The protection motivation theory deals with how people cope with and make decisions in times of harmful or stressful events in life. These decisions are a way of protecting oneself from perceived threats. The theory attempts to explain and predict what motivates people to change their behavior.
Application in Health
The theory is used mainly as a model to explain decision making and action about health. For example – How will a person who has a threat of cancer respond to the suggestion to quit smoking? What are the cognitive appraisals taking place that will ultimately influence his decision?
Cognitive Process in Behaviour
The decision on whether or not to engage in health-related behaviors is governed by two distinct cognitive processes – threat appraisal and coping appraisal. Both these processes deal with the consequences that can be expected as a result of engaging or not engaging in specific health behavior. Perceptions of what others will expect or react are aspects of both types of appraisal.
a) Threat Appraisal: It deals with how threatened one feels by the threat. For example, how threatened is an individual by the possibility that she may have breast cancer. In threat appraisal, the mind evaluates the various factors that are likely to influence one to get involved in a potentially unhealthy behavior like smoking or using drugs. Perceived vulnerability and perceived severity are the two sets of beliefs from which threat appraisals are derived.
Perceived vulnerability is the individual’s belief that he is susceptible to an illness that is a potential health threat. For example, the individual may be asked to rate his chances using a Likert scale of ‘how likely he is to get lung cancer based on his smoking habits.’
Feeling that the health threat will have severe consequences in one’s life is called as perceived severity. This is measured in terms of choosing from responses like I agree, I strongly disagree, and I disagree when given sentences like ‘AIDS is a very dangerous disease.’
Fear arousal is a means of assessing how much fear has been evoked as a result of perceived vulnerability and severity. Individuals can be asked how they feel about the thought of having a particular disease. Responses like not worried, very anxious are indicators of the level of fear regarding a threat.
b) Coping Appraisal: Here one evaluates the various factors that are likely to ensure that one engages in a recommended response that is preventive in nature. For example, taking a daily walk or using a condom. There are three sets of beliefs involved here.
Response efficacy is the belief that engaging in a certain behavior will result in the health threat getting reduced.For example, here there is a feeling that ‘If I exercise more, I will lose weight and lessen the threat of heart disease.’
The second, self-efficacy deals with the belief that one has the required capabilities to engage in a health behavior. This is measured by responses to a statement like ‘It is easy to wake up early every day and exercise’ with words like I agree, I disagree, etc.
The last set of beliefs, the perceived response-cost deals with the costs that one attaches to the performance of a health behavior. For example, a lady should feel comfortable getting a mammogram. Feeling awkward may deter her from undergoing the exam.
Sometimes if an individual is convinced that the rewards of not adopting a particular health reward are higher that the benefits received from adopting, he may continue his negative habits. For example, continuing to use drugs because it provides an escape from life or continuing to eat unhealthy fast food because it is cheaper than healthy food.
The theory therefore says that in order for an individual to adopt a health behavior, they need to believe that there is a severe threat that is likely to occur and that by adopting a health behavior, they can effectively reduce the threat. The individual should also be convinced that he is capable of engaging in the behavior which should not cost him a lot.
A ‘measure of intention’ to engage in the recommended preventive behavior is the most common index of protection motivation.