An Investigation of Cognitive Processing of Fear Appeal Messages Promoting HPV Vaccination: Predictors and Outcomes of Magnitude and Valence of Cognitive Responses

Abstract: An improvement in HPV vaccination rates is one of the primary goals of public health organizations. Toward this end, fear appeal communication is commonly used in health interventions, warning individuals of threats of HPV infection and promoting vaccination. However, little is known about how threat-related emotions, such as fear and anxiety, influence the cognitive processing of vaccination information and how this processing is associated with vaccination intention. To address this void, this study tests a model drawing upon functional emotion theories and dual-process models of persuasion. Results from an experimental study showed that fear and anxiety, which arose from exposure to threat information, triggered motivation to process HPV protection-related information, which in turn, was positively associated with depth of HPV vaccination information processing. Subsequently, greater depth of processing led to a greater number of positive cognitive responses when participants were presented with information with a high (vs. low), level of response efficacy. Finally, greater positivity of cognitive responses predicted greater intention to obtain HPV vaccination. Collectively, our findings provide a theory-based explanation about how the sequential provision and processing of threat and efficacy information in fear appeals contribute to the promotion of HPV vaccination. Implications for designing fear appeal messages are discussed.