Testing a Self-affirmation Intervention for Use in a Mobile Application

Study Overview
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Brief Summary
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The aim of these studies is to adapt the self-affirmation kindness questionnaire for use in a mobile application. Two studies will be conducted to test hypotheses that simplifying and shortening the original questionnaire in systematic ways will result in comparable effectiveness (compared to the original version) in promoting reduced defensive avoidance, less reactance, greater yielding, and higher intentions to quit smoking among a sample of smokers.

Detailed Description
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Research has shown that self-affirmation interventions, in which people are instructed to focus on their strengths and values, can offset self-threats and promote healthier behaviors, such as smoking cessation. A commonly used self-affirmation intervention is known as the kindness quiz. The original kindness questionnaire (Reed & Aspinwall, 1998) consists of 10 yes/no questions, and participants are asked to think about and write down an example of each. For example, one item is Have you ever been considerate of another person's feelings? ____ YES ____NO; IF YES, WRITE ABOUT A SPECIFIC EXAMPLE. The items were written so that all participants should be able to say yes in response to each question, which will affirm a positive view of themselves. The purpose of these studies are to test shorter and simpler versions of this kindness questionnaire so that it can be implemented on mobile phones. In Study 1, we will test whether written examples are necessary for the effectiveness of the self-affirmation intervention (compared to no examples or imagined examples) compared to a control. In Study 2, we will again test whether written examples are necessary, as well as whether shorter questionnaires (i.e., 5 items or 3 items) are as effective as the original 10 item questionnaire.

Official Title
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Testing a Self-affirmation Intervention for Use in a Mobile Application

Conditions
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Smoking, Smoking Cessation, Smoking, Tobacco

Intervention / Treatment
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* Behavioral: Self affirmation, 10 items, written examples
* Behavioral: Self affirmation, 10 items, no examples
* Behavioral: Self affirmation, 10 items, imagined examples
* Behavioral: Self affirmation, 5 items, written examples
* Behavioral: Self affirmation, 5 items, no examples
* Behavioral: Self affirmation, 5 items, imagined examples
* Behavioral: Self affirmation, 3 items, written examples
* Behavioral: Self affirmation, 3 items, no examples
* Behavioral: Self affirmation, 3 items, imagined examples


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Currently live in the US 21-65 years (several states have 21 as minimum legal age to smoke) self-identified every day or some day smoker no prior diagnosis of lung cancer, chronic obstructive pulmonary disease, or emphysema (the most common and well-known smoking-related diseases Exclusion Criteria: Not currently living in the US Less than 21 years of age or older than 65 Nonsmoker Prior diagnosis of lung cancer, chronic obstructive pulmonary disease, or emphysema (the most common and well-known smoking-related diseases

