Paschal Sheeran

University of North Carolina at Chapel Hill | UNC · Department of Psychology

Introduction Many people remove the tobacco leaf from cigars and replace it with cannabis (i.e., blunts), but few studies have examined whether messages about the risks of cigars, like warnings on cigar packages, can affect blunt use. Methods Participants were 438 US adults who reported past 30-day cigar use and ever blunt use, recruited from a pr...

Purpose We examined awareness and perceptions of the US FDA JUUL marketing denial order (MDO) that occurred in June 2022 among a nationally representative sample of US adolescents. Methods Data were collected in August 2022 via an online survey (n=1,603). Adolescents were asked whether they had heard about the JUUL MDO, and, if yes, where they hea...

Introduction US tobacco manufacturers can seek authorization from the US Food and Drug Administration (FDA) to market products using modified risk tobacco product (MRTP) claims. To inform regulatory decisions, we examined the impact of MRTP claim specificity and content, including whether the claims produced halo effects (ie, inferring health benef...

Implementation intentions (if-then plans) are an evidence-based behavior change strategy designed to translate behavioral intentions into habits [1]. Despite extensive evidence of its potential utility, this behavior change strategy is underutilized and under-researched in high-need healthcare contexts within the United States (U.S.) which face hig...

Introduction For cigars sold individually without packaging, including many premium cigars, the US Food and Drug Administration (FDA) proposed that retailers display six warning statements on a sign at the point-of-sale (POS). Aims and Methods To examine the potential effectiveness of cigar warning signs, we conducted a between-subjects online exp...

Background Although learning health information is beneficial for physical well-being, many people opt to avoid learning this information due to its potentially threatening nature. Such avoidance can lead to delays in seeking treatment. Purpose This study tested the effectiveness of a self-regulation technique, mental contrasting (MC), specificall...

Background Electronic cigarettes (e-cigarettes) are being advertised and sold with synthetic nicotine. Little research has examined youth awareness of synthetic nicotine or the impact of synthetic nicotine descriptors on perceptions of e-cigarettes. Methods Participants were a sample of 1603 US adolescents (aged 13–17 years) from a probability-bas...

Most tobacco warnings focus on health harms to the consumer, but other message themes may be promising. We assessed perceived message effectiveness (PME) among adults who smoke cigars for 12 cigar warning statements to discourage smoking, and measured PME across four message themes: explicit health effects to the consumer, secondhand smoke effects,...

Background: To evaluate the potential efficacy of increasing harm and relative addiction beliefs in discouraging e-cigarette use, we examined how adolescents' beliefs about e-cigarettes have changed over 6 years and how the predictive validity of these beliefs has changed over time. Methods: Using data from the 2014-2019 National Youth Tobacco S...

Background: There is little research on public support for banning the sale and purchase of combustible cigarettes even though a ban is an essential step towards achieving the endgame for tobacco products. Purpose: We report the first studies designed to (a) examine predictors of support for a ban (Study 1), and (b) test interventions to increas...

Persons with schizophrenia have reduced cardiorespiratory fitness (CRF), a predictor of all-cause mortality. Exercise is effective for improving CRF; however, motivational challenges affecting those with schizophrenia impact exercise engagement and maintenance. Virtual Physical Activity Can Enhance Life (Virtual PACE-Life), a multicomponent walking...

Background/purpose: We address four questions about interventions to promote physical activity in cancer survivors: (a) How often is both the adoption and maintenance of behavior change tested in trials? (b) How often do interventions generate adoption-plus-maintenance of behavior change? (c) Are intervention strategies specifically geared at prom...

Background Tobacco cessation, at the time of cancer diagnosis, has been associated with better oncologic outcomes. Cancer diagnosis has been shown to serves as a “teachable moment,” inspiring tobacco cessation. However, the sustainability of abstinence from smoking is understudied. Similarly, there is a paucity of data regarding the utility of beha...

Rising partisan animosity is associated with a reduction in support for democracy and an increase in support for political violence. Here we provide a multi-level review of interventions designed to reduce partisan animosity, which we define as negative thoughts, feelings and behaviours towards a political outgroup. We introduce the TRI framework t...

