By Fidelis Chinyepe
Psychology Sudent| Great Zimbabwe University
Imagine watching a television advert showing the devastating effects of drug abuse, smoking or
HIV. The images are frightening, the message is serious, and you are warned about the dangers.
For a moment, you feel afraid and promise yourself to make healthier choices. But a few days
later, your behaviour remains unchanged.
Why does this happen? If fear is meant to protect people from danger, why do fear-based health
campaigns sometimes fail to change behaviour?
This is an important question in health psychology, the branch of psychology that examines how
thoughts, emotions and behaviour influence our health. In Zimbabwe, where public health
campaigns address issues such as HIV prevention, substance abuse, unsafe sexual behaviour and
non-communicable diseases, understanding how people respond to health messages is essential.
Fear does not always lead to action
Fear appeals are messages designed to frighten people by highlighting the dangers of particular
behaviours. They may use disturbing images, serious warnings or stories about the consequences
of unhealthy choices. The aim is to convince people that changing their behaviour is necessary to
protect their health.
However, fear and behaviour change are not the same thing. A person may understand that a
behaviour is dangerous without feeling capable of changing it. Another person may become so
frightened that they avoid thinking about the message altogether.
For example, a young person may know the dangers of drug abuse but continue using substances
because of peer pressure, stress or a desire to fit in with friends. Similarly, someone may
understand the importance of HIV prevention but struggle to negotiate condom use in a
relationship where they fear rejection or conflict.
These examples show that health behaviour is influenced by more than knowledge or fear.
People’s social circumstances, emotions, beliefs and access to resources also matter.
What does psychology tell us?
One theory that helps explain this problem is the Extended Parallel Process Model, developed
by communication researcher Kim Witte in 1992. The model suggests that people respond to
fear-based messages by considering two important questions: How serious is the threat, and am I
capable of doing something to protect myself?
When people believe a threat is serious but also believe they can take effective action, they are
more likely to protect themselves. For example, a campaign that explains the dangers of HIV
while showing people where to obtain testing, counselling and prevention services offers both a
reason to act and a practical way forward.
However, when people feel threatened but believe they cannot do anything about the situation,
they may focus on reducing their fear instead of reducing the danger. They might deny the
message, ignore the warning or convince themselves that the problem will not affect them.
This explains why frightening people without giving them realistic solutions can be
counterproductive. Effective health communication should not only explain what can go wrong;
it should also show people what they can do about it.
When fear creates shame instead of change
Another weakness of fear-based campaigns is that they can unintentionally shame the people
they are trying to help. Consider a campaign that portrays people who use drugs as dangerous,
irresponsible or morally weak. Instead of encouraging someone with a substance-use problem to
seek assistance, such a message may make them afraid of being judged by family members,
friends or health workers.
The same problem can arise in sexual health campaigns. If people living with HIV are presented
as objects of fear, others may develop negative attitudes towards them. People who suspect they
may have HIV could also avoid testing because they fear the social consequences of a positive
result.
Stigma can therefore discourage the very behaviour that health campaigns are trying to promote.
A more effective approach communicates the seriousness of health risks without humiliating
people. It encourages responsibility while recognising that people may need information, support
and access to services to change their behaviour.
Why knowing the dangers is not enough
Health psychology also teaches us that behaviour is influenced by personal and environmental
factors. A person may want to adopt a healthier lifestyle but face obstacles that fear alone cannot
remove.
For example, someone may understand the health risks associated with an unhealthy diet but
struggle to afford nutritious food. Another person may want to attend a counselling service but
be unable to pay for transport. A young person may wish to avoid substance use but spend much
of their time in a social environment where drugs are readily available.
In such situations, simply repeating frightening warnings is unlikely to solve the underlying
problem.
The Theory of Planned Behaviour, developed by Icek Ajzen, helps explain why intentions do
not always translate into action. According to the theory, behaviour is influenced by a person’s
attitude towards the behaviour, perceived social expectations and perceived control over
performing it.
In simple terms, people are more likely to act when they believe the action is worthwhile, feel
supported by important people around them and believe they can realistically carry it out. Health
campaigns should therefore address practical barriers, social pressure and people’s confidence in
their ability to change.
A better approach for Zimbabwe
Zimbabwean health campaigns can be more effective when they combine accurate information
about risks with encouragement, practical guidance and access to services.
First, health messages should explain the dangers of unhealthy behaviour without relying entirely
on shocking images. People need clear information they can understand and use in everyday life.
Second, campaigns should offer achievable steps. A message about preventing HIV, for example,
can direct people to testing, counselling, condoms and other appropriate prevention services.
Campaigns addressing substance abuse can provide information about where to obtain support
and treatment.
Third, messages should build confidence. People need to believe that changing their behaviour is
possible, even when they have struggled in the past. Practical advice, positive examples and
supportive communication can help strengthen that belief.
Finally, health campaigns should consider the needs of different audiences. Young people,
parents, rural communities and urban populations may face different challenges. Messages that
recognise these differences are more likely to feel relevant and useful.
Health professionals, teachers, community leaders and the media can all contribute by creating
conversations that encourage people to seek help rather than hide their difficulties.
Conclusion
Fear has a place in health promotion. It can attract attention and help people recognise the
seriousness of a health threat. However, fear alone cannot guarantee lasting behaviour change.
When people feel helpless, ashamed or unable to act, frightening messages may lead to
avoidance rather than action. Effective campaigns must therefore combine awareness of danger
with practical solutions, confidence-building and supportive environments.
The goal of health promotion should not simply be to frighten people into changing. It should be
to help them understand the risks, believe that change is possible and know where to begin. A
successful health campaign does more than make people afraid of what might happen. It
empowers them with the knowledge, confidence and support to make something better happen.
