Fear and Hoping: Adding hope to health messages may motivate better behaviors

In two studies, hope and self-efficacy — the belief that a person can help themselves — significantly predicted intentions to take actions against skin cancer, such as wearing sunscreen or protective clothing.

"With health messages, it's not enough just to tell people, or merely educate them, you need to motivate them, and emotions are really good motivators," said Jessica Myrick, associate professor of communications, Penn State. "We often think of emotions as irrational, but what our research is pointing to is that emotions can help us do the things that will keep us healthy and safe, so it's important to understand the broad scope of emotional responses to different type of messages and messaging components."

According to the researchers, previous work indicated that while fear can grab attention and create awareness about a health problem, it might not necessarily lead to behaviors that could help people tackle the problem.

"There's a lot of interesting work done on fear appeals, but we were wondering, if you're going to tell people how to prevent something scary from happening, that might generate hope," said Myrick. "We don't understand a lot empirically about how shifting from being scared of something in a message to then being told how to fix it, or prevent it, might shift the emotional state from fear to hope."

Fear and hope may work together to create more persuasive messages, said Myrick, who worked with Robin Nabi, professor of media effects and health communication, University of California, Santa Barbara.

"We can think of hope and fear as the carrot and the stick," said Nabi. "Either one alone could be effective. But the two together may be an especially winning combination."

In the first study, 341 participants, whose ages ranged from 17 to 72 years old, were recruited from Amazon's online task-completion platform, Mechanical Turk. The participants reviewed and reacted to an article about skin cancer from a web page designed to resemble a page on the health site WebMD.

The article was divided into three sections with the subheads: "How susceptible are most of us to skin cancer?", "How severe is skin cancer?" and "What actions can we take to prevent skin cancer and how effective are those measures?" The subsections of the message reflect factors that can drive persuasive health messaging results, including whether a person feels susceptible to the condition, whether they believe the condition is serious — severity — and whether they believe that help exists and that they have access to that help, according to the researchers.

After reviewing the message, the participants reported on emotions they felt about the article, including hopeful, optimistic and encouraged, all emotions that the researchers considered hope states.

Self-efficacy and hope did serve as significant predictors of sun safety intentions, according to the researchers, who published their findings in the journal Health Communication, currently online.

In a second study, 382 undergraduate college students were recruited to watch a melanoma awareness video and then answer a series of questions about the video. A total of 367 students completed a follow-up survey sent a week later to determine if the participants engaged in any sun safety behaviors.

The findings in the second study indicated that hope played a role in adopting sun safety measures and that even a week later, the participants were engaged in those safety behaviors.

Myrick said that adding hope to messages not only may create more persuasive messages — it also may be more ethical.

"You don't just want to leave people in a state of fear," said Myrick. "You want to give them possible solutions to help."

According to the researchers, future work may look at not just thinking about designing singular messages, but understanding the greater message environment, including how health fears are reported in the media.

"This study is a nice early step in looking at the complex dance between different types of emotions and cognitions so that we can better promote public health," Myrick said. "And maybe this leads to ways to design other health campaigns — for instance, for influenza vaccination campaigns — that work in concert with the fear that is generated by news coverage to try to give people some hope and help them remember the things they can do daily — get a vaccine, wash your hands, and don't go to school when you're sick."