward trend reached 12% by December 2014 

  • those from low-income households reduced the amount of taxed sweetened drinks they bought more than any other group 

  • low-income consumers reduced their purchases by an average of 9% during 2014, reaching a 17% reduction by December 2014

• Worldwide research has found that low-income populations have the largest health benefit from sweetened drinks taxes, because their pre-tax consumption was high and post-tax reductions are relatively large

• In many countries, taxes raised from this measure have been invested into the national health system

Evaluation of taxing sweetened drinks as a health promotion programme

Strengths

• Taxing sweetened soft drinks has been shown by research to be successful in reducing their consumption

• This tax policy has become more acceptable to governments and the public through the transparent action of investing the tax gains into health promotion

Limitations

• There is a lack of research directly linking the sweetened soft drinks tax with health benefits, such as improved dental health or reduction in obesity

• There are variations in the tax implementation, with almost 46% of countries also applying it to unsweetened bottled water, discouraging consumers from switching to this healthier alternative

Research which investigates the effectiveness of health promotion programmes

• Murphy-Hoefer et al. (2020) found that the Centers for Disease Control and Prevention (CDC) anti-smoking programme based on fear arousal helped over 1 million people give up smoking

• Nakhimovsky et al. (2016) found that imposing a tax on sweetened soft drinks could reduce consumption, but this would not be enough to reduce obesity overall  

Both Murphy-Hoefer et al. (2020) and Nakhimovsky et al. (2016) are available as ‘Two Key Studies of the Effectiveness of Health Promotion Programmes’ – just navigate to the next section of the Effectiveness of Health Promotion Programmes topic.