Background Self-control is generally defined as the capacity to override impulses and is a robust predictor of health behaviors. This paper integrates trait, reasoned action, and habit approaches to develop and test a mechanistic account of how self-control influences health actions. Purpose We tested five potential pathways from self-control to b...

Close social connections drive mental and physical health and promote longevity. Positive, other-focused behavior like expressing gratitude may be a key mechanism for increasing close bonds. Existing evidence consistent with this claim is predominantly correlational, likely driven by challenges in causally influencing and sustaining behavior change...

Background and Purpose Interventions are effective in promoting health behavior change to the extent that (a) intervention strategies modify targets (i.e., mechanisms of action), and (b) modifying targets leads to changes in behavior. To complement taxonomies that characterize the variety of strategies used in behavioral interventions, we outline a...

Introduction: In recent years, vaping prevention campaigns have proliferated in response to a surge of e-cigarette use among adolescents in the USA. To date, the research literature has provided minimal guidance as to what vaping prevention message elements have the greatest potential for discouraging vaping, are ineffective or have unintended neg...

Objectives: Goal prioritization is a promising strategy for promoting health behavior change. The present research (a) tested whether goal prioritization engenders change in multiple health behaviors, (b) compared the effectiveness of prioritizing one versus two health behavior goals, and (c) assessed whether prioritization compromises the perform...

Rising partisan animosity is linked to less support for democracy and more support for political violence. Here we provide a multi-level review of interventions designed to improve partisan animosity, which we define as negative thoughts, feelings, and behaviors towards a political outgroup. We introduce the TRI framework for the three levels of in...

The desire to engage in waterpipe tobacco smoking (WTS) may occur when smokers and nonsmokers conjure positive mental simulations of WTS. However, effects of these simulations on desire to smoke waterpipe tobacco and potential mediators are unexplored. This research addressed these effects among young adult waterpipe tobacco smokers and nonsmokers....

Introduction Federal, state, local, and non-government officials have developed and implemented a variety of vaping prevention messages to curtail the vaping epidemic among youth in the US. This study sought to collect a comprehensive set of vaping prevention messages and characterize the themes and features of those messages. Methods We used a tw...

Introduction: Little systematic evidence exists about the effectiveness of cigar warnings. This study examined the perceived message effectiveness (PME) of warning statements about different health consequences caused by cigars. PME is a validated self-report scale of how effectively a health message discourages smoking. Methods: We conducted an...

Objective To understand the mechanisms of action underlying behavioral interventions, researchers typically examine whether the treatment changes cognitions and whether changes in cognition predict behavior (cognitive change). This current research explores an alternative mechanism whereby the intervention increases the impact of pre-existing cogni...

Objective: Despite abundant observational and experimental tests, it is not yet clear whether enhancing autonomous motivation or perceived competence leads to health behavior change. We identified interventions that aimed to change these constructs and quantified the magnitude of changes in behavior observed when interventions generated increases...

Objective: The effectiveness of physical activity interventions is typically evaluated using null hypothesis significance testing or conventional interpretations of effect size (i.e., "small," "medium," or "large"). As these criteria have recently attracted criticism, we conducted a quantitative integration of meta-analyses (a metasynthesis) in or...

Objective This review highlights the scope and significance of the coronavirus disease 2019 (COVID-19) pandemic with a focus on biobehavioral aspects and critical avenues for research. Methods A narrative review of the published research literature was undertaken, highlighting major empirical findings emerging during the first and second waves o...

Poor health and low cardiorespiratory fitness (CRF) contribute substantially to the shortened lifespan of individuals with schizophrenia spectrum disorders (SSDs). Increasing physical activity has demonstrated value; however, there are limited interventions that are accessible and adequately address motivational challenges. This paper reports on an...

Importance The US Food and Drug Administration (FDA) is required to communicate the risks of tobacco constituents to the public. Few studies have addressed how FDA media campaigns can effectively communicate about cigarette smoke constituents. Objective To examine whether messages about cigarette smoke constituents are effective in reducing smokin...

