title: Does changing the order of threat and efficacy information influence the persuasiveness of threat messages?
abstract: OBJECTIVE
  The aim of this study is to investigate the impact of changing the conventional threat-before-efficacy order of threat messages on the persuasiveness of a leaflet informing women smokers of the link between smoking and cervical cancer.
  
  
  METHODS
  The study used a between-groups design in which women smokers were sequentially allocated to one of three groups. Two groups received one of two leaflets aimed at providing information about the link between smoking and cervical cancer: one provided threat-before-efficacy information; the other provided efficacy-before-threat information. The third group received no leaflet.
  
  
  METHODS
  Participants (N=178) were recruited by a commercial survey organization. Purposeful sampling was used to ensure that women with a wide range of ages and educational qualifications were included. Outcomes were intention to stop smoking, recall of information, and threat and efficacy perceptions.
  
  
  RESULTS
  Although women in the 'efficacy-before-threat' group recalled more efficacy information, and those in the 'threat-before-efficacy' group recalled more threat information, the leaflets were similarly persuasive. Compared with women not given a leaflet, those given either of the two leaflets had greater intentions to stop smoking and higher threat and efficacy perceptions.
  
  
  CONCLUSIONS
  Informing women of the link between smoking and cervical cancer increases their intentions to stop smoking. Changing the order of threat and efficacy information does not influence the persuasiveness of this message. Order effects may be more likely in experimental contexts using weaker messages or those that are not novel.
authors.affiliation: Health Psychology Section, Department of Psychology, Institute of Psychiatry, King's College London, UK. sue.hall@kcl.ac.uk
authors.forename: Sue
authors.initials: S
authors.lastname: Hall
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Bishop
authors.forename: Theresa M
authors.initials: TM
authors.lastname: Marteau
mesh_terms: D000328:Adult; D001294:Attitude to Health; D004739:England; D005260:Female; D006266:Health Education / Q000379:methods*; D006801:Humans; D033182:Intention; D011939:Mental Recall; D008875:Middle Aged; D010174:Pamphlets; D010565:Persuasive Communication; D020377:Self Efficacy; D012907:Smoking / Q000009:adverse effects* / Q000523:psychology; D016540:Smoking Cessation / Q000523:psychology; D000074606:Smoking Prevention; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000209:etiology*; D014626:Vaginal Smears; D016387:Women's Health