When Risk Communication Backfires: Randomized Controlled Trial on Self-Affirmation and Reactance to Personalized Risk Feedback in High-Risk Individuals

Centre of Research Excellence for Chronic Respiratory Disease.
Health Psychology (Impact Factor: 3.59). 05/2013; 32(5):561-70. DOI: 10.1037/a0029887
Source: PubMed


Health promotion often faces the problem that populations with high behavioral risk profiles respond defensively to health promotion messages by negating risk or reactant behavior. Self-affirmation theory proposes that defensive reactions are an attempt of the self-system to maintain integrity. In this article, we examine whether a self-affirmation manipulation can mitigate defensive responses to personalized visual risk feedback in the skin cancer prevention context (ultraviolet [UV] photography), and whether the effects pertain to individuals with high behavioral risk status (high personal relevance of tanning).

We conducted a full-factorial randomized controlled trial (N = 292; age 11-71) following a 2 * 2 design (UV photo yes/no, self-affirmation yes/no). Follow-up period was 2 weeks. Subsequent tanning behavior, sun avoidance intentions, and risk perception.

A multivariate analysis of variance (MANOVA) revealed a three-way interaction between risk feedback, the self-affirmation manipulation, and risk status for the three outcome measures. Follow-up analyses of variance (ANOVAs) indicated that high-risk individuals receiving only the risk feedback intervention reacted defensively and reported higher exposure. A self-affirmation manipulation mitigates this reactance effect both on the level of cognitions and behavior.

Self-affirmation has influential implications not only for Social Psychology but also for health prevention measures. The findings support the effectiveness of self-affirmation in reducing reactant and defensive reactions to personalized visual risk feedback. Interactions with health risk status indicate that self-affirmation might increase the effectiveness of health promotion messages in high-risk populations.

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Available from: Benjamin Schüz, May 05, 2014
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    • "People exhibit greater reactance when they perceive less ability to choose their own actions (Miller et al., 2007). Other defensive reactions such as derogating risk information and downplaying personal vulnerability can also occur in response to communications about health threats (Harris et al., 2007; Erceg-Hurn and Steed, 2011; McQueen et al., 2013; Schüz et al., 2013). It may benefit public health to understand and, if possible, to avoid such " boomerang " effects in the implementation of smoke-free laws. "
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