Motivation and emotion/Book/2020/Protection motivation theory

Protection motivation theory:
What is protection motivation theory and how can it be applied?

Multimedia presentation (3 min)

Overview

Figure 1. Doctors stethoscope used to check on heart rate in general check ups

Protection motivation theory (PMT) describes cognitive psychological processes involved in responding to fear appeals and response in terms of self-efficacy (Maddux & Rogers, 1983; Rogers, 1975). The problem with fear appeals is that people can be persuaded to execute behaviours, through fear of punishment. PMT acknowledges a wide range of factors such as; the severity and vulnerability compared to the rewards in a intention and response efficacy and self efficacy compared to the response cost of a intention. An example which may be better understood through the PMT process is quitting smoking by using strategies to limit cigarette intake via education such as plain packaging to make a smoker aware and fear smoking to encourage healthy behaviours (Greening et al. 1997; Yan et al. 2014). The PMT model describes how the benefits need to outweigh the risk and the comforts need to outweigh the discomfort in some situations. PMT is useful in understanding the psychological process in preventative behaviours and risk mitigation behaviours in health care work but also in understanding maladaptive behaviours and destructive behaviours. The PMT is applicable to all changes in adaptive and maladaptive intentions. The PMT is used to understand cognitive processing in many areas predominantly health, but also areas such as pro-environmental intentions (Keshavarz & Karami, 2016).

Focus questions: What is the Protection motivation theory? What is the Application of Protection motivation theory? What are the benefits of Protection motivation theory?

History

Protection motivation theory comes from the work of R.W. Rogers (1975), later expanded upon with Maddux and Rogers (1983) to create a revised view on the theory (Maddux & Rogers, 1983; Rogers, 1975). PMT comes from the behavioural psychologist field specifically incorporated with fear appeal and self-efficacy. These researchers realised that people were either motivated to seek positive or negative change concerning health outcomes. They wished to understand how this process was happening in psychological setting and sort out a system/process to test how people access threats and made decisions (Maddux & Rogers, 1983; Rogers, 1975). PMT is used as a way in understanding reactions towards usually health related issues (Maddux & Rodgers, 1983; Rogers, 1975). The theory promotes self-efficacy in individuals and can be used to understand the impacts of fear appeals. Through the development and knowledge in PMT and how developed responses come into actions via our intentions. However more recently the theory is used to describe not only health related intentions but also into the aspects of many other adaptive or maladaptive intentions and behaviours.

Theory

Figure 2. Cognitive process of protection motivation theory developed by Ronald W. Rogers in 1975

The theory in the PMT process is that to cause a protection motivated intention for the wellbeing on an individual multiple steps must be considered and evaluated (Maddux & Rogers, 1983). There are two main processes that initiate the protection motivated intention which leads into a behavioural change, the first is Threat-appraisal and the second is Coping-appraisal. Both of these processes are a way which psychologists understand how adaptive or maladaptive intentions and behaviours are formed (Floyd, Prentice‐Dunn, & Rogers, 2000; Maddux & Rogers, 1983). The key point of this is either a person changes positively, negatively or continues to have the same intent behaviour based upon this theory. The process is a sort of equation taking in the aspects of decision making, evaluates them in the formula and the outcome is then changed (Floyd, Prentice‐Dunn, & Rogers, 2000; Maddux & Rogers, 1983). This model is how people are motivated to change, but importantly it helps us understand how we can change for the better (Maddux & Rogers, 1983).

Threat-appraisal

The threats severity and vulnerability of the person is the first step into creating an adaptive or maladaptive intention and behaviour (Maddux & Rogers, 1983). Severity is the implication and degree to which the effect of making the maladaptive behaviour will affect a person. The vulnerability is the likelihood of how a maladaptive behaviour will affect a person. A common example of severity and vulnerability is that of cigarette smokers and the severity and vulnerability to many types of cancer or developing other illnesses (Greening, 1997). The perceived vulnerability may be weak for someone who is young and otherwise healthy (Greening, 1997; Yan et al. 2014). The perceived vulnerability may be low in someone who only intakes small amounts of cigarette smoke (Greening, 1997; Yan et al. 2014). Fear is an impact upon these factors if an adolescent is sees the impacts of what smoking can do to someone in the long term or if they perceive a threat with smoking it can increase the perceived severity and vulnerability (Yan et al. 2014). Smoking for longer periods of time can create the negative association with addition and also create fear, causes the severity and vulnerability to rise (Greening, 1997; Maddux & Rogers, 1983). These factors of severity and vulnerability are there to safeguard us and provide worry so that positive outcomes may occur.

