Introduction

         Military communicators face the task of using mass media to educate the internal audience on how to live a more health-conscious lifestyle focused on preventing disease and illness.  To do this, public affairs practitioners use – among other things –Armed Forces Radio and Television (AFRTS) public service announcements (PSAs).  These PSAs, sometimes referred to as spots, substitute for traditional commercials and are a primary channel for disseminating information, especially at overseas locations.  Limited budgets for health care now and in the future demand that these preventive health messages be constructed in the most effective and efficient manner.

         For example, the National Defense Authorization Act (2000) appropriated billions of dollars to the U.S. Department of Defense (DoD) to spend on health care programs in fiscal year 2001.  As the DoD implements various new entitlements as part of the Act, the health care budget demands are likely to balloon.  President Bill Clinton, upon signing the Act, expressed concern “that the congress fails to deal fully with the high, long-term cost” (Clinton, 2000) of one of the key components of the Act, less restrictive medical benefits for retired military people.

         Because of the potential long-term financial burden on the military health care system, it is necessary for the Department of Defense to adopt preventive medicine strategies to keep servicemembers healthy.  While tobacco use has dropped significantly in the last two decades, 30 percent of the current force still smokes cigarettes.  The Pentagon would like to see this number decrease to fewer than 12 percent by 2010.  The DoD spends $930 million per year on healthcare for smoking-related illnesses and lost productivity (AFRTS, 2000).  In addition to smoking, the DoD is focusing on two other costly health risks: alcohol abuse and accidental injuries.

The purpose of this study is to examine the use of fear appeal messages in military-sponsored radio health campaigns.  Specifically, this paper reports the findings of a content analysis of existing PSAs in terms of the severity, susceptibility, efficacy, and self-efficacy themes in the fear messages.  First, an overview of the military’s use of PSAs will be presented in order to establish the extent of their use.  Second, a description of the theoretical basis of the content analysis is presented, and finally, the methodology, results, and discussion of the study will be presented.

PSAs in the Military

         Military leaders have an abundance of command information that must be communicated directly to servicemembers and their families in an effective manner.  As mentioned, AFRTS PSAs are a primary channel to accomplish this with audiences stationed abroad.  AFRTS broadcasts a variety of command information spots in place of advertisement commercials normally aired by commercial radio and television stations.  These spots provide information on a variety of topics, such as safety, health care, and family services.  The terminology and definitions for what the authors of this paper considered PSAs varied somewhat when different reference sources were reviewed. 

         In general, the Radio and Television Production Office (RTPO) divides spot announcements into two categories: PSAs and contract spots.  “PSAs” are developed by agencies typically for non-profit organizations catering to or providing a service for the general public.  However, “contract spots” are exclusively designed for the AFRTS by civilian contractors, for the sole purpose of delivering Department of Defense messages to a joint-service audience worldwide.  Together, PSAs and contract spots encompass 42 general subject areas and more than 200 topics.  Regardless of how they are developed, the RTPO is ultimately responsible for approving and authorizing spots for worldwide distribution over military radio and television networks (AFRTS, 1999).  Approximately 400 new contract spots and 300 PSAs are added to the RTPO inventory annually.  Old spots are routinely removed from the inventory as new spots are added, leaving an average inventory of approximately 4,000 radio spots and 4,000 television spots in circulation at any given time (AFRTS, 1999).  Due to the inconsequential differences of terms and definitions, for the sake of consistency and to avoid confusion, the term PSA will be used for all spots used by AFRTS throughout this paper.

Fear Appeals and The EPPM

         Fear appeals.  Fear appeals, when employed correctly, are useful in health behavior change (Witte & Allen, 2000).  Fear appeals attempt to motivate individuals to perform certain recommended behaviors by scaring people into action (Morman, 2000).  PSAs and campaigns using threats have been proven to elicit fear, a powerful motivator in persuading an individual to change an attitude, belief, or behavior (Witte, 1998; Clarke, 1998; Morman, 2000).  In light of these findings, it seems a study of fear appeals in military PSAs is in order.  Therefore, the current study will attempt to answer the following research question:

RQ1:  How prevalent is the use of fear appeals in Defense Department PSAs?

         While a considerable amount of research has concluded that fear appeals motivate behavior change, some advertisers and practitioners argue that fear appeals can actually backfire (Witte & Allen, 2000).  That is, some practitioners insist that the use of fear appeals may actually push the audience to adopt maladaptive responses, such as denial or avoidance.  Therefore, it is necessary to not only examine military PSAs in terms of the number of spots containing fear appeals, but also the types of fear appeals evident in current military spots.

Long-term behavior changes are possible when the fear appeal has been constructed according to specific theoretical guidelines (Rogers, 1983; Witte, 1992).  First, fear appeals are persuasive messages that emphasize the harmful physical or social consequences of failing to comply with the recommendations of the message (Dillard, 1994).  Over the years, research has identified three key variables that comprise the fear appeals: fear, perceived threat, and perceived efficacy (Witte & Allen, 2000).

Fear is an emotion, accompanied by a high level of arousal, and is caused by a threat that is perceived to be significant and personally relevant (Lang, 1984).  Fear may be expressed physiologically, through language behavior, or through overt acts, such as facial expressions (Lang, 1984).  Fear has been operationalized in various ways, including as anxiety, physiological arousal, and ratings of concern or worry (Leventhal, 1970; Rogers, 1975).  Rogers (1983) demonstrated that self-reported fear adequately captures the above definition of fear by showing a correspondence between physiological arousal and self-ratings of mood adjectives.

