Affective associations mediate the influence of cost-benefit beliefs on fruit and vegetable consumption

Extending and Testing Protection Motivation Theory in the Context of COVID-19 Contact-Tracing Technology: A Comparison of South Korea and the United States

This study applies protection motivation theory (PMT) to the COVID-19 contact-tracing context by including privacy concerns, collective efficacy, and a mediator (fear of COVID-19) and tests it in the US and South Korea. The study uses a structural equation modeling (SEM) approach and a sample of 418 Americans and 444 South Koreans. According to the results, fear was positively associated with adoption intentions in the US sample but not in the Korean sample. Coping appraisals positively affected adoption intentions in both samples. However, while all types of coping appraisals were significant in the Korean sample, response efficacy was the only significant predictor among US participants. Privacy concerns were negatively associated with adoption intentions in the US sample, but not in the Korean sample. The results indicate that differences exist in the mediating role of fear connecting threat appraisals and adoption intentions in both countries. These findings hold important implications for future studies in AI-based health communication, especially in the areas of privacy management, protection motivation, and diverse cultural contexts.

Factors Influencing Consumer Willingness to Use AI-Driven Autonomous Taxis

The advancement of autonomous driving technology, particularly Tesla's launch of its new Robotaxi, marks a transformation in transportation. Understanding the theoretical mechanisms that drive consumers' intention to use autonomous taxis is essential. This study develops a structural equation model (SEM), extending the applicability of the TAM and TPB model, and incorporates external factors like attitudes, subjective norms, traffic efficiency, and perceived cost-benefit into the model to analyze their impact on consumers' perceived characteristics (perceived usefulness and perceived ease of use). A survey of 427 valid responses revealed that attitudes, subjective norms, and perceived cost-benefit all have significant positive impacts on perceived usefulness and ease of use, which, in turn, are the primary drivers of consumers' intention to use. Additionally, perceived risk significantly weakens the positive effects of perceived usefulness and ease of use on the intention to use, underscoring its critical moderating role in the technology acceptance process. This paper suggests strategies to enhance consumer acceptance, including strengthening user perception through marketing and public experience activities, optimizing technology to improve user experience, reinforcing safety and privacy measures to reduce perceived risk, and highlighting the insurance mechanism, convenience, and economic benefits of autonomous taxis in marketing.

The Undoing Effect of Positive Emotions: A Meta-Analytic Review

The undoing hypothesis proposes that positive emotions serve to undo sympathetic arousal related to negative emotions and stress. However, a recent qualitative review challenged the undoing effect by presenting conflicting results. To address this issue quantitatively, we conducted a meta-analytic review of 16 studies ( N = 1,220; 72 effect sizes) measuring sympathetic recovery during elicited positive emotions and neutral conditions. Findings indicated that in most cases, positive emotions did not speed sympathetic recovery compared to neutral conditions. However, when a composite index of cardiovascular reactivity was used, undoing effects were evident. Our findings suggest the need for further work on the functions of positive emotions.

Associations of positive and negative affect on health risk behaviors among Latinos

OBJECTIVE

Negative affect is widely emphasized in behavior modification interventions. However, positive affect is associated with smoking cessation, physical activity, and healthy dietary habits and may be an important treatment target. Few studies have examined the relationship between positive affect and health behaviors among Latinos, who disproportionately experience modifiable health risk behaviors. This study examined the independent associations of positive affect and negative affect on modifiable health risk behaviors among Latino adults.

METHOD

Data came from 432 persons who participated in one of two studies examining determinants of modifiable health risk behaviors among Latino adults. Primary outcomes were current smoking, at-risk drinking, insufficient physical activity, and insufficient fruit and vegetable consumption. Predictors were positive and negative affect as measured by the Positive and Negative Affect Schedule. Associations between positive and negative affect and health risk behaviors were examined using multiple logistic regression.

RESULTS

Positive affect was associated with lower odds of insufficient physical activity and insufficient fruit and vegetable consumption and lower odds of engaging in multiple health risk behaviors. Negative affect was associated with higher odds of at-risk drinking and current smoking.