Severity and vulnerability are to prevent maladaptive behaviours such as the negative aspects in smoking then there is an opposing force, the factor of rewards (Maddux & Rogers, 1983). Rewards show that gratification for maladaptive behaviours both intrinsic and extrinsic increase the likelihood of maladaptive behaviours (Maddux & Rogers, 1983). With the smoking example, low severity and vulnerability are seen with adolescent high school students and the factors both of the enjoyment from a cigarette (intrinsic) and boosting the social status of an individual (extrinsic) have been shown to cause a maladaptive threat appraisal (Greening, 1997). This is a sort of formula, the perceived severity and vulnerability need to outweigh the perceived rewards for positive behaviours to occur and vise versa (Yan et al. 2014). This then ends in the threat appraisal being complete and the protection motivation either being achieved or not, which then predicts the behaviour of an individual. Once again in the smoking example, if an adolescent realizes the threat of smoking through severity and vulnerability, they see that the outcome of smoking does not outweigh the benefits that smoking entails. Then they will have the threat appraisal and behavioural change of attempting to quit smoking (Greening, 1997; Maddux & Rogers, 1983; Yan et al. 2014). This formula is applicable to many other maladaptive behaviours and not just necessarily about individual health, but also environmental and financial etc.

Coping-appraisal

Coping appraisal unlike threat appraisal comes down to the efficacy of the action and the self. If the desired outcome is actually helpful to the individual and if the action will drive a positive change is the response efficacy (Floyd, Prentice‐Dunn, & Rogers, 2000; Maddux & Rogers, 1983). Response efficacy is an evaluated process to which the individual must discover how change will actually create a perceived positive impact (Maddux & Rogers, 1983). It is about if making a change will create a desire effect, a study performed by Keshavarz & Karami (2016) showed that farmers within times of drought were more positively charged toward pro-environmental behaviours. Pro-environmental behaviour in itself, but response efficacy dictates that the action will create a positive outcome (Keshavarz & Karami, 2016). Therefore the farmers in this example would have to understand that pro-environmental behaviour would then lead to a positive health in their own crop (Keshavarz & Karami 2016; Maddux & Rogers, 1983). The direction of the response efficacy shows that these farmers did see the effect that pro-environmental behaviour had upon the benefit towards the outcome of preventing severe drought (Keshavarz & Karami 2016). This response efficacy is important in understanding what and how to make decisions can be important in the process of PMT.

The other major factor in coping appraisal and the factor within this model with a large amount of research in motivational theories is self efficacy. Self efficacy is apart of behavioural psychological theories outdating the PMT process. Self efficacy has been shown to be a motivational, cognitive, and affective process for an individual to have the belief they can accomplish an action (Floyd, Prentice‐Dunn & Rogers, 2000). It is important to understand that some areas of the PMT model are stronger in some settings than others, and that an individual's perception upon coping or threats is how the PMT process functions. Self-efficacy has been shown to predict intention formation which then results in behavioural change within sport settings (Plotnikoff & Trinh, 2010). However in setting such as self-efficacy may not be as impactful to the adolescent who should stop smoking (Greening, 1997). Self-efficacy is an integral part of how people have faith in themselves to accomplish something and has been a leading topic in behavioural psychology (Floyd, Prentice‐Dunn & Rogers, 2000). Self-efficacy does not just rely on the difficulty of something such as quitting smoking but also the intention of completing the action. If someone with high self-efficacy wanted to quit smoking they are at a higher chance of doing so and vise versa (Floyd, Prentice‐Dunn & Rogers, 2000).

