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.

Public Health Relevance

Individuals who are overweight or obese, and especially those who are sedentary, are at increased risk for cancer [54, 55], have higher rates of morbidity and mortality overall [56-58], and these factors are substantial drivers of U.S. healthcare costs [59, 60];physical activity mitigates these risks [1-10]. Our core hypothesis is that the balance of neural activity in regions associated with self-related processing versus defensive counterarguing is key in producing behavior change, and that self-affirmation (an innovative approach, relatively new to the health behavior area [46]) can alter this balance. Successful achievement of our aims will elucidate cognitive and affective mechanisms that prevent people from altering behaviors known to increase the risk of cancers (e.g. sedentary behavior), improve our ability to predict health behavior change, and hence improve our capacity to design and select interventions that successfully alter such behaviors.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Research Project (R01)
Project #
Application #
Study Section
Special Emphasis Panel (ZCA1)
Program Officer
Ferrer, Rebecca
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of Pennsylvania
Other Specialized Schools
United States
Zip Code
Cooper, Nicole; Tompson, Steven; O'Donnell, Matthew B et al. (2018) Associations between coherent neural activity in the brain's value system during antismoking messages and reductions in smoking. Health Psychol 37:375-384
Konrath, Sara; Meier, Brian P; Bushman, Brad J (2018) Development and validation of the Single Item Trait Empathy Scale (SITES). J Res Pers 73:111-122
Falk, Emily; Scholz, Christin (2018) Persuasion, Influence, and Value: Perspectives from Communication and Social Neuroscience. Annu Rev Psychol 69:329-356
Kang, Yoona; Cooper, Nicole; Pandey, Prateekshit et al. (2018) Effects of self-transcendence on neural responses to persuasive messages and health behavior change. Proc Natl Acad Sci U S A 115:9974-9979
Kang, Yoona; O'Donnell, Matthew Brook; Strecher, Victor J et al. (2017) Dispositional Mindfulness Predicts Adaptive Affective Responses to Health Messages and Increased Exercise Motivation. Mindfulness (N Y) 8:387-397
Cooper, Nicole; Bassett, Danielle S; Falk, Emily B (2017) Coherent activity between brain regions that code for value is linked to the malleability of human behavior. Sci Rep 7:43250
Kang, Yoona; O?Donnell, Matthew Brook; Strecher, Victor J et al. (2017) Self-Transcendent Values and Neural Responses to Threatening Health Messages. Psychosom Med 79:379-387
Chopik, William J; Konrath, Sara H (2016) Political orientation moderates worldview defense in response to Osama bin Laden's death. Peace Confl 22:396-400
Cascio, Christopher N; O'Donnell, Matthew Brook; Tinney, Francis J et al. (2016) Self-affirmation activates brain systems associated with self-related processing and reward and is reinforced by future orientation. Soc Cogn Affect Neurosci 11:621-9
Falk, Emily B; O'Donnell, Matthew Brook; Cascio, Christopher N et al. (2015) Self-affirmation alters the brain's response to health messages and subsequent behavior change. Proc Natl Acad Sci U S A 112:1977-82