Optimizing the Use of Personal Values to Promote Medication Adherence: A Randomized Controlled Trial Comparing Affective and Behavioral Responses to Theory-Driven Domain Congruent Versus Incongruent Values Approaches.

IF 3.6 2区 心理学 Q1 PSYCHOLOGY, MULTIDISCIPLINARY
Lauren B Finkelstein, Emma E Bright, Heng Chao J Gu, Joanna J Arch
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Abstract

Background: Self-affirmation theory (SAT) and acceptance and commitment therapy (ACT) embody competing approaches to leveraging personal values to motivate behavior change but are rarely compared in the domain of health behavior. This study compares these theory-driven values-based interventions for promoting medication adherence.

Purpose: To compare affective and behavioral responses to competing values-based medication adherence interventions.

Methods: In this three-armed randomized trial, participants with cancer (n = 95) or diabetes (n = 97) recruited online using Prolific and prescribed daily oral medication for that disease completed a one-session online writing intervention leveraging (1) a domain incongruent (DI) value, where the value was not connected to medication adherence; (2) a domain congruent (DC) value, where the value was connected to adherence; or (3) a control condition, focused on medication adherence procedures.

Results: There were no main effects of conditions on reported medication adherence at the 1-month follow-up. During the intervention, positive affect was higher in the values conditions than control (p < .001), and trended higher in DI versus DC (p = .054). Negative affect did not vary between the values and control groups (p = .093) but was lower in DI versus DC (p = .006). Improvements in positive affect over the course of the intervention were associated with increased adherence behavior for individuals who started with low levels of positive affect (p = .003). Disease type did not moderate findings.

Conclusions: Consistent with SAT, focusing on DI values led to more positive and less negative affect than connecting values directly to behavior in a threatening domain such as chronic illness. For some participants, increases in positive affect predicted greater adherence.

优化个人价值观的使用以促进坚持用药:一项随机对照试验:比较对理论驱动的领域一致与不一致价值观方法的情感和行为反应。
背景:自我肯定理论(SAT)和接受与承诺疗法(ACT)体现了利用个人价值观激励行为改变的竞争方法,但在健康行为领域却很少进行比较。本研究比较了这两种理论驱动的基于价值观的干预方法,以促进服药依从性。目的:比较两种相互竞争的基于价值观的服药依从性干预方法的情感和行为反应:在这项三臂随机试验中,使用 Prolific 在线招募的癌症患者(n = 95)或糖尿病患者(n = 97)完成了为期一次的在线写作干预,这些干预利用了(1)领域不一致(DI)价值观,即价值观与坚持用药无关;(2)领域一致(DC)价值观,即价值观与坚持用药有关;或(3)对照条件,侧重于坚持用药程序:结果:在 1 个月的随访中,各种条件对报告的服药依从性没有主要影响。在干预过程中,价值观条件下的积极情绪高于对照条件下(p < .001),而且 DI 与 DC 相比呈上升趋势(p = .054)。消极情绪在价值观组和对照组之间没有差异(p = .093),但在直接干预组和直觉干预组之间的差异较小(p = .006)。在干预过程中,积极情绪的改善与开始时积极情绪水平较低的人坚持治疗的行为增加有关(p = .003)。疾病类型并不影响研究结果:结论:与 SAT 一致的是,在慢性病等威胁性领域,关注 DI 价值观比直接将价值观与行为联系起来能带来更多的积极情绪和更少的消极情绪。对于一些参与者来说,积极情绪的增加预示着更大的依从性。
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来源期刊
Annals of Behavioral Medicine
Annals of Behavioral Medicine PSYCHOLOGY, MULTIDISCIPLINARY-
CiteScore
7.00
自引率
5.30%
发文量
65
期刊介绍: Annals of Behavioral Medicine aims to foster the exchange of knowledge derived from the disciplines involved in the field of behavioral medicine, and the integration of biological, psychosocial, and behavioral factors and principles as they relate to such areas as health promotion, disease prevention, risk factor modification, disease progression, adjustment and adaptation to physical disorders, and rehabilitation. To achieve these goals, much of the journal is devoted to the publication of original empirical articles including reports of randomized controlled trials, observational studies, or other basic and clinical investigations. Integrative reviews of the evidence for the application of behavioral interventions in health care will also be provided. .
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