Protection Motivation Theory is a theory that was originally created to help clarify fear appeals. The Protection Motivation Theory proposes that we protect ourselves based on four factors: the perceived severity of a threatening event, the perceived probability of the occurrence, or vulnerability, the efficacy of the recommended preventive behavior, and the perceived self efficacy[1]. Protection motivation stems from both the threat appraisal and the coping appraisal. The threat appraisal assesses the severity of the situation and examines how serious the situation is. The coping appraisal is how one responds to the situation. The coping appraisal consists of both efficacy and self-efficacy. Efficacy is the individual's expectancy that carrying out recommendations can remove the threat. Self-efficacy is the belief in one's ability to execute the recommended courses of action successfully.[2]. PMT is one model that explains why people engage in unhealthy practices and offers suggestions for changing those behaviors. It is educational and motivational. Primary prevention: taking measures to combat the risk of developing a health problem [3]. (e.g., controlling weight to prevent high blood pressure). Secondary prevention: taking steps to prevent a condition from becoming worse [4]. (e.g., remembering to take daily medication to control blood pressure).
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The protection motivation theory was originally founded by Dr. R.W. Rogers in 1975 in order to better understand fear appeals and how people cope with them.[1]. However Dr. Rogers would later expand on the theory in 1983 where he extended the theory to a more general theory of persuasive communication. The theory was originally based on the work of Richard Lazarus who spent much of his time researching how people behave and cope during stressful situations. In his book, "Stress, Appraisal, and Coping," Richard Lazarus discusses the idea of the cognitive appraisal processes and how they relate to coping with stress. He states that people, "differ in their sensitivity and vulnerability to certain types of events, as well as in their interpretations and reactions." [5]. While Richard Lazarus came up with many of the fundamental ideas used in the Protection Motivation Theory, Dr. Rogers was the first to apply the terminology when discussing fear appeals. Today the Protection Motivation Theory is mainly used when discussing health issues and how people react when diagnosed with health related illnesses.
The threat appraisal process consists of both the severity and vulnerability of situation. Severity refers to the degree of harm from the unhealthy behavior. Vulnerability is the probability that one will experience harm. Another aspect of the threat appraisal is rewards. Rewards refer to the positive aspects of starting or continuing the unhealthy behavior. To calculate the amount of threat experienced take the combination of both the severity and vulnerability, and then subtract the rewards. Threat appraisal refers to children's evaluation of the degree to which an event has significant implications for their well-being. Theoretically, threat appraisal is related to Lazaraus' concept of primary appraisal, particularly to the way in which the event threatens the child's commitments, goals, or values. Threat appraisal is differentiated from the evaluation of stressfulness or impact of the event in that is assesses what is threatened, rather than simply the degree of stress or negativity of an event. Threat appraisal is also differentiated from negative cognitive styles, because it assesses children's reported negative appraisals for specific events in their lives rather than their typical style of responding to stressful events. Theoretically, higher threat appraisals should lead to negative arousal and coping and to increased psychological symptomatology.
The use of threat-appraisal has been involved in many health campaigns such as anti-smoking and AIDS prevention. Many of the campaigns have to analyze the audience to see what kind of an effect that their message will have. In one study conducted by Dillard, Shen, and Vail they sought to examine whether perceived effectiveness had any relation to actual effectiveness. The looked at numerous public service announcements to see whether or not the creators had actual changed peoples' opinions or if they had perceived that the message had changed peoples' opinions.
The coping appraisal consists of the response efficacy, self-efficacy, and the response costs. Response efficacy is the effectiveness of the recommended behavior in removing or preventing possible harm. Self-efficacy is the belief that one can successfully enact the recommended behavior. The response costs are the costs associated with the recommended behavior. The amount of coping ability that one experiences is the combination of response efficacy and self-efficacy, minus the response costs. The coping appraisal process focuses on the adaptive responses and one's ability to cope with and avert the threat. The coping appraisal is the sum of the appraisals of the responses efficacy and self-efficacy, minus any physical or psychological "costs" of adopting the recommended preventive response. Coping Appraisal involves the individual's assessment of the response efficacy of the recommended behavior (i.e. perceived effectiveness of sunscreen in preventing premature aging) as well as one's perceived self-efficacy in carrying out the recommended actions [6]. (i.e. confidence that one can use sunscreen consistently).
The Threat and coping appraisal variables combine in a fairly straightforward way, although the relative emphasis may vary from topic to topic and with target population.
In his book, "Stress, Appraisal, and Coping," Richard Lazarus states that, "studies of coping suggest that different styles of coping are related to specific health outcomes; control of anger, for example, has been implicated in hypertension. Three routes through which coping can affect health include the frequency, intensity, duration, and patterning of neurochemical stress reactions; using injurious substances or carrying out activities that put the person at risk; and impeding adaptive health/illness-related behavior." [7].
Response efficacy concerns beliefs that adopting a particular behavioral response will be effective in reducing the diseases' threat, and self-efficacy is the belief that one can successfully perform the coping response.[8]. In line with the traditional way of measuring the consequences of behavior, response efficacy was operationalized by linking consequences to the recommended behavior as well as to whether the subject regarded the consequences as likely outcomes of the recommended behavior.[9].