Be fond of yourself and admit that you're at risk - Self-affirmation helps accepting personalised risk feedback

Objectives: Personalised risk feedback (e.g. UV photography) can motivate health behaviour change. However, risk feedback is not always effective in changing risk perception or behaviour, as individuals try to preserve their self-image by downplaying their risk. Selfaffirmation might palliate such defensive reactions. This study tests whether self-affirmation increases the efficacy of personalised risk feedback. Method: A 2-2 (UV photo: yes/no, selfaffirmation: yes/no) factorial RCT with 293 participants (mean age: 33 years, 69% female) was employed. Sun exposure and risk perception for skin cancer/premature aging were assessed at baseline and 2 weeks after the intervention. ANCOVAs were used to test hypotheses and mediation effects. Results: Participants receiving risk feedback only reported even more sun exposure and lower risk perception than participants in other groups. Participants receiving the self-affirmation intervention in combination with risk feedback had the highest levels of risk perception and sun protection. The effect of the intervention on behaviour was fully mediated by increased risk perception in the self-affirmation condition. Conclusions: Providing personalised risk feedback is not unconditionally effective, it can even have detrimental effects on behaviour and risk perception. However, if a person’s self-image is reaffirmed, risk feedback can be processed adaptively and leads to cognition and behaviour change.