1. Actionable communications and interventions to change HABITS
Thank you. It’s good to see old friends, new friends.
Dolores Albarracín
University of Illinois at Urbana Champaign

2. Actionability Action calls (behavior is recommended)
Actionable as behavior relevant (helps implement)
Actionable as number of recommendations
Actionable as action/inaction (d0 vs. not do)

3. Actionability Action calls Actionable as behavior relevant
Actionable as number of recommendations
Actionable as action/inaction

4. Action Calls Change we can believe in. (Barak Obama)
Let's make America great again. (Donald Trump)

5. Action Messages on Twitter and HIV Prevalence (Ireland,
Action Messages on Twitter and HIV Prevalence (Ireland,.., & Albarracin, 2016, Health Psychology)
1 billion tweets November 2008-January 2010 (random 10%)
Action word dictionaries (e.g., act, fly, gaming, gym, movement, trip): Measure of county level action language
Hypothesis: Association with county-level HIV prevalence

7. Action Messages as Action Calls and HIV Prevalence (Ireland, …& Albarracin, 2016)

8. Actionable Contents Action calls: Yes Actionable as behavior relevant
Actionable as number of recommendations
Actionable as action/inaction

9. Meta-Analysis of Condom Use Interventions (Albarracin et al., 2005)
224 groups or statistically-independent conditions
Total N = 82,798 participants
Average N of participants per group = 257
The search and selection led to an impressive universe of READ

10. Albarracin et al. (2005) North Dakota Idaho South Dakota Nebraska Utah
Colorado
Idaho
Kansas
Nebraska
North Dakota
South Dakota
Utah
Albarracin et al. (2005)

11. Active vs. Passive Interventions in HIV Prevention
Behavioral skills training
Client- centered counseling

12. Meta-Analysis of Condom Use Interventions (Albarracin et al., 2005)
In this slide, I subtracted the average d when a given strategy was not present (e.g., the intervention did not present information) from when a given strategy was present. Thus, positive numbers indicate improvements in condom use as a function of the type of strategy. As can be seen, 2 strategies had no overall effect (info and fear), 1 decreased condom use (normative arguments), and the rest (attitudinal arguments, behavior-skills arguments, and condom provision) increased condom use.

13. Meta-Analyses of Multi-Behavior Interventions
Lifestyle: Smoking, Diet, & Physical Activity (Wilson et al., 2014)
HIV: Condom use, medication adherence, testing (Sunderrajan et al., 2017)
Drugs/Alcohol: Prevention and treatment (Dai et al., 2017)

14. Multi-Behavior Change (Wilson, Durantini, Sanchez, & Albarracín, 2017, Health Psychology Review)
At least 2 domains (smoking and exercise)
Obtained d (post vs pre) to describe behavioral changes as well as changes in symptoms and biological measures
Lifestyle (k = 270), HIV (k =250), Drugs/Alcohol (k = 142)
Active vs. passive

15. Effect of Active Recommendations
Lifestyle:
Active = 0.20 vs. Passive = 0.33; Rx QB1 ns
HIV:
Active = 0.24 vs. Passive = 0.29; Rx QB1 ns
Drugs/Alcohol:
Active = 0.30 vs. Passive = 0.24; Rx QB1 ns

16. Actionability Action calls
Actionable as behavior relevant: Yes but not in multi-goal cases. Questions !
Actionable as number of recommendations
Actionable as action/inaction

17. Questions Puzzle: Too many recommendations? Too conflicting?
Too many actions (initiation or increase of demanding behavior) vs. inactions (relaxation or decreasing)?

