The Precaution Adoption Process Model

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Updated: Jul 10, 2021
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Category: Psychology
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If someone was faced with a health problem, how prepared would they be to resolve it? Would they have the knowledge to act in times of a crisis? The Precaution Adoption Process Model (PAPM) was developed to explain how a person makes decisions to take action and how he or she relates that decision into action (Sandman, Weinstein, & Blalock, 2001); it can be utilized to help people take part in health protective behaviors and move through its seven stages: (1) being unaware of the issue, (2) being aware of the issue but not engaging, (3) undecided about what to do, (4) deciding not to act, (5) deciding to act, (6) acting, and (7) maintaining the action (Sandman et al., 2001). A health protective behavior is an action linked to decreasing the risk of developing a disease and negative health outcomes as well as maintaining a healthy lifestyle (LumenCandela). In this paper, the author will be exploring PAPM’s stages and how they can be utilized. PAPM should be able to help the general population effectively move towards resolving an risk and maintain positive health protective behaviors through interventions aimed at each stage which show risk reducing benefits.


This paper explores how the Precaution Adoption Process Model (PAPM) and its seven stages can be used to help people become informed, act, and maintain action for health related issues. In two studies conducted by Sniehotta, Luszczynska, Scholz, & Lippke (2005) and Barnard, George, Perryman, & Wolff (2017), PAPM was used to educate the public and study changes that occur when moving from stage to stage. The results of these studies show that action usually occurs when participants are engaged with intervention gauged at their stage and when they perceive that their actions exhibit reduced risk of an issue.

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PAPM has been used to help examine perceived risk in many different health risk situations. For example, in November 2000, the first case of Bovine spongiform encephalophy (BSE), a fatal disease in cattle that stems from prions, occured in Germany. This was matched with a significant decrease in beef consumption. PAPM was used to help study that behavior changes in each stage (Sniehotta, Luszczynska, Scholz, & Lippke, 2005).

Also, a study on college students’ preparedness and knowledge of HPV was tested using PAPM. Human papillomavirus (HPV) is a widespread sexually transmitted infection correlated with increased cancer risks. About 79 million Americans are currently living with HPV, and there are about 14 million new cases every year. Although most of these cases being found in 15 to 24 year olds, little research has been conducted about how college-aged students transition into making their own health decisions. This study documented by Barnard, George, Perryman, & Wolff (2017) sought to examine HPV vaccination awareness in male and female college students and to use PAPM to examine how knowledgeable students are about HPV and HPV vaccines, assess concerns about vaccination, and find factors that influence whether or not students will receive a vaccine (Barnard et al., 2017).

Literature Review

PAPM was originally based on the ideas of Irving Janis and Leon Mann who tried to explain responses to threats by explaining that there are categories which were determined by people’s beliefs about their ability to cope with threats in 1977 (Sandman, Weinstein, & Blalock, 2001). PAPM has been used in a multitude of previous studies such as the study of home radon protection, the study of osteoprotective behavior, and the study for helping parents of kids with asthma stop smoking (Sharma, 2007). Sniehotta et al. (2005) examined stage models such as the health action process model, the transtheoretical model, continuum models, and PAPM to compare their stages and test which would best fit the study. PAPM was chosen, using five of the seven stages and two additional stages to replace the maintenance stage. Barnard et al. (2017) did not examine any past studies, only the background of the theory and its general effectiveness.



PAPM clearly makes a distinction between people who intend on maintaining their health protective behaviors and those who do not. Those who decided to act did so because of expected risk-reducing effects (Sniehotta et al., 2005). Also, PAPM could be used to help raise health protective behaviors when interventions are aimed at individuals in a certain stage. People in the early stages could quickly be brought through the model when early intervention is staged (Barnard et al., 2017). Limitations to using PAPM during these studies include a low number of participants in several stages and the fact that the measures were self-reported (Sniehotta et al., 2005; Barnard et al., 2017).


PAPM shows that issues that are important to a changed behavior appear before people ever consider taking action and different issues emerge after people have decided to act. It is a framework that can be used to identify discover what limits movement from one stage to the next (Sandman et al., 2001). Using PAPM, interventions can occur based on the stage a person is currently in. Because of this, organizations can better understand their audience and hold events that will benefit both parties (Barnard et al., 2017). Through PAPM, scientists will be able to learn more about the barriers that hold a person back from following through with health protective behaviors as well (Sandman et al., 2001).

Future Research

In the future, more studies will need to be conducted to verify a difference between stages in other precautionary acts (Sniehotta et al., 2005). According to Barnard et al. (2017), further research is needed to assure reliability of the model and study. Sharma (2007) explained that when there is more data available, there will be more information about the benefits of PAPM and its effectivity.

Answers to the Questions

The author chose to research the Precaution Adoption Process Model. In 1988, Weinstein created PAPM, which takes into account the different stages a person may be in with relation to a problem. This idea was later refined by Weinstein and Sandman in 1992 (Sharma, 2007). Their model proposed seven stages in PAPM: (1) being unaware of the issue, (2) being aware of the issue but not engaging, (3) undecided about what to do, (4) deciding not to act, (5) deciding to act, (6) acting, and (7) maintaining the action (Sandman et al., 2001).


Overall, PAPM can be used when studying a multitude of health related conditions. Studies conducted by Sniehotta et al. (2005) and Barnard et al. (2017) both utalyzed PAPM. Through these studies, the author found that participants who perceive risk reducing benefits from actions and are engaged by interventions aimed at their particular stage are more likely to maintain action of health protective behaviors when acting against a risk. The author is confident that PAPM can be helpful for people who are uneducated about a pertinent issue in the medical world or a person who has not decided to act. Although more studies are needed to truly verify the validity of PAPM, this model is has proven to be helpful with increasing a population’s education on a risk. Hopefully, the general population will be able to utilize this model to educate a wider group of people on more emerging medical issues.

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The Precaution Adoption Process Model. (2021, Jul 10). Retrieved from