The impact of self-affirmation on health-behavior change: A meta-analysis

Epton, Tracy; Harris, Peter R.; Kane, Rachel; van Koningsbruggen, Guido M.; Sheeran, Paschal

doi:10.1037/hea0000116

Cited by 277Behavioral Health and InterventionsMedia Influence and HealthDeath Anxiety and Social Exclusion

The impact of self-affirmation on health-behavior change: A meta-analysis

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Epton, Tracy, Harris, Peter R., Kane, Rachel, van Koningsbruggen, Guido M., Sheeran, Paschal·2015·Health Psychology

DOI 10.1037/hea0000116

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Abstract

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.

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A theory-based online health behaviour intervention for new university students (U@Uni:LifeGuide): results from a repeat randomized controlled trial
Cameron, D. S., Epton, T., Norman, P. E., Sheeran, P., Harris, P. R., Webb, T. L., Julious, S. A., Brennan, A., Thomas, C., Petróczi, A., et al. (2015) · Trials · doi:10.1186/s13063-015-1092-4 · Cited by 67 · see citing works
“First, a self-affirmation manipulation was used to reduce defensive processing of health messages [13].”
Method
Entertainment and Expanding Boundaries of the Self: Relief From the Constraints of the Everyday
Johnson, B. K., Slater, M. D., Silver, N. A., & Roskos‐Ewoldsen, D. R. (2016) · Journal of Communication · doi:10.1111/jcom.12228 · Cited by 59 · see citing works
The Dyadic Health Influence Model
Huelsnitz, C. O., Jones, R. E., Simpson, J. A., Joyal‐Desmarais, K., Standen, E. C., Auster‐Gussman, L. A., & Rothman, A. J. (2021) · Personality and Social Psychology Review · doi:10.1177/10888683211054897 · Cited by 57 · see citing works
“, self-affirmation interventions) allow them to more easily accept the information and act on changing their health behavior (Epton et al., 2015).”
Background
Spontaneous self-affirmation is associated with psychological well-being: Evidence from a US national adult survey sample
Emanuel, A. S., Howell, J. L., Taber, J. M., Ferrer, R. A., Klein, W., & Harris, P. (2018) · Journal of Health Psychology · doi:10.1177/1359105316643595 · Cited by 56 · see citing works
“induced participants to self-affirm, and these induced self-affirmations generally lead to positive health outcomes (Epton et al., 2014), including greater acceptance of health messages (Sherman et al.”
Background
Simulated thoughts in virtual reality for negotiation training enhance self-efficacy and knowledge
Ding, D., Brinkman, W., & Neerincx, M. A. (2020) · International Journal of Human-Computer Studies · doi:10.1016/j.ijhcs.2020.102400 · Cited by 59 · see citing works
The Actual Versus Idealized Self: Exploring Responses to Feedback About Implicit Bias in Health Professionals
Sukhera, J. I., Milne, A., Teunissen, P. W., Lingard, L., & Watling, C. (2017) · Academic Medicine · doi:10.1097/acm.0000000000002006 · Cited by 56 · see citing works
Self-affirmation improves performance on tasks related to executive functioning
Harris, P., Harris, P., & Miles, E. (2017) · Journal of Experimental Social Psychology · doi:10.1016/j.jesp.2016.11.011 · Cited by 46 · see citing works
“For example, self-affirmed individuals form stronger intentions to act in healthier ways than non-affirmed individuals after reading health-risk information and may subsequently act more healthily (Epton et al., 2014; Sweeney & Moyer, 2015).”
