Depression’s response to fear tactics: An integration of health promotion principles, eye-tracking technology and clinical tools

The Display of Medical Information: Content, Format, and Subjective Experience

“…A sample item is “My heart beats fast,” measured from 1 ( not at all ) to 4 ( very much so ; α = .951). Next, two items from Lueck et al (2019) that are intended to measure arousal were adapted for this study and included: “Please indicate whether they information in the exam room pointed to by the assistant made you feel,” measured from 1 = bored to 7 = stirred up ; and “The information in the exam room pointed to by the assistant,” measured from 1 = did NOT grab my attention to 7 = grabbed my attention . As in Lueck et al, the scores here correlated, r (91) = .770, p < .001, α = .864, and were summed to create a measure of arousal; higher scores indicate greater arousal.…”

“…Questions regarding information seeking and related behavior were included to measure differences in how interested people were in learning about skin cancer (which might affect their receptivity to the displayed information). Three questions using 7-point semantic differential scales were adapted from Lueck et al (2019) to measure attitudes toward seeking information. Here, the questions were “To you, seeking information about signs of skin cancer is: 1 = bad to 7 = good ; 1 = worthless to 7 = valuable ; and 1 = harmful to 7 = beneficial ” (α = .844).…”

“…We also included two questions about behaviors. The first measured intention to seek information and was adapted from Lueck et al (2019): “How likely is it that you will seek information about the signs of skin cancer (1 = very unlikely to 7 = very likely ).” The second was “As a result of participating in this study, how likely are you to take action to prevent skin cancer (e.g., use sun screen, avoid tanning beds, seek shade)?” (1 = not at all likely to 7 = extremely likely ). We also asked about the preference for the form of information (pamphlet or poster) the participant would select to learn about the signs that indicate the possibility of skin cancer.…”

“…We also included two questions about behaviors. The first measured intention to seek information and was adapted from Lueck et al (2019): "How likely is it that you will seek information about the signs of skin cancer (1 ¼ very unlikely to 7 ¼ very likely)." The second was "As a result of participating in this study, how likely are you to take action to prevent skin cancer (e.g., use sun screen, avoid tanning beds, seek shade)?"…”

“…While the meta-analysis of fear appeals by Tannenbaum et al (2015) concluded that fear appeals are effective, controversy remains in the literature surrounding the use of fear appeals (e.g., Rothenberg, 1990). Lueck et al (2019) urged caution in using fear tactics in health communications with topics like depression and suicide prevention because of unintended negative effects, such as turning attention away from the message, which was measured with eye tracking in the study. De Hoog et al (2008) argue that fear-arousing communications have broad use in health education because making someone concerned may motivate them to do something about the health risk (and they cite several meta-analyses in support of this explanation), but they also indicate the potential for adverse effects makes the fear-arousing approach controversial.…”