A threat is an appeal to fear.  It is a communication stimuli that attempts to evoke a fear response by showing some type of negative outcome that the audience wants to avoid (LaTour & Rotfeld, 1997).  Some research into the use of fear appeals has failed to distinguish between the threats, or the actual literal communication stimuli, and the actual fear arousal response that different type of threats might cause (LaTour & Rotfeld, 1997).  Threats illustrate undesirable consequences from certain behaviors, such as car damage, injury, or death, etc.  However, fear is an emotional response to threats, and different people fear different things.  No threat evokes the same response from all people, even within a narrowly defined demographic group (LaTour & Rotfeld, 1997).

While fear and threat are different, they are related, such that the higher the perceived threat, the greater the fear experienced (Witte, 1998).  Perceived severity refers to an individual’s beliefs about the seriousness of the threat (e.g., “If I breathe Anthrax spores I will die”).  Perceived susceptibility is an individual’s beliefs about his or her chances of experiencing the threat (e.g., “Terrorists have weaponized Anthrax and intend to use it on American servicemen”) (Witte, 1992).

The efficacy component of a fear appeal refers to the message cues or action steps to avoid the threat offered by the message (Morman, 2000).  Response efficacy refers to beliefs as to whether or not the recommended action step will actually avoid the threat (e.g., “I believe the Anthrax vaccine will protect me from a biological attack”).  Self-efficacy refers to beliefs about the ability to effectively perform a recommended action step (e.g., “I think that I have access to the Anthrax vaccine in order to prevent injury during a biological attack”) (Rogers, 1975).

Witte and Allen (2000) examined previous research, compiled a list of typical outcome variables to a fear appeal, and separated them into two categories.  First, those related to the acceptance of the message’s recommendation (i.e., changes in attitude, behavior, and intent), and second, those related to the rejection of the recommendation (i.e., defensive avoidance, reactance, and denial).  Defensive avoidance is a motivated resistance to the message’s recommendation, such as a minimization of the threat (Janis & Feshbach, 1953).  It refers to the tendency to ignore or deny the consequences conveyed in the message.  Reactance is what is said to occur when freedom is perceived to be reduced by the message’s recommendation (e.g., “I know they’re just trying to get me to do what they want instead of what I want”) (Brehm, 1966).

The EPPM.  Witte (1992) integrated previous theoretical perspectives (i.e., Janis & Feshbach, 1953; Leventhal, 1970; Rogers, 1975) to develop the Extended Parallel Process Model (EPPM).  Using Leventhal’s parallel process model, the EPPM differentiates between two processes Witte (1992) believes influence message acceptance in fear appeal research, danger control and fear control.

The EPPM proposes that a fear appeal initiates two appraisals of the message (Witte & Allen, 2000).  First, individuals appraise the threat in the message.  When an individual perceives that he or she is susceptible to a severe threat conveyed in the message (high threat), fear is elicited and people begin the second appraisal, the evaluation of the efficacy of the recommended action step (Witte, 1992). Alternatively, when the threat is perceived to be low, either because of low severity or low susceptibility, there is no motivation to appraise the message any further and the message is ignored and no action is taken (Witte & Allen, 2000).  For example, a non-smoker would not appraise a lung cancer fear appeal message as a high threat message because he or she is not susceptible to the threat.

However, if a message is viewed as high threat, individuals become scared.  In order to deal with this emotion, people choose one of two paths, danger control or fear control (Witte, 1992).  If the response efficacy and self-efficacy of the proposed action step are perceived to be high, then the danger control processes are triggered and people cognitively search for a way to avert the threat (Witte, 1992).  In contrast, if the efficacy is perceived to be low, then the fear control processes are engaged and people look for a way to deal with their fear by engaging in maladaptive responses (i.e., denial, defensive motivation) (Witte, 1992).  In summary, the threat appraisal determines the degree or intensity of the reaction to the message, while the efficacy appraisal determines the nature of the reaction (fear or danger control) (Witte, 1992).

Since 1992, empirical evidence in support of Witte's (1992) EPPM has emerged.  Clarke (1998) used the EPPM to conduct an anti-drunk driving campaign in Oklahoma.  Results indicated a 20-percent drop in drunk driving throughout the state as a result of the high threat/high efficacy campaign designed using the EPPM as the framework.

Additionally, Morman (2000) used the EPPM to study men's intentions to perform the testicular self-examination for signs of cancer.  Results supported the EPPM predictions that high threat/high efficacy messages will lead to positive outcomes like message adoption and attitude change.

Based on the growing trend of research reporting positive results in using Witte’s EPPM (See Appendix A), the current study will attempt to answer the following research question concerning the Defense Department’s PSA message construction:

RQ2:  When military health fear appeals are employed, do they contain elements of severity, susceptibility, response efficacy, and self-efficacy?

Although the source of the message within the ad and the phychological and/or demographic characteristics of the audience are highly salient aspects of fear appeals message research, the goal of this study is to begin research on military sponsored PSAs from a message production perspective.  We will be looking at the text of the health-related PSA messages to determine whether they contain important components that have proven in research (Witte & Allen, 2000) to be effective in fear appeal messages.