The DOI matches its Crossref record; 75 of the 75 references it cites were found in a registry or an index.
The impact of self-affirmation on health-behavior change: A meta-analysis
Open accessAbstract
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.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“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.”
From Effects of a Brief Preventive Intervention in Cyberbullying and Grooming in Adolescents (2021) · cites this paper as Epton et al., 2014
Citations
Cites
The theory of planned behavior
Ajzen, I. (1991) · Organizational Behavior and Human Decision Processes · doi:10.1016/0749-5978(91)90020-t · Cited by 90,587
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & for the PRISMA Group (2009) · BMJ · doi:10.1136/bmj.b2535 · Cited by 83,823
Measuring inconsistency in meta-analyses
Higgins, J. P. T., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003) · BMJ · doi:10.1136/bmj.327.7414.557 · Cited by 63,139
Wasserman, S. S., Hedges, L. V., & Olkin, I. (1988) · Journal of Educational Statistics · doi:10.2307/1164953 · Cited by 10,361
Cohen, J. (1992) · Psychological Bulletin · doi:10.1037//0033-2909.112.1.155 · Cited by 8,771
Putting the fear back into fear appeals: the extended parallel process model
Witte, K. (1992) · Communication Monographs · doi:10.1080/03637759209376276 · Cited by 3,880
Webb, T. L., & Sheeran, P. (2006) · Psychological Bulletin · doi:10.1037/0033-2909.132.2.249 · Cited by 3,732
Self-citationThe Psychology of Self-Affirmation: Sustaining the Integrity of the Self
Steele, C. M. (1988) · Advances in Experimental Social Psychology · doi:10.1016/s0065-2601(08)60229-4 · Cited by 3,697
Rogers, R. W., & Rogers, R. W. (1983) · Medical Entomology and Zoology · Cited by 2,577
Petty, R. E., Wegener, D. T., & Fabrigar, L. R. (1997) · Annual Review of Psychology · doi:10.1146/annurev.psych.48.1.609 · Cited by 2,290
Effective techniques in healthy eating and physical activity interventions: A meta-regression.
Michie, S., Abraham, C., Whittington, C., McAteer, J., & Gupta, S. (2009) · Health Psychology · doi:10.1037/a0016136 · Cited by 2,229
Improved tests for a random effects meta‐regression with a single covariate
Knapp, G., & Hartung, J. (2003) · Statistics in Medicine · doi:10.1002/sim.1482 · Cited by 2,075
A Brief Social-Belonging Intervention Improves Academic and Health Outcomes of Minority Students
Walton, G. M., & Cohen, G. L. (2011) · Science · doi:10.1126/science.1198364 · Cited by 1,992
The psychology of self-defense: Self-affirmation theory
Sherman, D. K., & Cohen, G. L. (2006) · Advances in Experimental Social Psychology · doi:10.1016/s0065-2601(06)38004-5 · Cited by 1,614
Experimental disclosure and its moderators: A meta-analysis.
Frattaroli, J. (2006) · Psychological Bulletin · doi:10.1037/0033-2909.132.6.823 · Cited by 1,502
The precaution adoption process.
Weinstein, N. D. (1988) · Health Psychology · doi:10.1037//0278-6133.7.4.355 · Cited by 1,459
Values, attitudes, and interpersonal behavior.
Triandis, H. C. (1980) · PubMed · Cited by 1,414
Health Message Framing Effects on Attitudes, Intentions, and Behavior: A Meta-analytic Review
Gallagher, K. M., & Updegraff, J. A. (2011) · Annals of Behavioral Medicine · doi:10.1007/s12160-011-9308-7 · Cited by 1,156
Motivated inference: Self‐serving generation and evaluation of causal theories
Kunda, Z. (1987) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.53.4.636 · Cited by 1,059
Prejudice as self-image maintenance: Affirming the self through derogating others.
Fein, S., & Spencer, S. J. (1997) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.73.1.31 · Cited by 1,047
Sheeran, P., Harris, P. R., & Epton, T. (2013) · Psychological Bulletin · doi:10.1037/a0033065 · Cited by 964
A meta-analysis of computer-tailored interventions for health behavior change
Krebs, P., Prochaska, J. O., & Rossi, J. S. (2010) · Preventive Medicine · doi:10.1016/j.ypmed.2010.06.004 · Cited by 854
Recursive Processes in Self-Affirmation: Intervening to Close the Minority Achievement Gap
Cohen, G. L., Garcia, J., Purdie-Vaughns, V., Apfel, N., & Brzustoski, P. (2009) · Science · doi:10.1126/science.1170769 · Cited by 800
Interventions to change health behaviours: evidence-based or evidence-inspired?
