Fear appeals are a polarizing issue, with proponents confident in their efficacy and opponents confident that they backfire. We present the results of a comprehensive meta-analysis investigating fear appeals’ effectiveness for influencing attitudes, intentions, and behaviors. We tested predictions from a large number of theories, the majority of which have never been tested meta-analytically until now. Studies were included if they contained a treatment group exposed to a fear appeal, a valid comparison group, a manipulation of depicted fear, a measure of attitudes, intentions, or behaviors concerning the targeted risk or recommended solution, and adequate statistics to calculate effect sizes. The meta-analysis included 127 papers (9% unpublished) yielding 248 independent samples (NTotal = 27,372) collected from diverse populations. Results showed a positive effect of fear appeals on attitudes, intentions, and behaviors, with the average effect on a composite index being random-effects trued¯ = 0.29. Moderation analyses based on prominent fear appeal theories showed that the effectiveness of fear appeals increased when the message included efficacy statements, depicted high susceptibility and severity, recommended one-time only (vs. repeated) behaviors, and targeted audiences that included a larger percentage of female message recipients. Overall, we conclude that (a) fear appeals are effective at positively influencing attitude, intentions, and behaviors, (b) there are very few circumstances under which they are not effective, and (c) there are no identified circumstances under which they backfire and lead to undesirable outcomes.

Although research on Health Behavior Theory (HBT) is being conducted at a rapid pace, the extent to which the field is truly moving forward in understanding health behavior has been questioned. This issue is examined in the current article. First, we discuss the problems within the HBT literature. Second, we discuss the proliferation of HBT and why theory comparison is essential to this area of research. Finally, we reflect on ways that the field might move forward by suggesting a new agenda for HBT research. It is argued that increased recognition of the similarity of health behavior constructs as well as increased empirical comparisons of theories are essential for true scientific progress in this line of inquiry.

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The aim of this paper is to advance rigorous Internet-based HIV/STD Prevention quantitative research by providing guidance to fellow researchers, faculty supervising graduates, human subjects' committees, and review groups about some of the most common and challenging questions about Internet-based HIV prevention quantitative research. The authors represent several research groups who have gained experience conducting some of the first Internet-based HIV/STD prevention quantitative surveys in the US and elsewhere. Sixteen questions specific to Internet-based HIV prevention survey research are identified. To aid rigorous development and review of applications, these questions are organized around six common criteria used in federal review groups in the US: significance, innovation, approach (broken down further by research design, formative development, procedures, sampling considerations, and data collection); investigator, environment and human subjects' issues. Strategies promoting minority participant recruitment, minimizing attrition, validating participants, and compensating participants are discussed. Throughout, the implications on budget and realistic timetabling are identified.

The purpose of the current study was to conduct a 10-year systematic review of HIV/AIDS mass communication campaigns focused on sexual behavior, HIV testing, or both (1998-2007) and to compare the results with the last comprehensive review of such campaigns, conducted by Myhre and Flora (2000). A comprehensive search strategy yielded 38 HIV/AIDS campaign evaluation articles published in peer-reviewed journals, representing 34 distinct campaign efforts conducted in 23 countries. The articles were coded on a variety of campaign design and evaluation dimensions by two independent coders. Results indicated that compared with the previous systematic review (1986-1998 period), campaigns increasingly have employed the following strategies: (1) targeted defined audiences developed through audience segmentation procedures; (2) designed campaign themes around behavior change (rather than knowledge change); (3) used behavioral theories; (4) achieved high message exposure; (5) used stronger research designs for outcome evaluation; and (6) included measures of behavior (or behavioral intentions) in outcome assessments. In addition, an examination of 10 campaign efforts that used more rigorous quasi-experimental designs revealed that the majority (8 of 10) demonstrated effects on behavior change or behavioral intentions. Despite these positive developments, most HIV/AIDS campaigns continue to use weak (i.e., preexperimental) outcome evaluation designs. Implications of these results for improved design, implementation, and evaluation of HIV/AIDS campaign efforts are discussed.