Should Awareness Campaigns Be Fear-based or Support-based?

Study exploring FASD awareness messages in college women revisits old, but still unanswered, questions

An article published recently in Health Communications raises more questions about how to frame FASD awareness messages. (You may want to check out a previous post Are shock tactics effective?, March 22, 2011).

The researchers asked college women to read four different messages about FASD and evaluated their responses. They found that women responded much more strongly to reading a story that concluded with a child being born with FASD (i.e., potential losses associated with drinking during pregnancy) as compared to a “happy story” of a child being born without FASD (i.e., potential benefits associated with not drinking during pregnancy). They also found that messages which used the stories of a woman or a group of women that they could identify with were more effective than statistics or abstract generalizations.

The study was only able to look at attitudes and intention to change behaviours immediately after being exposed to various messages. It’s impossible to know what kind of effect the messages would actually have on various behaviours such as using contraception effectively, changing alcohol use patterns, and drinking during pregnancy in the future. The researchers did comment that less than 2% of participants said they were going to get pregnant in the near future – implying that this particular group of college women did not perceive FASD as something that could happen to them.

It’s unclear as to what approach awareness campaigns should take – fear-based or support-based? In this study, the researchers commented on how different messages portrayed mothers. In the messages that focused on potential losses resulting from drinking alcohol during pregnancy, mothers were portrayed as irresponsible. In messages that focused on the benefits of not drinking during pregnancy, mothers were portrayed as responsible.

Judgment and stigma are just some of the issues to consider when developing awareness campaigns. And FASD may be different than other types of health concerns and behaviours. Burgoyne (2005), in her review of Canadian FASD awareness campaigns comments:

“It is still unclear if fear-based appeals are effective and appropriate in campaigns for pregnant women, and more specifically, in raising awareness about alcohol and pregnancy. There are concerns about possible side effects of fear-based campaigns, such as increased stigma about alcohol use in pregnancy, increased stress for pregnant women, decreased access to services and increased fear of disclosure of alcohol use in pregnancy.” (p. 41)

She also comments on the need to strike a balance between threat (i.e., is it serious? could it happen to me?) and efficacy (i.e., can I do what the message is suggesting?). As well, sometimes the problem is not really awareness in which case the message could be alienating.

“The risks can be presented in a context that is fear-based (e.g. an image of a fetus in a wine glass), or the risks can be presented in a manner that is positive and supportive (e.g. an image of community support for a pregnant woman). When initial awareness strategies are not effective, it can be tempting to increase the level of threat to scare people into changing their behaviour. However, the barrier to change may not be the awareness of the risks, but may be a need for information and support to assist in the process of behaviour change.” (p. 16)

Check out some examples below of different messages, approaches, and intended audiences. What do you think works?


Burgoyne, Wendy. (2005). What We Have Learned : Key Canadian FASD Awareness Campaigns. Best Start: Ontario’s Maternal Newborn and Early Child Development Resource Centre & Public Health Agency of Canada.

Yu, N. , Ahern, L.A. , Connolly-Ahern, C. and Shen, F. (2010). Communicating the Risks of Fetal Alcohol Spectrum Disorder: Effects of Message Framing and Exemplification. Health Communication, 25: 8, 692- 699. PMID: 21153985 DOI: 10.1080/10410236.2010.521910

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