CONCLUSIONS

Emphasis on increasing positive affect may be warranted for multiple health risk behavior interventions targeting Latinos. Intervention development efforts may also consider prioritizing positive affect for physical activity and dietary interventions, and negative affect for at-drinking and smoking cessation interventions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Cognitive-affective appraisal of technostressors by ICT-based mobile workers and their impacts on technostrain

BACKGROUND: ICT based mobile working gives organizational flexibility, productivity and performance but at the same time it can lead to techno-stress and technostrain perceptions. A high level of technostrain amongst ICT-based mobile workers would impact their well-being, leading to lesser than expected gains from such organizational ICT investments. Given this paradox, we examine the actual transactional and relational stressor-strain coping response processes in this novel context. OBJECTIVE: The broad research aim of this paper is to explain the relative importance of the cognitive and affective processes used amongst ICT-based mobile workers when coping with technostressors. METHODS: Specifically, based on technology frames literature, we develop dual-path serial mediation models, showing the relationships between technostress-technostrain via two processes: (a) the primary cognitive appraisal process mobilization (threat/opportunity technology frame) and (b) the secondary affective resource process mobilization (affect towards ICT use) to account for technostrain perceptions. We use survey data from 165 ICT-based mobile managers from diverse work settings to empirically confirm the theorized models. RESULTS/CONCLUSIONS: A predominant cognitive ‘threat frames’ leads to increase in technostrain, which decreases if ‘affective resource’ is available for coping. This relationship is inverse in the case of ‘opportunity frames’ path, as technostrain perceptions decreases with and without affective resource mobilization. Implications to theory, practice and methods are also discussed.

The influence of affect on HPV vaccine decision making in an HPV vaccine naïve college student population

The HPV vaccine is recommended for all adolescents starting at age 11, but coverage is low, especially in the young adult population. The CDC is prioritizing catch-up vaccination and has expanded recommendations for all young adults to age 26. College students may be ideal targets for HPV vaccine interventions as they typically have on-site clinics that offer prevention services and students are in the position to make decisions about their own healthcare. We examined the risk perceptions of 101 HPV vaccine-naïve college students, both in terms of risk cognition (beliefs about susceptibility to HPV-related cancers and genital warts) and affect (worry and fear regarding HPV-related health outcomes) as they relate to HPV vaccine intentions. Participants completed an online survey, reporting absolute and comparative risk perceptions for HPV-related cancers/genital warts, fear and worry related to getting HPV-related cancer and/or genital warts, desire for positive emotions, affective associations with the HPV vaccine, and intentions to get the HPV vaccine. More fear/worry about vaccination was directly associated with increased vaccine intentions. The perceived risk to intentions relation included an indirect effect via fear/worry. Desire for positive affect strengthened this relation. Positive affective associations with the HPV vaccine were also related to increased vaccine intentions. Given the public health impact of increasing HPV vaccine coverage for young adults, educational strategies framing the HPV vaccine positively while decreasing fear/worry related to negative health outcomes might increase interest in on-campus catch-up vaccination.

Behaviour change interventions: getting in touch with individual differences, values and emotions

Systematic reviews and meta-analyses suggest that behaviour change interventions have modest effect sizes, struggle to demonstrate effect in the long term and that there is high heterogeneity between studies. Such interventions take huge effort to design and run for relatively small returns in terms of changes to behaviour.So why do behaviour change interventions not work and how can we make them more effective? This article offers some ideas about what may underpin the failure of behaviour change interventions. We propose three main reasons that may explain why our current methods of conducting behaviour change interventions struggle to achieve the changes we expect: 1) our current model for testing the efficacy or effectiveness of interventions tends to a mean effect size. This ignores individual differences in response to interventions; 2) our interventions tend to assume that everyone values health in the way we do as health professionals; and 3) the great majority of our interventions focus on addressing cognitions as mechanisms of change. We appeal to people's logic and rationality rather than recognising that much of what we do and how we behave, including our health behaviours, is governed as much by how we feel and how engaged we are emotionally as it is with what we plan and intend to do.Drawing on our team's experience of developing multiple interventions to promote and support health behaviour change with a variety of populations in different global contexts, this article explores strategies with potential to address these issues.