Ages Eligible for Study
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Minimum Age: 21 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Factorial Assignment
Interventional Model Description: Study 1 will use a 2 (self-affirmation: self-affirmation, control) X 3 (Mode of example: none, write, imagine) experimental design. In the self-affirmation condition, participants will complete the self-affirmation kindness quiz (10 questions) and in the control condition they will complete a personal opinion survey (10 questions). Depending on the mode of example condition, participants will not be asked to provide examples, asked to write examples for each of the 10 questions, or asked to imagine examples for each of the 10 questions. Based on examination of data from Study 1 (i.e., which items receive more yes responses and for which items examples are provided), in Study 2 we will test whether using fewer self-affirmation items influences dependent variables. Study 2 will use a 3 (Number of questions: 10, 5, 3) X 3 (Mode of example: none, write, imagine) experimental design.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Self-affirm, No examples, Study 1<br>Behavioral: Self affirmation, 10 items, no examples | Behavioral: Self affirmation, 10 items, no examples<br>* Participants will complete the 10 item self-affirmation kindness quiz and will not be asked to provide examples for any items they respond yes to.<br>|
| Active Comparator: Self-affirm, Write examples, Study 1<br>Behavioral: Self affirmation, 10 items, written examples | Behavioral: Self affirmation, 10 items, written examples<br>* Participants will complete the 10 item self-affirmation kindness quiz and will be asked to provide written examples for each item they respond yes to.<br>|
| Experimental: Self-affirm, Imagine examples, Study 1<br>Behavioral: Self affirmation, 10 items, imagined examples | Behavioral: Self affirmation, 10 items, imagined examples<br>* Participants will complete the 10 item self-affirmation kindness quiz and will be asked to imagine examples for each item they respond yes to.<br>|
| No Intervention: Opinion survey, No examples, Study 1<br>No intervention: control. Participants will complete the 10 item personal opinion survey and will not be asked to provide examples for any items they respond yes to. | |
| No Intervention: Opinion survey, Write examples, Study 1<br>No intervention: control. Participants will complete the 10 item personal opinion survey and will be asked to provide written examples for each item they respond yes to. | |
| No Intervention: Opinion survey, Imagine examples, Study1<br>No intervention: control. Participants will complete the 10 item personal opinion survey and will be asked to imagine examples for each item they respond yes to. | |
| Experimental: Self-affirm, 10-item, No ex, Study 2<br>Behavioral: Self affirmation, 10 items, no examples | Behavioral: Self affirmation, 10 items, no examples<br>* Participants will complete the 10 item self-affirmation kindness quiz and will not be asked to provide examples for any items they respond yes to.<br>|
| Experimental: Self-affirm, 5-item, No ex, Study 2<br>Behavioral: Self affirmation, 5 items, no examples | Behavioral: Self affirmation, 5 items, no examples<br>* Participants will complete a 5 item self-affirmation kindness quiz and will not be asked to provide examples for any items they respond yes to.<br>|
| Experimental: Self-affirm, 3-item, No ex, Study 2<br>Behavioral: Self affirmation, 3 items, no examples | Behavioral: Self affirmation, 3 items, no examples<br>* Participants will complete a 3 item self-affirmation kindness quiz and will not be asked to provide examples for any items they respond yes to.<br>|
| Active Comparator: Self-affirm, 10-item, Write ex, Study 2<br>Behavioral: Self affirmation, 10 items, written examples | Behavioral: Self affirmation, 10 items, written examples<br>* Participants will complete the 10 item self-affirmation kindness quiz and will be asked to provide written examples for each item they respond yes to.<br>|
| Experimental: Self-affirm, 5-item, Write ex, Study 2<br>Behavioral: Self affirmation, 5 items, written examples | Behavioral: Self affirmation, 5 items, written examples<br>* Participants will complete a 5 item self-affirmation kindness quiz and will be asked to provide written examples for each item they respond yes to.<br>|
| Experimental: Self-affirm, 3-item, Write ex, Study 2<br>Behavioral: Self affirmation, 3 items, written examples | Behavioral: Self affirmation, 3 items, written examples<br>* Participants will complete a 3 item self-affirmation kindness quiz and will be asked to provide written examples for each item they respond yes to.<br>|
| Experimental: Self-affirm, 10-item, Imagine ex, Study2<br>Behavioral: Self affirmation, 10 items, imagined examples | Behavioral: Self affirmation, 10 items, imagined examples<br>* Participants will complete the 10 item self-affirmation kindness quiz and will be asked to imagine examples for each item they respond yes to.<br>|
| Experimental: Self-affirm, 5-item, Imagine ex, Study 2<br>Behavioral: Self affirmation, 5 items, imagined examples | Behavioral: Self affirmation, 5 items, imagined examples<br>* Participants will complete a 5 item self-affirmation kindness quiz and will be asked to imagine examples for each item they respond yes to.<br>|
| Experimental: Self-affirm, 3-item, Imagine ex, Study 2<br>Behavioral: Self affirmation, 3 items, imagined examples | Behavioral: Self affirmation, 3 items, imagined examples<br>* Participants will complete a 3 item self-affirmation kindness quiz and will be asked to imagine examples for each item they respond yes to.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Defensive Avoidance | Indicator of defensive information processing, 3 items (Witte) | immediately post-intervention | 
| Reactance | Indicator of defensive information processing, 27 items (Hall et al., 2016) | immediately post-intervention | 
| Yielding | Indicator of defensive information processing, 7 items (Brennan et al., 2011, 2014) | immediately post-intervention | 
| Intentions to quit smoking in the next 3 months | Intentions to quit smoking, 3 items | immediately post-intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cognitive perceived likelihood of developing smoking related disease | 3 items | immediately post-intervention | 
| Perceived severity | 3 items | immediately post-intervention | 
| Response efficacy of quitting smoking | 3 items | immediately post-intervention | 
| Self-efficacy to quit smoking | 3 items | immediately post-intervention | 
| Affective perceived likelihood | 3 items | immediately post-intervention | 
| Anticipated regret | 3 items | immediately post-intervention | 
| Worry | 3 items | immediately post-intervention | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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smoking, self-affirmation, mobile application, cessation