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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

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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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Result
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Background
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Background
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“Accordingly, much research shows that when people have an opportunity to reflect on, for example, their cherished values before being exposed to threatening health information, such as a graphic warning label [24,28] or personal disease risk [29], they are more receptive to that information and may be more likely to e…”
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Result
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Background
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Self-affirmation impacts behavioral intentions but not preferences for delayed outcomes
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Lee, H., & Albarracín, D. (2025) · Journal of Consumer Psychology · doi:10.1002/jcpy.70014 · Cited by 5
“For example, when it comes to behavioral change, self-affirmation has small positive effects on health behaviors (Epton et al., 2015; Sweeney & Moyer, 2015).”
Evermore Wellbeing for Teens: A Scoping Review of Stand-alone and Brief Positive Psychology Interventions for Potential Use in Educational Settings
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Why listening to traumatic disclosures sometimes fails and how it can succeed.
Harber, K. (2023) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2023.101589 · Cited by 6
Lowering the barriers to change: Can processing‐related self‐affirmations overcome resistance?
Emonds, T., Verwijmeren, T., & Müller, B. C. N. (2023) · Journal of Applied Social Psychology · doi:10.1111/jasp.12977 · Cited by 4
Using peer-ethnography to explore the health and well-being of college students affected by COVID-19
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Effects of a self-affirmation intervention on responses to bowel cancer screening information
Travis, E., Ashley, L., & O'Connor, D. B. (2024) · Psychology and Health · doi:10.1080/08870446.2024.2332265 · Cited by 5
“The current study builds on the existing literature (Good & Abraham, 2007; Epton et al., 2015; lles et al., 2022), with no main effect of experimental condition on levels of state anxiety, message acceptance and behavioural intention.”
Public Health Communication Approaches for Building Common Ground
Chou, W. S., Iles, I. A., Gaysynsky, A., & Klein, W. M. P. (2025) · American Journal of Public Health · doi:10.2105/ajph.2024.308003 · Cited by 4
Positive Affirmation Self-Talk, Impacts on Well-Being, When and How to Start Doing it
Zuraidy, N. A. (2025) · International Journal of Social health · doi:10.58860/ijsh.v4i1.279 · Cited by 4
“The relevance, belief, and emotional response of an affirmation significantly influence its effectiveness (Epton et al., 2015).”
A pilot randomised test of a self-affirmation implementation intention intervention to reduce dietary salt intake
Bradbury, D., Upsher, R. J., & Chilcot, J. (2016) · Journal of Health Psychology · doi:10.1177/1359105316650511 · Cited by 5
“A recent meta-analysis found reliable positive (although small) effects on these three outcomes across various health behaviours (Epton et al., 2014a).”
BackgroundMethod
Impact of Self-Affirmation on Responses to Health Warning Messages: Does Consideration of Future Consequences Matter?
Nan, X., Iles, I. A., & Ma, Z. (2021) · Health Communication · doi:10.1080/10410236.2021.1885773 · Cited by 4
Comparing self-affirmation manipulations to reduce alcohol consumption in university students
Vogt, K. S., Stephenson, J. R., & Norman, P. E. (2021) · Journal of American College Health · doi:10.1080/07448481.2021.1968409 · Cited by 4
“33 SAT poses that when individuals are presented with health-risk information, they experience a threat to both their physical integrity (including their current or future health) and their self-integrity (i.e. their view of themselves as a ‘good’ and moral person).”
BackgroundMethodInfluential
Physical Health Under the Shadow of Mortality
Bultmann, M. N., & Arndt, J. (2019) · Elsevier eBooks · doi:10.1016/b978-0-12-811844-3.00016-0 · Cited by 5
Combining a UV photo intervention with self-affirmation or self-compassion exercises: implications for skin protection
Hagerman, C. J., Stock, M. L., Molloy-Paolillo, B. K., Beekman, J. B., Klein, W. M. P., & Butler, N. (2019) · Journal of Behavioral Medicine · doi:10.1007/s10865-019-00104-6 · Cited by 4
“Although meta-analyses have established that self-affirmation is generally effective in enhancing message acceptance (Epton et al., 2015; Sweeney & Moyer, 2015), overall effect sizes are relatively small and backfire effects are not unheard of within this literature.”
