Razones por las que los estudiantes experimentan sentimientos negativos al comienzo de TEAB

2.2.3 Protection Motivation Theory

Rogers (1975, 1983) developed protection motivation theory which, as identified above in sections 2.2.1 and 2.2.2) draws upon elements of both the parallel response model (Leventhal, 1970) and the health belief model (Rosenstock, 1974). Protection motivation theory is based on the principle that an individual’s motivation toward protection of the self, results from the perception of a threat and a desire to avert the negative outcome, both depicted in a threat appeal. Protection motivation is proposed as the variable that encourages the adoption of the suggested behaviour to avert the threat presented in a threat appeal. Thus, when protective motivation does not occur, the suggested behaviour presented as the recommendation to avert the threat, has been deemed to be ineffective or impossible to carry out and therefore no intention to act results from the cognitive

processing.

Rogers (1975) identified two core appraisal processes in protection motivation theory that dictate behaviour responses, namely threat appraisal and coping appraisal. Threat

appraisal is the process by which individuals judge factors that increase or decrease the probability of maladaptive behaviour (e.g. avoiding the message or inaction). Coping appraisal on the other hand refers to an individual’s evaluation of their ability to cope with and avert the negative consequences depicted in the advertisement. These two appraisal processes expand the danger control process identified by Leventhal (1970) in the parallel response model. As described in section 2.2.1, the parallel response model theorises the cognitive appraisals that occur in response to exposure to a threat appeal, where danger

control, represents cognitive appraisals to identify how an individual can cope with the threat presented and influences the acceptance (or not) of recommended action presented in a threat appeal.

Indeed, Rogers (1975; 1983) elaborated on the parallel response model’s process of danger control by specifying in more detail the actual processes of cognitive appraisal. This occurred in two stages. First, Rogers (1975) identified three elements that comprise the threat appraisal and the coping appraisal processes. Perception of severity of the threat and perception of susceptibility to the threat underpin the threat appraisal process. This is akin to the role of perceived severity and perceived susceptibility presented by Rosenstock (1974) in the health belief model as discussed in section 2.2.2. An individual’s belief that the recommended response is effective in averting the threat (response efficacy) underpins the coping appraisal process. Rogers (1975) proposed a three-way interaction between severity, susceptibility and response efficacy, which was not supported by empirical

research (e.g. Rogers and Mewborn, 1976; Kleinot and Rogers, 1982; Maddux and Rogers, 1983). Based on this evidence Rogers (1983) reviewed protection motivation theory and added further variables to the model. The first of these variables was self–efficacy which is defined as an individual’s belief in their ability to perform that recommended response was added to the coping appraisal process (Rogers, 1975). Additionally, Rogers (1983)

introduced response costs (perceived costs of engaging in adaptive behaviour) and perceived rewards (benefits of maladaptive responses) to protection motivation theory.

These constructs reflect those of perceived benefits and perceived barriers proposed in the health belief model (Rosenstock, 1974) as discussed in section 2.2.2.

Rogers (1983) proposed that threat appraisals specifically evaluate the threat and the factors that increase or decrease the likelihood of a maladaptive response (e.g. avoidance or denial). The perceived severity and susceptibility to the threat (e.g. the perceived severity of lung cancer and likelihood of developing the disease from smoking), and any fear

associated with this appraisal, serve to reduce the likelihood of maladaptive responses.

Rogers (1983, p96) identified that “fear may be considered a relational construct, aroused in response to a situation that is judged as dangerous and toward which protective action is taken”.