Is it disgusting or am I just easily disgusted? The relation between situational disgust, dispositional disgust, and colonoscopy intentions

OBJECTIVE

While early detection is an effective way to reduce mortality from colorectal cancer, screening rates are low. An underlying factor in screening completion failure may be experiences of disgust when learning about screening and/or dispositional disgust.

METHOD

Participants recruited via Amazon MTurk (N = 296) read information about colonoscopy and completed an online survey assessing both dispositional forms of disgust (i.e. trait disgust and disgust sensitivity) and situational forms, including state disgust and disgust associated with colonoscopy. Participants reported intentions to discuss colonoscopy with a provider and to prepare for and complete screening.

RESULTS

Greater state disgust and the degree to which one associated disgust with colonoscopy predicted lower screening, preparation and provider discussion intentions. By contrast, neither trait disgust nor disgust sensitivity was associated with intentions. Both disgust sensitivity and trait disgust moderated the state disgust to intentions relation.

CONCLUSIONS

This is one of few investigations of disgust examining the relation between specific types and colonoscopy intentions. Screening uptake may be improved by identifying specific components of disgust that have an effect on colonoscopy intentions. Future work focusing on the interplay between different disgust mechanisms as they relate to colonoscopy behaviour is important for intervention development.

Affective components of perceived risk mediate the relation between cognitively-based perceived risk and colonoscopy screening

Perceived risk is a common component of health decision making theory. When affective components of risk are assessed as predictors of a behavior, they are usually examined separately from cognitive components. Less frequently examined are more complex interplays between affect and cognition. We hypothesized that cognitive and affective risk components would both have direct effects on colonoscopy behavior/intentions and that affective components would mediate the relationship of cognitively-based perceived risk to colonoscopy screening. In two secondary analyses, participants reported their cognitive and affective perceived risk for colorectal cancer, past colonoscopy behavior, and future screening intentions. In both studies, cognitive and affective risk components were associated with increased screening behavior/intentions and cognitive risk components were mediated through affective risk. Given the impact of early detection on colorectal cancer prevention, educational strategies highlighting both components of risk may be important to increase screening rates.

"I had the feeling that I was trapped": a bedside qualitative study of cognitive and affective attitudes toward noninvasive ventilation in patients with acute respiratory failure

Background

Noninvasive ventilation (NIV) is the application of mechanical ventilation through a mask. It is used to treat certain forms of acute respiratory failure in intensive care units (ICU). NIV has clinical benefits but can be anxiogenic for the patients. This study aimed at describing cognitive and affective attitudes toward NIV among patients experiencing NIV for the first time in the context of an ICU stay.

Methods

Semi-structured interviews were conducted in 10 patients during their ICU stay and soon after their first NIV experience. None of the patients had ever received NIV previously. Evaluative assertion analysis and thematic analysis were used to investigate cognitive and affective attitudes toward NIV before, during, and after the first NIV experience, as well as patient attitudes toward caregivers and relatives.

Results

Before their first NIV session, the cognitive attitudes of the patients were generally positive. They became less so and more ambiguous during and after NIV, as the patients discovered the actual barriers associated with NIV. Affective attitudes during NIV were more negative than affective attitudes before and after NIV, with reports of dyspnea, anxiety, fear, claustrophobic feelings, and reactivation of past traumatic experiences. The patients had more positive attitudes toward the presence of a caregiver during NIV, compared to the presence of a family member.

Conclusion

This study corroborates the possibly negative—or even traumatic—nature of the NIV experience, with emphasis on the role of affective attitudes. This is a rationale for evaluating the impact of NIV-targeted psychological interventions in ICU patients with acute respiratory failure.

