Methods: Participants (n=132) were randomly allocated to either a conditioning procedure pairing images of snack foods with images related to cardiovascular disease, or a control condition featuring images of snack foods alone. They completed a measure of implicit attitudes (pre and post-intervention) and two behavioural choice tests in which they chose between fruit or snack products (post-intervention). Results: The conditioning intervention made implicit attitudes towards energy-dense snacks more negative (F(1,129) Background: Health promotion interventions frequently employ visual images to influence knowledge, beliefs, attitudes, and thus behaviour. However, such interventions are often highly pragmatic and lack clear theoretical underpinning. The stages of development are often also poorly documented. Objectives: To develop a visual intervention informed by behavioural theory and concepts in order to increase understanding of arteriosclerosis and intentions to behaviour change. Methods: A multidisciplinary group applied the first two stages of the MRC Framework for the Development and Evaluation of Complex Interventions. This was operationalised in 4 subphases. 1. Establishing a theoretical basis: the creation of conceptual content 2. Establishing structure: creating a visual narrative 3. Establishing the "look": visual rendering of narrative and concepts 4. Establishing interpretation and impact: creating evidence Initial testing of the animation included in-depth interviews with 15 patients and 5 health professionals. Understanding of the animation was explored, followed by emotional reaction, acceptability and suggestions for improvement. Interviews were recorded, transcribed and analysed using the "Framework" method. Results: Phases 1 to 3 established an animation of the body and heart that sought to increase knowledge, perceived severity, susceptibility, self-efficacy and coherence. In phase 4 testing all but one participant provided an accurate and unprompted interpretation of the animation. Increases in knowledge, perceived susceptibility, self-efficacy and coherence were reported. Numerous participants indicated that the animation moved illness representations from the abstract to the concrete. An increase in anxiety and worry was reported but regarded as acceptable by all participants. Conclusions: We have established a detailed stepwise process to develop and document the creation of visual-based, theory-informed behavioural interventions. The digital animation appears acceptable to staff and patients, and to influence intended behavioural concepts. These features could heighten many types of health messages conveyed via visual imagery. For example, a major purpose for invoking imagery is to demonstrate consequences of one's behavior (e.g., illustrating detrimental effects of smoking). These consequences can be experienced firsthand in an IVE, and an interactive component could include practicing and building efficacy for cessation behaviors while observing how these behaviors mitigate health consequences. Indeed, an imagery-based IVE for smoking cessation was recently created by Canadian researchers. Another use of imagery involves conveying health concepts, often via metaphor (e.g., a ladder as a metaphor for varying risk levels). In IVEs individuals can directly experience a visual metaphor. They might also manipulate situational variables to gain nuanced understanding of the processes a metaphor conveys. Our group created and tested immersive visual metaphors based on an elevator and a bridge for conveying genetics concepts. Going forward, IVEs are poised to become an innovative medium for imagery provision and a vital research tool for exploring issues around image effectiveness. Recent research has highlighted the possibility that the emotion of disgust can act as a significant driver to initiate behaviour change as a separate or even additional component to traditional fear appeal approaches. Pictorial images may be particularly effective in generating disgust emotion. Therefore the aim of this investigation was to test the specific image qualities associated with reported disgust and rating of potential success in promoting behaviour change. Data were obtained from a public consultation exercise (Department of Health, England and Wales, 2006) that requested, through a web-based answering system, participant preferences of 42 images that might be effective to encourage tobacco cessation in smokers. Initial results indicated preferences for effectiveness of cessation message were rank ordered according to the level of disgust emotion generated, i.e. images that might persuade smokers to quit tobacco consumption appeared revolting. To confirm that disgust emotion generated by the UK tobacco packet images was associated to the public's selection of possible effective images; three cross-sectional opinion surveys were conducted. These included students from medicine and psychology disciplines, and a section of the public. The web opinion consultation database was utilised for secondary analysis. A total of 291 participants were involved in the three convenience surveys and 19812 participants gave complete replies to the public consultation website. The pictorial Disgust Sensitivity Scale was used to assess the individual's rating of every image on a five category rating ranging from 'extremely disgusting' to 'not disgusting'. Significant correlations (ranging from 0.91 to 0.94) existed between the image rank order aggregated preference ratings from the original public consultation and the average final score of the disgust ratings for specific items for the three groups. The correlations were very similar regardless of smoking status of respondents (in both public preference and opinion surveys). The emotion of disgust may be a possible intervening variable to explain the initial reactions to health promotion materials and smoking cessation. Future research needs to explore the strength of disgust emotions and fear generated by images of this nature with actual behaviour change and other intervening constructs. Over the last decade, the technique of using ambulatory saliva sampling has become increasingly popular in field research and clinical studies. The non-invasive method is easy to administer and analyze, and therefore allows implementation in large scale study designs. However, this large interest in use of saliva cortisol measurement is paralleled with frustrations on opposing Results: This symposium is based on a critical evaluation of existing literature on salivary cortisol, aiming to evaluate the utility of salivary cortisol as a biomarker in various settings and how we can understand cortisol reactivity using evidence of experiences from different study designs. The work is compiled by the Scandinavian Stress and Cortisol Network, a network financed by the Swedish Research Council, and one main question asked was: is it possible that different results of studies involving cortisol assessments are functions of differences in the theoretical assumptions made and methods used? In particular the symposium will focus on how the many different ways of evaluating levels and dynamics of salivary cortisol (i.e. with regards to time points of assessment and different algorithms based on multiple time points) may have an impact on the interpretation of cortisol measurements in various contexts. Salivary cortisol has been studied in relation to the following topics: demographic variables, psychosocial work environment, psychological resources (e.g. mastery) and outcomes (eg burnout), sleep quality, biological markers (markers of cardiovascular risk, inflammation and metabolism) and somatic outcome. The following topics shall be covered at the symposium; where all data shall refer to how results of analyses can differ depend on methods used. Over the last decade, the technique of using ambulatory saliva sampling has become increasingly popular in field research and clinical studies. The non-invasive method is easy to administer and analyze, and therefore allows implementation in large scale study designs. However, this large interest in use of saliva cortisol measurement is paralleled with frustrations on opposing Results: This presentation is based on a critical evaluation of existing literature on salivary cortisol, aiming to evaluate the utility of various measures of salivary cortisol as a biomarker in relation to psychosocial work stressors. Various measures of salivary cortisol were studied in relation to psychosocial work stressors. Twenty-seven papers including psychosocial work stress in terms of the Job Demand-Control-Support model or the Effort-Reward Imbalance model were reviewed. The presentation focuses on how salivary cortisol relates to work stressors, and discusses how these results may vary depending on measurement and data analysis.