However, it is important to note that here fear is treated as an incidental construct (to be discussed later in this section). These evaluations are weighed against the perceived rewards of

engaging in maladaptive behaviour (e.g. the belief that smoking prevents weight gain or facilitates social interaction) and a threat appraisal is reached. Alternatively, coping appraisal processes refer to the resources available to an individual to avert the threat which will increase or decrease the likelihood of adaptive responses (e.g. undertaking the

recommendation for action presented in a threat appeal such as stop smoking). The

individual’s belief that the recommended action is capable of averting the threat is response efficacy (e.g. giving up smoking will reduce the risk of lung cancer) and belief that the individual can undertake the recommended action is self-efficacy (e.g. I have the ability to give up smoking). These appraisals are weighed against perceived costs of engaging in the adaptive behaviour (e.g. if I give up smoking I will gain weight and be miserable) to form the coping appraisal. In order for protection motivation (i.e. the intention to perform a

recommended behaviour) to occur, the perceptions of severity and vulnerability should outweigh the perceived rewards of engaging in the maladaptive behaviour and the response efficacy and self-efficacy should outweigh the costs of engaging in the adaptive behaviour.

Figure 6 below depicts the cognitive mediating processes of protection motivation theory, as described.

Figure 6 - Cognitive mediating processes of protection motivation theory (adapted from Floyd et al, 2000)

Both versions of the model are intended to operationalise the components of what was called in the relevant research a ‘fear appeal’. As Milne et al (2000, p 107) state “It was assumed that each component of a fear appeal would initiate a corresponding cognitive

Maladaptive responses

Adaptive responses

Response efficacy

Self-efficacy

Perceived costs

Coping appraisal Fear

Perceived rewards

Severity

Susceptibility

Threat appraisal

Protection Motivation

mediating process. These processes would, in turn, influence protection motivation.” Thus, Rogers (1975) proposed that the variables of severity, susceptibility, response efficacy (and then in 1983 self-efficacy) could be included in the so-called fear appeal and would

therefore be received as intended by individuals and as such underpin the threat appraisal and coping appraisal processes. As previously discussed in section 1.1, this clearly

conflates the stimulus variables and cognitive responses to those variables, but nonetheless the cognitive threat and coping appraisals are grounded in theory (as described above) and were subject to empirical testing (to be discussed later in this section). Rogers (1983, p96) identified that “fear may be considered a relational construct, aroused in response to a situation that is judged as dangerous and toward which protective action is taken”. Thus an emotional response was included in protection motivation theory but it was viewed as incidental. Indeed, Rogers (1983) suggests that the emotion of fear may occur but not as a necessary factor to influence behaviour. The appraisal process outlined in protection motivation theory concentrates upon the cognitive appraisals to the threat appeal and not any emotional response.

As previously indicated, protection motivation theory has been subject to empirical testing which has generated mixed results. Interestingly, while little support was observed for the three-way interaction proposed in Rogers (1975) original protection motivation theory (severity, susceptibility and response efficacy), more support has been found for the two-way threat appraisal by coping appraisal interaction predicted by Rogers’ (1983) revised protection motivation theory. In fact, many early studies have found two-way interactions between one of the threat appraisal variables (severity or susceptibility) and one of the coping appraisal variables (response efficacy or self- efficacy) on outcome measures such as attitudes, intention, and behaviour (e.g. Maddux and Rogers, 1983; Mulilis and Lippa, 1990; Wurtele and Maddux, 1987). However, the specific variables which interact have been inconsistent across studies. For example, whereas some studies have found that susceptibility interacts with response efficacy (e.g. Mulilis and Lippa, 1990), others have found instead that severity interacts with self-efficacy to change attitudes, intentions or behaviour (e.g., Maddux and Rogers, 1983; Wurtele and Maddux, 1987). Indeed, even though a large number of studies have found at least some interaction-effects between threat appraisal and coping appraisal variables, an equally large number of studies have been unable to find any of these

interaction-effects (see Rogers and Prentice-Dunn, 1997).

These inconsistencies in results have been observed since the early studies that empirically tested protection motivation theory (as described above). However, a number of meta-analyses have been conducted which generate a more consistent synopsis of empirical

findings. Floyd et al (2000) conducted a meta-analysis of studies that used protection motivation theory variables and behaviour intention or behaviour as a dependent measure.

