Primary author: Erica Foster


The Protection Motivation Theory (PMT) is a more specified version of the Health Belief Model that was first presented by Rogers in 1975 as a way to better understand fear appeals (University of Twente, n.d.). He “... originally proposed that perceived vulnerability, severity, and response efficacy should combine multiplicatively to influence intentions (self-efficacy was not a component of the original model). Thus, if vulnerability, severity, or response efficacy were 0, intentions to change behavior would be 0 (Block, L. G. & Keller, P. A., n.d.).” Rogers later presented an amended version of the Protection Motivation Theory in 1983 as, “... a more general theory of persuasive communication, with an emphasis on the cognitive processes mediating behavioral change (University of Twente, n.d.).” This modified version was based on the additive rule that states “ ... even if one of the predictor variables were 0,this could be compensated for by high levels of the other two variables (Block, L. G. & Keller, P. A., n.d.).”

“Protection motivation has been described by Rogers as "an intervening variable that ... arouses, sustains, and directs activity (Grindley, E. J., Zizzi, S. J., Nasypany, A. M., Thortensson, C. A., 2008)." He also used adaptive and maladaptive responses to explain a person’s behavior regarding their health. Adaptive reactions result in active responses to health threats and maladaptive reactions do not result in active responses to health threats (Allen, R., Phillips, L., Pekmezi, D., Crowther, M., & Prentice-Dunn, S., 2009). An example of adaptive reactions would be a person being informed of breast cancer risk, being informed of prevention techniques and taking action to completed those prevention techniques. A maladaptive reaction would failing to use those prevention techniques because they may be to costly. The likelihood of an individual taking part in an adaptive response is higher for those who perceive their response efficacy as high. If an individual’s perceived response efficacy is low and they think they will benefit or be rewarded more by not participating in the adaptive response or action the likelihood of an adaptive response is low(Beirens, T. et al, 2008). A reward can be external (like peer pressure) or internal (personal satisfaction) (Li, X., et al., 2004).

“PMT is a framework particularly suited for interventions of protective, precautionary behaviours (spelling of behaviors is quoted as seen in article) (Beirens, T. et al, 2008).” This theory states the likelihood a person will participate in a health protective behavior (aka adaptive response) is increased by four items: the perceived severity of the health threat, the perceived vulnerability to the health threat, response efficacy to the health threat, and self-efficacy (Beirens, T. et al, 2010). These four items can be broken down into two separate appraisal categories. “According to PMT, environmental and personal factors combine to pose a potential health threat. The health threat message initiates two cognitive processes: threat appraisal and coping appraisal (Wu, Y., Stranton, B. F., Li, X., Galbraith, J., Cole, M. L., 2005).” Threat appraisal involves a person reviewing a health threat and whether they regard it as severe and whether they think they are vulnerable to it. Coping appraisal deals with a person determining whether or not the suggested response or action in regards to this health threat is seen as effective and whether or not that person feels they have the ability to engage in the adaptive response/action (Ouimet, M. C. et al, 2009). The below attached figure from Lee, T. S., Kilbreath, S. L., Sullivan, G., Refshauge, K. M., & Beith, J. M. (2007) allows you to visually see the items that are included in this theory and how they lead to a health behavior:

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This theory has been used in several different studies regarding health behaviors. Beirens, T. et al (2010), determined that by using the PMT in developing their model they were able to
obtain a better understanding of what causes this behavior. This resulted in the determination that in order to encourage parents to safely store their poisonous products they must focus on the parents’ self-efficacy regarding safely storing these substances so their children are not vulnerable to them. In reviewing HIV/STD risk behaviors and perceptions among rural-to-urban migrants in China PMT was used to develop prevention intervention programs using it’s seven constructs to determine causal factors (Li, X., et al., 2004).

Overall the Protection Motivation Theory is a theory that can be used in addressing, attempting to prevent, and changing individuals reactions to a health threat. Community health organizations such as the Centers for Disease Control (CDC) can use this theory to determine why a community’s rate of syphilis has greatly increased. It can also be used by national organizations such as the American Cancer Society (ACS) to help determine how likely an individual is to participate in preventative measures for cancer. One drawback to this theory is that it does not tell you how to adjust the four factors that lead to protection health behavior so that there is a higher rate of adaptive responses to a health threat (Block, L. G. & Keller, P. A., n.d.).


References
Allen, R., Phillips, L., Pekmezi, D., Crowther, M., & Prentice-Dunn, S. (2009). Living well with living wills: application of Protection Motivation Theory to living wills among older caucasian and african american adults. PubMed Central 32(1): 44–59. doi: 10.1080/07317110802474643

Beirens, T., Brug, J., Van Beeck, E., Dekker, R., Den Hertog, P., & Raat, H. (2008). Assessing psychosocial correlates of parental safety behaviour using Protection Motivation Theory; stair gate presence and use among parents of toddlers. PubMed Central 23(4): 723-731. doi:10.1093/her/cym058

Beirens, T., Brug, J., Van Beeck, E., Dekker, R., Den Hertog, P., & Raat, H. (2010). Why do Parents with toddlers store poisonous products safely? PubMed Central 2010: 702821. doi:10.1155/2010/702827

Block, L. G. & Keller, P. A. (n.d.). Beyond protection Motivation: An Intergrative theory of health appeals. Tuck School of Buisness at Dartmouth. Retireved from
http: mba.tuck.dartmouth.edu/pages/faculty/punam.keller/Downloads/BeyondProtection.pdf

Grindley, E. J., Zizzi, S. J., Nasypany, A. M., & Thortensson, C. A. (2008). Use of protection motivation theory, affect, and barriers to understand and predict adherence to outpatient rehabilitation. Retrieved from http://findarticles.com/p/articles/mi_hb237/is_12_88/ai_n31297863/

Lee, T. S., Kilbreath, //S. L., Sullivan, G., Refshauge, K. M., & Beith, J. M. (2007). The development of an arm activity survey for breast cancer survivors using the Protection Motivation Theory. PubMed Central 7: 75. doi: 10.1186/1471-2407-7-75

Li, X., Stanton, B., Fang, X., Lin, D., Mao, R., Wang, J., . . . Harris, C. (2004). HIV/STD risk behaviors and perceptions among rural-to-urban migrants in China. PubMed Central 16(6): 538-556. doi:10.1521/aeap.16.6.538.53787

Ouimet, M. C., Simons Morton, B. G. , Noelcke, E. A., Williams, A. F., Leaf, W. A., Preusser, D. F., & Hartos, J. L. (2009). Perceived risk and other predictors and correlates of teenagers’ safety belt use during the first year of licensure. PubMed Central 9(1): 1-10. doi:10.1080/15389580701638793

University of Twente (n.d.). Protection Motivation Theory. Retrieved fromhttp: owl.english.purdue.edu/owl/resource/560/10/

Wu, Y., Stranton, B. F., Li, X., Galbraith, J., & Cole, M. L. (2005). Protection Motivation Theory and adolescent drug trafficking: relationship between health motivation and longitudinal risk involvement. Journal of Pediatric Psychology 30(2) 127-137. doi: 10.1093/jpepsy/jsi001