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临床试验/NCT03849924
NCT03849924已完成不适用

Promoting and Protecting Subjective Well-Being Using Self-Affirmation

University of Manchester2 个研究点 分布在 1 个国家目标入组 66 人开始时间: 2018年9月3日最近更新:
适应症
干预措施

试验速览

阶段
不适用
状态
已完成
入组人数
66
试验地点
2
主要终点
Change from baseline subjective well-being at 2-weeks follow up

研究概览

简要总结

This study evaluates whether a brief psychological intervention, known as a self-affirmation intervention which works by allowing one to recognise their own value, can improve well-being. This study also evaluates whether more of these interventions will lead to greater increases in well-being, and also measures self-esteem and anxiety to examine their potential involvement in the self-affirmation process. Participants are randomly assigned to either a self-affirmation intervention group, a 'booster' self-affirmation group whereby they receive the intervention twice, or a control group (no intervention). Participant's well-being, self-esteem and anxiety are assessed at baseline (before the intervention), 1 week, and 2 weeks after the intervention. It is hypothesised that those who undergo self-affirmation will have more improved levels of well-being than those who do not; those who undergo the self-affirmation twice will have the most improved levels of well-being. It is also hypothesised that self-esteem and state anxiety will be involved in the self-affirmation process and potentially mediate the effects of self-affirmation on well-being.

详细描述

Subjective well-being, refers to an appraisal of one's own life as a whole. Subjective well-being is regularly being used by governments as a measure of observing social progress, informing new policy and promoting behaviour change, in comparison to more objective measures of social progress such as gross domestic product. A key aim of government policies is therefore to find the most efficient, cost-effective ways to improve people's subjective well-being, to determine the most efficient ways of improving quality of life. There are currently a number of ways in which the government is attempting to address this, with programs in place that are designed to improve people's well-being, such as Altogether Better (Yorkshire and Humber Strategic Health Authority) and Target Well-being (Federation of Groundwork Trust), as well as NHS programmes and free well-being courses. However, these programmes were not always found to be effective in improving people's well-being, particularly when the programmes involved health awareness activities. This limited effectiveness of programmes involving health awareness activities makes them unlikely to be cost-effective as a well-being intervention. This suggests the importance of developing an effective intervention to improve people's well-being, that could also be used within government/NHS well-being programs, to enhance the effectiveness of said programs in improving well-being to make them more cost-effective, particularly in those promoting health awareness.

Self-affirmation theory provides an approach to improve subjective well-being by overcoming feelings of threat to the self. A threat to one's sense of self could undermine one's subjective well-being. Self-affirmation theory states that people strive to maintain a positive, moral and adaptive self-image, and that threats to the self (e.g., a smoker being told that smoking is bad for them), motivates them to defend their global sense of self (e.g., by convincing themselves that the information is flawed). According to self-affirmation theory, people's sense of self can also be protected by bolstering self-image in a domain that is not under direct threat. For example, if one feels that their sense of self is threatened in a certain domain (e.g., by anti-smoking messages), then one can bolster self-image by compensating in another domain (e.g., by doing charity work). There is a large amount of evidence to support this theory, mostly from studies in which self-affirmation manipulations (i.e. by reminding people of their 'core values') have been found to be effective in overcoming threats to the self and promoting receptiveness to health-risk communications.

The effectiveness of self-affirmation in overcoming threats to the self is not specific to health-risk communications as research has found self-affirmation also to be effective in overcoming threats to the self that occur within other domains, such as self-esteem, anxiety and well-being, suggesting that they could be employed to protect subjective well-being across populations at a low cost. There are limitations associated with research in this area however, as there have only been very few studies that have looked at the effects of self-affirmation on well-being and their samples are often limited and lack generalisability. Also, no research to date has measured whether more self-affirmation interventions would produce greater effects. This is of importance as research has regularly demonstrated evidence of dose dependant relationships between a psychological intervention and its subsequent effects, with a greater number of psychological interventions being associated with greater effects. It would also be beneficial if research were to be conducted to determine the effects of self-affirmation in a sample of people who are already undergoing a well-being intervention (e.g., a government programme or NHS course), to see whether self-affirmation can enhance the effectiveness of the intervention in improving well-being, as this has not yet been explored and could help to make the intervention more cost-effective. Therefore, the present study aims to confirm this positive effect of self-affirmation on subjective well-being in a sample that consists of a wider range of backgrounds and demographics that are already undergoing a well-being intervention.