Moving beyond categorization to understand affective influences on real world health decisions

This paper provides an overview of affect and health decision-making research, with a focus on identifying gaps, opportunities, and challenges to guide future research. We begin by defining common categorical distinctions of affective processes that influence health decisions: integral (i.e., related to the decision) and incidental (i.e., normatively unrelated to the decision) influences, and current (experienced in the moment) and anticipated ("cognitive representations" of future affect) affect. We then summarize key discoveries within the most common categories of affective influences on health decision making: current integral affect, current incidental affect, and anticipated integral affect. Finally, we highlight research gaps, challenges, and opportunities for future directions for research aimed at translating affective and decision science theory to improve our understanding of, and ability to intervene upon, health decision making.

Affective determinants of physical activity in cancer survivors

Objective: Research with non-cancer survivor populations finds affective variables to be important determinants of physical activity. This study assessed the ability of explicit and implicit affective variables to predict the physical activity of cancer survivors, above that accounted for by cognitive variables. The study also tested whether the affective variables were connected to physical activity directly or indirectly through their association with behavioural intentions. Design: In a cross-sectional design, cancer survivors (n = 122) completed questionnaires and an implicit affect task. Main outcome measures: Self-report measures assessed three affective variables (e.g. positive affective associations), five cognitive variables (e.g. cognitive beliefs), physical activity estimates, behavioural intentions and participants also completed an implicit affect task regarding physical activity. Results: Two of the three explicit affect variables and the implicit affect variable accounted for significant variability in physical activity estimates beyond that accounted for by the cognitive variables. Positive affective associations were the strongest predictor in multivariate analyses. Behavioural intentions did not mediate the link between the affect variables and physical activity estimates. Conclusions: Explicit and implicit affective variables are direct and unique predictors of physical activity in cancer survivors. Physical activity interventions for cancer survivors should target both explicit affect and implicit affect.

Feel good now or regret it later? The respective roles of affective attitudes and anticipated affective reactions for explaining health-promoting and health risk behavioral intentions

Evidence supporting the incorporation of affective constructs, such as affective attitudes and anticipated regret, into theoretical models of health behavior has been mounting in recent years; however, the role of positive anticipated affective reactions (e.g., pride) has been largely unexplored. The purpose of the present investigation was to assess how affective attitudes and anticipated affective reactions (both pride and regret for performing a behavior or not) may provide distinct utility for understanding intentions to perform health-promoting and health risk behaviors over and above cognitive attitudes and other established theoretical constructs from the theory of planned behavior (TPB). Participants (N = 210) were recruited via Amazon's Mechanical Turk to complete a one-time online battery assessing TPB and affective constructs. Self-reported intentions served as the main outcome measure, and hierarchical linear modeling was used to examine the effects of TPB and affective constructs across behaviors. Controlling for TPB constructs, more positive affective attitudes and greater anticipated regret, but not anticipated pride, predicted intentions to engage in future health behaviors. Anticipated affective reactions contributed explanatory variance for intentions to perform health risk behaviors, but anticipated pride and regret were not associated with intentions to perform health risk behaviors. Contributions made via the inclusion of both positively and negatively valence anticipated affective reactions for both action and inaction (performing a behavior or not) across a range of health promoting and health risk behaviors are discussed, as well as implications for future intervention work.

Interventions to Engage Affective Forecasting in Health-Related Decision Making: A Meta-Analysis

Background

People often use affective forecasts, or predictions about how a decision will make them feel, to guide medical and health decision making. However, these forecasts are susceptible to biases and inaccuracies that can have consequential effects on decision making and health.

Purpose

A meta-analysis was performed to determine the effectiveness of intervening to address affective forecasting as a means of helping patients make better health-related choices.

Methods

We included between-subjects experimental and intervention studies that targeted variables related to affective forecasting (e.g., anticipated regret, anticipated affect) as a means of changing health behaviors or decisions. We determined the overall effect of these interventions on targeted affective constructs and behavioral outcomes, and whether conceptual and methodological factors moderated these effects.

