PQA - 3: Neural predictors of receptivity to health communication and behavior ch

PQA - 3：健康沟通和行为接受度的神经预测因子

• 批准号: 8733640
• 负责人: Emily Falk
• 金额: $ 53.17万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-12 至 2017-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8733640
• 关键词: Accounting; Achievement; Adult; Affective; Agreement; Area; Attitude; Behavior; Benchmarking; Brain; Cognitive; Conscious; Coupled; Data; Effectiveness of Interventions; Equilibrium; Exposure to; Functional Magnetic Resonance Imaging; Goals; Health; Health Benefit; Health Care Costs; Health Communication; Health behavior; Health behavior change; Individual; Intervention; Lateral; Light Exercise; Maintenance; Malignant Neoplasms; Measures; Medial; Mediating; Mental Health; Meta-Analysis; Methods; Morbidity - disease rate; Neurocognitive; Obesity; Overweight; Participant; Patient Self-Report; Physical activity; Planning Theory; Prefrontal Cortex; Process; Recruitment Activity; Relative (related person); Resistance; Rewards; Risk; Risk Behaviors; Self Efficacy; Signal Transduction; System; Testing; Ventral Striatum; Work; base; behavior change; cancer risk; cingulate cortex; design; driving behavior; effective intervention; emotional factor; fight against; high risk; improved; information processing; innovation; interest; meetings; mortality; neuroimaging; neuromechanism; physical conditioning; prevent; public health relevance; relating to nervous system; response; sedentary; theories; therapy design

DESCRIPTION (provided by applicant): Promoting physical activity and decreasing sedentary behavior are key goals in the fight against cancers; physical activity is associated with lower risk of several cancers [1-10], and lower overall morbidity and mortality [11-26]. Thus, theory-driven initiatives to change these behaviors are essential [1-10, 26-40]. PQ#3 highlights the necessity for new perspectives on the interplay of cognitive and emotional factors in promoting behavior change. Current theories, which focus primarily on predictors derived from self-report measures, do not fully predict behavior change. For example, recent meta-analyses suggest that on average, variables from the Theory of Planned Behavior account for ~27% of the variance in behavior change [41, 42]. This limits our ability to design optimally effective interventions [43], and invites new methods that may explain additional variance. Our team has shown that neural activation in response to health messages in hypothesized neural regions of interest can double the explained variance in behavior change, above and beyond self-reports of attitudes, intentions, and self-efficacy [44, 45]. We now propose a next leap, inspired by PQ3, to identify how cognitive and affective processes interact in the brain to influence and predict behavior change. Our core hypothesis is that the balance of neural activity in regions associated with self-related processing versus defensive counterarguing is key in producing health behavior change, and that self-affirmation (an innovative approach, relatively new to the health behavior area [46]) can alter this balance. Self-affirmation theory [47] posits that people are motivated to maintain a sense of self-worth, and that threats to self-worth will be met with resistance, often i the form of counterarguing. One common threat to self-worth occurs when people are confronted with self-relevant health messages (e.g. encouraging less sedentary behavior in overweight, sedentary adults). This phenomenon speaks to a classic and problematic paradox: those at highest risk are likely to be most defensive and least open to altering cancer risk behaviors [48]. A substantial, and surprisingly impressive, body of evidence demonstrates that affirmation of core-values (self-affirmation priming) preceding messages can reduce resistance and increase intervention effectiveness [46, 49-53]. Uncovering neural mechanisms of such affirmation effects [46], has transformative potential for intervention design and selection. To test our conceptual assumptions and core hypothesis we will: (1) Identify neural signals associated with processing health messages as self-relevant versus counterarguing; (2) Test whether self-affirmation alters the balance of these signals; (3) Use these neural signals to predict physical activity behavior change, above and beyond what is predicted by self-report measures alone. Our approach is innovative methodologically (using fMRI to understand and predict behavior change), and conceptually (self-affirmation may dramatically increase intervention effectiveness). Benchmarks will include objectively measured decreases in sedentary behavior in affirmed vs. control subjects (using accelerometers), and increases in predictive capacity afforded by neuroimaging methods, compared to self-report alone.

描述（由申请人提供）：促进体力活动和减少久坐行为是对抗癌症的关键目标;体力活动与 降低几种癌症的风险[1-10]，降低总体发病率和死亡率[11-26]。因此，理论驱动的改变这些行为的举措是必不可少的[1-10，26-40]。PQ#3强调了对认知和情感因素在促进行为改变方面的相互作用提出新观点的必要性。目前的理论，主要集中在预测来自自我报告的措施，不完全预测行为的变化。例如，最近的荟萃分析表明，平均而言，来自计划行为理论的变量占行为变化方差的约27%[41，42]。这限制了我们设计最佳有效干预措施的能力[43]，并邀请新的方法来解释额外的差异。我们的团队已经证明，在假设的感兴趣的神经区域中，响应健康信息的神经激活可以使行为变化的解释方差加倍，超出态度，意图和自我效能的自我报告[44，45]。我们现在提出了受PQ 3启发的下一个飞跃，以确定认知和情感过程如何在大脑中相互作用以影响和预测行为变化。我们的核心假设是，与自我相关的处理与防御性反驳相关的区域中的神经活动的平衡是产生健康行为变化的关键，自我肯定（一种创新方法，对健康行为领域相对较新[46]）可以改变这种平衡。自我肯定理论[47]认为，人们有动机 保持自我价值感，对自我价值的威胁将受到抵制，通常是以反驳的形式。当人们面对与自我相关的健康信息时（例如，鼓励超重、久坐的成年人减少久坐行为），自我价值感就会受到一种常见的威胁。这种现象说明了一个经典的和有问题的悖论：那些风险最高的人可能是最具防御性的，最不愿意改变癌症风险行为[48]。大量令人印象深刻的证据表明，在信息之前对核心价值观的肯定（自我肯定启动）可以减少阻力并提高干预效果[46，49-53]。揭示这种肯定效应的神经机制[46]，对干预设计和选择具有变革性的潜力。为了验证我们的概念假设和核心假设，我们将：（1）识别与处理健康信息相关的神经信号，将其视为自我相关的信号与反驳的信号;（2）测试自我肯定是否会改变这些信号的平衡;（3）使用这些神经信号来预测身体活动行为的变化，超出自我报告测量的预测范围。我们的方法在方法论上是创新的（使用功能磁共振成像来理解和预测行为变化），在概念上（自我肯定可能会大大提高干预的有效性）。基准将包括客观测量的久坐行为减少肯定与对照受试者（使用加速度计），并增加神经成像方法提供的预测能力，与自我报告相比。