Peter R. Harris

Self-Affirmation and the Biased Processing of Threatening Health-Risk Information

Self-affirming before reading about the link between alcohol and breast cancer promoted increased message acceptance among young women at higher risk. Differences were maintained on variables measured up to 1 month later. Relative to their nonaffirmed counterparts, higher risk, self-affirmed participants had higher ratings of risk, imagination, intention to reduce alcohol consumption, and negative affect, such as fear, while reading the leaflet. In contrast, there were no differences between the groups on measures of broader message acceptance (belief in the link, evidence strength). Thus, self-affirmation promoted acceptance of the personal relevance of the message, a critical step in the precaution adoption process. Overall, the findings support the view that self-affirmation in an unrelated domain can offset defensive processing of a threatening health message, promoting central route persuasion and producing consequential and durable increases in message acceptance.

Trust and mistrust of online health sites

Do different design and information content factors influence trust and mistrust of online health sites? Fifteen women faced with a risky health decision were observed while searching the Internet for information and advice over four consecutive weeks. In some sessions their searches were unstructured, whilst in other sessions they were directed to review specific sites, chosen for their trust design elements. Content analysis of concurrent verbalisations and group discussion protocols provided support for a staged model wherein design appeal predicted rejection (mistrust) and credibility of information and personalisation of content predicted selection (trust) of advice sites.

Self-affirmation reduces smokers' defensiveness to graphic on-pack cigarette warning labels

OBJECTIVE Little is known about how smokers respond to graphic images depicting the health consequences of smoking. The authors tested whether smokers respond defensively to such images and whether allowing them to self-affirm reduces their defensiveness. DESIGN Young smokers (N = 87) were randomly allocated to self-affirm or perform a control task prior to viewing 4 images intended for future use on cigarette packs in the European Union. Measures were taken immediately postexposure and after 1 week. MAIN OUTCOME MEASURES Participants rated each image for threat and personal relevance. Once all 4 images had been viewed, they completed measures of intentions, self-efficacy, and perceived behavioral control for reducing cigarette consumption, negative thoughts and feelings about smoking, personal vulnerability to 6 smoking-related diseases, desire to quit, and plans to quit. At the 1-week follow-up, measures of self-reported smoking and desire to reduce consumption were taken. RESULTS Relative to controls, self-affirmed participants rated the images as more threatening and personally relevant, and they reported more negative thoughts and feelings and higher levels of control, self-efficacy, and intentions. Risk level moderated the effect of self-affirmation on relevance and intentions: Self-affirmation increased ratings on both measures among those who smoked more. In addition, self-affirmation moderated the threat-intention relationship, which was weaker in the self-affirmed group. At follow-up, motivation to reduce consumption remained higher in self-affirmed participants, but there were no differences in reported consumption. CONCLUSION Self-affirmation can promote less defensive responding even to visual material about well-established health risks such as smoking.

A framework for understanding trust factors in web-based health advice

Trust is a key factor in consumer decisions about website engagement. Consumers will engage with sites they deem trustworthy and turn away from those they mistrust. In this paper, we present a framework for understanding trust factors in web-based health advice. The framework is derived from a staged model of trust and allows predictions to be made concerning user engagement with different health websites. The framework is then validated via a series of qualitative, longitudinal studies. In each study, genuine consumers searched online for information and advice concerning their specific health issue. They engaged in free searching and were directed towards sites previously reviewed using the framework. Thematic analysis of the group discussions provided support for the framework and for the staged model of trust wherein design appeal predicted rejection (mistrust) and credibility of information and personalization of content predicted selection (trust) of advice sites. The results are discussed in terms of the merits of the framework, its limitations and directions for future work.

Self-affirmation promotes health behavior change

OBJECTIVE Evidence shows that self-affirmation has a positive effect on message acceptance and other variables that motivate health behavior change; however, this has not been translated into actual behavioral change. We propose that particular features of the previous studies may account for this failure; the current study addresses this. It is designed to test whether a self-affirmation manipulation can increase a health-promoting behavior (fruit and vegetable consumption). It also explores the extent to which efficacy variables mediate the self-affirmation and behavior relationship. DESIGN Women (N = 93) were randomly allocated to a self-affirmation or control task prior to reading a message regarding the health-promoting effects of fruit and vegetables. MAIN OUTCOME-MEASURES: Response-efficacy, self-efficacy, and intention measures were taken immediately after exposure to the message, followed by a 7-day diary record of fruit and vegetable consumption. RESULTS Self-affirmed participants ate significantly more portions of fruit and vegetables, an increase of approximately 5.5 portions across the week, in comparison to the control group. This effect was mediated by response-efficacy. CONCLUSION Self-affirmation interventions can successfully influence health-promoting behaviors.

Testing the limits of optimistic bias: event and person moderators in a multilevel framework.

