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Self-Affirmation Moderates Self-Congruency Effect in Health Messaging.

ABSTRACT: Previous research found that health risk messages framed to be congruent with people's independent or interdependent self-construal were not consistently more effective than incongruent messages. We argue that people potentially process the self-construal congruent health risk messages in a biased manner. To test this proposition, we examined the role of self-affirmation, which is expected to reduce defensive processing, in college nonsmokers' responses to an antismoking message congruent vs. incongruent with their dominant self-construals. Results from an online experiment suggested that self-affirmation moderated the self-congruency effect. Specifically, among college nonsmokers endorsing a dominant interdependent self-construal, self-congruency effect emerged only when the group was engaged in self-affirmation. Among college nonsmokers endorsing a dominant independent self-construal, with no prior affirmation, the group reported self-incongruent messages better than the self-congruent messages. After being engaged in self-affirmation, the group reported similar effects for self-congruent and self-incongruent messages. Theoretical and practical implications of our findings are discussed.

SUBMITTER: Yang B

PROVIDER: S-EPMC6942231 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Self-Affirmation Moderates Self-Congruency Effect in Health Messaging.

Yang Bo B Nan Xiaoli X

Health communication 20190704 11

Previous research found that health risk messages framed to be congruent with people's independent or interdependent self-construal were not consistently more effective than incongruent messages. We argue that people potentially process the self-construal congruent health risk messages in a biased manner. To test this proposition, we examined the role of self-affirmation, which is expected to reduce defensive processing, in college nonsmokers' responses to an antismoking message congruent vs. in ...[more]

PMID: 31269824

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Project description:mHealth interventions can help to improve the physical well-being of participants. Unfortunately, mHealth interventions often have low adherence and high attrition. One possible way to increase adherence is instructing participants to complete self-affirmation exercises. Self-affirmation exercises have been effective in increasing many types of positive behaviors. However, self-affirmation exercises often involve extensive essay writing, a task that is not easy to complete on mobile platforms.This study aimed to adapt a self-affirmation exercise to a form better suited for delivery through a mobile app targeting healthy eating behaviors, and to test the effect of differing self-affirmation doses on adherence to behavior change goals over time.We examined how varied self-affirmation doses affected behavior change in an mHealth app targeting healthy eating that participants used for 28 days. We divided participants into the 4 total conditions using a 2×2 factorial design. The first independent variable was whether the participant received an initial self-affirmation exercise. The second independent variable was whether the participant received ongoing booster self-affirmations throughout the 28-day study. To examine possible mechanisms through which self-affirmation may cause positive behavior change, we analyzed three aspects of self-affirmation effects in our research. First, we analyzed how adherence was affected by self-affirmation exercises. Second, we analyzed whether self-affirmation exercises reduced attrition rates from the app. Third, we examined a model for self-affirmation behavior change.Analysis of 3556 observations from 127 participants indicated that higher doses of self-affirmation resulted in improved adherence to mHealth intervention goals (coefficient 1.42, SE 0.71, P=.04). This increased adherence did not seem to translate to a decrease in participant attrition (P value range .61-.96), although our definition of attrition was conservative. Finally, we examined the mechanisms by which self-affirmation may have affected intentions of behavior change; we built a model of intention (R2=.39, P<.001), but self-affirmation did not directly affect final intentions (P value range .09-.93).Self-affirmations can successfully increase adherence to recommended diet and health goals in the context of an mHealth app. However, this increase in adherence does not seem to reduce overall attrition. The self-affirmation exercises we developed were simple to implement and had a low cost for both users and developers. While this study focused on an mHealth app for healthy eating, we recommend that other mHealth apps integrate similar self-affirmation exercises to examine effectiveness in other behaviors and contexts.

Project description:BackgroundThe college experience is often the first time when young adults live independently and make their own lifestyle choices. These choices affect dietary behaviors, exercise habits, techniques to deal with stress, and decisions on sleep time, all of which direct the trajectory of future health. There is a need for effective strategies that will encourage healthy lifestyle choices in young adults attending college.ObjectiveThis preliminary randomized controlled trial tested the effect of coaching and text messages (short message service, SMS) on self-selected health behaviors in the domains of diet, exercise, stress, and sleep. A second analysis measured the ripple effect of the intervention on health behaviors not specifically selected as a goal by participants.MethodsFull-time students aged 18-30 years were recruited by word of mouth and campuswide advertisements (flyers, posters, mailings, university website) at a small university in western Pennsylvania from January to May 2015. Exclusions included pregnancy, eating disorders, chronic medical diagnoses, and prescription medications other than birth control. Of 60 participants, 30 were randomized to receive a single face-to-face meeting with a health coach to review results of behavioral questionnaires and to set a health behavior goal for the 8-week study period. The face-to-face meeting was followed by SMS text messages designed to encourage achievement of the behavioral goal. A total of 30 control subjects underwent the same health and behavioral assessments at intake and program end but did not receive coaching or SMS text messages.ResultsThe texting app showed that 87.31% (2187/2505) of messages were viewed by intervention participants. Furthermore, 28 of the 30 intervention participants and all 30 control participants provided outcome data. Among intervention participants, 22 of 30 (73%) showed improvement in health behavior goal attainment, with the whole group (n=30) showing a mean improvement of 88% (95% CI 39-136). Mean improvement in any behavioral domains was not seen in the control group. Intervention participants also increased their exercise significantly compared with controls, regardless of their self-selected goal category. The increased exercise was paralleled by significantly lower fasting glucose levels.ConclusionsThe health coaching session plus tailored SMS text messages improved self-selected health behaviors with a modest ripple effect to include unselected health behaviors.Trial registrationClinicaltrials.gov NCT02476604; https://clinicaltrials.gov/ct2/show/NCT02476604 (Archived by WebCite at http://www.webcitation.org/6qAAryS5t).

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Self-Affirmation Moderates Self-Congruency Effect in Health Messaging.

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Self-Affirmation Moderates Self-Congruency Effect in Health Messaging.

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