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Accepted for/Published in: JMIR Formative Research

Date Submitted: Aug 27, 2025
Open Peer Review Period: Aug 28, 2025 - Oct 23, 2025
Date Accepted: Jan 20, 2026
(closed for review but you can still tweet)

The final, peer-reviewed published version of this preprint can be found here:

The Role of Fear, Hope, Message Fatigue, and Message Shocking Value in Promoting the Public’s Understanding and Support Toward COVID-19 Wastewater Monitoring: Experimental Study

Jeon M, Kim Y

The Role of Fear, Hope, Message Fatigue, and Message Shocking Value in Promoting the Public’s Understanding and Support Toward COVID-19 Wastewater Monitoring: Experimental Study

JMIR Form Res 2026;10:e83060

DOI: 10.2196/83060

PMID: 41773660

PMCID: 12954702

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

How Emotions, Pronoun Use, and Message Values Shape Public Understanding and Support for Wastewater Monitoring: Experimental Study

  • Moonsun Jeon; 
  • Youllee Kim

ABSTRACT

Background:

Although wastewater monitoring is an effective, non-intrusive public health strategy for tracking community-level COVID-19 prevalence, there has been limited research on public perceptions of this novel surveillance method. A significant gap exists in understanding how to design effective communication campaigns to gain public support for wastewater monitoring and persuade individuals to take preventive actions based on the data.

Objective:

This study examines the impact of emotional appeals (fear vs. hope) and pronoun use (we vs. you) on public support for COVID-19 wastewater monitoring, intentions to discuss the intervention, and intentions to engage in preventive behaviors.

Methods:

An online 2 (emotional appeal: fear vs hope) × 2 (pronoun use: you-language vs we-language) between-subjects experiment with a control condition was conducted. A total of 603 US residents were recruited via Prolific in July 2023. Participants were randomly assigned to view one of five message stimuli and then completed a survey measuring emotional responses, message judgments (fatigue and shocking value), and the primary outcome variables.

Results:

Fear appeals led to greater support and stronger intentions to engage in preventive behaviors than hope appeals, while pronoun use had no significant effect. Additionally, message fatigue and shock value mediated the relationship between the message-evoked emotions and the outcome variables, whereby message fatigue was negatively associated with the outcome variables, and message shock value was positively correlated with policy support and communication intention.

Conclusions:

The findings suggest that while fear-based messages are effective, communication strategies should also aim to mitigate message fatigue to sustain public engagement and support for long-term public health initiatives.


 Citation

Please cite as:

Jeon M, Kim Y

The Role of Fear, Hope, Message Fatigue, and Message Shocking Value in Promoting the Public’s Understanding and Support Toward COVID-19 Wastewater Monitoring: Experimental Study

JMIR Form Res 2026;10:e83060

DOI: 10.2196/83060

PMID: 41773660

PMCID: 12954702

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