BackgroundInfluential
A SERIOUS GAME APPROACH IN ANTI-DOPING EDUCATION: THE GAME PROJECT
Barkoukis, V., Tsiatsos, Τ., Politopoulos, N., Stylianidis, P., Ziagkas, E., Lazuras, L., & Ypsilanti, A. (2019) · eLearning and Software for Education · doi:10.12753/2066-026x-19-200 · Cited by 4
Bias in the mirror
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“Additionally, although a meta-analysis discovered that self-affirmation manipulations had an average behavioral effect on responses to threatening information [28], the effects of self-affirmation are relatively modest and heterogeneous [29,30].”
Background
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You, D. S., Hettie, G., Darnall, B. D., & Ziadni, M. S. (2023) · Scandinavian Journal of Pain · doi:10.1515/sjpain-2022-0099 · Cited by 4
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“…can take the form of having people write about what they value in structured exercises, have been shown to increase openness and engagement with threatening information related to health (Harris & Napper, 2005; Sherman et al., 2000; see Epton et al., 2015; Sweeney & Moyer, 2015 for meta-analyses).”
Background
Modelle gesundheitsbezogenen Handelns und Verhaltensänderung
Lippke, S., Schüz, B., & Godde, B. (2021) · Springer Reference Pflege – Therapie – Gesundheit · doi:10.1007/978-3-662-58314-2_29 · Cited by 4
Examining self‐affirmation as a tactic for recruiting inactive women into exercise interventions
More, K. R., Phillips, L. A., Green, Z., & Mentzou, A. (2021) · Applied Psychology Health and Well-Being · doi:10.1111/aphw.12303 · Cited by 3
“This task was chosen because meta-analytic evidence has shown that self-affirmation interventions have the largest influence on behaviour when the manipulation is comprised of a values essay (Epton et al., 2015).”
BackgroundMethodResultInfluential
Cancer and cardiovascular-related perceived risk in a diverse cancer center catchment area
Pinheiro, L. C., Soroka, O., Razon, D., Ramos, R., Antoine, F., Dannenberg, A. J., Safford, M. M., Peterson, S. J., Tamimi, R. M., Nanus, D. M., et al. (2022) · Cancer Causes & Control · doi:10.1007/s10552-022-01560-3 · Cited by 3
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“, changes in doping related-behaviours, such as abuse/misuse of nutritional supplements or other ergogenic drugs that are not banned from WADA; long-term avoidance of doping; and reductions/abstinence from doping use among former users) - the effectiveness of interventions can, therefore, be evaluated against these th…”
Background
Identifying Core Values with a Hierarchical, Ipsative, Preference Assessment
Stanislaw, H., & McCreary, J. (2022) · Journal of Personality Assessment · doi:10.1080/00223891.2022.2090369 · Cited by 2
“Values-based interventions can improve health care follow-through (Epton et al., 2015) and promote healthy lifestyles more effectively than alternative approaches (e.g., Anshel et al., 2010; Hardcastle et al., 2015).”
Background
Effects of experimentally induced self-affirmation on the openness to meat reduction and alternative protein sources
Branković, M., Budžak, A., Tulić, N., & Janković, J. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1021891 · Cited by 4
“individual and group affirmations can increase openness to reduce meat consumption and consider alternative, plantbased sources of protein and lab-grown meat (Cohen and Sherman, 2014; Epton et al., 2015; Ferrer and Cohen, 2019), 2.”
BackgroundResultInfluential
Optimism bias regarding COVID-19: a cross-sectional study of lower-income older adults in Thailand
Vicerra, P. M. M. (2023) · Annals of Medicine · doi:10.1080/07853890.2023.2258893 · Cited by 3
Does other‐affirmation increase self‐directed exposure to and persuasiveness of a threatening anti‐alcohol message?
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Evaluation of an online “teachable moment” dietary intervention
Marks, L., & Ogden, J. (2017) · Health Education · doi:10.1108/he-02-2016-0007 · Cited by 3
“People are often unwilling to hear health promotion information and to change their behaviour (Epton et al., 2015).”
Background
A pre-registered test of competing theories to explain ego depletion effects using psychophysiological indicators of mental effortPreprint
Gieseler, K., Loschelder, D. D., Job, V., & Friese, M. (2020) · doi:10.31234/osf.io/ufk52 · Cited by 3
Finding the 'Self' in Self-Regulation: The Identity-Value ModelPreprint
Berkman, E. T., Livingston, J., & Kahn, L. E. (2015) · SSRN Electronic Journal · doi:10.2139/ssrn.2621251 · Cited by 3

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
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 › Communication › 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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