Results showed that the threat appraisal variables (severity and susceptibility) and the coping appraisal variables (response efficacy and self-efficacy) all facilitated adaptive behaviour across the studies, although coping appraisal variables were found to have more impact on adaptive responses. Indeed, decreases in maladaptive response rewards and adaptive response costs, increased adaptive intentions or behaviours. Milne et al (2000) also conducted a meta-analysis which demonstrated that both threat appraisal and coping appraisal variables were found to predict health related behaviour intentions. Milne et al (2000) also found that the coping appraisal variables, specifically self-efficacy, were found to have greater predictive ability on behavioural intention than the threat appraisal variables, which is in line with the finding by Floyd et al (2000). Moreover, they suggested that threat appraisal (severity and susceptibility) variables are poor predictors of behaviour intention in comparison to self-efficacy (Milne et al, 2000). Interestingly Milne et al (2000) found that protection motivation theory was more useful when the dependent variables concerned concurrent behaviour (i.e. behaviour that was occurring at the time of exposure to the threat appeal) in comparison to measures of behaviour intention which measure future behaviour.

Indeed, other studies report the success of protection motivation variables in predicting behaviour (e.g. Pechmann et al, 2003 and Beck, 1994).

Protection motivation theory (Rogers, 1983) has been criticised on the basis that more research is needed regarding the impact of fear generated by threat appeals (e.g.

Henthorne et al, 1993). Indeed, Tanner et al (1991) highlighted that a weakness of

protection motivation theory is a lack of recognition concerning the importance of emotional responses to threats. It is their contention that emotional responses are important to

cognitive appraisal and that they are indirectly linked to behavioural intentions through cognitive appraisal. Another limitation of the theory identified by Tanner et al (1991) is the assumption that individuals have not already adopted a coping response to the threat, either in terms of removal of the threat or reducing the fear associated with the threat. In light of these criticisms Tanner et al (1991) proposed four amendments to the protection motivation theory which were intended to include additional variables that may influence behaviour.

The first amendment was an emphasis placed on the emotional aspects of the model as the authors surmised that this had been ignored. Second, the authors suggested that the appraisal processes of the theory were sequential or ordered, rather than parallel or

unordered as Rogers (1983) had indicated. Third, a consideration was given to maladaptive coping behaviours. These were defined as behaviour of individuals, when faced with a threat, to employ a coping response that reduces the emotion of fear experienced but not

reduce the threat or danger (the cause of the emotional response of fear.) The authors cite that such maladaptive coping responses are greatly influenced by past experience. Fourth, the social context of danger was introduced into the model on the basis that many adaptive behaviours are influenced by normative components.

Tanner et al (1991) empirically tested the adapted protection motivation theory and found support for the ordering of the variables. However, Hall et al (2006) could not replicate this finding. Tanner et al (1991) found evidence that fear response has an impact on the threat appraisal variables and is not necessarily merely a consequence of the threat appraisal process. However, Schoenbachler and Whittler (1996) found that fear had no impact on persuasion but rather sensation seeking moderated the relationship between threat appeal and protection motivation variables. In addition, Tanner et al (1991) found prior maladaptive behaviours were found to influence the perceptions of probability of occurrence. In support of this, Eppright et al (1994) found that prior knowledge or past experience increased self-efficacy and susceptibility which increased adaptive behaviour intention. However, in this study, susceptibility also increased maladaptive behaviour intention. Tanner et al (1991) found no support for the introduction of the social danger context to protection motivation theory.

As can be seen, modifications to protection motivation theory have also generated mixed results. Nevertheless, protection motivation theory is utilised in many contemporary studies (e.g. Ritland and Rodriguez, 2014; Cismaru et al, 2011; Nelson et al, 2011). Indeed,

