"Fear the Flu, Not the Flu Shot": A Test of the Extended Parallel Process Model

Area of Science:

• Health Communication
• Social Psychology
• Behavioral Science

Background:

• Fear-appeal research has limited studies orthogonally manipulating threat and efficacy with behavioral outcomes.
• The Extended Parallel Process Model (EPPM) is a key theoretical framework for understanding health behavior responses to threat and efficacy messages.

Purpose of the Study:

• To investigate the effects of manipulated threat and efficacy on college students' attitudes, intentions, and behavior regarding influenza vaccination.
• To test the Extended Parallel Process Model in the context of health behavior change.

Main Methods:

• A 2x2 between-subjects experimental design was used, randomly assigning participants to high/low threat and high/low efficacy conditions.
• Dependent variables included attitudes and intentions (measured immediately after message exposure) and self-reported vaccination behavior (measured 30 days later).

Main Results:

• Higher threat levels increased perceived severity, susceptibility, and fear.
• Higher efficacy levels increased self-efficacy and response-efficacy.
• A significant threat x efficacy interaction was not found for attitude, intention, or behavior. Efficacy, but not threat, affected attitudes and intentions. Neither factor influenced behavior.

Conclusions:

• While efficacy messages positively influence attitudes and intentions toward influenza vaccination, they do not directly drive behavior change in this context.
• The findings suggest a need to re-evaluate the direct impact of threat and efficacy components of the EPPM on health behavior, particularly vaccination.
• Future research should explore other mediators and moderators influencing the attitude-intention-behavior gap in health decision-making.