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Freijy - ASBHM - Do interventions based on cognitive dissonance promote health behaviour

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Freijy, T., & Kothe, E., (2013). Do interventions based on cognitive dissonance promote health behaviour?. Paper presented at the Australasian Society of Behavioural Health and Medicine (ASBHM) 10th Annual Proceedings, Newcastle, Australia

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Freijy - ASBHM - Do interventions based on cognitive dissonance promote health behaviour

  1. 1. Do interventions based oncognitive dissonance promote health behaviour change? A systematic review Tanya Freijy and Emily Kothe
  2. 2. What is cognitive dissonance?› Cognitive dissonance: A state of psychological discomfort that arises from conflicting attitudes or beliefs (Festinger, 1957).› Reduce dissonance via adaptation of cognitions or behaviour. 2
  3. 3. How is dissonance induced?Interventions based on cognitive dissonance usually follow one ofseveral experimental paradigms:›Induced compliance paradigm (Festinger & Carlsmith, 1959)›Hypocrisy paradigm (Aronson, Fried, & Stone, 1991)›Belief-disconfirmation paradigm (Festinger, Riecken, &Schachter, 1956)›Free choice paradigm (Brehm, 1956)›Effort justification paradigm (Aronson & Mills, 1959) 3
  4. 4. Existing evidenceDissonance-based interventions have targeted:›Water conservation (Dickerson et al., 1992)›Energy conservation (Pallak, Cook, & Sullivan, 1980)›Smoking (Simmons et al., 2004)›Racism (Son Hing, Li, & Zanna, 2002)›Generosity (McKimmie et al., 2003)›Eating disorder (ED) prevention (Stice et al., 2008; Beckeret al., 2010) 4
  5. 5. Existing evidenceSo, dissonance-based interventions are strong in the clinical literature, but what about non-clinical? 5
  6. 6. AimsThe current review aimed to:1.Determine whether dissonance-based interventions areeffective in changing participants’ health behaviour, attitude, orintention.2.Assess the risk of bias associated with such interventions.3.Explore whether some health behaviours are more amenable to change than others. 6
  7. 7. Search strategy› PsychINFO, Medline, Web of Science, Embase, and CINAHL from database inception to March 2012.› Search terms included dissonance, hypocrisy, cognitive dissonance, health, behavio(u)r, lifestyle and prevention.› Included: All pre/post studies described as dissonance-based that measured one or more of attitude, intention, or behaviour.› Excluded: clinical behaviours e.g., ED prevention studies.› Records after duplicates removed n = 1420; after title screen n = 670; after abstract screen n = 42; after full-text screen n = 18 (20 studies) 7
  8. 8. ResultsIntervention effects›In 15 of 20 studies changes were achieved in one or moremeasures of participants’ behaviour, attitude or intention. 8
  9. 9. ResultsIntervention effects›In 15 of 20 studies changes were achieved in one or moremeasures of participants’ behaviour, attitude or intention.›Intervention effects were not influenced by type of healthbehaviour, but were influenced by experimental paradigm. 9
  10. 10. ResultsIntervention effects›In 15 of 20 studies changes were achieved in one or moremeasures of participants’ behaviour, attitude or intention.›Intervention effects were not influenced by type of healthbehaviour, but were influenced by experimental paradigm.› Hypocrisy appears to be most reliable (+ve effects on all measures in 10 of 14 studies) rather than induced compliance (null or mixed results in all 4 studies). 10
  11. 11. ResultsIntervention effects›In 15 of 20 studies changes were achieved in one or moremeasures of participants’ behaviour, attitude or intention.›Intervention effects were not influenced by type of healthbehaviour, but were influenced by experimental paradigm.› Hypocrisy appears to be most reliable (+ve effects on all measures in 10 of 14 studies) rather than induced compliance (null or mixed results in all 4 studies).› Long-term effects difficult to determine. 11
  12. 12. ResultsIntervention effects›In 15 of 20 studies changes were achieved in one or moremeasures of participants’ behaviour, attitude or intention.›Intervention effects were not influenced by type of healthbehaviour, but were influenced by experimental paradigm.› Hypocrisy appears to be most reliable (+ve effects on all measures in 10 of 14 studies) rather than induced compliance (null or mixed results in all 4 studies).› Long-term effects difficult to determine.›Self-esteem and gender emerged as potential moderators. 12
