How to Better Communicate Health Risks and Improve Health Outcomes: Self-Affirmation and Feeling Good

Date: 01/17/18

Sometimes decisions about health risks are easy. Administering CPR to save a life makes sense. But sometimes the risks result from behaviors a person is taking or a complicated combination of factors, as with diabetes or a heart attack. How do people think about and respond to these risks?

What if you could reduce the risk of getting diabetes by 50 percent by losing weight? What sort of trade-offs would you be willing to make? What other information would you want before making that decision? How would you feel? Understanding risk matters for decisions about medication, surgery, and our everyday behaviors when it comes to our health.

We’re running a three-part blog series about health risks and communication in health, walking through psychological pitfalls, and offering behavioral science solutions. In Part II, we’re discussing self-affirmation techniques.

As we discussed in Part 1 of this series, changing the format and presentation of risk information to make it easier to understand is a good first step. Using absolute numbers and visual aids can improve how people calculate risk likelihood.

Unfortunately, people also struggle with managing their emotional reaction to risk information. In fact, those most at risk are often the ones most likely to respond poorly to health information or to ignore it altogether. Understanding these emotional pitfalls can help us rethink when and how we deliver risk information to people.

Psychological pitfalls of risk communication

Getting information about a health risk can be scary. Trying to figure out how to feel and what to do can be overwhelming. People must balance their immediate emotions to the threat (fear, worry) and their anticipated emotions if the bad event comes to pass (regret, guilt). Together, these emotions can get in the way of listening – as a result, risk communication often results in no behavior change or poor decision-making. Here’s why:

The Ostrich Effect – Sometimes it’s easier to just ignore threatening information.

People may also try to discredit the threatening information and its sources, or seek out and cling to dubious sources of reassuring information.

For example, when presented with information about the dangers of cigarettes, smokers tune out that information to avoid dealing with it, and continue smoking.

It’s not always easy to know how to address a health risk.

Risk appeals can be effective when presented with a clear next step and a person feels capable. But, people are often unsure where to start making changes, or they may feel that the changes are out of their hands. In the healthcare system, where insurance can influence the treatments available, people may feel particularly helpless. Presenting risk information without the opportunity for actionable change may leave people with good intentions but no difference in behaviors, or it might even backfire, leaving them anxious and afraid with no recourse.

Solutions to help people respond better to risk information

Help people “self-affirm” before presenting risk information so they have an emotional buffer.

A brief self-affirmation exercise can bolster people’s emotional resources so they are better equipped to receive and process negative or threatening information. In a self-affirmation, people think about their cherished values and the things they like about themselves. A self-affirmation might be something like, “I am never too busy to help my friends,” or “I successfully adapt to challenges at work.”

In one study, two groups of women were all given dietary advice. When people were given the diet advice by itself, nothing changed; people ate the exact same amount of fruits and vegetables the next week. But, women who walked through a brief affirmation before receiving dietary advice ate four additional servings of fruits and vegetables during the next week! Self-affirmation makes it easier for people to respond to threatening health information and take the next step.

If people self-affirm before receiving risk information, they may be less likely to ignore advice or to have negative emotional reactions that get in the way of action.

About the Authors

Lindsay Juarez is a senior behavioral scientist in the Center for Advanced Hindsight at Duke University. She has a Ph.D. in social psychology and specializes in goal pursuit and self-control. She works with the Envolve Center’s Behavioral Economics (BE) team, which incorporates BE and social science into health-related behavioral modification programs.

Julia O’Brien is a principal behavioral scientist and leads the Better Living and Health Group at the Center for Advanced Hindsight at Duke University. She has a Ph.D. in social psychology and a background in product research. Julia loves behavioral science and believes it has the potential to solve lots of the world’s problems – especially when paired with technology and bold ideas.

About Envolve, Inc.®

Envolve, Inc.® is a family of health solutions, working together to make healthcare simpler, more effective and more accessible for everyone. As an agent for change in healthcare, Envolve is committed to transforming the health of the community, one person at a time. Envolve unifies specialty pharmacyPBMvisiondental24/7 nurse advice servicesdiabetes managementMSO solutions, and more. For more information, please visit our website or contact us at

About the Envolve Center for Health Behavior Change™

The Envolve Center for Health Behavior Change™ is a community-corporate-academic healthcare partnership that advances life-centric health research to improve lives so that communities can thrive. For more information regarding the Envolve Center for Health Behavior Change, visit