Background
Self‐affirmation reduces the socioeconomic attainment gap in schools in England
Hadden, I. R., Easterbrook, M. J., Nieuwenhuis, M., Fox, K. J., & Dolan, P. (2020) · British Journal of Educational Psychology · doi:10.1111/bjep.12291 · Cited by 43 · see citing works
Low Health Literacy and Health Information Avoidance but Not Satisficing Help Explain “Don’t Know” Responses to Questions Assessing Perceived Risk
Orom, H., Schofield, E., Kiviniemi, M. T., Waters, E. A., Biddle, C., Chen, X., Li, Y., Kaphingst, K. A., & Hay, J. L. (2018) · Medical Decision Making · doi:10.1177/0272989x18799999 · Cited by 42 · see citing works
<i>Digital Bodies</i> : A controlled evaluation of a brief classroom‐based intervention for reducing negative body image among adolescents in the digital age
Bell, B. T., Taylor, C., Paddock, D., & Bates, A. (2022) · British Journal of Educational Psychology · doi:10.1111/bjep.12449 · Cited by 43 · see citing works
Attitudes in an interpersonal context: Psychological safety as a route to attitude change
Itzchakov, G., & DeMarree, K. G. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.932413 · Cited by 41 · see citing works
A psychological health support scheme for medical teams in COVID‐19 outbreak and its effectiveness
Cheng, W., Zhang, F., Liu, Z., Zhang, H., Lyu, Y., Xu, H., Hua, Y., Gu, J., Yang, Z., & Liu, J. (2020) · General Psychiatry · doi:10.1136/gpsych-2020-100288 · Cited by 42 · see citing works
Intention of health experts to counter health misinformation in social media: Effects of perceived threat to online users, correction efficacy, and self-affirmation
Chen, L., & Tang, H. (2022) · Public Understanding of Science · doi:10.1177/09636625221138357 · Cited by 40 · see citing works
“Epton et al. (2015) meta-analyzed a broad range of self-affirmation studies and found that self-affirmation can significantly increase message acceptance that is highly relevant to the subsequent health behaviors.”
Background
TypeOut: Leveraging Just-in-Time Self-Affirmation for Smartphone Overuse Reduction
Xu, X., Zou, T., Han, X. L., Li, Y., Wang, R., Yuan, T., Wang, Y., Shi, Y., Mankoff, J. C., & Dey, A. K. (2022) · CHI Conference on Human Factors in Computing Systems · doi:10.1145/3491102.3517476 · Cited by 40 · see citing works
“Prior studies have shown that self-afrmation is efective in a wide range of behavior change intervention domains, such as improving academic performance [12, 66], reducing stereotyping towards minority group members [5, 23], and promoting health behavior change [20, 22].”
Background
The influence of framed messages and self-affirmation on indoor tanning behavioral intentions in 18- to 30-year-old women.
Mays, D. M., & Zhao, X. (2015) · Health Psychology · doi:10.1037/hea0000253 · Cited by 39 · see citing works
“This effect size is consistent with similar studies of selfaffirmation and message framing manipulations (e.g., Epton et al., 2015; Mays & Tercyak, 2015).”
Result
Alcohol pictorial health warning labels: the impact of self-affirmation and health warning severity
Rejon, C. S., Attwood, A. S., Blackwell, A. K. M., Ibáñez‐Zapata, J., Munafo, M. R., & Maynard, O. (2018) · BMC Public Health · doi:10.1186/s12889-018-6243-6 · Cited by 39 · see citing works
Physiotherapy education and training prior to upper abdominal surgery is memorable and has high treatment fidelity: a nested mixed-methods randomised-controlled study
Boden, I. J., El‐Ansary, D., Zalucki, N., Robertson, I. K., Browning, L., Skinner, E. H., & Denehy, L. (2017) · Physiotherapy · doi:10.1016/j.physio.2017.08.008 · Cited by 38 · see citing works
Intergroup conflict and barriers to common ground: A self‐affirmation perspective
Sherman, D. K., Brookfield, J., & Ortosky, L. (2017) · Social and Personality Psychology Compass · doi:10.1111/spc3.12364 · Cited by 34 · see citing works
“, 2015) and diet (Epton et al., 2015), and educational outcomes such as college enrollment over a period of years (e.”