Results

A total of 133 independent effect sizes were identified from 37 publications (N = 72,020). Overall, affective forecasting interventions changed anticipated regret, d = 0.24, 95% confidence interval (CI) (0.15, 0.32), p < .001, behavior, d = 0.29, 95% CI (0.13, 0.45), p < .001, and behavioral intentions, d = 0.19, 95% CI (0.11, 0.28), p < .001, all measured immediately postintervention. Interventions did not change anticipated positive and negative affect, and effects on intentions and regret did not extend to follow-up time points, ps > .05. Generally, effects were not moderated by conceptual model, intervention intensity, or behavioral context.

Conclusions

Affective forecasting interventions had a small consistent effect on behavioral outcomes regardless of intervention intensity and conceptual framework, suggesting such constructs are promising intervention targets across several health domains.

The interplay between feelings and beliefs about condoms as predictors of their use

OBJECTIVE

Negative feelings about condoms are a key barrier to their use. Using the behavioural affective associations model, we examined the joint effects of affective associations and cognitive beliefs about condoms on condom use.

DESIGN

In Study 1 (N = 97), students completed measures of their affective associations and cognitive beliefs about sex and condoms, sexual activity and condom use. In Study 2 (N = 171), a measure of behavioural intentions and condom selection task were added.

MAIN OUTCOME MEASURES

Condom use measured in Study 1 as (1) current condom use, and (2) willingness to use condoms; in Study 2 as: (1) behavioural intentions, (2) number of condoms selected.

RESULTS

Affective associations with sex and condoms were behaviour-specific, were directly associated with the respective behaviour, and mediated the relations of cognitive beliefs to behaviour, ps < .05. In Study 2, affective associations were associated with behavioural intentions and the number of condoms selected, ps < .05; cognitive beliefs were indirectly associated with these outcomes through affective associations, indirect effects: ps < .05.

CONCLUSIONS

Affective associations are a behaviour-specific and proximal predictor of condom use, mediating the effect of cognitive beliefs, suggesting they may be a particularly viable intervention target.

Positive affective processes underlie positive health behaviour change

Positive health behaviours such as physical activity can prevent or reverse many chronic conditions, yet a majority of people fall short of leading a healthy lifestyle. Recent discoveries in affective science point to promising approaches to circumvent barriers to lifestyle change. Here, we present a new theoretical framework that integrates scientific knowledge about positive affect with that on implicit processes. The upward spiral theory of lifestyle change explains how positive affect can facilitate long-term adherence to positive health behaviours. The inner loop of this spiral model identifies nonconscious motives as a central mechanism of behavioural maintenance. Positive affect experienced during health behaviours increases incentive salience for cues associated with those behaviours, which in turn, implicitly guides attention and the everyday decisions to repeat those behaviours. The outer loop represents the evidence-backed claim, based on Fredrickson's broaden-and-build theory, that positive affect builds a suite of endogenous resources, which may in turn amplify the positive affect experienced during positive health behaviours and strengthen the nonconscious motives. We offer published and preliminary evidence in favour of the theory, contrast it to other dominant theories of health behaviour change, and highlight attendant implications for interventions that merit testing.

Sensation Seeking and Online Gaming Addiction in Adolescents: A Moderated Mediation Model of Positive Affective Associations and Impulsivity

Based on the Dual Systems Model (Somerville et al., 2010; Steinberg, 2010a) and the biosocial-affect model (Romer and Hennessy, 2007) of adolescent sensation seeking and problem behaviors, the present study examined how (affective associations with online games as a mediator) and when (impulsivity as a moderator) did sensation seeking influence online gaming addiction in adolescence. A total of 375 Chinese male adolescents (mean age = 16.02 years, SD = 0.85) from southern China completed anonymous questionnaires regarding sensation seeking, positive affective associations with online games, impulsivity, and online gaming addiction. Our findings revealed that sensation seeking, positive affective associations with online games and impulsivity were each significantly and positively associated with online gaming addiction in adolescents. Positive affective associations mediated the relationship between sensation seeking and online gaming addiction. Further, impulsivity moderated the relationship between positive affective associations and online gaming addiction, such that the association between positive affective association and online gaming addiction was stronger for high than for low impulsivity adolescents. These findings underscore the importance of integrating the biosocial-affect model and the Dual Systems Model to understand how and when sensation seeking impacts adolescent online gaming addiction.

