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Cognitive and emotional reactions to pictorial-based risk communication on subclinical atherosclerosis: a qualitative study within the VIPVIZA trial
Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.ORCID-id: 0000-0002-9847-4196
Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa.ORCID-id: 0000-0002-9643-5257
Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.ORCID-id: 0000-0003-1699-1681
Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa.ORCID-id: 0000-0003-4942-611x
2023 (Engelska)Ingår i: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 41, nr 1, s. 69-80Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Objectives, setting and subjects: Atherosclerosis screening with ultrasound is non-invasive and can be used as part of risk communication. The potential of personalised and pictorial-based risk communication is assessed in VIPVIZA, a population-based randomised controlled trial that aims at optimising cardiovascular disease (CVD) prevention by investigating the impact of visualisation of subclinical atherosclerosis. The present aim was to explore cognitive and emotional reactions evoked by the intervention as well as attitudes to any implemented life style changes in VIPVIZA participants in the intervention group with improved health status and furthermore to study possible interactions between these factors. Understanding mechanisms of action was central since non-adherence to preventive guidelines are often faced in clinical practice. Design: In-depth interviews with 14 individuals were analysed with qualitative content analysis. Results: Cognitive and emotional processes were highly interlinked and described by the main theme Cognitive and emotional reactions in strong interplay for orchestration of health oriented behavioural change. The informants’ descriptions revealed two distinctly different psychological processes which constituted the two subthemes, Problem-focused coping and Encouragement-driven process. Conclusions: The results highlight that an interaction between emotional reactions and efficacy beliefs is important in facilitating behavioural change. Furthermore, the results underscore the importance of the risk message being perceived as clear, accurate, reliable and also emotionally engaging and thereby show why atherosclerosis screening and pictorial-based risk communication have the potential to contribute to effective CVD prevention strategies and shared decision making in primary care.

Ort, förlag, år, upplaga, sidor
Taylor & Francis, 2023. Vol. 41, nr 1, s. 69-80
Nyckelord [en]
Cardiovascular disease, decision making, health behaviour, prevention, qualitative content analysis
Nationell ämneskategori
Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi Kardiologi och kardiovaskulära sjukdomar
Identifikatorer
URN: urn:nbn:se:umu:diva-205734DOI: 10.1080/02813432.2023.2178850ISI: 000942309100001PubMedID: 36855328Scopus ID: 2-s2.0-85149358906OAI: oai:DiVA.org:umu-205734DiVA, id: diva2:1744133
Forskningsfinansiär
Region Västerbotten, ALFVLL-298001Region Västerbotten, ALFVLL-643391Vetenskapsrådet, 521-2013-2708Vetenskapsrådet, 2016-0189Hjärt-Lungfonden, 20150369Hjärt-Lungfonden, 20170481Svenska läkaresällskapetSTROKE-RiksförbundetVisare NorrTillgänglig från: 2023-03-17 Skapad: 2023-03-17 Senast uppdaterad: 2025-02-10Bibliografiskt granskad
Ingår i avhandling
1. From risk communication to lifestyle modification: interactions of reactions for actions
Öppna denna publikation i ny flik eller fönster >>From risk communication to lifestyle modification: interactions of reactions for actions
2024 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Alternativ titel[sv]
Från riskkommunikation till levnadsvaneförändring : vikten av att reagera för att agera
Abstract [en]

Aim: From a health psychological perspective, the great need of effective cardiovascular disease (CVD) prevention and the potential of pictorial presentation of subclinical atherosclerosis as part of risk communication implies two important lines of inquiry which constitute the overall aims of this thesis: 1) To explore and assess psychological intervention response in terms of cognitive and emotional reactions to health risk communication about subclinical atherosclerosis, 2) To assess associations between psychological intervention response and lifestyle modification.

Methods: The pragmatic population-based randomized controlled trial VIPVIZA investigates the impact of pictorial information about subclinical atherosclerosis, added to traditional risk factor-based communication. The intervention includes a personalized, colour-coded and age-related risk communication strategy and a motivational conversation, and has been shown to reduce cardiovascular disease risk. Study 1 assessed cognitive and emotional reactions to the intervention, and how reactions were associated to lifestyle modification, measured with a lifestyle index based on physical activity, diet, smoking and alcohol consumption. To gain deeper understanding of why the intervention is effective, Study 2 qualitatively explored reactions evoked by the intervention as well as attitudes to any implemented lifestyle changes among VIPVIZA participants in the intervention group with improved health status. Study 3 assessed risk perception and efficacy beliefs in the intervention group and the control group after one and three years. Furthermore, this study assessed whether risk perception increased with message severity. Study 4 assessed the impact of the VIPVIZA intervention on participants' risk perception accuracy, and also whether risk perception accuracy after one and three years was associated with sustained lifestyle change.

Results: The result letter was easy to understand and the intervention increased understanding of personal CVD risk, the possibility to influence the risk, and how to influence the risk. High level of cognitive response in combination with high level of emotional arousal was found to be most beneficial for lifestyle modification. Informants perceived risk messages to be clear, accurate, reliable and emotionally engaging. Study 1 and Study 2 suggest that an interplay between cognitive and emotional reactions is crucial from early reactions to risk messages, through the decision-making process of behavioural change to maintenance of a healthy lifestyle. The intervention group perceived their cardiovascular disease risk as higher after one year, compared to the control group, with the effect persisting after three years. Within the intervention group, differences in CVD risk perception were found among participants receiving different color-coded risk messages on atherosclerosis status. The intervention had an impact on accuracy of risk perception. Accuracy of risk perception was associated with long-term behaviour change. Underestimating risk was associated with a decrease in health behaviours.

Conclusions: As captured by the idiom "A picture says more than a thousand words", the results indicate that pictorial communication of atherosclerosis is easy to understand, enhances comprehension of risk, and evoke a powerful response. In other words: the communication is effective. Furthermore, in line with the idiom "Seeing is believing", which suggests that seeing something first-hand makes it more credible or believable, the results suggest that pictorial communicating on atherosclerosis status increase understanding of CVD risk since being perceived as accurate, reliable and convincing. In other words: pictorial communication is trustworthy and convincing. Future CVD interventions should acknowledge the role of accuracy of risk perception for behaviour change and focus on strengthening efficacy beliefs.

Ort, förlag, år, upplaga, sidor
Umeå: Umeå University, 2024. s. 144
Nyckelord
Atherosclerosis, Pictorial communication, Lifestyle, Health behaviour, Prevention, Health promotion, Decision making
Nationell ämneskategori
Psykologi Medicin och hälsovetenskap
Forskningsämne
Hälsopsykologi
Identifikatorer
urn:nbn:se:umu:diva-228846 (URN)978-91-8070-460-1 (ISBN)978-91-8070-459-5 (ISBN)
Disputation
2024-09-20, Zoom + Åhörarplatser i Hörsal HUM.D.230, 09:00 (Svenska)
Opponent
Handledare
Anmärkning

Avhandlingen framläggs till offentligt försvar via Zoom, åhörarplatser även i Hörsal HUM.D.230, Humanisthuset. 

För att ansluta via Zoom: https://umu.zoom.us/j/67093086984

Mötes ID: 670 9308 6984

Tillgänglig från: 2024-08-30 Skapad: 2024-08-26 Senast uppdaterad: 2024-08-29Bibliografiskt granskad

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Andersson, Elin M.Johansson, HeleneNordin, StevenLindvall, Kristina

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Scandinavian Journal of Primary Health Care
Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomiKardiologi och kardiovaskulära sjukdomar

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