The opposing factor of response-efficacy and self-efficacy is response cost. The response cost to completing an action is the availability or lack of availability of resources. If someone has the means to complete an action it makes it more likely that the following action will take place. Response cost can be overlooked as it is usually falls within the negative means of scoring low of efficacy (Plotnikoff & Trinh, 2010). The response cost for quitting smoking could be that of fear of cravings or weight gain these are perceived at a high level in smoking because of the addictive intent of the maladaptive behaviour (Greening, 1997; Yan et al. 2014). In the case of the farmers dealing with a drought, who are positively charged towards pro-environmental behaviour the response cost is high with the effects of finance, time, effort, and emotional costs all present (Keshavarz & Karami, 2016). The response cost is the roadblock in the way to the progressive action. With high response-efficacy and self-efficacy it can be controlled and an adaptive behaviour can be formed.

Quiz questions

Read the section 'theory' and choose the correct answers related then click "Submit":

1 What is self efficacy? A person's judgement about whether they can accomplish something. Self-confidence, capability, and worth. The factor which increases severity and vulnerability. Another term for Protection Motivation Theory. 2 According to Maddix & Rogers (1983) what equals Threat Appraisal? Self Efficacy and Response Efficacy + Severity and Vulnerability = Severity and Vulnerability - Rewards = Rewards - Self Efficacy and Response Efficacy = None of the above. 3 Is the following statement true or false: PMT describes how both maladaptive and adaptive behaviours are processed cognitively. TRUE. FALSE.

Applications

Current Research

Figure 3. Young girl about to receive a vaccine in her upper arm

Health Research

The healthcare sectors all around the world are subjected to not only providing a health care service, but also in convincing and acknowledging the benefits and communicating that to their patients (Floyd, Prentice‐Dunn, & Rogers, 2000; Maddux & Rogers, 1983). The PMT model has been shown to be able to predict health care behaviours and understanding this we can start to understand how we can comply systems so that people can live healthier and more protected lives against illness (Bockarjova & Steg, 2014). In understanding this predictability for future studies into health care can display a more versatile understanding of how to assist in the development of adaptive intentions being formed over maladaptive intentions.

Vaccinations

Vaccinations play a large role in the history of the prevention of illnesses and to be able to better understand the process of why people vaccinate themselves or their children can help maintain a healthier environments. A recent study by Camerini, Diviani, Fadda, & Schulz (2019) showed the concern of measles vaccination effectiveness in Switzerland due to the fact that a significant amount of people a region were not receiving their measles vaccinations (Camerini, Diviani, Fadda, & Schulz, 2019). These researchers believe through the PMT that education and promotion of vaccination will increase the likelihood that people form the intentions and actions for their children to receive vaccinations (Camerini, Diviani, Fadda, & Schulz, 2019). Other health concerns in this area which form around prevention of illness in aspects of travel and adhering to health advice in unfamiliar places whilst traveling involve PMT process application (Wang, Liu-Lastres, Ritchie & Mills, 2019). In situations which people put themselves out of their comfort zone and should be adhering to health advice in new countries, the PMT process is followed and shown to be used in the promotion of safe behaviours against possible illness (Wang, Liu-Lastres, Ritchie & Mills, 2019). These threats upon an individual's health happen with change and humans need to adapt to change and process this information to have an adaptive outcome.

Exercise and Physiology Research

Exercise and healthy lifestyle choices are recommended by all health physicians, especially to people who are more at risk or hurting themselves who do not make good lifestyle changes (Gaston, & Prapavessis 2014; Plotnikoff, & Higginbotham, 2002). Studies based on pregnancy show low levels of response efficacy and self efficacy along with low severity and vulnerability to the contrary factors of rewards and the response cost in relation to health advice to exercise (Gaston, & Prapavessis, 2014). Exercise has been shown to be beneficial to women who are pregnant in decreasing the risk of cardiovascular disease, diabetes, cancer, hypertension, obesity and depression across the lifespan (Gaston, & Prapavessis, 2014). An Australian study performed by Plotnikoff, & Higginbotham (2002) describes the system of how reducing in positive factors of the PMT process depletes intention in exercise behaviour. Follow up studies show the reaction of people with heart related issues and the correlation of the PMT process in adaptive and maladaptive exercise intentions (Plotnikoff, & Higginbotham, 2002; Blanchard, 2009). Another factor in exercise and physiology is in rehab settings for people who are in competitive settings show low compliance for proactive rehabilitation (Taylor & May, 1996). Non-compliance for rehabilitation is due to the low response efficacy, the athlete's believe that they reduce the amount of rehabilitation. When the pain is present and the effects are well known and well understood this perception is lowered as the response cost increases (Taylor & May, 1996). In this evidence, even individuals who have the necessity for the promotion of a healthier lifestyle through exercise choose maladaptive behaviors. People who are at risk or not are confronted with the same PMT process. The PMT is designed to identify and acknowledge these differences and be able to then create and predict the promotion of healthier adaptive intentions to turn into positive behaviours.