Background Premature mortality in individuals with schizophrenia spectrum disorders (SSDs) is largely due to high rates of chronic health conditions. Although exercise has been shown to improve health in this population, scalable and accessible interventions are limited. Aim To examine the impact of Physical Activity Can Enhance Life (PACE-Life),...

Socioeconomic status (SES)-related health disparities persist for numerous chronic diseases, with lower-SES individuals exhibiting greater risk of morbidity and mortality compared to their higher-SES counterparts. One likely contributor is disparities in health messaging efforts, which are currently less effective for motivating health behavior cha...

This entry presents a framework for intervening with implicit processes to promote health behavior change. Three approaches are delineated. Context change interventions alter features of the setting in order to simplify decisions or install prompts. Training interventions aim to modify impulsive responses or strengthen reflective control over impul...

Background: Accelerating advances in health behavior change requires releasing the brake as well as applying the throttle. This paper discusses 6 challenges or ‘brakes’ that have slowed progress. Purpose/Methods/Results. We engage with 6 issues that limit investigators ability to delineate and test the strategy-target and target-behavior relations...

Objective: Appetitive risk behaviors (ARB), including tobacco use, alcohol consumption, consumption of calorie dense/nutrient-poor foods, and sexual risk behavior contribute substantially to morbidity and mortality. Affective states that arise from a wide array of unrelated circumstances (i.e., incidental affect) may carry over to influence ARB. A...

Evidence suggests that flavoring may impact reactions to tobacco products. In the present research, we tested the impact and mechanisms of cigarillo flavor descriptors on susceptibility to use in order to determine whether exposure to cigarillos with characterizing flavors increases susceptibility in young adult nonusers of tobacco and, if so, why...

Combustible tobacco users appear to be at greater risk for serious complications from COVID-19. This study examined cigar smokers’ perceived risk of COVID-19, quit intentions, and behaviors during the current pandemic. We conducted an online study between 23 April 2020 to 7 May 2020, as part of an ongoing study examining perceptions of different he...

The model of action phases makes a distinction between motivational (goal setting) and volitional (goal implementation) phases of goal pursuit. The model implies that changing the behavior of individuals who are in a pre-decisional action phase (i.e., have not crossed the “Rubicon” yet with respect to turning their many wishes into binding goals) n...

Efficacious translational research in health psychology relies on specifying why intervention strategies change health behaviors, and when, for what behaviors, and for whom, do these strategies promote change. Whereas interventions’ mechanism of action (the why question) has attracted considerable attention, there is a need to conceptualize and int...

Objective Doctors are generally thought of as very intelligent and capable. This perception has upsides—doctors are afforded respect and esteem—but it may also have downsides, such as neglecting the mental and physical health of physicians. Two studies examine how Americans “typecast” doctors as Godlike “thinkers” who help others, rather than as vu...

Objective: We conducted a meta-analysis of randomized controlled trials (RCTs) to promote health behavior change based on self-determination theory (SDT). The review aimed to (a) quantify the impact of SDT interventions on health behaviors, (b) test mediation by theoretically specified variables (autonomous motivation and perceived competence), an...

Objective: Skin cancer is the most frequently diagnosed cancer and rates are increasing because of global warming. This article reports a meta-analysis of randomized controlled trials of behavioral interventions to reduce exposure to ultraviolet radiation (UVR). The review aimed to (a) quantify the magnitude of intervention effects on indoor tannin...

Objective: We conducted meta-analyses and meta-analytic structural equation modeling of longitudinal studies among cancer survivors to (a) quantify associations between psychosocial predictors and physical activity, (b) test how psychosocial predictors combine to influence physical activity, and (c) identify study, demographic, and clinical charac...

The current meta-analysis explored relationships between functional outcomes in schizophrenia spectrum disorders and different domains of neurocognition and social cognition. Literature searches were conducted in PsycINFO, PubMed, and ProQuest to identify articles reporting correlations between cognition domains and functional outcomes. Of 1,361 ar...

