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

基本信息

批准号：
8590270
负责人：
Emily Falk
金额：
$ 59.76万
依托单位：
UNIVERSITY OF PENNSYLVANIA
依托单位国家：
美国
项目类别：
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/8590270
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

项目摘要

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）：促进身体活动和减少久坐行为是抗击癌症的关键目标；体力活动与降低多种癌症的风险[1-10]，并降低总体发病率和死亡率[11-26]。因此，改变这些行为的理论驱动举措至关重要 [1-10, 26-40]。 PQ#3 强调了认知和情感因素在促进行为改变中相互作用的新视角的必要性。当前的理论主要关注从自我报告测量得出的预测因素，并不能完全预测行为变化。例如，最近的荟萃分析表明，平均而言，计划行为理论中的变量约占行为变化方差的 27% [41, 42]。这限制了我们设计最佳有效干预措施的能力[43]，并需要新的方法来解释额外的差异。我们的团队已经表明，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]。受 PQ3 的启发，我们现在提出了下一个飞跃，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改变的关键，而自我肯定（一种创新方法，对健康行为领域来说相对较新[46]）可以改变这种平衡。自我肯定理论[47]认为人们有动机去保持自我价值感，对自我价值的威胁会遭到抵制，通常是反驳的形式。当人们面临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），就会出现对自我价值的一种常见威胁。这种现象说明了一个经典且有问题的悖论：那些风险最高的人可能最具防御性，并且最不愿意改变癌症风险行为[48]。大量且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]，对于干预设计和选择具有变革潜力。为了测试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是自相关的还是反驳的；（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，超出仅通过自我报告测量的预测。我们的方法在方法论上（使用功能磁共振成像来理解和预测行为变化）和概念上都是创新的（自我肯定可能会显着提高干预效果）。基准将包括客观测量的确认受试者与对照受试者（使用加速计）久坐行为的减少，以及与单独自我报告相比，神经影像方法提供的预测能力的增加。