Fatalism and the Processing of Fear Appeals Among Chinese: An Exploratory Study in the Context of Lung Cancer Prevention

Xing Tong

Advisor: Xiaoquan Zhao, PhD, Department of Communication

Committee Members: Katherine E. Rowan, Kevin B. Wright, Xiaomei Cai

The Hub, #1
April 14, 2017, 01:00 PM to 10:00 AM


Public health practitioners and researchers often use persuasive messages to inform, convince, and motivate people to practice healthy behaviors or abandon unhealthy ones. For this reason, designing culturally appropriate health messages which are both theory-based and audience-centered is a question that deserves close attention. This dissertation research represents the first effort to examine the influence of fatalistic beliefs in the contexts of lung cancer prevention messages targeting the Chinese population. Guided by Witte’s (1992) Elaborated Paralleled Processing Model (EPPM), this study investigated the effects of two dimensions of fatalism, negative interpretation and active coping, on Chinese people's processing of lung cancer prevention messages. Moreover, this investigation tested whether these two dimensions of fatalism impacted the message outcomes through changing their perceived threat or perceived efficacy. Lastly, this research examined if fatalism moderated the relationship between individuals' perceived threat, or perceived efficacy, and the message outcome variables. 

In this experimental study (N=1249), research participants were randomly assigned to read a health message about lung cancer prevention. The health message varied in level of threat (high vs. low) and efficacy (high vs. low). After exposure, respondents completed measures assessing their perceived threat and perceived efficacy towards lung cancer, as well as their negative emotional response, message evaluation, attitude and behavior intention towards lung cancer prevention. Results showed a low level of negative interpretation and a high level of active coping regarding lung cancer prevention among the participants. The original EPPM framework was partially supported -- participants high in perceived threat reported stronger negative emotional response, but threat perceptions had no effects on message evaluation, attitude and behavior intention toward lung cancer prevention. Participants with high perceived efficacy, on the other hand, reported more positive message evaluation, and stronger attitude and behavior intention. Additional analyses revealed significant indirect effects of negative interpretation on emotional response and message evaluation through perceived threat, as well as significant indirect effects of active coping tendency on message evaluation, attitude, and behavior intention through perceived efficacy. The hypothesized interaction between perceived threat and perceived efficacy received no clear support from the data. The study’s findings offer two practical implications for cancer communication interventions in China. First, as cancer is an inauspicious topic in the Chinese culture, health practitioners should be aware of the potential limitation of fear appeals, and employ them with caution. Second, culturally appropriate efficacy components should be highlighted in future lung cancer prevention message design. The partial support EPPM received also suggests that the theory has utility in informing and guiding cancer communication efforts in China, although continued testing is still needed to further assess the validity of its key hypotheses.