Abstract
Asking questions about a behavior has been found to influence subsequent performance of that behavior, a phenomenon termed the question-behavior effect (QBE). The present study addressed two under-researched questions concerning the QBE: (1) Can the QBE be used to change multiple health behaviors, and (2) does enhancing dissonance during questionnaire completion increase the magnitude of the QBE? Participants (N = 1534) were randomized to one of three conditions (dissonance-enhanced QBE; standard QBE; control) that targeted three health-protective behaviors (eating fruit and vegetables, physical activity, dental flossing) and three health-risk behaviors (alcohol intake, sedentariness, unhealthy snacking). The dissonance-enhanced intervention comprised a message designed to pressurize participants into forming healthful behavioral intentions. Behavior was assessed via self-reports at four-week follow up. Findings showed significant overall effects of the QBE both in increasing performance of health-protective behaviors (p = .001) and in reducing performance of health-risk behaviors (p = .04). Compared to the standard QBE condition, the dissonance-enhanced QBE intervention increased performance of health-protective behaviors (p = .04) and marginally reduced performance of health-risk behaviors (p = .07). The dissonance-enhanced QBE intervention outperformed the control condition in all analyses. This is the first report that a brief QBE intervention influences performance of multiple health behaviors. Findings supported the idea that magnifying dissonance increases the impact of the QBE.
Highlights
Pairwise comparisons again indicated that performance of health-risk behaviors was significantly (p = .008) higher in the control condition compared to the dissonance-enhanced question-behavior effect (QBE) condition, but was not significantly different between the control and the standard QBE condition (p = .41)
The question-behavior effect (QBE) has a small effect (Cohen, 1988) in promoting health behaviors (e.g., d ≈ 0.14; Wilding et al, 2016). Even such small effects of brief, low-cost interventions can be important when interventions are applied at a population level (e.g., Babor et al, 2007; Wutzke, Shiell, Gomel, & Conigrave, 2001), especially if the intervention can change multiple health behaviors and is scalable (Kazdin & Blasé, 2011)
The present research offers two advances in using the QBE to promote health behaviors: (1) This is the first study to test the impact of the QBE on multiple health behaviors – including both health-risk and healthprotective behaviors – among a large sample using an Randomized Controlled Trial (RCT) design; and (2) We tested a novel dissonance-enhanced QBE condition and compared its behavioral impact both to a standard QBE intervention and a control condition
Summary
The question-behavior effect refers to the finding that answering questions about a behavior produces a small-sized change in subsequent performance of that behavior A meta-analysis by Wood et al (2016) reported that asking questions about intentions, multiple cognitions, satisfaction, self-predictions, and past behavior was associated with small but significant impacts on subsequent performance of the behavior (d = 0.24). In relation to health behaviors, Wilding et al (2016) showed that the QBE had significantly stronger effects for promoting protective behaviors (e.g., taking physical activity) than for reducing risk behaviors (e.g., drinking alcohol), and recommended further studies testing both effects. Lawrence and Ferguson (2012) undertook the only QBE study that tested the impact of assessing intentions and past behavior in relation to multiple health behaviors (quitting cigarette smoking, reducing alcohol use, practicing safe sex, driving safely, dieting, and exercising). The present study minimized risk of bias by recruiting an online sample that was blinded and allocation to condition was concealed; online recruitment reduces potential experimenter demand effects (e.g., Birnbaum, 2004)
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