Structure and content of affective associations with health behaviours: Is the behaviour 'good OR bad' or 'good AND bad'

OBJECTIVE

The feelings and emotions individuals associate with health-related behaviours influence engagement in those behaviours. However, the structure and the content of these affective associations have not been examined. The studies reported here examined competing hypotheses about the structure (unidimensional or bidimensional) and content (generalised affect or specific emotions) of affective associations with two health-related behaviours: physical activity and fruit/vegetable consumption.

DESIGN

For each behaviour, participants (fruit and vegetable consumption n = 149; physical activity n = 199) completed an assessment of the association of 40 positive and 51 negative affect concepts with the behaviour.

MAIN OUTCOME MEASURES

Ratings of affective associations with each behaviour.

RESULTS

Confirmatory factor analyses comparing unidimensional and bidimensional affect structure models showed that the structure of individuals' affective associations was bidimensional for both behaviours - positive and negative affective associations were shown to be separate and distinct constructs. Exploratory factor analyses supported a model of affective associations as generalised affect for both behaviours.

CONCLUSION

Affective associations with both physical activity and with fruit/vegetable consumption consist of separate positive and negative dimensions of generalised affect. These findings lead to recommendations for research and intervention development based on the implications for how affective associations might operate to influence behavioural decision-making.

The reasoned/reactive model: A new approach to examining eating decisions among female college dieters and nondieters

Female college students are prone to unhealthy eating patterns that can impact long-term health. This study examined female students' healthy and unhealthy eating behaviors with three decision-making models. Specifically, the theory of reasoned action, prototype/willingness model, and new reasoned/reactive model were compared to determine how reasoned (logical) and reactive (impulsive) factors relate to dietary decisions. Females (N=583, M_age=20.89years) completed measures on reasoned cognitions about foods (attitudes, subjective norms, nutrition knowledge, intentions to eat foods), reactive cognitions about foods (prototypes, affect, willingness to eat foods), dieting, and food consumption. Structural equation modeling (SEM) revealed the new reasoned/reactive model to be the preeminent model for examining eating behaviors. This model showed that attitudes were related to intentions and willingness to eat healthy and unhealthy foods. Affect was related to willingness to eat healthy and unhealthy foods, whereas nutrition knowledge was related to intentions and willingness to eat healthy foods only. Intentions and willingness were related to healthy and unhealthy food consumption. Dieting status played a moderating role in the model and revealed mean-level differences between dieters and nondieters. This study highlights the importance of specific factors in relation to female students' eating decisions and unveils a comprehensive model for examining health behaviors.

Planning versus action: Different decision-making processes predict plans to change one's diet versus actual dietary behavior

Most health decision-making models posit that deciding to engage in a health behavior involves forming a behavioral intention which then leads to actual behavior. However, behavioral intentions and actual behavior may not be functionally equivalent. Two studies examined whether decision-making factors predicting dietary behaviors were the same as or distinct from those predicting intentions. Actual dietary behavior was proximally predicted by affective associations with the behavior. By contrast, behavioral intentions were predicted by cognitive beliefs about behaviors, with no contribution of affective associations. This dissociation has implications for understanding individual regulation of health behaviors and for behavior change interventions.

Disgusted, embarrassed, annoyed: affective associations relate to uptake of colonoscopy screening

BACKGROUND

Uptake of colorectal cancer screening is lower than desired. Screening decision making research has traditionally focused on benefits and barriers to screening. This study examines the relation of affective associations with screening (feelings and emotions associated with screening) to colonoscopy screening uptake.

METHODS

Participants were 103 African American community adults. Participants completed a structured interview assessing perceived benefits of and barriers to colonoscopy screening, affective associations with colonoscopy, colonoscopy screening behavior, and intentions for future screening.

