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Positive Affect and Self-affirmation Are Beneficial, but Do They Facilitate Maintenance of Health-Behavior Change?: A Self-determination Theory Perspective:  Comment on “A Randomized Controlled Trial of Positive-Affect Intervention and Medication Adherence in Hypertensive African Americans”

Geoffrey C. Williams, MD, PhD; Christopher P. Niemiec, PhD
Arch Intern Med. 2012;172(4):327-328. doi:10.1001/archinternmed.2011.1830.
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We acknowledge the efforts of Peterson et al,1 Ogedegbe et al,2 and Mancuso et al3 in developing randomized controlled trials to test the effects of an intervention that was designed to increase positive affect and self-affirmation on sustained health-behavior change. Aligned with psychosocial models of behavior change, patients in both groups received an educational workbook relevant to the clinical focus of the study, a behavioral contract committing them to behavior change, and bimonthly telephone calls intended to assist them in overcoming perceived barriers to change. Also, patients in the intervention group received small gifts and were encouraged to incorporate positive, self-affirming thoughts into their daily lives during the bimonthly telephone calls. Across the 3 trials, results showed that the intervention had a significant effect on physical activity at 12 months among patients after percutaneous coronary intervention1 but not among patients with asthma3 and that the intervention had a significant effect on medication adherence at 12 months but not on reduction in blood pressure among hypertensive African American patients.2 Such findings are the first (to our knowledge) to show a salubrious effect of induced positive affect on sustained behavior change in a clinical population.

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