Applications of the Extended Parallel Process Model in health promotion: A systematic review

The Extended Parallel Process Model (EPPM) is a widely recognized theoretical framework for promoting health-related behavior change through fear-based messaging. This study aimed to systematically review national and international research that applied the EPPM in the design of health education interventions and enhancing the effectiveness and integration of such interventions. A systematic review was conducted on studies published between 1992 and 2024 that utilized the EPPM in the development of health-related interventions. Eligible studies were retrieved through a structured search of academic databases. The identified studies were analyzed and categorized into four thematic domains: systematic coordination of care components, continuous feedback mechanisms, creative design of intervention processes, and coherence in healthcare team performance. Nineteen studies met the inclusion criteria and were reviewed. Most interventions focused on core EPPM constructs such as perceived threat, message efficacy, and behavior change outcomes. However, the comprehensive and integrated use of the model across all components was limited. Few studies incorporated interdisciplinary collaboration, innovative process design, or systemic feedback loops in their application of EPPM. The findings suggest that while the EPPM holds significant promise for developing effective health promotion strategies, its full potential is best realized when applied within a broader structural and process-oriented framework. Future research should emphasize the operational integration of these models to enhance the coherence, adaptability, and sustainability of health education interventions.