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）：促进体育锻炼和减少久坐行为是与癌症作斗争的关键目标；体育锻炼与 较低的几种癌症的风险[1-10]，降低了总体发病率和死亡率[11-26]。因此，理论驱动的改变这些行为是必不可少的[1-10，26-40]。 PQ＃3突出了对促进行为改变的认知和情感因素相互作用的新观点的必要性。当前的理论主要集中在自我报告措施中获得的预测因素，并不能完全预测行为的变化。例如，最近的荟萃分析表明，平均而言，计划行为理论的变量占行为改变差异的约27％[41，42]。这限制了我们设计最佳有效干预措施的能力[43]，并邀请了可以解释其他方差的新方法。我们的团队表明，对假设的感兴趣的神经区域中的健康信息的神经激活可以使行为改变的解释差异增加一倍，超过自我报告，态度，意图和自我效能感的自我报告[44，45]。现在，我们提出了一个受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的变化。我们的核心假设是，与自我相关的处理与防御性反应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（一种创新的方法，相对较新的健康行为领域[46]）可以改变这种平衡。自我肯定理论[47]认为人们有动力 保持一种自我价值感，对自我价值的威胁将受到抵抗，通常是反宣教的形式。当人们面对自我相关的健康信息时，就会发生自我价值的一个普遍威胁（例如，在超重，久坐的成年人中鼓励久坐不动的行为）。这种现象说明了经典和有问题的悖论：那些风险最高的悖论可能是防御性最大，最不愿意改变癌症风险行为[48]。大量的证据表明，对核心价值（自我肯定启动）前后信息的肯定可以降低抵抗力并提高干预效率[46，49-53]。发现这种肯定作用的神经机制[46]具有干预设计和选择的变革潜力。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与自我相关的与反宣传； （2）测试自我确认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，超出了仅由自我报告措施所预测的。我们的方法在方法论上是创新的（使用fMRI来理解和预测行为变化），从概念上讲（自我肯定可能会大大提高干预效率）。与仅自我报告相比，基准测试将包括在肯定对控制对象（使用加速度计）（使用加速度计）（使用加速度计）（使用加速度计）中久坐行为的久坐行为减少，与单独进行自我报告相比，通过神经成像方法的预测能力增加。