How death reminders influence breast self-examination: testing the terror management health model among Chinese women

Death-related messaging is frequently used to promote preventive health behaviors, yet its psychological effects remain mixed and culturally dependent. Drawing on the Terror Management Health Model (TMHM), this study tested how mortality reminders influence breast self-examination (BSE) intentions in a Chinese cultural context, focusing on the moderating roles of individual traits and message framing. Across three experiments, we examined: (1) whether health optimism moderates the impact of mortality salience on BSE intention; (2) whether objectified imagery (e.g. lemons as metaphors) increases willingness more than biologized depictions under mortality salience; and (3) whether sociocultural value - oriented messages (e.g. celebrity-endorsed) sustain BSE intentions longer than health value - oriented ones. Mortality cues increased BSE willingness among women with high health optimism but reduced it among those with low optimism. Objectified representations enhanced short-term willingness more than anatomically framed ones. Health value messaging was more effective immediately post-exposure, while sociocultural framing better sustained intentions over time. Findings support TMHM's dual-defense framework and underscore the need to culturally adapt mortality-based health interventions. In the Chinese context - where body-related discourse remains sensitive - strategic message design and timing are critical to promoting preventive screening behaviors. These insights offer practical implications for designing culturally sensitive breast cancer campaigns that effectively motivate early screening behaviors.