Objective: We conducted a meta-analysis of randomized controlled trials designed to promote smoking cessation among cancer survivors to (a) assess how effective interventions are at increasing quit rates, and (b) determine which intervention strategies are associated with effect sizes. Methods: Out of 10,848 records that were located using compu...

Background People often fail to translate their intentions into health behaviors. Purpose The present research examined a new potential moderator of intention–behavior relations, namely, how realistic or unrealistic are respective goal intentions. Goal realism was defined as the degree to which intentions are aligned with expectations (i.e., predi...

Background: Research is needed to understand factors that attenuate the association between habits and health behavior performance. Purpose: We tested whether degree of reasoned action (DRA) moderates both intention-behavior and habit-behavior relations. DRA was defined by how well cognitions predict behavioral intentions, and was measured by the r...

Objective: We conducted a meta-analysis of physical activity interventions among cancer survivors to (a) quantify the magnitude of intervention effects on physical activity and (b) determine what combination of intervention strategies maximizes behavior change. Method: Out of 32,626 records that were located using computerized searches, 138 inde...

Objective: A substantial proportion of psychotherapeutic treatments are prematurely terminated because the client discontinues attendance. Interventions have been developed to reduce premature termination, but these are only moderately effective and often place considerable burden on clients and services. This research evaluated a brief, low-cost s...

Asking questions about a behavior has been found to influence subsequent performance of that behavior, a phenomenon termed the question-behavior effect (QBE). The present study addressed two under-researched questions concerning the QBE: (1) Can the QBE be used to change multiple health behaviors, and (2) does enhancing dissonance during questionna...

Introduction Product packaging has long been used by the tobacco industry to target consumers and manipulate product perceptions. This study examines the extent to which cigarillo packaging influences perceptions of product flavor, taste, smell, and appeal. Methods A web-based experiment was conducted among young adults. Participants viewed three...

Least square means for pack perceptions. (DOCX)

Unadjusted mixed-effects model results for pack perceptions. (DOCX)

While the Food and Drug Administration (FDA) has had regulatory authority over tobacco products since 2009, public awareness of this authority remains limited. This research examines several broad types of information about FDA tobacco regulatory mission that may improve the perceptions of FDA as a tobacco regulator. Using Amazon Mechanical Turk, 1...

Although risk perception is a key concept in many health behavior theories, little research has explicitly tested when risk perception predicts motivation to take protective action against a health threat (protection motivation). The present study tackled this question by (a) adopting a multidimensional model of risk perception that comprises delib...

Supporting information. (DOCX)

Study data file. (SAS7BDAT)

Objective: When do people decide to do something about problematic health behaviours? Theoretical models and pragmatic considerations suggest that people should take action when they feel bad about their progress – in other words, when they experience negative progress-related affect. However, the impact of progress-related affect on goal striving...

Objective: Exercise behaviour change involves multiple experiences with success and failure. The Model of Action Phases (MAP) offers a dynamic account of how success and failure influence both immediate evaluations and future decisions and actions. However, predictions from the MAP have not been formally tested. Design: A longitudinal daily diary s...

Objective Pictorial warnings on cigarette packs increase motivation to quit smoking. We sought to examine the potential mediating role of negative affect, message reactance (ie, an oppositional reaction to a message) and perceived risk in shaping quit intentions. Methods In 2014 and 2015, we randomly assigned 2149 adult US smokers to receive eithe...

Objective: Stroke is the most common cause of physical impairment, and having already had a stroke dramatically increases the risk of having another one. Although greater physical activity lowers rates of stroke recurrence, patients often fail to act in line with this recommendation. The present intervention tested whether teaching the self-regula...

Introduction: Communication campaigns are incorporating tobacco constituent messaging to reach smokers, yet there is a dearth of research on how such messages should be constructed or will be received by smokers. Methods: In a 2x2x2 experiment, we manipulated three cigarette constituent message components: (1) the toxic constituent of tobacco (a...