Covid-19 Research

Figure 4. Hygea - Greek Goddess of Health. Hygea is the personification of the word hygiene (Hygiene 2020).

The current Coronavirus Pandemic has been a recent indicator from health official for people to do the right thing in prevention of the virus. The World Health Organization with this pandemic has tried to promote social distancing, the use of frequent hand washing and wearing of masks to safeguard people (Advice for the public on COVID-19, 2020). A study reported by Barati et al. (2020) that during SARS CoV 2 effecting a hospital in Iran showed evidence of how physicians, nurses, paramedics, technician staff, service personnel, and office staff helped protect themselves and other via this psychological process (Barati et al. 2020). This preventative behaviours of dealing with SARS-CoV-2 is inline with the process of PMT. The actions such as washing hands, wearing face protection and keeping distance are examples of motivated behaviour coming from self efficacy inline with the PMT process to help prevent damage to one's self and others. Barati et al. (2020) also talks about how lower levels of severity and concern around SARS CoV 2 increases the likelihood of maladaptive behaviours around PPE and hygiene (Barati et al. 2020). These actions were seen to be significantly correlated to the cognitive process of PMT (Barati et al. 2020). A different study performed in Iran as a online-survey showed that "Statistically significant positive correlation coefficients were estimated between preventive behaviors of COVID-19 and perceived vulnerability,...perceived severity,...response efficacy and...self efficacy" (Rad et al. 2020). The perceived factors in PMT are encouraged to cause a positive adapted response to the pandemic in causing higher preventional behaviour. Further research is yet to come in this topic as Covid-19 research in a new and developing topic, but PMT is still a prominent cognitive process to which psychologist use to discover more about the psychological effects on this pandemic (Barati et al. 2020; Rad et al. 2020).

Environmental Research

Environmental protection and promotion of a diverse habitat has seen to support a workable soil, water quality etc, and to regulate climate, water quality and prevent from natural disasters such as floods (Keshavarz & Karami, 2016). The protection of natural habitats are a positive for farmers wanting to prevent from draughts and PMT have been shown to show the cognitive process which make up farmers decisions about pro-environmental behaviour (Keshavarz & Karami, 2016). This is also true for waste management and pro-social behaviours in people who are not directly affected by natural impacts including college students (Janmaimool 2017; Rainear & Christensen, 2017). This pro-environmental behaviour from people who do not see the direct benefit from the rewards and see limited response cost dictates that the factors of severity and vulnerability and self efficacy and response efficacy are high. The pro-environmental actions are also associated to what people can do in their day to day. The difference between intention and behaviours is that behaviours happen, intention is what is being acted on, intent can be good but positive outcomes are better (Floyd, Prentice‐Dunn, & Rogers 2000; Maddux & Rogers, 1983). Pro-environmental behaviours such as driving an electronic vehicle (EV) is a way which is studied as a positive PTM process (Bockarjova & Steg 2014). Buying EVs is a way which psychologists can analyse regular people making positive PTM decisions which do not directly affect the individual (Bockarjova & Steg, 2014). The PMT model of cognitive process was found to be reliable in understanding the process people make about purchasing EVs (Bockarjova & Steg, 2014). The PMT model have a large domain in adaptive and maladaptive cognitive understanding, when people are motivated to make decisions. The decisions people make do not need to directly benefit the person in order for the PMT to be used in discussion adaptive behaviours.