Background
Self-Affirmation Before Exposure to Health Communications Promotes Intentions and Health Behavior Change by Increasing Anticipated Regret
van Koningsbruggen, G. M., Harris, P. R., Smits, A. J., Schüz, B., Scholz, U., & Cooke, R. W. I. (2014) · Communication Research · doi:10.1177/0093650214555180 · Cited by 37 · see citing works
The role of emotions and injunctive norms in breastfeeding: a systematic review and meta-analysis
Russell, P. S., Smith, D. M., Birtel, M. D., Hart, K. H., & Golding, S. E. (2021) · Health Psychology Review · doi:10.1080/17437199.2021.1893783 · Cited by 36 · see citing works
“Similarly, according to self-affirmation theory, if we affirm our self-concept in another domain this can foster positive outcomes, behaviour change, and wellbeing (Epton et al., 2015).”
Background
Social class and identity-based motivation
Fisher, O., O’Donnell, S. C., & Oyserman, D. (2017) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2017.07.035 · Cited by 36 · see citing works
Randomized Controlled Pilot Trial of a Low-Touch Remotely-Delivered Values Intervention to Promote Adherence to Adjuvant Endocrine Therapy Among Breast Cancer Survivors
Arch, J. J., Crespi, C. M., Levin, M. E., Genung, S. R., Nealis, M., Mitchell, J. L., Bright, E. E., Albright, K., Magidson, J. F., & Stanton, A. L. (2022) · Annals of Behavioral Medicine · doi:10.1093/abm/kaab118 · Cited by 34 · see citing works
Integrating Self-Affirmation with Health Risk Messages: Effects on Message Evaluation and Response
Arpan, L. M., Lee, Y., & Wang, Z. (2016) · Health Communication · doi:10.1080/10410236.2015.1113483 · Cited by 34 · see citing works
“, 2011), a meta-analysis (Epton et al., 2014) found that affirmation manipulations involving an essay had stronger effects on outcomes than those involving responding to value scales, perhaps indicating that manipulations requiring greater effort, time, and/or elaboration could be more affirming.”
BackgroundInfluential
“She Finally Smiles … for Real”: Reducing Depressive Symptoms and Bolstering Resilience Through a Camp Intervention for LGBTQ Youth
Gillig, T. K., Miller, L. C., & Cox, C. M. (2017) · Journal of Homosexuality · doi:10.1080/00918369.2017.1411693 · Cited by 33 · see citing works
Effects of a Brief Preventive Intervention in Cyberbullying and Grooming in Adolescents
Calvete, E., Cortazar, N., Fernández-González, L., Echezarraga, A., Beranuy, M., León, A., González-Cabrera, J., & Orue, I. (2021) · Psychosocial Intervention · doi:10.5093/pi2020a22 · Cited by 31 · see citing works
“In a meta-analysis, Epton et al. (2014) found that deploying SA inductions together with persuasive health information promoted message acceptance, intention to change, and subsequent positive behavior.”
Background
Coronavirus conspiracy beliefs and distrust of science predict risky public health behaviours through optimistically biased risk perceptions in Ukraine, Turkey, and Germany
Chayinska, M., Uluğ, Ö. M., Ayanian, A. H., Gratzel, J. C., Brik, T., Kende, A., & McGarty, C. (2021) · Group Processes & Intergroup Relations · doi:10.1177/1368430220978278 · Cited by 31 · see citing works
“Meta-analytic evidence has suggested that optimistically biased risk perceptions, defined as underestimated probabilistic assessments of certain events, are a critical determinant of risky health behaviour (e.g., Brewer et al., 2007; Epton et al., 2015).”
Background
Combining self-affirmation and implementation intentions to reduce heavy episodic drinking in university students.
Norman, P. E., & Wrona-Clarke, A. (2015) · Psychology of Addictive Behaviors · doi:10.1037/adb0000144 · Cited by 31 · see citing works
Investigating the Potential of Inoculation Messages and Self-Affirmation in Reducing the Effects of Health Misinformation
Iles, I. A., Gillman, A. S., Platter, H. N., Ferrer, R. A., & Klein, W. (2021) · Science communication · doi:10.1177/10755470211048480 · Cited by 28 · see citing works
“One of the meta-analyses conducted with studies of self-affirmation in the domain of health did not find sex differences either (Epton et al., 2015).”
