Overview of Findings

Many current threats to health in developed countries are “lifestyle” illnesses that can be prevented through behavior change. Intensive work by social scientists has focused on how best to convince people to change risky patterns of behavior such as smoking, poor diet, and sedentary lifestyle. Persuasive appeals in the broadcast and print media have been the primary method used to reach large numbers of people to promote these changes.

At a time when rates of many cancers are declining, the incidence of skin cancer continues to climb. Persuasive appeals that target sunbathing routinely attempt to increase individuals’ sense of threat about skin cancer and about the negative effects on one’s appearance from overexposure to the sun. However, research has shown that scare tactics can be a risky proposition as some individuals will disengage from messages when they contain material that is frightening or that blatantly restricts their freedom to behave as they please.

Persuasive messages produce the best results when they are based on a comprehensive health model such as protection motivation theory. This model states that when individuals are confronted by information about a health threat, they first evaluate its severity and whether or not it is likely to happen to them. Second, individuals appraise their coping options by considering the effectiveness of the recommended behavior change (such as limiting sun exposure or using sunscreen) and considering whether they have the ability to follow through with the necessary changes. Protection motivation theory research has shown that all of these thought processes should be addressed to create the most effective health message.

Sadly, health message designers often do not follow theories and therefore produce messages that concentrate on only a few of the elements required for changing an audience’s attitudes and behaviors. Furthermore, they neglect to consider that audience members do not have the same personalities and that some of these “individual differences” may affect the way the messages are processed.

In this study, we measured the personality characteristics that might affect the way young adults interpret health messages about skin cancer. We then had them read one of four messages that varied in the amount of threatening information and coping information presented. In this way we were able to examine how subtle differences between people might affect their reactions to messages about sunbathing and skin cancer.

Key findings include:

• Emphasizing the severity of skin cancer and individuals’ vulnerability to it increases  intentions to use sunscreen and reduce sunbathing. In addition, presenting coping information about how to prevent skin cancer and sun damage reduces a person’s avoidance of skin cancer messages and decreases hopelessness about preventing the disease.
• People with certain personality characteristics tend to avoid messages about skin cancer. They also feel hopeless about preventing skin cancer when they read highly threatening information without accompanying coping information. These characteristics include a high level of concern about one’s appearance, belief that one’s health is determined by chance or is in the hands of powerful others (such as physicians), and a tendency to dislike mental activities, such as reading complex material.
• Both avoidance of skin cancer messages and feelings of hopelessness about preventing the disease are strongly related to a lack of attitude change about risky sun-behavior.

Implications of the Research

Our results confirm previous research about the importance of combining threatening health information with a strong message about how to take healthy actions. Although threat motivates people, it is the accompanying coping information that influences individuals to take the message’s recommendations. These findings show that protection motivation theory can be used to produce “one-size-fits-all” health messages that will be effective for most people.

Brief, low-cost interventions have been designed that alter sun behavior attitudes and intentions, and create at least short-term reductions in sunbathing. These interventions consist of lectures, brochures, video clips, testimonials, and group discussions over a period of a few hours. Participants are energized to act by threatening information and images. Their subsequent beliefs and actions are affected by convincing, easy-to-follow information about how to reduce the likelihood of skin cancer. For teens and young adults, the impact of sun overexposure on appearance is an especially important addition to warnings about skin cancer.

Our findings about individual differences are valuable for those wishing to tailor health messages for maximum effectiveness. For example, messages for those who believe health to be determined by “chance” should attempt to increase perceived self-control about such matters. Messages directed to those who view a tan as central to their appearance might emphasize alternatives to sunbathing such as the newer, sunless tanning products. Finally, messages for those who are less likely to thoroughly read written health messages might be more effective if they contained vivid illustrations to help get their points across.

In sum, we recommend that health messages be based on comprehensive health behavior models. Such models will effectively reach most people. However, even a complete health message might be optimized by considering pertinent differences among people.

Article Reference

McMath, B. F., & Prentice-Dunn, S. (2005). Protection motivation theory and skin cancer risk: The role of individual differences in responses to persuasive appeals. Journal of Applied Social Psychology, 35, 621-635.

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