School of Psychology, University of Sydney, New South Wales, Australia.
Br J Health Psychol. 2013 May;18(2):310-37. doi: 10.1111/bjhp.12035.
Increasing evidence suggests that various health behaviours are amenable to change following the induction of cognitive dissonance. This systematic review sought to evaluate the effectiveness and methodological quality of dissonance-based health behaviour interventions and to explore identified sources of heterogeneity in intervention effects.
Bibliographic databases were searched for relevant articles from inception to March 2012. Only studies targeting non-clinical health behaviour in non-clinical populations were included in the review. One author extracted data and assessed quality of evidence and a second author verified all content.
Reports of 20 studies were included. A variety of health behaviours and outcome measures were addressed across studies. Most studies produced one or more significant effects on measures of behaviour, attitude or intention. Across studies, methodological risk for bias was frequently high, particularly for selection bias. Gender and self-esteem were identified as potential moderator variables.
The evidence for the effectiveness of dissonance-based interventions was generally positive. The hypocrisy paradigm was found to be the most commonly applied research paradigm and was most effective at inciting change across a range of health behaviours. There was no observable link between type of target behaviour and positive outcomes. Researchers are encouraged to minimize potential for bias in future studies and explore moderators of the dissonance effect.
What is already known on this subject? A recent meta-analysis indicates that dissonance-based interventions primarily based on the induced compliance paradigm are effective for eating disorder prevention (Stice, Shaw, Becker, & Rohde, 2008, Prev. Sci., 9, 114). However, it is currently unclear whether such outcomes are generalizable to interventions targeting non-clinical health behaviours such as smoking, sun protection and sexual risk taking. Other research indicates that studies based on the hypocrisy paradigm may lead to changes in non-clinical health behaviours (Stone & Fernandez, 2008, Soc. Personal. Psychol. Compass, 2, 1024; Stone & Focella, 2011, Self Identity, 10, 295) although this literature lacks systematic evaluation of interventions across a range of experimental paradigms. What does this study add? The hypocrisy paradigm appears most effective in inciting change across a range of non-clinical health behaviours. The dissonance effect may be moderated by variables such as self-esteem and gender. Risk of bias needs to be minimised to increase the validity of studies within this topic area.
越来越多的证据表明，在产生认知失调后，各种健康行为都可以改变。本系统评价旨在评估基于不和谐的健康行为干预的有效性和方法学质量，并探讨干预效果中确定的异质性来源。
从开始到 2012 年 3 月，对相关文献数据库进行了搜索。本综述仅纳入针对非临床人群中非临床健康行为的研究。一位作者提取数据并评估证据质量，另一位作者验证所有内容。
报告了 20 项研究。研究涉及各种健康行为和结果测量。大多数研究对行为、态度或意图的测量产生了一个或多个显著影响。在研究中，方法学偏倚风险通常较高，特别是选择偏倚。性别和自尊被确定为潜在的调节变量。
基于不和谐的干预措施的有效性证据总体上是积极的。虚伪范式被发现是最常应用的研究范式，在引发一系列健康行为的改变方面最有效。目标行为的类型与积极结果之间没有明显的联系。研究人员被鼓励在未来的研究中尽量减少潜在的偏差，并探索不和谐效应的调节因素。
关于这个主题，目前已经知道了什么？最近的一项荟萃分析表明，主要基于诱导顺应范式的不和谐干预措施对饮食失调预防有效（Stice、Shaw、Becker 和 Rohde，2008，Preventive Science，9，114）。然而，目前尚不清楚这些结果是否可推广到针对吸烟、防晒和性风险行为等非临床健康行为的干预措施。其他研究表明，基于虚伪范式的研究可能会导致非临床健康行为的改变（Stone 和 Fernandez，2008，Social and Personal Psychology Compass，2，1024；Stone 和 Focella，2011，Self Identity，10，295），尽管这方面的文献缺乏对一系列实验范式的干预措施的系统评价。这项研究有什么新发现？虚伪范式在引发一系列非临床健康行为的改变方面似乎最为有效。不和谐效应可能受到自尊和性别等变量的调节。为了提高该主题领域内研究的有效性，需要尽量减少偏倚风险。