Michie, S., & Abraham, C. (2004) · Psychology and Health · doi:10.1080/0887044031000141199 · Cited by 783
Hofmann, W., Friese, M., & Wiers, R. W. H. J. (2008) · Health Psychology Review · doi:10.1080/17437190802617668 · Cited by 707
A meta-analysis of web-delivered tailored health behavior change interventions
Lustria, M. L. A., Noar, S. M., Cortese, J., Van Stee, S. K., Glueckauf, R. L., & Lee, J. (2013) · Journal of Health Communication · doi:10.1080/10810730.2013.768727 · Cited by 689
Sherman, D. A. K., Nelson, L. D., & Steele, C. M. (2000) · Personality and Social Psychology Bulletin · doi:10.1177/01461672002611003 · Cited by 660
Defensive processing of personally relevant health messages
liberman, A., & Chaiken, S. (1992) · Personality and Social Psychology Bulletin · doi:10.1177/0146167292186002 · Cited by 619
Self-affirmation and self-control: Affirming core values counteracts ego depletion.
Schmeichel, B. J., & Vohs, K. (2009) · Journal of Personality and Social Psychology · doi:10.1037/a0014635 · Cited by 602
Nonconscious processes and health.
Sheeran, P., Gollwitzer, P. M., & Bargh, J. A. (2013) · Health Psychology · doi:10.1037/a0029203 · Cited by 579
Experimental manipulations of self-affirmation: A systematic review
MCQueen, A., & Klein, W. M. P. (2006) · Self and Identity · doi:10.1080/15298860600805325 · Cited by 563
When a Day Means More than a Year: Effects of Temporal Framing on Judgments of Health Risk
Chandran, S., & Menon, G. (2004) · Journal of Consumer Research · doi:10.1086/422116 · Cited by 442
Self-Affirmation Reduces Biased Processing of Health-Risk Information
Reed, M. B., & Aspinwall, L. G. (1998) · Motivation and Emotion · doi:10.1023/a:1021463221281 · Cited by 374
Sherman, D. K., Hartson, K. A., Binning, K. R., Purdie-Vaughns, V., Garcia, J., Taborsky-Barba, S., Tomassetti, S., Nussbaum, A. D., & Cohen, G. L. (2013) · Journal of Personality and Social Psychology · doi:10.1037/a0031495 · Cited by 371
Crocker, J., Niiya, Y., & Mischkowski, D. (2008) · Psychological Science · doi:10.1111/j.1467-9280.2008.02150.x · Cited by 345
Self-Affirmation and the Biased Processing of Threatening Health-Risk Information
Harris, P. R., & Napper, L. (2005) · Personality and Social Psychology Bulletin · doi:10.1177/0146167205274694 · Cited by 319
The Effect of Construal Level on Subjective Probability Estimates
Wakslak, C. J., & Yaacov Trope, B. (2008) · Psychological Science · doi:10.1111/j.1467-9280.2008.02250.x · Cited by 281
Self-affirmation reduces smokers' defensiveness to graphic on-pack cigarette warning labels.
Harris, P. R., Mayle, K., Mabbott, L., & Napper, L. (2007) · Health Psychology · doi:10.1037/0278-6133.26.4.437 · Cited by 234
An affirmed self and an open mind: Self‐affirmation and sensitivity to argument strength
Correll, J., Spencer, S. J., & Zanna, M. P. (2004) · Journal of Experimental Social Psychology · doi:10.1016/j.jesp.2003.07.001 · Cited by 225
Affirmed yet unaware: Exploring the role of awareness in the process of self-affirmation.
Sherman, D. K., Cohen, G. L., Nelson, L. D., Nussbaum, A. D., Bunyan, D. P., & Garcia, J. (2009) · Journal of Personality and Social Psychology · doi:10.1037/a0015451 · Cited by 223
Self-affirmation promotes health behavior change.
