The Extended Parallel Processing Model (also widely known as Threat Management or Fear Management) describes how rational considerations (efficacy beliefs) and emotional reactions (fear of a health threat) combine to determine behavioural decisions. As stated in The Extended Parallel Processing Model: An HC3 Research Primer [PDF], the degree to which a person feels threatened by a health issue determines his or her motivation to act, while one’s confidence to effectively reduce or prevent the threat determines the action itself. The theory is designed to be used in social and behaviour change communication (SBCC) campaigns when a health issue "poses a real or perceived threat to personal health."


"There are four key variables...In the case of HIV/AIDS, [for example], the questions you would ask someone to measure these beliefs might be as follows:

  • Threat variables: 
    • Perceived severity - How serious are the consequences if you became infected with HIV?
    • Perceived susceptibility - How likely is it that you might contract HIV?
  • Efficacy variables:
    • Response efficacy - How effective is a proposed solution, such as abstinence or condom use, at preventing HIV infection?
      • Self-efficacy - How confident are you that you could successfully practice the proposed solution?"


    The theory suggests that, through question responses, people in an intended audience can be classified as having either high or low levels of perceived efficacy and either high or low levels of perceived threat. These four different audience segments would need to be addressed with different health message strategies that increase threat perceptions or increase efficacy beliefs. "Communication campaigns using the EPPM framework can help audiences develop realistic risk perceptions and provide realistic and actionable information about how to reduce risk."

    According to this document, implementers should know: "SBCC programs that use EPPM emphasize efficacy variables rather than the threat variables and provide just enough threat messaging to create motivation to act. If individuals perceive the threat to be higher than their perceived ability to do something about it, then behavior change is unlikely to occur. Thus, it is important to balance messages that encourage individuals to accurately assess their level of risk with messages that empower them to overcome or avoid that risk."


The Extended Parallel Processing Model: An HC3 Research Primer [PDF], Health Communication Capacity Collaborative (HC3), March 16 2015.