BackgroundMethod
Just a Spoonful of Sugar Helps the Messages Go Down: Using Stories and Vicarious Self-Affirmation to Reduce e-Cigarette Use
Walter, N., Demetriades, S. Z., & Murphy, S. T. (2017) · Health Communication · doi:10.1080/10410236.2017.1407275 · Cited by 30 · see citing works
Neural mechanisms of self-affirmation’s stress buffering effects
Dutcher, J. M., Eisenberger, N. I., Woo, H., Klein, W. M. P., Harris, P. R., Levine, J. M., & Creswell, J. D. (2020) · Social Cognitive and Affective Neuroscience · doi:10.1093/scan/nsaa042 · Cited by 29 · see citing works
“Furthermore, self-affirmation has been shown to reduce defensive responses to threatening health information (for a review: Cohen and Sherman, 2014), and to facilitate health behavior change (for reviews: Epton et al., 2015; Ferrer and Cohen, 2019).”
Background
Gender Bias in Student Evaluations of Teaching: Students’ Self-Affirmation Reduces the Bias by Lowering Evaluations of Male Professors
Hoorens, V., Dekkers, G. J. M., & Deschrijver, E. (2020) · Sex Roles · doi:10.1007/s11199-020-01148-8 · Cited by 48 · see citing works
Associations of spontaneous self-affirmation with health care experiences and health information seeking in a national survey of US adults
Taber, J. M., Howell, J. L., Emanuel, A. S., Klein, W. M. P., Ferrer, R. A., & Harris, P. R. (2015) · Psychology and Health · doi:10.1080/08870446.2015.1085986 · Cited by 29 · see citing works
“The effect sizes in the present study were generally small to medium (Cohen, 1992), consistent with the relatively small effect sizes of induced self-affirmations on message acceptance, intentions, and behaviour in health contexts (Epton et al., 2015; Sweeney & Moyer, 2015).”
Result
Enhancing the effectiveness of alcohol warning labels with a self-affirming implementation intention.
Armitage, C. J., & Arden, M. A. (2016) · Health Psychology · doi:10.1037/hea0000376 · Cited by 28 · see citing works
“Consistent with the broader literature on self-affirmation theory (e.g., Epton et al., 2015) and the self-affirming implementation intention (Armitage et al., 2011; 2014), we were unable to identify significant mediators of the observed effects, which is potentially problematic for self-affirmation…”
Targeting hardcore smokers: The effects of an online tailored intervention, based on motivational interviewing techniques
Bommelé, J., Schoenmakers, T. M., Kleinjan, M., Peters, G.-J., Dijkstra, A., & van de Mheen, D. (2017) · British Journal of Health Psychology · doi:10.1111/bjhp.12256 · Cited by 28 · see citing works
Investigating which behaviour change techniques work for whom in which contexts delivered by what means: Proposal for an international collaboratory of Centres for Understanding Behaviour Change (CUBiC)
Armitage, C. J., Conner, M. T., Prestwich, A., de Bruin, M., Johnston, M., Sniehotta, F. F., & Epton, T. (2020) · British Journal of Health Psychology · doi:10.1111/bjhp.12479 · Cited by 28 · see citing works
Smoke-free air laws and quit attempts: Evidence for a moderating role of spontaneous self-affirmation
Persoskie, A., Ferrer, R. A., Taber, J. M., Klein, W. M. P., Parascandola, M. J., & Harris, P. R. (2015) · Social Science & Medicine · doi:10.1016/j.socscimed.2015.07.015 · Cited by 27 · see citing works
Self-affirmation increases defensiveness toward health risk information among those experiencing negative emotions: Results from two national samples.