N. D. Weinstein (1980) established that optimistic bias, the tendency to see others as more vulnerable to risks than the self, varies across types of event. Subsequently, researchers have documented that this phenomenon, also known as comparative optimism, also varies across types of people. The authors integrate hypotheses originally advanced by Weinstein concerning event-characteristic moderators with later arguments that such optimism may be restricted to certain subgroups. Using multilevel modeling over 7 samples (N = 1,436), the authors found that some degree of comparative optimism was present for virtually all individuals and events. Holding other variables constant, higher perceived frequency and severity were associated with less comparative optimism, higher perceived controllability and stereotype salience with more comparative optimism. Frequency, controllability, and severity were associated more with self-risk than with average-other risk, whereas stereotype salience was associated more with average-other risk than with self-risk. Individual differences also mattered: comparative optimism was related negatively to anxiety and positively to defensiveness and self-esteem. Interaction results imply that both individual differences and event characteristics should jointly be considered in understanding optimistic bias (or comparative optimism) and its application to risk communication.

The impact of working life on health behavior: the effect of job strain on the cognitive predictors of exercise.

The theory of planned behavior (TPB) and R. A. Karaseks (1979) job strain model were used to investigate the predictors of exercise in a group of employees. A total of 241 employees completed an initial questionnaire; 1 week later 213 employees responded to a questionnaire measuring behavior. Employees in high-strain jobs did significantly less exercise than those in low-strain jobs, although they did not intend to do less, suggesting that work may impede the intention implementation. Intenders who failed to exercise had significantly higher work demands and lower exercise self-efficacy than intenders who succeeded in exercising. Work also affected exercise indirectly through self-efficacy. Thus, work may be a target for behavior change intervention because of its impact at 2 stages of the TPB.

Self-Affirmation Enhances Attentional Bias Toward Threatening Components of a Persuasive Message

We explored whether self-affirmation enhances attentional bias toward threatening elements of a persuasive message. Female alcohol consumers read an article linking alcohol to breast cancer and were then exposed supraliminally to threat and nonthreat words from the article (as well as threat and nonthreat words that did not appear in the article). Among moderately heavy drinkers who were not self-affirmed, there emerged an attentional bias away from the threatening words in the article—a result suggesting an avoidant response. However, among moderately heavy drinkers who were self-affirmed, there was a bias toward the threatening words. No attentional biases appeared for threat words not in the message, which suggested that the effect was threat specific. Moreover, no attentional biases were found among the heaviest drinkers. Self-affirmation may facilitate targeted implicit processing of threatening messages, although the effects could attenuate among individuals engaging in high levels of the behavior featured in the message.

The Impact of Self-Affirmation on Health-Behavior Change: A Meta-Analysis

OBJECTIVES Self-affirmation (induced by reflecting upon important values, attributes, or social relations) appears to reduce defensive resistance to health-risk information and increase subsequent readiness for health behavior change. However, these effects of self-affirmation have yet to be subjected to formal, quantitative integration. Consequently, the current article reports a meta-analysis of the impact of self-affirmation on outcomes at 3 key points in the process of health-behavior change: (a) message acceptance, (b) intentions to change, and (c) subsequent behavior. METHOD The literature search identified 144 experimental tests of the effects of manipulating self-affirmation on these outcomes. Effect sizes were extracted and meta-analyzed. RESULTS Across 34 tests of message acceptance (N = 3,433), 64 tests of intentions (N = 5,564), and 46 tests of behavior (N = 2,715), random effects models indicated small but reliable positive effects of self-affirmation on each outcome: acceptance, d+ = .17(CI = .03 to .31); intentions, d+ = .14 (CI = .05 to .23); behavior, d+ = .32 (CI = .19 to .44). Findings held across a range of health problems and behaviors. CONCLUSIONS The results suggest that deploying self-affirmation inductions alongside persuasive health information has positive effects, promoting message acceptance, intentions to change, and subsequent behavior. Though the effects are small in magnitude, they are comparable to those obtained in meta-analyses of other health-behavior change interventions. These findings are relevant to researchers and practitioners working to understand why people resist beneficial health information and how such resistance can be reduced.

Developing and testing a self-affirmation manipulation.

We developed a new manipulation of self-affirmation that is simple to use, can be employed when circumstances prevent pre-screening or using essay-based methods, and has a highly equivalent control task. In the process, we addressed theoretical and empirical questions highlighted in a recent review as requiring attention. In comparison to five controls, the manipulation promoted positive changes on measures designed to test whether people are self-affirmed. It produced a similar pattern on these measures to an existing self-affirmation manipulation. The matched control also performed well. There was no evidence of mediation by mood or state self-esteem or moderation by trait self-esteem. We discuss the potential of the method and associated dependent measures in future self-affirmation research.