Future Research

Future research into PMT has been suggested to interact with more areas of the researchable factors suggested. Future research should be used to test more of the variables discussed in things such as the predictive nature of environmental research (Bockarjova & Steg, 2014). For health research better understanding of factors in the decision making process for prevention against preventable illness and how to advocate for this is required (Camerini, Diviani, Fadda, & Schulz, 2019). Future research areas into Covid-19 should look at the PMT cognitive process for showing how to effectively explain why people have maladaptive behaviour to something so serious and present (Barati et al. 2020; Rad et al. 2020). Future research should be directed towards the understanding of other facets of adaptive and maladaptive behaviour and the outcomes which fit within the PMT process. Future research should combine PMT with other existing theories to allow for fuller views into how PMT alone describes health behaviour compared to other models (Vance, Siponen & Pahnila, 2012). PMT is a robust theory and does well at describing aspects of human behaviour but research is still needed to understanding many parts of human intentions behaviour.

Criticisms

The Critics of the PMT are that the limited revision of the process itself leads to different versions of the process being used by different studies. Some studies incorporate large parts of the fear factor in severity and vulnerability and some do not use solely the PMT model to describe health based outcomes (Gaston, & Prapavessis, 2014). Using combined approaches can provide more understanding upon one topic, therefore the PMT alone lacks certain aspects in judging cognitive behavioural processes (Gaston, & Prapavessis, 2014). PMT inherently works as a dominitally fear based model yet not how all human behaviours is based upon fear. One aspect that the PMT does not cover is habitual nature in individuals intentions and behaviour (Vance, Siponen & Pahnila, 2012). This is an overlooked part of the theory of PMT but it helps gain a greater understanding as to why people do certain things (Vance, Siponen & Pahnila, 2012). An example of this used in the study by Vance, Siponen & Pahnila (2012) shows how PMT does not fully explain the lack of employees security compliance (Vance, Siponen & Pahnila, 2012). This study shows that habits are instead more of a dictator towards threat appraisal and coping appraisal than previously thought. This impact also shows that future search upon the PMT and habits could help develop a robust theory of cognitive behaviour (Vance, Siponen & Pahnila, 2012).

Conclusion

PMT is a cognitive process used to identify the reasons for changes in intentions of an individual for better or worse. The PMT works along a formula, threat appraisal responses are based on the difference between severity and vulnerability of a situation and the rewards of completing the action. If the severity and vulnerability outweigh the rewards of an already existing behaviour, the intention for the behaviour will change. In coping appraisal responses, the difference between the response efficacy and self-efficacy is taken away from the response cost to identify if the intention is valued to change. If an individual has high levels of response efficacy and self-efficacy, the intention to change the current behaviour becomes high. The application of this theory is based in health and how people respond to positive or negative health actions by changing their thought process enabling people to be healthier through understanding this process. The application of this theory has many other facets including pro-environmental intentions and behaviour and more recently seen with the Covid-19 pandemic. The application of this theory is useful in understanding how an individual makes decisions and how an individual changes their decisions with either adaptive or maladaptive response and why. The future research of this theory should include further understanding into habitual behaviours. PMT is an important theory in behavioural psychology in the understanding of how individuals form and change adaptive and maladaptive behaviours, yet further research is required in understanding all of human behaviour.

Focus questions answered: What is the Protection motivation theory? Protection motivation theory is a cognitive process theory based on threat and coping appraisals to produce adaptive or maladaptive responses. What is the Application of Protection motivation theory? Protection motivation theory can be applied realistically whenever there is a behavioural change. More commonly used to understand with individuals have maladaptive intentions towards health situations. What are the benefits of Protection motivation theory? Protection motivation theory allows us to understand the cognitive process and identify and predict how people will act in certain situations. This is mainly useful in the promotion of adaptive intentions to benefit individual's decision making.

See also

• Emotional self-efficacy (Book chapter, 2020)
• Protection motivation theory (Wikipedia)
• Self-efficacy (Wikipedia)

References

Advice for the public on COVID-19. (2020). Retrieved 14 October 2020, from https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public

Barati, M., Bashirian, S., Jenabi, E., Khazaei, S., Karimi-Shahanjarini, A., Zareian, S., ... & Moeini, B. (2020). Factors associated with preventive behaviours of COVID-19 among hospital staff in Iran in 2020: an application of the Protection Motivation Theory. Journal of Hospital Infection, 105(3), 430-433.

