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Images and cue reminders to reduce implicit risk taking in the context of alcohol use

Projectomschrijving

Het project is gericht op het verminderen van alcoholgebruik bij jongvolwassenen via een tweetal strategieën, imago verandering en cue reminders. Imago’s zijn stereotype ideeën die mensen hebben over bijvoorbeeld een roker, drinker of sporter (stoer, egoïstisch, populair). Deze imago’s beïnvloeden in belangrijke mate hoe wij ons gedragen, bewust en onbewust (‘Ik wil (niet) zo zijn als….’). Imagoverandering is gericht op het verminderen van positieve kenmerken van risicoimago’s, en het benadrukken van positieve kenmerken van wenselijke imago’s. Dit stimuleert het nastreven van wenselijke imago’s. Cue reminders zijn materiële zaken of situaties, die mensen een geheugensteuntje bieden om zich wenselijke imago’s te herinneren: elke keer dat iemand een cue ziet activeert dit imago gedachten. Beide strategieën worden geëvalueerd binnen een bestaand internetprogramma ‘drinktest.nl’, met het doel de effectiviteit van dat programma te vergroten. Vooronderzoek tot dusver toont aan dat jongvolwassenen verschillende alcoholimago’s onderscheiden, met elk specifieke kenmerken. Met deze bevindingen kan de imagostrategie ontwikkeld worden.

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Samenvatting van de aanvraag

Excessive alcohol use is associated with short- and long-term health damaging consequences. The prevalence of excessive drinking among young adults is high, young adults being the largest group of alcohol abusers. Despite this knowledge, there are hardly any preventive interventions available for this group. Hence, it is essential that alcohol use among young adults is targeted. Most interventions that have targeted risk behaviors have done so assuming people are rational decision makers. This view, however, seems erroneous, given that quite a number of people engage in unhealthy behaviors, including excessive drinking, without any intention or even a negative intention NOT to do so. This finding can be explained by means of dual-process theory (Gibbons, 2003; Strack & Deutch, 2004; Wiers, 2006), which suggest that behaviors are the result of two systems; an explicit, planful system and an implicit, associative system. The implicit system has shown to play a prominent role in the context of excessive alcohol and young adults, where behaviour is often induced by a social context (Gibbons, 2003; Wiers, 2006). This suggests that excessive alcohol can – more successfully- be reduced by targeting the implicit system. The project aims to test two strategies that could successfully address the implicit route; image alteration and cue reminders. Images can be defined as (1) perceptions of a stereotypical person (‘a typical drinker of your age’), with identifiable, distinct characteristics (e.g., ‘cool’, ‘reckless’), which can be considered without the need to be personally experienced, and (2) ideas a person has of the kind of person he/she desires to become or fears of becoming in the future. Both types of images can influence behavior. In the project, images will be related to alcohol use. Cue reminders can be defined as potential situations or materials that can function as a cue to remind people of their goals, values (i.e. (un)desirable images that are attainable/avoidable) in a specific (risk) situation. Image alteration is aimed at changing the favorability of risk-related images and promoting healthy images. Images have shown to be important predictors of health behavior (change), and affect behavior via implicit processes. Cue reminders will be used to remind people in risk situations of the content of the intervention. Both strategies have the potential to establish long-term health behavior changes/avoid risk relapse, given that they reduce a person’s responsiveness to risk situations via implicit processes. However, thorough tests are required to examine the potential and boundaries of the strategies. Three studies are proposed within the project. Study 1 has two purposes. First, it is aimed at identifying risk and health images and the underlying (un)favorable characteristics that may guide (reductions in) drinking. Second, study 1 is aimed at the elicitation of potential cue reminders that could help people remind of (un)desirable images and identify risk situations. Hence, study 1 is an essential prerequisite for the operationalisation of our strategies. Study 2 is aimed at validating the images in the context of drinking in a prospective study design, including at-risk populations. From this study we can select images that can alter drinking. Moreover, subpopulation analysis will provide parameters of image alteration per subgroup. In study 3, an intervention is developed to test the effectiveness of image alteration and cue reminders in promoting reductions in excessive alcohol use. Using a randomized controlled design, a standard, online tailored intervention (drinktest.nl) is compared with three experimental interventions (image only vs. cue reminder only vs. combined). In the image conditions image information will be tailored to pretest information on image evaluations. Specifically, it is aimed at increasing the discrepancy between excessive drinking and desired images, highlighting opportunities to protect, sustain or attain positive self-images. In the cue reminder conditions people receive an instruction to remind themselves of the content of the intervention every time when being exposed to reminder cues. Reminder cues are based on participant’ baseline characteristics. Based on the design chosen and the additional subtype analyses we will be able to show whether (specific elements of) these interventions are effective, why (examining mediating processes) and for whom (examining moderators such as type of education and individual differences). In sum, the project addresses some of the critical gaps in health promotion by pursuing health behavior changes via implicit processes. The project is likely to (1) provide strategies which can target implicit routes of behavior change and relapse (specifically alcohol reduction), (2) strengthen an existing program, which has already been implemented, (3) provide knowledge about the boundaries and conditions of effectiveness.

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Projectnummer:
121020020
Looptijd: 100%
Looptijd: 100 %
2010
2014
Onderdeel van programma:
Projectleider en penvoerder:
Dr. P. Empelen
Verantwoordelijke organisatie:
TNO