RESULTS

Higher positive and lower negative affective associations with screening were both significant predictors of colonoscopy uptake. Affective associations fully mediated the relation of perceived benefits and barriers to screening uptake. Affective associations were associated with intentions for future screening.

CONCLUSIONS

Incorporation of affective associations into models of screening decision making and intervention approaches to address screening compliance has utility for advancing our understanding of screening adherence as well as increasing screening rates.

A new approach to assessing affect and the emotional implications of personal genomic testing for common disease risk

AIMS

Personal genomic testing (PGT) for common disease risk is becoming increasingly frequent, but little is known about people's array of emotional reactions to learning their genomic risk profiles and the psychological harms/benefits of PGT. We conducted a study of post-PGT affect, including positive, neutral, and negative states that may arise after testing.

METHODS

A total of 228 healthy adults received PGT for common disease variants and completed a semistructured research interview within 2 weeks of disclosure. The study participants reported how the PGT results made them feel in their own words. Using an iterative coding process, the responses were organized into three broad affective categories: negative, neutral, and positive affect.

RESULTS

Neutral affect was the most prevalent response (53.9%), followed by positive affect (26.9%) and negative affect (19.2%). We found no differences by gender, race, or education.

CONCLUSIONS

While <20% of participants reported negative affect in response to learning their genomic risk profile for common diseases, a majority experienced either neutral or positive emotions. These findings contribute to the growing evidence that PGT does not impose significant psychological harms. Moreover, they point to a need to better link theories and assessments in both emotional and cognitive processing to capitalize on PGT information for healthy behavior change.

Current Emotion Research in Health Behavior Science

In the past two to three decades health behavior scientists have increasingly emphasized affect-related concepts (including, but not limited to emotion) in their attempts to understand and facilitate change in important health behaviors, such as smoking, eating, physical activity, substance abuse, and sex. This article provides a narrative review of this burgeoning literature, including relevant theory and research on affective response (e.g., hedonic response to eating and drug use), incidental affect (e.g., work-related stress as a determinant of alcohol use), affect processing (e.g., anticipated regret for illicit sex or skipping an exercise session), and affectively charged motivation (e.g., cigarette craving). An integrative dual-processing framework is presented that suggests pathways through which affect-related concepts may interrelate to influence health behavior.

Implicit affective associations predict snack choice for those with low, but not high levels of eating disorder symptomatology

The central purpose of the current study was to examine whether eating disorder symptomatology moderates the extent to which implicitly and explicitly measured affective associations with fruits, or the feelings individuals associate with them, predict food choice. Participants (N = 107) completed both implicit and explicit measures of affective associations with fruits, a self-report of eating disorder symptomatology. In a subsequent snack selection task, they selected either a granola bar or fruit as a measure of their food choice behavior. Logistic regression analyses revealed that eating disorder symptomatology moderated the relation of implicit affective associations on behavior, OR = 0.27, p = .024, 95% CI (0.085, 0.84). A test of the simple effects indicated that implicit affective associations predicted snack choice at or below mean symptomatology levels [OR = 2.073, p = .02, 95% CI (1.12, 3.84)], but not at high levels [OR = 0.56, p = .28, 95% CI (0.18, 1.74)]. The effects of explicit measures on eating behavior were not moderated by eating disorder symptomatology (ps > .05). These findings advance our understanding of both the relation of implicit affective associations on behavior, as well as the ways in which eating disorder symptomatology may impact the decision-making process, thereby perpetuating disorder-related eating behavior. As such, they have implications for both health decision-making theory, as well as for the study and treatment of eating disorders.