Ferrer, R. A., Klein, W. M. P., & Graff, K. A. (2017) · Health Psychology · doi:10.1037/hea0000460 · Cited by 25 · see citing works
“However, variable effects suggest the possibility that self-affirmation inductions are not always effective (Epton et al., 2015; Sweeney & Moyer, 2015), and it is critical to identify moderating conditions under which self-affirmation inductions are more or less promising as an intervention tool.”
The Impact of Stress on Life, Working, and Management Styles: How to Make an Organization Healthier?
Katić, I., Knežević, T., Berber, N., Ivanišević, A., & Leber, M. (2019) · Sustainability · doi:10.3390/su11154026 · Cited by 28 · see citing works
Securing self-integrity over time: Self-affirmation disrupts a negative cycle between psychological threat and academic performance
Binning, K. R., Cook, J. E., Greenaway, V. P., Garcia, J., Apfel, N., Sherman, D. K., & Cohen, G. L. (2021) · Journal of Social Issues · doi:10.1111/josi.12461 · Cited by 25 · see citing works
“, an anti-smoking message for peoplewho smoke) and improved health behavior (Epton et al., 2015; Ferrer &Cohen, 2019).”
Background
Increasing Receptivity to COVID-19 Public Health Messages with Self-Affirmation and Self vs. Other Framing
Gillman, A. S., Iles, I. A., Klein, W. M. P., & Ferrer, R. A. (2022) · Health Communication · doi:10.1080/10410236.2022.2043024 · Cited by 25 · see citing works
“The decision to power the study for detecting a small effect size was based on self-affirmation metaanalyses (Epton et al., 2015).”
Method
Impact of brief self‐affirmation manipulations on university students' reactions to risk information about binge drinking
Knight, R., & Norman, P. E. (2016) · British Journal of Health Psychology · doi:10.1111/bjhp.12186 · Cited by 25 · see citing works
“In contrast to Epton et al. (2015), these studies have reported null effects on behaviour (Harris & Napper, 2005; Meier et al., 2015).”
BackgroundResultInfluential
Mental Time Travel as Self-Affirmation
Stephan, E., & Sedikides, C. (2023) · Personality and Social Psychology Review · doi:10.1177/10888683231203143 · Cited by 28 · see citing works
“By bringing to mind their future and past selves, and thus affirming their self-esteem, coherence, and control, MTT will decrease defensiveness to health-risk information and strengthen readiness for health behavior change (Epton et al., 2015).”
Background
Integrating Self-Affirmation and Implementation Intentions: Effects on College Student Drinking
Ehret, P. J., & Sherman, D. K. (2018) · Annals of Behavioral Medicine · doi:10.1093/abm/kax032 · Cited by 23 · see citing works
“Despite growing evidence that self-affirmation is generally effective at promoting healthful behaviors [3, 13], some recent research has failed to find actual changes in drinking behavior [35, 36].”
