PurposePrior researches on the adoption of mobile health services (MHS) concentrate on the subjective cognitive appraisals resulting in technology adoption, while ignoring how to shape those cognitive appraisals by the objective message design strategies which are easier to operate in practice. Based on protection motivation theory (PMT), the current research aims to explore the antecedents of cognitive appraisals by focusing on message design strategies of fear appeal and coping appeal.Design/methodology/approachA two-stage scenario-based survey of 204 participants was conducted to collect data. The authors chose SPSS and covariance-based structural equation modeling (CB-SEM) approach with the software LISREL 8.8 to test our model.FindingsThe results show that the relationship between fear appeal and fear arousal is inverted U-shaped such that the degree of fear arousal is the greatest when the fear appeal is at a moderate level. Perceived usefulness for the message with negative framing is higher than that with positive framing. Furthermore, fear appeal and coping appeal have a significant interaction on the adoption of MHS at different stages.Research limitations/implicationsThe sample data of this study come from a special health service of a special group in China, which limits the universality of our research results for other groups or health care services. Therefore, future researchers can validate the model in other research scenarios and sample populations.Originality/valueThis study shows how fear appeal and coping appeal work together to influence individuals' adoption intention. The authors’ findings expand the theoretical depth of PMT and fear theory, enriching the theoretical connotation of framing effect in mobile health technology adoption context, which add new insights to design more persuasive messages through fear appeal and coping appeal for researchers and MHS providers in mobile health communication or propaganda.