18. Actionable Contents Action calls Actionable as behavior relevant
Actionable as number of recommendations
Actionable as action/inaction

19. Number of Recommendations (Wilson, …, & Albarracin, )
The more the merrier?
Less is more?
Happy medium?
Test: Lifestyle meta-analysis; Count of goals or recommendations

20. Lifestyle, Effects of Number of Recommendations on Behavioral & Clinical Change (d)

21. Across Domains, Effects of Number of Recommendations on Average Change (d)

22. Principle of Relation
When the recommended changes are related , more is not disruptive!
Alcohol   Drugs
Smoking   Exercise, Diet ? Exercise
Testing, condom use, adherence to ARV, alcohol/drugs (either or)

23. Actionable Contents Action calls
Actionable as behavior relevant: Yes but…
Actionable as number of recommendations: More of related (drugs/alcohol) but fewer unrelated (HIV)
Actionable as action/inaction: What mix and which one is easier?
Actionable Contents

24. Action/Inaction Direction of Recommendations (Wilson, Durantini, Sanchez, & Albarracín, 2017)
Meta-analysis of lifestyle
Begin aerobic exercise program (action)
Rest between strength training sessions (inaction)
Eat fruits and vegetables (action)
Decrease fat intake (inaction)
Quit smoking (inaction)
Examining potential for change
Assigned between 2 and 20 behavior instructions: Think positive thoughts as much as possible, exercise, learn to relax, quit smoking, don’t think negative thoughts at all
75% inactions, 50/50, 75% actions
Measured recognition of behavior recommendations and compliance intentions

25. Principle of Relation Mix
When the recommended changes are homogeneous, change is easier!
Corollary: Homogeneous action/inaction direction seems better

26. Behavioral and Clinical Change (Wilson, Durantini, Sanchez, & Albarracín, 2017, Health Psychology Review) OR
Random effects QB4 = 36.42, p < .001

27. Actionable Contents Action calls
Actionable as behavior relevant: Yes but…
Actionable as number of recommendations: More of related (drugs/alcohol) but fewer unrelated (HIV)
Actionable as action/inaction: What mix? Homogeneous mix
Actionable Contents

28. Behavioral and Clinical Change (Wilson, Durantini, Sanchez, & Albarracín, 2017, Health Psychology Review) OR
Random effects QB4 = 36.42, p < .001

29. Experimental Work on Action vs. Inaction
Is action overall more disruptive than inaction?
Hypothesis: Yes; chronic action focus

30. Multiple Behavior GNG (Albarracin et al., 2017)
Mapping rules
Go targets and # of trials
No-go targets and # of trials
High action-proportion
(Action predominance)
Health-12 Doctor-12 Energy-12
Green-12
Low action proportion
(Inaction predominance)
Health-12
Doctor-12 Energy-12
Multiple Behavior GNG (Albarracin et al., 2017)

31. Trials; G to Health, Doctor, Energy
Action Predominance Health 👆 Doctor Energy Green
Inaction Predominance
Health 👆
Doctor
Energy
Green

32. Multiple Behavior GNG Mapping rules Go targets and # of trials
Mapping rules
Go targets and # of trials
No-go targets and # of trials
High action-proportion =
Lower Accuracy
Health Doctor Energy
Green
Low action proportion =
Higher Accuracy
Health
Doctor Energy
Multiple Behavior GNG

33. Experiment 1 (Albarracin et al., 2017)

34. Experiment 2 (Albarracin et al., 2017)

35. Experiment 4: Introducing an Action Focus (Albarracin et al., 2017)

36. Actionable Contents Action calls
Actionable as behavior relevant: Yes but…
Actionable as number of recommendations: More of related (drugs/alcohol) but fewer unrelated (HIV)
Actionable as action/inaction: What mix and which one is easier? Homogeneous mix and inactions over actions; inaction focus
Actionable Contents

37. But Chronic focus on action
Higher value for action than inaction (Sunderrajan & Albarracin, 2017)
Pressing a button seen as better and more intentional than not pressing a button (Sunderrajan & Albarracin, 2017)
Removing idealization of action may be part of the solution (Sunderrajan & Albarracin, 2017)

38. Health and Social Media Group
Social Action Lab
Health and Social Media Group
National Institutes of Health
And these are the members…Some of the people are at other institutions, NORC, Hopkins, Emory, and there are different disciplines: psychology, computer science, linguistics