Lentis/Protection Motivation Theory

Definition
Protection Motivation Theory (PMT) is a social cognition theory which attempts to explain motivation to respond to health threats ranging from COVID-19 to smoking. It is a framework used by researchers to evaluate the likelihood of individuals engaging in a protective behavior when faced with a general threat. For example, PMT seeks to explain what would motivate an individual to partake or refrain from getting a vaccine while in the midst of a global pandemic. PMT states that an individuals protection motivation is a product of two evaluations carried out by the individual: the threat appraisal and the coping appraisal.

Threat Appraisal
The threat appraisal is the evaluation of the degree to which an event has significant implications on an individual's wellbeing. It is composed of three components: the severity of the threat, the vulnerability to the threat, and the rewards of the behavior. The severity of the threat is the degree of harm from the threat. The vulnerability is the likelihood of experiencing harm. The rewards are the possible benefits from partaking in the behavior, and can be both intrinsic and extrinsic. For example, when faced with the threat of COVID-19, the severity of the threat would be the likelihood that contracting the disease would do harm to the individual, the vulnerability to the threat is the likelihood of contracting the disease, and the rewards might be sticking by political beliefs or increased mask sales.

Coping Appraisal
The coping appraisal is the evaluation of the capability to respond to the threat with the recommended preventative behavior. It is composed of three components: response efficacy, self efficacy, and the response costs. Response efficacy is the belief that a certain behavior will reduce the threat. Self efficacy is the belief that the individual has the ability to perform the behavior. Finally, response costs are the perceived costs of partaking in the preventative behavior. . In the COVID-19 example, response efficacy is the belief that that vaccines work, self efficacy is the belief that an individual has the ability to get a vaccine, and the response costs may be potential side effects

Health Sector Applications
PMT is frequently used as a cognitive framework in research studies to understand people's behaviors in response to threats. Researchers have sought to test the predictive value of PMT by comparing a prediction model to observed behavior; they have consequently diagnosed the primary factors (e.g., threat appraisal components and coping appraisal components) determinant of subject behavior. Identifying these factors advises policymaking groups such as government bodies, the CDC, boards of education, or advocacies on how they might influence individuals' behavior in similar situations (see choice architecture.) PMT was first developed and applied "to describe how individuals are motivated to react in a self-protective way towards a perceived health threat," but it is also relevant to any sector involving a perceived threat. For individuals to adapt their behavior they must perceive a high level of threat, vulnerability, behavioral efficacy, and self efficacy as well as a low cost. Representative case studies of PMT as a predictive model for categories of health-related behavior are outline below.

Exercise
Researchers examine "the utility of [PMT] in the prediction of exercise intentions and behavior in the year following hospitalization for coronary artery disease (CAD.) Based upon patient questionnaires measuring PMT's threat and coping appraisal, they find a good fit between structural equation modeling  and empirial exercise behavior data at 6 months post hospitalization, but less so after 12 months. Thus, they recommend "health education...concentrate on providing positive coping messages to enhance patients' confidence regarding exercise and their belief that exercise provides health benefits, as well as realistic information about disease severity."

Drugs and Alcohol
Researchers compare PMT constructs with "intention and tobacco use behavior" among a group of 440 high school boys in Noshahr, Iran. The "validity and reliability" of a questionnaire including "demographic information, the constructs of [PMT], and tobacco use behavior." Based on structural equation modeling they conclude that "PMT provides a useful framework for investigating factors of tobacco use among male students, [and] future tobacco prevention interventions should focus on increasing the vulnerability and fear, decreasing intrinsic reward, and improving self-efficacy to reduce tobacco use."

Sexually Transmitted Infections (STI)
To inform HIV prevention, researchers "explored youth's knowledge, attitudes and behaviors related to sexual risk taking through the lens of [PMT]." Focus groups among reservation-based American Indian youth suggest low perceived self-efficacy of condom use, HIV prevention knowledge, and vulnerability to STIs. They also identify factors such as alcohol, parental monitoring, and peer influence as related to sexual risk taking. Guided by the PMT framework, they submit that "future HIV prevention interventions should be delivered to gender-specific peer groups, include a parental component, teach sexual health education and communication skills, integrate substance-use prevention, and work to remove stigma around obtaining and using condoms."

Disease
Researchers evaluate the predictive value of PMT and the Big Five (B5) model of personality in regard to the SARS-CoV-2 pandemic (COVID-19). They measure "both adaptive (i.e., preventive) and maladaptive (i.e., avoidant behavior and wishful thinking) coping behavior" during the first wave of the pandemic among the general Polish population. They find "strong support for the PMT constructs' predictive value, especially with regard to pandemic-related adaptive behavior" and incremental validity of the PMD model over demographic variables and personality traits. Thus "to increase adherence to preventive measures during an epidemic, all the PMT constructs should be considered while persuasive communication to the public is formulated."

Other Sectors Applications
While PMT gained legitimacy in the health sector, it has since expanded into research in various other fields. In all sectors, researchers are using PMT to find connections between threats and public response, aimed at understanding this relationship to alter public response in the future. The same concepts of threat severity, vulnerability, and coping efficacy that were originally applied to medical decisions are being applied to understand the decisions and responses the public has to threats from all directions.

Cybersecurity
Researchers are evaluating if messages sent to subjects can generate a response that strengthens their cybersecurity habits while online. A recent study sent either threatening or coping messages to participants and evaluated participants responses through their online behaviors. Using the results, the researchers were able to draw conclusions on what kind of message generates the greatest response and can apply this information to nudge users towards behavior that will prevent theft, fraud, etc.

Natural Disasters
In the field of natural disaster preparedness, a large gap exists between those who are aware of an impending natural disaster and those who are prepared for it. Similar to the cybersecurity studies, researchers are using PMT to evaluate public service messaging to find what kind of message resonates the most with individuals. Further understanding of how to use PMT with messaging aims to achieve "safer processes and response behavior," when the population is faced with an impending disaster to ultimately protect human and animal life.

Climate Change
Researchers are also examining in the fields of climate change seeking fossil fuel reduction are using PMT to find any correlation between an intent to reduce fossil fuel use and PMT concepts such as severity of the threat and self efficacy. A study asking participants to rank their agreement with PMT constructs as the relate to climate change found that those who perceive climate change as a greater threat and that they had the ability to cope with this threat were most likely to change their fossil fuel habits.

Key Takeaways

 * Broader Application - Predictive models like PMT can be used to predict behavior and influence policy decision making (i.e. choice architecture), in any field. Several studies across various fields have concluded that PMT constructs can act as indicators of individuals' intentions to refrain or partake in a given behavior.
 * Connecting Sosh and Tech - Technical innovations require social strategies (like PMT) for meaningful implementation. The understanding of PMT constructs can act as a bridge between advancing technology and implementation by the public.