Background
Psychometric properties of the Spanish version of the Valuing Questionnaire in Colombian clinical and nonclinical samples
Ruiz, F. J., Suárez‐Falcón, J. C., Segura‐Vargas, M. A., & Gil‐Luciano, B. (2022) · Journal of Clinical Psychology · doi:10.1002/jclp.23212 · Cited by 22 · see citing works
Staying-at-Home with Tragedy: Self-expansion Through Narratives Promotes Positive Coping with Identity Threat
Khoo, G., Oh, J., & Nah, S. (2021) · Human Communication Research · doi:10.1093/hcr/hqab005 · Cited by 23 · see citing works
Time-evolving dynamics in brain networks forecast responses to health messaging
Cooper, N., Garcia, J. O., Tompson, S., O’Donnell, M. B., Falk, E. B., & Vettel, J. M. (2018) · Network Neuroscience · doi:10.1162/netn_a_00058 · Cited by 20 · see citing works
Using Self-affirmation to Increase the Effects of Emotive Health Warnings on Smoking: A Randomized Exploratory Trial
Memish, K. E., Schüz, N., Frandsen, M., Ferguson, S. G., & Schüz, B. (2016) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntw167 · Cited by 21 · see citing works
Online Self‐Affirmation Increases Fruit and Vegetable Consumption in Groups at High Risk of Low Intake
Fielden, A. L., Sillence, E., Little, L., & Harris, P. R. (2016) · Applied Psychology Health and Well-Being · doi:10.1111/aphw.12059 · Cited by 19 · see citing works
Situational HIV stigma and stimulant use: A day-level autoregressive cross-lagged path model among HIV-positive gay and bisexual men
Rendina, H. J., Millar, B. M., & Parsons, J. T. (2018) · Addictive Behaviors · doi:10.1016/j.addbeh.2018.01.003 · Cited by 21 · see citing works
Proscriptive Injunctions Can Elicit Greater Reactance and Lower Legitimacy Perceptions Than Prescriptive Injunctions
Pavey, L., Churchill, S., & Sparks, P. (2021) · Personality and Social Psychology Bulletin · doi:10.1177/01461672211021310 · Cited by 18 · see citing works
“Although metaanalysis has confirmed a small but reliable effect of selfaffirmation across a range of health behaviors (Epton et al., 2015), the beneficial effect of self-affirmation on reducing defensive responses may be particularly pronounced when using a proscriptive injunction, or for behaviors that are typically…”
Background
The metamotivation approach: Insights into the regulation of motivation and beyond
Fujita, K., Le, P. Q., Scholer, A. A., & Miele, D. (2024) · Social & Personality Psychology Compass · doi:10.1111/spc3.12937 · Cited by 20 · see citing works
Leveraging Self-Affirmation to Improve Behavior Change: A Mobile Health App Experiment
Springer, A., Venkatakrishnan, A., Mohan, S., Nelson, L., Silva, M., & Pirolli, P. L. T. (2018) · JMIR mhealth and uhealth · doi:10.2196/mhealth.9151 · Cited by 20 · see citing works
“An effective technique to increase adherence to recommended health behaviors is through the use of self-affirmation exercises [10-12].”
BackgroundMethod
Adapting a self-affirmation intervention for use in a mobile application for smokers
Taber, J. M., McQueen, A., Simonovic, N., & Waters, E. A. (2019) · Journal of Behavioral Medicine · doi:10.1007/s10865-019-00028-1 · Cited by 20 · see citing works
Heart health whispering: A randomized, controlled pilot study to promote nursing student perspective-taking on carers’ health risk behaviors
Lobchuk, M., Hoplock, L. B., Halas, G., West, C., Dika, C., Schroeder, W., Ashcroft, T., Clouston, K., & Lemoine, J. (2018) · BMC Nursing · doi:10.1186/s12912-018-0291-1 · Cited by 19 · see citing works
“We speculate, as have other researchers [16, 37–40], that having the undivided attention of students who focused on carer self-care helped the carer to take ownership, feel empowered, become positive about personal strengths, and have confidence to change a challenging behavior; this is also supported in a review on t…”
Result
Preventing falls among older fallers: study protocol for a two-phase pilot study of the multicomponent LIVE LiFE program
Granbom, M., Clemson, L. M., Roberts, L., Hladek, M. D., Okoye, S. M., Liu, M., Felix, C., Roth, D. L., Gitlin, L. N., & Szanton, S. L. (2019) · Trials · doi:10.1186/s13063-018-3114-5 · Cited by 19 · see citing works
Technology-Based Early Warning Systems for Bipolar Disorder: A Conceptual Framework
Depp, C. A., Torous, J. B., & Thompson, W. K. (2016) · JMIR Mental Health · doi:10.2196/mental.5798 · Cited by 18 · see citing works
“…risk of harm [42]; (2) identify strategies that require low effort or facilitate reducing effort such as through implementation intentions [43]; and (3) provide affirmations of the individual prior to requiring the processing of threat, if delivering information about the threat is necessary [44].”