Worry about skin cancer mediates the relation of perceived cancer risk and sunscreen use

Preventive health behaviors are believed to be motivated in part by a person's perception of risk for a particular health problem. Risk contains a cognitive component, beliefs about the chances of a health problem occurring, and an affective component, fear or worry about the health problem. Although both have been shown to influence behavior, the nature of their interrelation as an influence on behavior has not been examined. Data from the 2005 Health Information National Trends Survey, a US nationally-representative telephone survey was analyzed. Participants reported perceived absolute and comparative risk for skin cancer, feelings of worry about skin cancer, and sunscreen use behavior. Analyses examined main effects models for the relation between perceived risk, worry, and sunscreen use, as well as both moderated and mediated models. For both absolute and comparative risk, the relation between cognitively-based perceived risk for skin cancer and sunscreen use was fully mediated by feelings of worry, as evidenced by significant direct effects of worry (bs > 0.046, ps < 0.01) and indirect effects of risk through worry (bs > 0.19, ps < 0.01). When worry was included in the models, direct effects of risk perceptions were non-significant (bs < 0.11, ps < 0.10). No evidence was found for moderated effects of worry on the relation between risk and behavior. While cognitive risk appraisals do influence decision making and may be addressed by interventions, these findings demonstrate that affectively-based risk components play a key role in behavior regulation. Affectively-based risk might be an effective target for interventions and should be incorporated more fully in decision-making models.

Changing how I feel about the food: experimentally manipulated affective associations with fruits change fruit choice behaviors

Fewer than half of Americans meet current recommendations for fruit and vegetable intake. The behavioral affective associations model posits that feelings and emotions associated with a behavior are a proximal influence on decision making. Cross-sectional evidence supports the model and suggests that affective associations predict fruit and vegetable consumption. The purpose of this study was to test whether a causal relation exists between affective associations about fruits and future fruit consumption behavior, as measured by a snack selection task. Following a baseline assessment of cognitive and affective variables, participants' (N = 161) affective associations about fruits were experimentally manipulated with an implicit priming paradigm. Images of fruits were repeatedly paired with positive, negative, or neutral affective stimuli. The key outcome measure was a behavioral choice task in which participants chose between fruit and a granola bar. Participants in the positive prime condition were three times more likely than those in the negative condition to select a piece of fruit over the granola bar alternative in the snack selection task. They were also twice as likely as those in the neutral condition to select fruit. There were no changes in self-reported affective associations or cognitive beliefs. These findings provide further evidence of the implicit and direct influence of affective associations on behavior, suggesting the need to both incorporate the role of affect in health decision making models, as well as the potential utility of intervention strategies targeting affective associations with health-related behaviors.

Worry as a Predictor of Nutrition Behaviors

Worry has been shown to predict a variety of health behaviors, such as cancer screening, yet there are few studies linking worry and nutrition. This study used nationally representative data from National Cancer Institute’s Food Attitudes and Behavior Survey ( n = 3,397) to examine the association between health-related worry and a variety of nutrition behaviors. Greater worry was associated with higher fruit and vegetable consumption ( B = 0.19, p < .01), but also more meals eaten when watching television ( B = 0.34, p < .01) and fewer with family ( B = −0.13, p = .02). Importantly, and counterintuitively, greater worry appeared to reverse the conventional relationship between self-efficacy and dietary restriction; those who were self-efficacious and worried were less likely to restrict unhealthy foods. Similarly, worry attenuated the relationship between perceived benefits and special effort to buy produce. A complex relationship between worry and nutrition emerged, with potentially important clinical implications.

Race/ethnicity, psychological distress, and fruit/vegetable consumption. The nature of the distress-behavior relation differs by race/ethnicity

OBJECTIVE

We explored how the relation between psychological distress and fruit/vegetable consumption differed as a function of race/ethnicity.

METHOD

Data from the 2007 Health Information National Trends Survey was analyzed. Participants reported current psychological distress, race/ethnicity, and current fruit and vegetable consumption. Linear regression analyses were used to examine the association between race/ethnicity, distress, and their interaction and fruit and vegetable consumption.

RESULTS

There was a significant interaction between race/ethnicity and psychological distress in predicting fruit and vegetable consumption. Follow-up analyses indicated that distress was related to fruit and vegetable consumption for White and Hispanic but not for African American respondents.

CONCLUSION

The association between psychological distress and fruit/vegetable consumption differs as a function of race/ethnicity. The findings have implications for understanding the role of distress in eating behavior regulation and for developing interventions to address fruit/vegetable consumption targeted to members of different race/ethnic groups.