Epton, T., & Harris, P. R. (2008) · Health Psychology · doi:10.1037/0278-6133.27.6.746 · Cited by 187
Harris, P. R., & Epton, T. (2009) · Social and Personality Psychology Compass · doi:10.1111/j.1751-9004.2009.00233.x · Cited by 168
Meta-Synthesis of Health Behavior Change Meta-Analyses
Johnson, B. T., Scott-Sheldon, L. A. J., & Carey, M. P. (2010) · American Journal of Public Health · doi:10.2105/ajph.2008.155200 · Cited by 160
Reducing Information Avoidance Through Affirmation
Howell, J. L., & Shepperd, J. A. (2012) · Psychological Science · doi:10.1177/0956797611424164 · Cited by 145
Kraemer, H. C., Gardner, C., Brooks, J. O., & Yesavage, J. A. (1998) · Psychological Methods · doi:10.1037/1082-989x.3.1.23 · Cited by 141
Armitage, C. J., Harris, P. R., Hepton, G., & Napper, L. (2008) · Psychology of Addictive Behaviors · doi:10.1037/0893-164x.22.1.88 · Cited by 130
Self-citationArmitage, C. J., Harris, P. R., & Arden, M. A. (2011) · Health Psychology · doi:10.1037/a0023738 · Cited by 128
Self-citationHarris, P. R., Brearley, I., Sheeran, P., Barker, M. E., Klein, W. M. P., Creswell, J. D., Levine, J. M., & Bond, R. (2014) · Health Psychology · doi:10.1037/hea0000065 · Cited by 127
Self-Affirmation Enhances Attentional Bias Toward Threatening Components of a Persuasive Message
Klein, W. M. P., & Harris, P. R. (2009) · Psychological Science · doi:10.1111/j.1467-9280.2009.02467.x · Cited by 125
When Self-Affirmations Reduce Defensiveness: Timing Is Key
Critcher, C. R., Dunning, D., & Armor, D. A. (2010) · Personality and Social Psychology Bulletin · doi:10.1177/0146167210369557 · Cited by 118
Recognition memory impairment in Parkinson's disease: Power and meta-analyses.
Whittington, C. J., Podd, J., & Kan, M. M. (2000) · Neuropsychology · doi:10.1037//0894-4105.14.2.233 · Cited by 112
Tests for publication bias in meta-analysis
Steichen, T. J. (1998) · Stata technical bulletin · Cited by 103
The Effect of Self-Affirmation in Nonthreatening Persuasion Domains: Timing Affects the Process
Briñol, P., Petty, R. E., Gallardo, I., & DeMarree, K. G. (2007) · Personality and Social Psychology Bulletin · doi:10.1177/0146167207306282 · Cited by 102
Jessop, D. C., Simmonds, L., & SPARKS, P. B. (2008) · Psychology and Health · doi:10.1080/08870440801930320 · Cited by 101
van Koningsbruggen, G. M., Das, E., & Roskos-Ewoldsen, D. R. (2009) · Health Psychology · doi:10.1037/a0015610 · Cited by 100
Advancing the science of behaviour change: a plea for scientific reporting
MICHIE, S., & ABRAHAM, C. (2008) · Addiction · doi:10.1111/j.1360-0443.2008.02291.x · Cited by 99
Don't derogate this message! Self-affirmation promotes online type 2 diabetes risk test taking
van Koningsbruggen, G. M., & Das, E. H. H. J. (2008) · Psychology and Health · doi:10.1080/08870440802340156 · Cited by 95
Coyne, J. C., Thombs, B. D., & Hagedoorn, M. (2010) · Health Psychology · doi:10.1037/a0017633 · Cited by 83
Feelings of vulnerability in response to threatening messages: Effects of self-affirmation
Klein, W. M. P., Harris, P. R., Ferrer, R. A., & Zajac, L. E. (2011) · Journal of Experimental Social Psychology · doi:10.1016/j.jesp.2011.05.005 · Cited by 74
Self-citationSchüz, N., Schüz, B., & Eid, M. (2013) · Health Psychology · doi:10.1037/a0029887 · Cited by 70
Influence of Self-Affirmation on Responses to Gain- Versus Loss-Framed Antismoking Messages
Zhao, X., & Nan, X. (2010) · Human Communication Research · doi:10.1111/j.1468-2958.2010.01385.x · Cited by 67
Effects of Coping Information and Value Affirmation on Responses to a Perceived Health Threat
Fry, R. B., & Prentice-Dunn, S. (2005) · Health Communication · doi:10.1207/s15327027hc1702_2 · Cited by 63
