Using the Extended Parallel Process Model to Explain Physicians' Decisions to Test Their Patients for Kidney Disease

Abstract

A study was conducted to determine the effects of perceived threat and efficacy on physicians' intentions and behavior to test their patients' level of kidney functioning. Guided by the extended parallel process model, 151 physicians completed an initial survey measuring threat to patients (i.e., susceptibility and severity) and efficacy (i.e., response-efficacy and self-efficacy), as well as their current intentions and behavior. One-hundred and twelve of these physicians also completed and returned a follow-up survey sent approximately 4 months later using identical measures of intentions and behavior. As predicted, physicians who perceived greater threat to patients and greater efficacy demonstrated greater intentions and behavior to test their patients' level of kidney functioning. The theoretical and practical insights and implications of these findings are discussed.

The Extended Parallel Process Model

“…Smalec and Klingle (2000) in an experiment on the effects of an interpersonal message to persuade bulimics to seek help, in which levels of threat and efficacy were manipulated as attributes of the message, found that at high levels of efficacy perceived threat was positively correlated with cognitive message acceptance and behavioral message acceptance. Roberto and Goodall (2009) focused on threat to others and found that the highest behavioral intentions and actual behavior (physicians proscribing kidney tests to their patients) was highest in the high threat-high efficacy group. This study was a survey, so perceptions of both threat and efficacy were measured and then median split was used to create four groups.…”

Scaring the Snus Out of Smokers: Testing Effects of Fear, Threat, and Efficacy on Smokers’ Acceptance of Novel Smokeless Tobacco Products

“…Several studies found evidence for this proposition (Basil, Basil, Deshpande, & Lavack, 2013; Roberto & Goodall, 2009; Smalec & Klingle, 2000; Terblanche-Smit & Terblanche, 2010; Witte & Allen, 2000; Witte, Berkowitz, Cameron, & McKeon, 1998). For example, in a survey, Roberto and Goodall (2009) used median split to divide respondents into four groups based on their levels of perceived threat and efficacy and found that the high threat/high efficacy group had the highest message acceptance (behavioral intentions and behavior at both the initial and follow-up survey). In an experiment pertaining to safe sexual behavior, Terblanche-Smit and Terblanche (2010) manipulated levels of threat (low, medium, and high) and although they did not manipulate efficacy, measured efficacy was relatively high (e.g., 3.9-4.0 on a 5-point scale).…”

“…On the other hand, several studies found evidence against this proposition (Rimal & Real, 2003; Roberto & Goodall, 2009; Witte, et al, 1993). In a survey, Witte et al (1993) found that when efficacy was low, greater defensive avoidance, perceived manipulation, and issue derogation were exhibited in the low threat group.…”

Rethinking Susceptibility: Examining the Cognitive and Emotional Processing of Other-Directed Persuasive Fear Appeal Messages

“…Morrison focused on personal relationships, finding that men could be motivated to speak to women they care about regarding sexual assault through the use of indirect fear appeal messages. Roberto and Goodall (2009) examined physician-patient relationships, finding that primary care physicians perceiving greater efficacy and threat to patients were more motivated to test their patients for kidney disease. Finally, Goei and colleagues (2010) studied an asthma intervention in K-8 level schools and demonstrated the efficacy of educating school workers with interventions that include threat and efficacy information to respond effectively to students' asthma.…”

“…Several researchers have begun to extend the concept of personal susceptibility to articulate the ideas of indirect fear appeals (Morrison, 2005), and threat to others (Goie et al, 2010;Roberto & Goodall, 2009). Morrison focused on personal relationships, finding that men could be motivated to speak to women they care about regarding sexual assault through the use of indirect fear appeal messages.…”