Blanchard, C. M., Reid, R. D., Morrin, L. I., McDonnell, L., McGannon, K., Rhodes, R. E., ... & Edwards, N. (2009). Does protection motivation theory explain exercise intentions and behavior during home-based cardiac rehabilitation?. Journal of Cardiopulmonary Rehabilitation and Prevention, 29(3), 188-192.

Bockarjova, M., & Steg, L. (2014). Can Protection Motivation Theory predict pro-environmental behavior? Explaining the adoption of electric vehicles in the Netherlands. Global environmental change, 28, 276-288.

Camerini, A. L., Diviani, N., Fadda, M., & Schulz, P. J. (2019). Using protection motivation theory to predict intention to adhere to official MMR vaccination recommendations in Switzerland. SSM-Population Health, 7, 100321.

Floyd, D. L., Prentice‐Dunn, S., & Rogers, R. W. (2000). A meta‐analysis of research on protection motivation theory. Journal of applied social psychology, 30(2), 407-429.

Gaston, A., & Prapavessis, H. (2014). Using a combined protection motivation theory and health action process approach intervention to promote exercise during pregnancy. Journal of behavioral medicine, 37(2), 173-184.

Greening, L. (1997). Adolescents' Cognitive Appraisals of Cigarette Smoking: An Application of the Protection Motivation Theory 1. Journal of Applied Social Psychology, 27(22), 1972-1985.

Hygiene (2020). Retrieved 14 October 2020, from https://www.etymonline.com/word/hygiene

Keshavarz, M., & Karami, E. (2016). Farmers' pro-environmental behavior under drought: Application of protection motivation theory. Journal of Arid Environments, 127, 128-136.

Janmaimool, P. (2017). Application of protection motivation theory to investigate sustainable waste management behaviors. Sustainability, 9(7), 1079.

Maddux, J. E., & Rogers, R. W. (1983). Protection motivation and self-efficacy: A revised theory of fear appeals and attitude change. Journal of experimental social psychology, 19(5), 469-479.

Plotnikoff, R. C., & Higginbotham, N. (2002). Protection motivation theory and exercise behaviour change for the prevention of heart disease in a high-risk, Australian representative community sample of adults. Psychology, health & medicine, 7(1), 87-98.

Plotnikoff, R. C., & Trinh, L. (2010). Protection motivation theory: is this a worthwhile theory for physical activity promotion?. Exercise and sport sciences reviews, 38(2), 91-98.

Rad, R. E., Mohseni, S., Takhti, H. K., Azad, M. H., Shahabi, N., Aghamolaei, T., & Norozian, F. (2020). Predicting COVID-19 Preventive Behaviors based on Protection Motivation Theory in Hormozgan, Iran.

Rainear, A. M., & Christensen, J. L. (2017). Protection motivation theory as an explanatory framework for pro environmental behavioral intentions. Communication Research Reports, 34(3), 239-248.

Rogers, R. W. (1975). A protection motivation theory of fear appeals and attitude change1. The journal of psychology, 91(1), 93-114.

Taylor, A. H., & May, S. (1996). Threat and coping appraisal as determinants of compliance with sports injury rehabilitation: An application of protection motivation theory. Journal of sports sciences, 14(6), 471-482.

Vance, A., Siponen, M., & Pahnila, S. (2012). Motivating IS security compliance: insights from habit and protection motivation theory. Information & Management, 49(3-4), 190-198.

Wang, J., Liu-Lastres, B., Ritchie, B. W., & Mills, D. J. (2019). Travellers' self-protections against health risks: An application of the full Protection Motivation Theory. Annals of Tourism Research, 78, 102743.

Yan, Y., Jacques-Tiura, A. J., Chen, X., Xie, N., Chen, J., Yang, N., ... & MacDonell, K. K. (2014). Application of the protection motivation theory in predicting cigarette smoking among adolescents in China. Addictive behaviors, 39(1), 181-188.

External links

• Paul Norman, Henk Boer & Erwin R. (2005). Protection motivation theory. Conner, M., & Norman, P. Predicting health behaviour (pp. 81-127). Berkshire, England:McGraw-Hill Education.