Background
Individual differences in spontaneous self-affirmation predict well-being
Jessop, D. C., Harris, P. R., & Gibbons, T. (2022) · Self and Identity · doi:10.1080/15298868.2022.2079711 · Cited by 17 · see citing works
“Self-affirmed participants have also been shown to respond to personally relevant health-risk information less defensively, rendering them more open to persuasion and, ultimately, to healthy behavior change (Epton et al., 2015; Sweeney & Moyer, 2015).”
Background
Individual differences in spontaneous self-affirmation and mental health: relationships with self-esteem, dispositional optimism and coping
Harris, P., Richards, A., & Bond, R. A. (2022) · Self and Identity · doi:10.1080/15298868.2022.2099455 · Cited by 18 · see citing works
The Mediating Role of Temporal Considerations on the Effects of Self-Affirmation on Responses to Organ Donation Messages
Wang, X., & Zhao, X.-Q. (2018) · Health Communication · doi:10.1080/10410236.2016.1250190 · Cited by 17 · see citing works
“Because self-affirmed participants are more likely to focus on long-term consequences than short-term defensive reactions, they are more likely to accept persuasive messages and change behaviors to achieve long-term health benefits (Cohen & Sherman, 2014; Epton et al., 2015; Wakslak & Trope, 2009).”
Background
Coping with stress: A pilot study of a self-help stress management intervention for patients with epileptic or psychogenic nonepileptic seizures
Nováková, B., Harris, P. R., Rawlings, G. H., & Reuber, M. (2019) · Epilepsy & Behavior · doi:10.1016/j.yebeh.2019.03.002 · Cited by 17 · see citing works
Attitudes, Intentions, and Behavior Change
Conner, M. T., & Norman, P. E. (2025) · Annual Review of Psychology · doi:10.1146/annurev-psych-013125-042110 · Cited by 20 · see citing works
Can self-affirmation exacerbate adverse reactions to stress under certain conditions?
Jessop, D., Ayers, S., Burn, F., & Ryda, C. (2018) · Psychology and Health · doi:10.1080/08870446.2017.1421187 · Cited by 16 · see citing works
Scaffolding the Mastery of Healthy Behaviors with Fittle+ Systems: Evidence-Based Interventions and Theory
Pirolli, P. L. T., Youngblood, G. M., Du, H., Konrad, A., Nelson, L., & Springer, A. (2018) · Human-Computer Interaction · doi:10.1080/07370024.2018.1512414 · Cited by 15 · see citing works
Self-affirmation and physical activity messages
Strachan, S., Myre, M., Berry, T., Ceccarelli, L. A., Semenchuk, B., & Miller, C. (2020) · Psychology of sport and exercise · doi:10.1016/j.psychsport.2019.101613 · Cited by 14 · see citing works
The conceptualization and measurement of values: A review of the psychometric properties of measures developed to inform values work with adults
Serowik, K. L., Khan, A. J., LoCurto, J., & Orsillo, S. M. (2018) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-018-9679-1 · Cited by 15 · see citing works
Preliminary support for a brief psychological intervention to improve first‐time hearing aid use among adults
Armitage, C. J., Lees, D., Lewis, K., & Munro, K. J. (2017) · British Journal of Health Psychology · doi:10.1111/bjhp.12244 · Cited by 16 · see citing works
“Nevertheless, it is notable that the size of the present effect (d = 0.43) is stronger than that found in a recent meta-analysis of self-affirmation-based intervention studies (d = 0.32, Epton et al., 2015).”
BackgroundMethodResultInfluential
An experimental comparison of two Acceptance and Commitment Therapy (ACT) values exercises to increase values-oriented behavior
Engle, J. L., & Follette, V. M. (2018) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2018.08.001 · Cited by 16 · see citing works
Self-affirmation effects on doping related cognition among exercisers who use nutritional supplements
Barkoukis, V., Rowe, R., Harris, P. R., & Lazuras, L. (2019) · Psychology of sport and exercise · doi:10.1016/j.psychsport.2019.101609 · Cited by 15 · see citing works
“…based on self-affirmation theory have demonstrated the effectiveness of this approach to improving message acceptance and changing intentions and behavior, in a wide range of health-related (e.g., Epton et al., 2015; Sweeney & Moyer, 2015) and non-health behaviors (Cohen & Sherman, 2014).”
