The use of fear appeals for pandemic compliance: A systematic review of empirical measurement, fear appeal strategies and effectiveness.

Interventions to pandemic outbreaks are often associated with the use of fear-appeal to trigger behavioral change, especially in public health issues. However, no systematic review exists in the literature on the effectiveness of fear appeal strategies in the context of pandemic compliance. This paper aims at providing systematic literature review that answers the following thought-provoking research questions: (1) What is the standard measurement of fear in relation to pandemics in the existing literature? (2) What are the fear appeal strategies used in the empirical literature? (3) How effective are fear appeal strategies in changing behavior toward adopting pandemic preventive measures? A total of 22 studies were selected from 455 potential studies, following a comprehensive literature search and assessment in accordance with the PRISMA guidelines. The findings show that nearly all the available studies on fear measurement used the Likert scale (as the standard approach) with different points of degree and fear appeal strategies such as fear triggers in media channels, print advertisements, and verbal descriptions. Furthermore, most studies conclude that fear appeal is effective in making participants adopt pandemic preventive measures; hence, it is effective for positive behavioral change (the degree of effectiveness depends on gender, population group, etc.), especially when combined with self-efficacy and socio-cultural considerations. Very few studies, however, find an insignificant association, arguably due to the kind and intensity of the fear appeal messages and strategies used.