**1. Introduction**

Physical activity and healthy eating are part of the solution for the ongoing obesity epidemic [1,2]. In the last decade, national policy initiatives focused on physical activity and healthy eating have spread in Latin American countries. Programs aimed at promoting healthy lifestyles by addressing eating behaviors and physical activity are at the center of every government's agenda. Despite these efforts, in Latin America, the prevalence of overweight and obese adults has increased markedly in the last three decades [3–7].

Emotions play a significant role in advertising [8,9]. The emotions of fear and hope could stimulate individuals to make health-related decisions [10–12]. In the U.S., Krishen and Bui [13] reported that fear-based framing of health messages could lead to positive decision intentions and, consequently, help people make better health-related decisions. Fear is a powerful emotion in getting individuals to change their behavior. Advertising, especially health advertising, is meant to be effective and aims to change individuals' behaviors towards their health. Thus, fear advertising may be considered a useful tool for changing people's attitudes towards healthy eating and participating in physical activity [10,14]. The frequency of fear appeals in advertisements varies across countries

and cultures [15,16]. Unfortunately, in Latin America, not enough is known about the potential that fear-mongering could have in health advertisements. There is no research analyzing its effectiveness in the region, and fear-mongering advertising has seldom been employed. Consequently, this research study's first objective is to examine the effects of fear-based framing of health advertisements on healthy eating intention and physical activity intention among adults in Chile.

A major limitation of the Krishen and Bui [13] study was that they treated subjects as a homogenous group. The way recipients process messages from fear appeals could be affected by their particular characteristics [17,18]. No studies have addressed the way the effectiveness of fear-based advertisements differs across differently characterized individuals, or the circumstances under which fear-based advertisements could potentially influence health-related choices. In fact, Krishen and Bui [13] recommend that future research includes the moderating roles of self-esteem, self-control, and other individual characteristics on subsequent health decisions. For these reasons, this study's second objective is to incorporate the individual characteristics (frequency of fast food consumption, body weight, past behavior, subjective norms, social influences regarding physical activity, self-efficacy, self-esteem, and self-control) as moderators. This research aims to identify the situations related to different individual attributes in which fear-mongering advertisements work as a useful tool to elicit behavior changes. Table 1 summarizes the identified hypotheses to achieve both research objectives.



Note: (+) indicates that the variable has a positive effect on the dependent variable and (−) indicates that the variable has a negative effect on the dependent variable.

#### *1.1. Fear Versus Hope Appeals in Health Advertisements*

The frequency of fear appeals in advertisements varies across countries and cultures [15,16]. Fear appeals are more frequently used in Canada and China than in France [15]. This resonates with the cultural value of uncertainty avoidance, a characteristic more present in France than in Canada or China [15,19]. Previous studies have found evidence that fear works [20]. Krishen and Bui [13] reveal that, in the U.S., fear-based framing of health messages can direct individuals to positive decision intentions, thus helping them make better-planned health-related decisions. The question then arises: do cultural aspects influence the effects of fear versus hope appeals in health advertisements? Latin America has higher uncertainty avoidance levels than the U.S. [19,21]. The uncertainty avoidance score expresses the extent to which the members of a culture feel threatened by ambiguous or unknown situations and have created beliefs and institutions to try avoiding these circumstances [19]. Given that cultures with high uncertainty avoidance levels have beliefs and institutions to deal with fear, Matsumoto [22] suggests that people may tend not to recognize fear or may attenuate attributions

of its intensity when sensed or expressed. As there is no information on the potential of fear appeals in health advertisements in Latin America, to examine the fear-priming effects, the first hypothesis is proposed:

**Hypothesis 1.** *When subjects view a fear advertisement in Chile, they will be more likely to report (a) greater healthy eating intention and (b) greater physical activity intention, than when they view a hope advertisement.*

#### *1.2. The Moderating Role of Individual Characteristics*

A major limitation of Krishen and Bui's [13] study was that they treated subjects as a homogenous group. The way recipients process messages from fear appeals could be affected by their particular characteristics [17]. No research has studied the circumstances under which fear advertisements can potentially influence health-related decisions and how their effectiveness varies across individuals. This study aims at figuring out if different reactions from people with different characteristics will affect the results of fear advertising. Krishen and Bui [13] suggest that traits such as self-esteem and self-control, among others, should be considered in future research.

#### 1.2.1. Fear Appeals and Avoiding an Aversive State

Fast food is generally low cost and the promotion is active, referring to consumers' social surroundings and behaviors [23,24]. Frequent fast food consumption has been linked to obesity, diabetes, hypertension, and heart disease [25,26]. In a hope environment, a favorable outcome could occur (e.g., healthy living), whereas, in a fear environment, an unfavorable outcome could be avoided or even resolved (e.g., death) [27]. The emotion of fear could stimulate individuals to deal with the causes of that emotion (fast food consumption) [10]. Fear engenders a desire to escape from or avoid an aversive state [28]. As a primary aversive emotion, fear arises in situations of menace to the organism (i.e., the individual) and enables them to respond to them adaptively [29]. Through fear, individuals with frequent fast food consumption may have a greater intention to eat healthily and do physical activity in order to escape from this aversive state [28,29], that is, the negative effects (e.g., obesity, diabetes, hypertension, heart disease) associated with frequent consumption of fast food. [25,26]. Consequently, the effects of fear (vs. hope) appeals in health advertisements on healthy eating intention and physical activity intention could be stronger among individuals having higher (e.g., once a day, more than once a day) rather than lower (e.g., occasionally, never) frequency of fast food consumption. Hence:
