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Background: Previous research has raised a number of questions about the core propositions of the Extended Parallel Process Model (EPPM). Very few previous examinations of the model have included qualitative assessments. Methods: The current study utilised a mixed method approach to experimental test EPPM-based threat-to-efficacy ratios in health risk messages about CVD and the associated health behaviours among older adults (60+ years) who would be at an alleviated risk of CVD. The current focus is on the qualitative aspect of this assessment and utilised a think aloud methodology in order to gain greater insight into participants’ thinking and problem-solving processes when presented with EPPM-based communications about cardiovascular disease (CVD). 24 participants (4 per group; Female = 14; Age, M = 74.38, SD = 7.16) were randomly assigned to one of six EPPM threat-to-efficacy ratio CVD message groups. Results: A thematic analysis was conducted, and the important themes were those of different threat perceptions for varying CVD manifestations (heart disease versus stroke), and the role of comparative (versus personal) threat and efficacy perceptions for all participants. The difference between threat appraisals for stroke versus other CVD manifestations was a novel finding. Conclusions : For the EPPM and other theories of health risk and decision-making, the impact of comparative risk and social examples for individual threat and efficacy perceptions needs to be counted.

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Examining the Extended Parallel Process Model for communicating about cardiovascular disease to an at-risk population utilising a think aloud methodology