Using the question-behavior effect to promote disease prevention behaviors: Two randomized controlled trials.

Conner, Mark; Godin, Gaston; Norman, Paul; Sheeran, Paschal

doi:10.1037/a0023036

Cited by 57 publications

(100 citation statements)

References 41 publications

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“…Like previous studies (Conner, Godin, Norman, & Sheeran, 2011) all our interventions were significantly more effective than the control condition among participants who completed and returned the questionnaires. More interestingly, at 6-months, the implementation intention condition produced significantly more donor registrations than intention plus regret, intention plus moral norm, and intention plus positive self-image.…”

Section: Question -Behavior Effect Interventions 19supporting

confidence: 76%

“…Whereas previous studies focused on the initiation of behaviors among community samples, students, and healthcare workers (Conner, Godin, Norman, & Sheeran, 2011;Godin, BelangerGravel, Amireault, Vohl, & Perusse, 2011;Godin et al, 2010;Godin, Sheeran, Conner, & Germain, 2008;Williams, Block, & Fitzsimons, 2006), here we tested whether the QBE could be used to reinvigorate behavior among a sample who had failed to perform the focal action for at least two years (i.e., lapsed blood donors). The present findings thus indicate that the QBE can be used also to promote effective resumption of a behavior as well promoting getting started on new behaviors, as previous research has shown.…”

Section: Discussionmentioning

confidence: 99%

“…Conner et al (2011) showed the QBE to be more effective among those with more positive intentions and attitudes towards the behavior. More recently, Ayres et al (2013) manipulated both the QBE and motivation and showed the combined condition to produce the greatest engagement with the behavior.…”

mentioning

confidence: 94%

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Promoting the return of lapsed blood donors: A seven-arm randomized controlled trial of the question–behavior effect.

Godin¹,

Germain²,

Conner³

et al. 2014

Health Psychology

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Objective: The aim of this study was to test key variations in the question-behavior effect against a control condition or an implementation intention condition on returning to give blood among lapsed donors (individuals who had not given blood in past two years).Design: At baseline, 7000 lapsed donors were randomized to one of six experimental or to a control condition. Participants in the experimental conditions were asked to complete a 6-item postal questionnaire assessing: intentions-only, interrogative intention, moral norm plus intention, anticipated regret plus intention, positive self-image plus intention, or implementation intentions. Objective measures of behavior were obtained 6 and 15 months later.Main Outcome Measure: The frequency of registrations to give blood over the next 6 and 15 months.Results: Intention-to-treat analysis of the frequency of registrations (GENMOD procedure, Poisson distribution) indicated main effects for condition (experimental versus control) at both 6 months,  2 (1) = 4.64, p < .05, and 15 months,  2 (1) = 5.88, p < .05. Positive self-image and implementation intention interventions outperformed the control condition at 6 months. At 15 months, standard intention, interrogative intention, and regret plus intention conditions each showed more frequent registrations compared to controls and were just as effective as implementation intention formation. Moderation analysis showed the moral norm and positive self-image conditions were significant for first-time (one previous donation) but not repeat (two or more previous donations) donors.Conclusions: The question-behavior effect can be used to reinvigorate blood donation among lapsed donors, and can be as effective as forming implementation intentions. extends previous work on the QBE in three key ways. First, we examine whether the impact of measuring intentions on subsequent behavior can be augmented by using the interrogative form or by measuring constructs in addition to intentions. Second, we compare the QBE not only to a standard nocontact control condition, but also in relation to an established behavior change intervention (i.e., implementation intentions; see (Gollwitzer & Sheeran, 2006) for a review). Third, we investigate the moderating effects of whether a questionnaire was returned or not and participants' age, sex, and donor status (first-time vs. repeat). The research focuses on a behavior of considerable importance for public health and on a sample of particular significance in this domain, namely, returning to give blood among lapsed blood donors. Augmenting the Question-Behavior EffectSeveral studies have tested the QBE in relation to blood donation, with mixed results. In the first study in this area, Godin et al. (2008) observed significantly more frequent attempts to give blood at both 6-and 12-month follow-ups among repeat blood donors who were asked to complete a Question -Behavior Effect Interventions 4 questionnaire based on an extended version of the theory of planned behavior (TPB; (Ajzen, 19...

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Section: Question -Behavior Effect Interventions 19supporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

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Promoting the return of lapsed blood donors: A seven-arm randomized controlled trial of the question–behavior effect.

