Fear and Failiure: HIV and Swine Flu

UK AIDS Advert (1986)I’m still trying to find good examples of effective fear appeals (mostly, I have to admit, in order to prove myself wrong that fear appeals are, for the most part, not a good idea). It’s also an interesting discussion, which tends to regularly come up when teaching about social marketing – very much in tune with this article by Hastings, Stead & Webb. I was sort of excited when I then recently discovered this article that seemed to link negative framing to culture (which I do realise is not quite the same as fear appeals, but I’d say fear appeals are a subset of negative framing). The gist of the argument, based on Regulatory Focus Theory, was that individuals in individualist cultures tend to be more promotion focused (and prefer gain framed messages), while in collectivist cultures fear of failure (or prevention focus) is more prevalent – and therefore loss-framed messages work better. However, when we tested gain vs loss framed messages related to condom-use and smoking in Portugal vs the UK, we couldn’t find much evidence to support this claim. Both actually preferred the gain-framed messages.

Going back to fear appeals, some researchers (e.g. here) have suggested that these could be quite useful in situations where there is an easy (or highly efficient) solution. In other words, something that has pretty fatal consequences (e.g. death) but an easy and effective solution (e.g. a vaccine) should be a pretty safe bet for the use of fear appeals. This seemed pretty logical to me – until I had a look at the vaccine uptake numbers for swine flu vaccine vs seasonal flu. In many ways I’d think that the swine flu pandemic was petty much a text book case for the use of fear appeals: It seemed pretty lethal, there seemed to be a lot more panic around, and it was certainly a lot more hyped than seasonal flu would ever be.  In many ways it was very similar to the early AIDS pandemic years (which is often used as a somewhat controversial argument for the success of fear appeals). But, of course, it has one major difference when compared to the early 80s, there was a highly effective and easy prevention strategy, which did not require long-term behaviour change – but rather a short trip to the doctor to get vaccinated. Thus, based on these arguments, surely the uptake of the vaccine should have been much, much higher than seasonal flu uptake. Well, the truth is, that actually the uptake was much, much lower: Looking at the figures, the uptake amongst all the “at risk”-groups in England for H1N1 was 37.1% . In 2009/10, the uptake for seasonal flu was 72.4% for over 65s and 56.1% for all other “at-risk” groups – a pretty substantial difference I’d say (figures can be found here). A failure to incentivise doctors or low targets doesn’t seem to have been at the root of the problem, in fact QAF targets in other areas were eased if targets were met, and GPs were pretty openly criticised for profiteering from the situation (I’m really not usually endorsing the Daily Mail – but here‘s their take on the story).

Given the experience with swine flu, I’m starting to become even more skeptical of fear appeals. And I start to wonder why there was a claimed effect in the early 1980s – but not now (there are a lot of arguments about exactly how effective this effect really was, especially related to reactance resulting from this). Surely both situations were pretty similar – with the exception of the much easier/permanent solution in the form of a vaccine. Maybe, I wonder if fear appeals really only work in cases where something is very novel? Maybe, they are just good to quickly raise awareness for an issue (like a pandemic, AIDS etc), but they should then be very swiftly replaced by more supportive messages? Maybe the lesson from the swine flu pandemic should be that supportive messages should be much more readily deployed? Even in areas where high intensity fear and highly efficient solutions are available?

What do you think? Fear appeals for novelty value only? Do you have any good examples of fear appeals? Let me know!

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