  13. 13. ResultsAssessment of risk of bias›Majority of studies had inadequate randomisation and concealment of allocation.›Reporting bias high in 5 studies – data withheld or provided graphically only.›Self-report data  social desirability bias. 13
  14. 14. Limitations›Publication bias.›Search restricted to English-language papers.›Analysis relied upon statistical p-values. 14
  15. 15. Future directions›Hypocrisy should be used when targeting non-clinicalhealth behaviours. Induced compliance paradigm has thepotential to be strengthened. 15
  16. 16. Future directions›Hypocrisy should be used when targeting non-clinicalhealth behaviours. Induced compliance paradigm has thepotential to be strengthened.›Minimise bias via adequate selection & randomisation, fullreporting of data, demographic variables, social desirabilityscale. 16
  17. 17. Future directions›Hypocrisy should be used when targeting non-clinicalhealth behaviours. Induced compliance paradigm has thepotential to be strengthened.›Minimise bias via adequate selection & randomisation, fullreporting of data, demographic variables, social desirabilityscale.›Explore moderators: - self-esteem & gender - readiness for change? - ethnicity? 17
  18. 18. Thank you tfre6453@uni.sydney.edu.au emily.kothe@deakin.edu.auFreijy, T., & Kothe, E. J. (in press). Dissonance-based interventions for health behaviour change: A systematic review. British Journal of Health Psychology. 18
  19. 19. ReferencesAronson, E., Fried, C., & Stone, J. (1991). Overcoming denial and increasing the intention to use condoms through the induction of hypocrisy. AmericanJournal of Public Health, 81(12), 1636-1638.Aronson, E., & Mills, J. (1959). The effect of severity of initiation on liking for a group. The Journal of Abnormal and Social Psychology, 59(2), 177.Becker, C. B., Wilson, C., Williams, A., Kelly, M., McDaniel, L., & Elmquist, J. (2010). Peer-facilitated cognitive dissonance versus healthy weight eatingdisorders prevention: A randomized comparison. Body Image, 7(4), 280-288.Brehm, J. W. (1956). Postdecision changes in the desirability of alternatives. The Journal of Abnormal and Social Psychology, 52(3), 384.Dickerson, C. A., Thibodeau, R., Aronson, E., & Miller, D. (1992). Using cognitive dissonance to encourage water conservation. Journal of Applied SocialPsychology, 22(11), 841-854.Festinger, L., & Carlsmith, J. M. (1959). Cognitive consequences of forced compliance. The Journal of Abnormal and Social Psychology, 58(2), 203.Festinger, L., Riecken, H. W., & Schachter, S. (1956). When prophecy fails. New York: Harper-Torchbooks.Fointiat, V. (2004). "I know what I have to do, but..." When hypocrisy leads to behavioral change. Social Behavior and Personality, 32(8), 741-746.Kantola, S., Syme, G., & Campbell, N. (1984). Cognitive dissonance and energy conservation. Journal of Applied Psychology, 69(3), 416.McKimmie, B. M., Terry, D. J., Hogg, M. A., Manstead, A. S. R., Spears, R., & Doosje, B. (2003). Im a hypocrite, but so is everyone else: Group supportand the reduction of cognitive dissonance. Group Dynamics: Theory, Research, and Practice, 7(3), 214-224.Pallak, M., Cook, D., & Sullivan, J. (1980). Commitment and energy conservation. In L. Bickman (Ed.), Applied social psychology annual (Vol. 1, pp. 235-253). Beverly Hills: Sage.Simmons, V. N., & Brandon, T. H. (2007). Secondary smoking prevention in a university setting: A randomized comparison of an experiential, theory-basedintervention and a standard didactic intervention for increasing cessation motivation. Health Psychology, 26(3), 268-277.Simmons, V. N., Webb, M. S., & Brandon, T. H. (2004). College-student smoking: An initial test of an experiential dissonance-enhancing intervention.Addictive Behaviors, 29(6), 1129-1136.Son Hing, L. S., Li, W., & Zanna, M. P. (2002). Inducing hypocrisy to reduce prejudicial responses among aversive racists. Journal of Experimental SocialPsychology, 38(1), 71-78.Stice, E., Shaw, H., Becker, C. B., & Rohde, P. (2008). Dissonance-based interventions for the prevention of eating disorders: Using persuasion principlesto promote health. Prevention Science, 9(2), 114-128.Stone, J., Aronson, E., Crain, A., Winslow, M. P., & Fried, C. B. (1994). Inducing hypocrisy as a means of encouraging young adults to use condoms.Personality and Social Psychology Bulletin, 20(1), 116-128. 19

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