Dickinson-Delaporte and Holmes (2011) focus solely on the coping appraisal process and examine how coping appraisal and health resistance responses to threat appeals impact attitude to behaviour (in this case, smoking). Dickinson-Delaporte and Holmes (2011) compared the effect of social compared to physical threat appeals and found that social threat appeals resulted in more adaptive coping responses than psychical threat appeals. In other words, social threat appeals encouraged more participants in the study to have

increased response efficacy and self-efficacy, which resulted in increased negative attitudes toward smoking behaviour. Passyn and Sujan (2006) also focus on the coping appraisal process in response to ‘fear appeals’ that add high accountability (regret, guilt or challenge) or low accountability emotions (hope) to the appeal. As identified in section 2.1.4 this study conflates stimulus variables and emotional responses (see also section 1.1). However, Passyn and Sujan (2006) identified two different levels of coping (abstract and specific) and found that the high accountability emotions (regret, guilt and challenge) when added to fear, resulted in the generation of specific and concrete coping strategies that are representative of a readiness for action. Interestingly, no differences were found in perceptions of severity,

susceptibility, response efficacy or self-efficacy, which protection motivation theory suggests are the key variables that influence behaviour. The findings of the study by Passyn and Sujan (2006) therefore suggest that self-efficacy and self-accountability are separate constructs, and that accountability (or obligation) is more important than self-efficacy (an individual’s belief they can carry out an action) in determining behaviour responses.

Studies that have empirically tested protection motivation theory have generated mixed results (see Rogers and Prentice-Dunn, 1997; Floyd et al, 2000; Milne et al, 2000).

Arguably more recent studies (e.g. Dickinson-Delaporte and Holmes, 2011; Passyn and Sujan, 2006) have actually split the theory according to the two original processes (threat appraisal processes and coping appraisal; Rogers, 1975) and focused primarily on coping appraisal processes. This is not surprising, because the results of the meta-analyses (e.g.

Floyd, 2000 and Milne et al, 2000) identify that coping appraisal processes, particularly the variable of self-efficacy, are most effective in generating behaviour intention or behaviour change. Despite the equivocal empirical support, the development of protection motivation theory (Rogers 1975; 1983) heralded a significant shift in the field. Whilst the parallel response model (Leventhal, 1970) was not empirically tested and the health belief model concerned generalised health behaviour, they both laid the foundations for the development of protection motivation theory. Specifically, protection motivation theory made a significant contribution by attempting to identify the relationship between stimulus variables and cognitive responses in the specific context of responses to threat appeals. Whilst, as discussed in section 1.1 a retrospective view allows the identification of flaws in the approach taken (e.g. conflation of stimulus and response variables) this was at the time a very novel approach (as opposed to the assumptions of the fear and persuasion

relationship as identified in sections 2.1.1 and 2.1.2).

However, the mixed findings (e.g. Rogers and Prentice-Dunn, 1997; Floyd et al, 2000; Milne et al, 2000) serve to add to the identified confusion in the field (as described in chapter 1).

Indeed, a number of specific criticisms are presented by Witte (1992), which in hindsight can be seen to have instigated another development in the cognitive focussed approach, namely the introduction of the extended parallel process model. Specifically, Witte (1992) identifies logical flaws regarding the variables in protection motivation theory (e.g. an absence of explanation regarding how threat appraisal and coping appraisal work together to result in protection motivation). This is evidenced, in part, by researchers to focusing on coping appraisals and neglecting threat appraisals as outlined above. Interestingly, it could be argued that this split actually highlights that indeed, the two processes were never theorised to interact. Additionally, Witte (1992) identifies a failure of protection motivation

theory to offer an explanation of what happens when threat appeals do not work, in other words how and when they may fail to generate a behavioural response. Indeed (as reported above) Eppright et al (1994), found in their examination of the adapted protection motivation theory (Tanner et al, 1991) that susceptibility increased both adaptive and maladaptive behaviour intentions. Whilst Witte (1992) presents strong criticisms of the adapted and developed protection motivation theory (e.g. Tanner et al, 1991) it is acknowledged that the original constructs of the protection motivation theory (severity, susceptibility, response efficacy and self-efficacy) have explanatory power as mediators between exposure to a threat appeal and message acceptance (Witte, 1992). Based on the criticism and

acknowledgement of the positives of protection motivation theory, Witte (1992) re-examined the cognitive processes that underpin the responses to threat appeals and developed the extended parallel process model which will be discussed in section 2.2.4.