From scaring to stigma: an examination of stigma's and related constructs' association with EPPM-framed messages and the ethical dilemmas of health communication
Health communication;Persuasion;Health psychology;Stigma;Tobacco;Fear appeals;Extended parallel process model (EPPM);Health education;Health campaigns
Fear appeals have long been one tool in the communication discipline’s strategy to inform the public about health behaviors and conditions. More specifically, one fear appeal framework, the Extended Parallel Process Model (EPPM), has received the lion’s share of scholarly attention in the past few decades. However, this project posits that by increasing the public’s perception of a health behavior’s threat and efficacy (the two prominent components of the EPPM), that secondary audiences (those who do not participate in the specific health behavior) may create or maintain stigma and other negative attitudes toward primary audiences (those who do engage in the particular behavior). This research explores the relationships between threat, efficacy, stigma, perceived responsibility for one’s behavior and health outcomes, and discrimination via messages on two similar topics: smoking and vaping (using electronic cigarettes). The original aim of the study was to use an experimental design to manipulate secondary audience perceptions of the threat and efficacy related of smoking and vaping behaviors and cessation. However, the manipulation checks were only partially successful, so, instead, the study utilized general threat and efficacy perceptions to examine relationships stigma as a predominantly observational study. Additionally, two constructs and measures, responsibility and stigma, were critiqued and explored for their robustness and predictive power, and components of perceived responsibility were tested for mediation between perceived threat and efficacy and stigmatization of people who smoke or vape. Finally, locus of control and selected demographic variables were tested for potential differences in the amount of stigma or related concepts assigned to others who smoked or vaped.Messages regarding smoking or vaping, along with measures for perceptions of threat, efficacy, controllability, attributions, negative emotions toward people who engage in the behavior, stereotypes about people who engage in the behavior, blame, and discrimination were randomly disseminated to a large number of participants via Amazon’s MTurk. Using correlations, multiple regression, and univariate analyses yielded partial support for the project’s main premises. Although the smoking topic mostly produced null findings (perhaps because of ceiling or floor effects), the vaping topic did demonstrate moderate relationships between threat perceptions, responsibility constructs, stigma, blame, and discrimination for secondary audiences. Responsibility perceptions also partially mediated the relationship between threat and stigma. Efficacy was not associated with any of the aforementioned variables for either topic. Finally, a new discrimination measure was investigated, responsibility did include controllability and attribution perceptions, and additional variance was established by enhancing traditional stigma scales with measures of negative emotions and stereotypical thoughts.This dissertation discusses the rationales for the importance of considering ethical dilemmas when communicating threat to the public, provides rationales for the proposed hypotheses and research questions, explicates the methods used to collect and analyze data, presents the specific findings, and discusses implications, future research, and limitations of the project.
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From scaring to stigma: an examination of stigma's and related constructs' association with EPPM-framed messages and the ethical dilemmas of health communication