In addition to this, there has been research that has looked at examining mediators of the self-affirmation process, however the mechanisms for explaining the effects of self-affirmation are not yet clearly understood. Some research has found evidence of self-esteem acting as a mediator in the self-affirmation process. However, more research needs to be conducted to confirm these findings as they have been inconsistent, with some research showing no evidence of self-esteem acting as a mediator. Furthermore, other research has found that self-affirmation led to reductions in state anxiety. This suggests state anxiety may be acting as a mediator in the self-affirmation process, as undergoing self-affirmation resulted in changes in state anxiety, with the self-affirming effects possibly being occurring due to reductions in state anxiety. As there has been no research that has addressed this possibility of state anxiety acting as a mediator in the self-affirmation process, research should be conducted on this as this as this would allow greater understanding of the mechanisms involved.

Accordingly, the present study will test the ability of self-affirmation to promote and/or protect subjective well-being by comparing differences in subjective well-being in those that undergo self-affirmation interventions with those that do not. The study will also compare the difference between the effects of one self-affirmation intervention with that of two self-affirmation interventions (i.e. the 'booster' condition), to determine whether there is a dose-dependent relationship of the effects of self-affirmation. The present study will also measure the effects of self-affirmation on self-esteem and state anxiety to test the possibility of mediators of the self-affirmation process. Participants will be recruited from an NHS college which runs free courses that are designed to help people improve their health and/or well-being. It is likely that those who attend this college may feel threatened by the courses, such as feeling threatened by opening-up and talking through issues during the courses, which would lead to defensive processing and undermine the effectiveness of the courses in their aim of improving people's well-being. Self-affirmation could help to overcome these feelings of threat by reducing defensive processing, which could then enhance the effectiveness of the courses in helping people improve their well-being. This is a particularly important population to recruit from as the courses ran by the college often promote health awareness, which research has identified as being less effective in improving well-being. Self-affirmation interventions could therefore help to improve the cost-effectiveness of the courses.

研究设计

研究类型
Interventional
分配方式
Randomized
干预模型
Parallel
主要目的
Supportive Care
盲法
Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)

盲法说明

The questionnaire administrator/investigator and participants are blind to the condition, as participants are not informed of the questionnaires being different from one another, and participants should return their questionnaires in sealed envelopes.

入排标准

年龄范围
18 Years 至 —(Adult, Older Adult)
性别
All
接受健康志愿者

入选标准

  • Anyone that attends the NHS college designed to improve health and well-being that is willing to participate in the study

排除标准

  • Any cognitive/psychological deficits that would affect the individual's capacity to consent

研究组 & 干预措施

Self-affirmation

Experimental

Participants assigned to the self-affirmation intervention condition will undergo a self-affirmation intervention in the form of a questionnaire at time point one (one week after the intervention). This is a brief intervention that involves forming self-affirming implementation intentions. Implementation intentions are formulated plans that encourage one to link critical situations with appropriate behavioural responses. In this study participants are encouraged to write out the stem and their response to the stem from the four options.

干预措施: Self-affirmation (Behavioral)

Self-affirmation 'booster'

Experimental

Participants assigned to this condition will undergo the self-affirmation intervention described above twice, in comparison to just once, in the form of a questionnaire at time points one (one week after the intervention) and two (two weeks after the intervention).

干预措施: Self-affirmation (Behavioral)

Control

No Intervention

Participants assigned to the control condition will not undergo a self-affirmation intervention. Instead they will still complete the same questionnaire as participants in the intervention conditions but without the self-affirmation intervention included (normally included on the last page of the questionnaire).

结局指标

主要结局

Change from baseline subjective well-being at 2-weeks follow up

时间窗: Through study completion, up to 2 weeks

This questionnaire assesses the three main components of subjective well-being, using the four items advised by the UK Office for National Statistics. These subjective well-being components include evaluation ("Overall, how satisfied are you with your life nowadays?"), experience ("Overall, how happy did you feel yesterday?" and "Overall, how anxious did you feel yesterday?") and eudemonic ("Overall, to what extend do you feel the things you do in your life are worthwhile?"). Participants were asked to respond to questionnaire items on 11-point Likert-type scales from 'not at all' (0) to 'completely' (10).

次要结局

  • Change from baseline self-esteem at 2-weeks follow up(Through study completion, up to 2 weeks)
  • Change from baseline self-esteem domains at 2-weeks follow up(Through study completion, up to 2 weeks)
  • Change from baseline state anxiety at 2-weeks follow up(Through study completion, up to 2 weeks)

研究者

申办方类型
Other
责任方
Principal Investigator
主要研究者

Charlotte Entwistle

Research Assistant

University of Manchester

研究点 (2)

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