Objectives: Excessive alcohol consumption increases when students enter university. This study tests whether combining (1) messages that target key beliefs from the theory of planned behaviour (TPB) that underlie binge drinking, (2) a self-affirmation manipulation to reduce defensive processing, and (3) implementation intentions (if-then plans to...

Objective: This paper introduces a new construct termed motivational coherence, and tests its influence upon the process of translating intentions into health actions. Motivational coherence was defined as the extent to which predictors of intentions (e.g., attitudes, norms, perceived control) cohere or point in the same direction. The prediction...

Health behaviors occur within a milieu of lifestyle activities that could conflict with health actions. We examined whether cognitions about, and performance of, other lifestyle activities augment the prediction of health behaviors, and whether these lifestyle factors are especially influential among individuals with low health behavior engagement....

Supporting information for milieu matters. (DOCX)

Reactance to persuasive messages involves perceived threat to freedom, anger, and counterarguing that may undermine the impact of health warnings. To understand reactance’s effects, reliable and valid assessment is critical. We sought to develop and validate a brief Reactance to Health Warnings Scale (RHWS). Two independent samples of US adults com...

Objective: The present research tested whether incidental positive affect promotes pursuit of physical activity goals. Four key features of goal pursuit were examined – setting physical activity goals (Study 1), goal activation (Study 2), and goal prioritization and goal attainment (Study 3). Design: Participants (Ns = 80, 81, and 59, in Studies 1–...

Experience has a paradoxical effect on intention-behavior consistency. In some studies greater experience is associated with weaker intention-behavior relations (due to habit formation), whereas in other studies experience strengthens the relationship between intention and behavior (by stabilizing intentions). The present research tests the idea th...

Objective: When do people decide to do something about problematic health behaviours? Theoretical models and pragmatic considerations suggest that people should take action when they feel bad about their progress – in other words, when they experience negative progress-related affect. However, the impact of progress-related affect on goal striving...

Situation selection involves choosing situations based on their likely emotional impact and may be less cognitively taxing or challenging to implement compared to other strategies for regulating emotion, which require people to regulate their emotions "in the moment"; we thus predicted that individuals who chronically experience intense emotions or...

Rationale: The question-behaviour effect (QBE) refers to the finding that survey questions about a behaviour can change that behaviour. However, little research has tested how the QBE can be maximized in behavioural medicine settings. The present research tested manipulations of cognitive targets (questions about anticipated regret or beneficence)...

Background Although correlational studies have demonstrated that implicit and explicit attitudes are both important in predicting eating behavior, few studies targeting food choice have attempted to change both types of attitudes. PurposeWe tested the impact of (a) an evaluative learning intervention that uses the self to change attitudes (i.e., a...

How can progress in research on health behavior change be accelerated? Experimental medicine (EM) offers an approach that can help investigators specify the research questions that need to be addressed and the evidence needed to test those questions. Whereas current research draws predominantly on multiple overlapping theories resting largely on co...

The present chapter analyses relations between affect and health behaviors from the perspective of the Action Control Model of Affect Regulation (Webb et al., 2012). We present evidence that forming if-then plans or implementation intentions (Gollwitzer, 1999) can emancipate health actions from unwanted influence by three kinds of affect - experien...

Introduction: Little is known on how to communicate messages on tobacco constituents to tobacco users. This study manipulated three elements of a message in the context of a theory-based communication campaign about tobacco constituents: (1) latency of response efficacy (how soon expected health benefits would accrue), (2) self-efficacy (confidenc...

Implementation intentions (Gollwitzer, 1993, 1999, 2014) are if-then plans that help individuals attain their goals. Implementation intentions have proven beneficial in various domains in which individuals fall short of attaining their goals, from health behavior through academic achievement to interpersonal issues (for reviews, see Adriaanse, Vink...

Although teenage conceptions rates in the United Kingdom (UK) have seen a downward trend recently, it remains imperative that contraceptive services for young people continue to improve. To ensure that evidence-based interventions are sustained in clinical practice, it is useful to assess the experiences of those delivering them. This study explore...