Theory-based interventions to help people process “threatening” behaviour change information
Messages often tell us about the risks of health-related behaviours but they do not necessarily change those behaviours. One reason is that the messages they contain can often be perceived as threatening by the intended recipient. For example, drinkers who are told about the negative effects of alcohol often respond defensively by ignoring the message, refusing to believe it, or thinking that it does not apply to them. The same can be said about all messages that attempt to change people’s behaviour by alerting people to the fact that their current behaviour is at odds with what is good for them (e.g., poor diet) or for the people around them (e.g., aggression).
Self-affirmation theory (Steele, 1988) provides one way of understanding why people respond like this when confronted with threatening messages. According to self-affirmation theory, people are motivated to preserve a positive image of themselves and to maintain self-integrity. This means that if a person’s self-image can be bolstered (affirmed) so that they feel good about themselves, they should be less likely to process threatening information defensively. One way of doing this is to ask people to think about things that are important to them such as having performed acts of kindness in the past, (for example, remembering a time when they have been considerate of a person’s feelings) before they see a health message. If people process threatening information such as a message about the risks of drinking excessive alcohol less defensively, then they are much more likely actually to change their behaviour in line with the message they are being given (i.e. reduce their alcohol consumption). Thus self-affirmation offers a simple way to help people to respond to health messages.
We have conducted a series of studies in which we have randomised people at whom a behaviour change intervention has been targeted either to be self-affirmed or not. Once we have reminded people in the self-affirmation group that they are positive, moral and kind, we then observe whether there are changes in message processing, motivation and/or behaviour.
What was found
In one study we measured alcohol consumption before and after we: (a) presented information about the risks of excessive alcohol consumption, and (b) asked people allocated at random either to: (i) complete questionnaires about their past acts of kindness (designed to affirm them), or (ii) complete a neutral questionnaire about their opinions (designed to be neutral).
We found that although everyone received the same health risk information, people who completed the self-affirming questionnaire were much more likely to be drinking within government-recommended levels at follow-up (93.48%) than if they completed the non-affirming questionnaire (78.49%).
We have replicated this finding in numerous studies among people including smokers, adult and adolescent consumers of alcohol, children who are perpetrators of relational aggression and end-stage renal patients. We have consistently shown that people who are self-affirmed are significantly more receptive to behaviour change interventions, are more motivated to change their behaviour, and are more likely actually to change their behaviour.
Implications of the research
In addition to our work showing that self-affirmation positively affects behaviour change and even biological outcomes 6-months post-intervention, embedding self-affirming statements in existing health information could have far-reaching effects. The basis of the intervention means that, in theory, several behaviours that are perceived as threatening could be changed simultaneously.
Find out more:
- Armitage, C. J., Lees, D., Lewis, K., & Munro, K. J. (2017). Preliminary support for a brief psychological intervention to improve first-time hearing aid use among adults. British Journal of Health Psychology, 22, 686-700. doi: 10.1111/bjhp.12244
- Armitage, C. J., & Arden, M. A. (2016). Enhancing the effectiveness of alcohol warning labels with a self-affirming implementation intention. Health Psychology, 35, 1159-1163. doi: 10.1037/hea0000376
- Wileman, V., Chilcot, J., Armitage, C. J., Farrington, K., Wellsted, D. M., Norton, S., Davenport, A., Franklin, G., Gane, M. D., Horne, R., & Almond, M. (2016). Evidence of improved fluid management in patients receiving haemodialysis following a self-affirmation theory-based intervention: A randomised controlled trial. Psychology and Health, 31, 100-114. doi: 10.1080/08870446.2015.1073729
- Armitage, C. J., Rowe, R., Arden, M. A., & Harris, P. R. (2014). A brief psychological intervention that reduces adolescent alcohol consumption. Journal of Consulting and Clinical Psychology, 82, 546-550. doi: 10.1037/a0035802
- Armitage, C. J., Harris, P. R., & Arden, M. A. (2011). Evidence that self-affirmation reduces alcohol consumption: Randomized exploratory trial with a new, brief means of self-affirming. Health Psychology, 30, 633-641.