Godin¹,

Germain²,

Conner³

et al. 2014

Health Psychology

Self Cite

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“…In total, 12,459 participants were allocated, 8571 through the in-practice recruitment method and 3888 through the fully automated recruitment method. The median age of participants was 45 (interquartile range [40][41][42][43][44][45][46][47][48][49][50][51][52][53][54] years, 33% were in the most deprived quintile of deprivation for England and 39% were of 'white' ethnicity, with no differences among trial arms.…”

Section: Main Trial Resultsmentioning

confidence: 99%

Enhanced invitation methods and uptake of health checks in primary care: randomised controlled trial and cohort study using electronic health records

McDermott

Wright

Cornelius

et al. 2016

Health Technol Assess

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BackgroundA national programme of health checks to identify risk of cardiovascular disease (CVD) is being rolled out but is encountering difficulties because of low uptake.ObjectiveTo evaluate the effectiveness of an enhanced invitation method using the question–behaviour effect (QBE), with or without the offer of a financial incentive to return the QBE questionnaire, at increasing the uptake of health checks. The research went on to evaluate the reasons for the low uptake of invitations and compare the case mix for invited and opportunistic health checks.DesignThree-arm randomised trial and cohort study.ParticipantsAll participants invited for a health check from 18 general practices. Individual participants were randomised.Interventions(1) Standard health check invitation only; (2) QBE questionnaire followed by a standard invitation; and (3) QBE questionnaire with offer of a financial incentive to return the questionnaire, followed by a standard invitation.Main outcome measuresThe primary outcome was completion of the health check within 6 months of invitation. Ap-value of 0.0167 was used for significance. In the cohort study of all health checks completed during the study period, the case mix was compared for participants responding to invitations and those receiving ‘opportunistic’ health checks. Participants were not aware that several types of invitation were in use. The research team were blind to trial arm allocation at outcome data extraction.ResultsIn total, 12,459 participants were included in the trial and health check uptake was evaluated for 12,052 participants for whom outcome data were collected. Health check uptake was as follows: standard invitation, 590 out of 4095 (14.41%); QBE questionnaire, 630 out of 3988 (15.80%); QBE questionnaire and financial incentive, 629 out of 3969 (15.85%). The increase in uptake associated with the QBE questionnaire was 1.43% [95% confidence interval (CI) –0.12% to 2.97%;p = 0.070] and the increase in uptake associated with the QBE questionnaire and offer of financial incentive was 1.52% (95% CI –0.03% to 3.07%;p = 0.054). The difference in uptake associated with the offer of an incentive to return the QBE questionnaire was –0.01% (95% CI –1.59% to 1.58%;p = 0.995). During the study period, 58% of health check cardiovascular risk assessments did not follow a trial invitation. People who received an ‘opportunistic’ health check had greater odds of a ≥ 10% CVD risk than those who received an invited health check (adjusted odds ratio 1.70, 95% CI 1.45 to 1.99;p < 0.001).ConclusionsUptake of a health check following an invitation letter is low and is not increased through an enhanced invitation method using the QBE. The offer of a £5 incentive did not increase the rate of return of the QBE questionnaire. A high proportion of all health checks are performed opportunistically and not in response to a standard invitation letter. Participants receiving opportunistic checks are at higher risk of CVD than those responding to standard invitations. Future research should aim to increase the accessibility of preventative medical interventions to increase uptake. Research should also explore the wider use of electronic health records in delivering efficient trials.Trial registrationCurrent Controlled Trials ISRCTN42856343.FundingThis project was funded by the NIHR Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 20, No. 84. See the NIHR Journals Library website for further project information.

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“…It is possible that the mere fact of being measured influences the formation of judgments and/or accessibility of these for respondents (Chandon, Morwitz, & Reinartz, 2005). Research comparing QBEs for different theoretical measures and/or different constructs has been published in recent years (Conner, Godin, Norman, & Sheeran, 2011;Godin, et al, 2008) and it is likely that these comparative trials will enhance our understanding of if, how and when measurement changes behavior. The range of cognitive measures investigated to date has predominantly focused around constructs abstracted from the Theory of Planned Behavior as well as on anticipated regret.…”

Section: Implications For Research and Practicementioning

confidence: 99%

The question–behavior effect: Genuine effect or spurious phenomenon? A systematic review of randomized controlled trials with meta-analyses.

Rodrigues¹,

O’Brien²,

French³

et al. 2015

Health Psychology

112

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Using the question-behavior effect to promote disease prevention behaviors: Two randomized controlled trials.

Abstract: The question-behavior effect represents a simple, cost-effective means to increase disease prevention behaviors among the general public and health professionals. Implications for promoting health behaviors are discussed.

Cited by 57 publications

References 41 publications

Promoting the return of lapsed blood donors: A seven-arm randomized controlled trial of the question–behavior effect.

Promoting the return of lapsed blood donors: A seven-arm randomized controlled trial of the question–behavior effect.

Enhanced invitation methods and uptake of health checks in primary care: randomised controlled trial and cohort study using electronic health records

The question–behavior effect: Genuine effect or spurious phenomenon? A systematic review of randomized controlled trials with meta-analyses.

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