Self-Affirmation Promotes Physical Activity
Cooke, R. W. I., Trebaczyk, H., Harris, P. R., & Wright, A. J. (2014) · Journal of Sport and Exercise Psychology · doi:10.1123/jsep.2013-0041 · Cited by 50
Dillard, A. J., McCaul, K. D., & Magnan, R. E. (2007) · Journal of Applied Biobehavioral Research · doi:10.1111/j.1751-9861.2005.tb00010.x · Cited by 49
Klein, W. M. P., Lipkus, I. M., Scholl, S., McQueen, A., Cerully, J., & Harris, P. R. (2010) · Psychology and Health · doi:10.1080/08870440903261970 · Cited by 48
Cognitive self‐affirmation inclination: An individual difference in dealing with self‐threats
Pietersma, S., & Dijkstra, A. (2010) · British Journal of Social Psychology · doi:10.1348/014466610x533768 · Cited by 40
Good, A., & Abraham, C. (2011) · Psychology and Health · doi:10.1080/08870446.2010.495157 · Cited by 38
Pietersma, S., & Dijkstra, A. (2011) · British Journal of Health Psychology · doi:10.1111/j.2044-8287.2011.02018.x · Cited by 37
Self-Affirmation, Intentions and Alcohol Consumption in Students: A Randomized Exploratory Trial
Scott, J. L., Brown, A. C., Phair, J. K., Westland, J. N., & Schüz, B. (2013) · Alcohol and Alcoholism · doi:10.1093/alcalc/agt027 · Cited by 35
Pavey, L., & SPARKS, P. B. (2011) · Psychology and Health · doi:10.1080/08870446.2011.556251 · Cited by 30
Message Framing and Defensive Processing: A Cultural Examination
Ko, D. M., & Kim, H. S. (2010) · Health Communication · doi:10.1080/10410230903473532 · Cited by 28
36. The Reciprocal relation between principles and practice: social psychology and health behavior
Rothman, A. J., & Salovey, P. (2007) · Dialnet (Universidad de la Rioja) · Cited by 28
An Experimental Test of Women's Body Dissatisfaction Reduction through Self‐Affirmation
Bucchianeri, M. M., & Corning, A. F. (2012) · Applied Psychology Health and Well-Being · doi:10.1111/j.1758-0854.2012.01068.x · Cited by 12
van Koningsbruggen, G. M. (2009) · Cited by 7
Neumann, C. A. (2005) · SHAREOK (University of Oklahoma; Oklahoma State University; Central Oklahoma University) · Cited by 2
Flagged first, then by citations
Cited by
Sorted by citations
Health Behavior Change: Moving from Observation to Intervention
Sheeran, P., Klein, W. M. P., & Rothman, A. J. (2016) · Annual Review of Psychology · doi:10.1146/annurev-psych-010416-044007 · Cited by 476
Unique effects of setting goals on behavior change: Systematic review and meta-analysis.
Epton, T., Currie, S., & Armitage, C. J. (2017) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000260 · Cited by 383
“Where studies measured behavior at multiple time points, we adopted the conservative strategy of calculating the effect size only for the measure at the final time-point (e.g., Epton et al., 2015; Sheeran, Harris, & Epton, 2014).”
MethodResultInfluentialHennessy, E. A., Johnson, B. T., Acabchuk, R. L., McCloskey, K., & Stewart-James, J. (2019) · Health Psychology Review · doi:10.1080/17437199.2019.1679654 · Cited by 262
Self-Affirmation Reduces Delay Discounting of the Financially Deprived
Moeini‐Jazani, M., Albalooshi, S., & Seljeseth, I. M. (2019) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.01729 · Cited by 221
Engagement in digital interventions.
Nahum-Shani, I., Shaw, S. D., Carpenter, S. M., Murphy, S. A., & Yoon, C. (2022) · American Psychologist · doi:10.1037/amp0000983 · Cited by 177
Metadata
- 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)
- Venue
- Health Psychology
- Published
- 2015
- Volume
- 34
- Issue
- 3
- Pages
- 187-196
- ISSN
- 0278-6133 (ISSN-L)
- 1930-7810
- 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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review