Background
Using the theory of self-affirmation and self-regulation strategies of mental contrasting and forming implementation intentions to reduce social anxiety symptoms
Łakuta, P. (2020) · Anxiety Stress & Coping · doi:10.1080/10615806.2020.1746283 · Cited by 16 · see citing works
“…Crowell et al., 2015; Finley et al., 2018), allows individuals to process threatening information more openly, reduces the effect of negative emotions, and broadens a person’s overall perspective (c.f., Cohen & Sherman, 2014; Sherman, 2013; see also Epton et al., 2015; Sweeney & Moyer, 2015).”
Background
Using Behavioral Science to Address COVID-19 Vaccine Hesitancy Among Cancer Survivors: Communication Strategies and Research Opportunities
Vanderpool, R. C., Gaysynsky, A., Chou, W. S., & Tonorezos, E. S. (2022) · Journal of Behavioral Medicine · doi:10.1007/s10865-022-00304-7 · Cited by 15 · see citing works
“…in response to COVID-19 vaccine information could also be used in patient-centered communication approaches to address vaccine hesitancy given evidence suggesting self-affirmation has positive effects on message acceptance, intentions to change, and resultant behavior (Epton et al., 2015).”
Background
Public Policy and Health
Ehret, P. J., & Sherman, D. K. (2014) · Policy Insights from the Behavioral and Brain Sciences · doi:10.1177/2372732214549472 · Cited by 15 · see citing works
“For example, across 46 experimental tests (N = 2,715), self-affirmation relative to control affects many different health behaviors (Epton et al., 2014).”
Background
Can reflecting on personal values online increase positive beliefs about counseling?
Lannin, D. G., Vogel, D. L., & Heath, P. J. (2017) · Journal of Counseling Psychology · doi:10.1037/cou0000201 · Cited by 15 · see citing works
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Authors: Epton, T., Harris, P. R., Kane, R., van Koningsbruggen, G. M., & Sheeran, P.
Affiliations: University of Manchester (GB)
University of Sussex (GB)
University of Sheffield (GB)
University of North Carolina at Chapel Hill (US)
ORCID: Epton, Tracy
Harris, Peter R.
Venue: Health Psychology
Publisher: American Psychological Association (APA)
Published: 2015
Volume: 34
Issue: 3
Pages: 187-196
ISSN: 0278-6133 (ISSN-L)
1930-7810
DOI: 10.1037/hea0000116
OpenAlex: W2023653705
Cited by: 277
References: 75
Citations by year: 2026: 11 · 2025: 20 · 2024: 18 · 2023: 17 · 2022: 27 · 2021: 40 · 2020: 31 · 2019: 30 · 2018: 24 · 2017: 23 · 2016: 25 · 2015: 9 · 2014: 2
FWCI: 30.45
Type: journal article
Language: en
Open access: green
figshare.com
Licence: cc-by
Locations: Health Psychology (publishedVersion)
PubMed (publishedVersion)
VU Research Portal (publishedVersion)
Figshare (submittedVersion, cc-by)
Research Explorer (The University of Manchester) (submittedVersion)
Sussex Research Online (University of Sussex) (submittedVersion)
Data Archiving and Networked Services (DANS) (submittedVersion)
Topics: Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
Social Sciences › Arts and Humanities › Literature and Literary Theory › Media Influence and Health
Social Sciences › Psychology › Social Psychology › Death Anxiety and Social Exclusion
Keywords: self-affirmation, health behavior change, message acceptance, health risk information, persuasive health communication
MeSH terms: Adult, Female, Health Promotion, Humans, Male, Persuasive Communication, Health Behavior, Self Efficacy, Intention, Young Adult

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The impact of self-affirmation on health-behavior change: A meta-analysis

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