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

描述(申请人提供)：促进体力活动和减少久坐行为是抗击癌症的主要目标；体力活动与 患多种癌症的风险更低[1-10]，总体发病率和死亡率更低[11-26]。因此，改变这些行为的理论驱动的倡议是必不可少的[1-10，26-40]。PQ#3强调了从新的角度看待认知和情感因素在促进行为改变中相互作用的必要性。目前的理论主要关注来自自我报告测量的预测因素，并不能完全预测行为变化。例如，最近的元分析表明，平均而言，计划行为理论中的变量占行为变化变量的~27%[41，42]。这限制了我们设计最佳有效干预措施的能力[43]，并引发了可能解释额外差异的新方法。我们的团队已经证明，在假想的感兴趣的神经区域中，对健康信息做出反应的神经激活可以使行为变化的解释差异增加一倍，超过态度、意图和自我效能的自我报告[44，45]。我们现在提出一个受PQ3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，在与自我相关的处理和防御性反驳相关的区域中，神经活动的平衡是产生健康行为变化的关键，自我肯定(一种创新的方法，在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]假设人们有动机去 保持一种自我价值感，对自我价值感的威胁会遇到阻力，这通常是反驳的形式。自我价值的一个常见威胁发生在人们面临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)。这一现象说明了一个经典而有问题的悖论：那些风险最高的人可能最具防御性，而对改变癌症风险行为最不开放[48]。大量的、令人惊讶地令人印象深刻的证据表明，肯定核心价值观(自我肯定启动)之前的信息可以减少阻力，增加干预有效性[46，49-53]。揭示这种肯定效应的神经机制[46]，对于干预设计和选择具有变革的潜力。为了检验我们的概念假设和核心假设，我们将：(1)确定与处理健康信息相关的神经信号是自我相关的还是反驳的；(2)测试自我肯定是否改变了这些信号的平衡；(3)使用这些神经信号来预测身体活动行为的变化，而不仅仅是自我报告测量所预测的。我们的方法在方法上是创新的(使用功能磁共振成像来理解和预测行为变化)，在概念上(自我肯定可以极大地提高干预效果)。基准将包括(使用加速计)被确认的受试者与对照受试者相比，客观测量的久坐行为的减少，以及与单独的自我报告相比，神经成像方法所提供的预测能力的增加。

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.