Potential role of cannabis in ameliorating observed racialized disparities in cancer pain management.

Cancer-related pain affects a large proportion of all patients with cancer yet remains inadequately managed, particularly among patients from certain racialized backgrounds. Recently, there has been increased research and clinical interest in the use of medical cannabis for cancer pain management, including its potential to ameliorate race-based disparities in cancer pain control. Although medical cannabis is not currently a US Food and Drug Administration-approved treatment option for cancer-related pain, many oncologists discuss and recommend its use with their patients, underscoring the need for researchers and clinicians to proactively identify barriers to cannabis for cancer pain management that may disproportionately affect patients from certain racial groups. In this commentary, we highlight challenges that patients from racialized backgrounds may face when incorporating cannabis into their palliative care regimens and discuss opportunities for researchers and clinicians to address these challenges should medical cannabis become a recommended treatment option for cancer pain management. In particular, we identify challenges at the structural (eg, lack of insurance coverage), clinician (eg, racialized stereotypes regarding addiction and pain), and individual (eg, internalized stigma) levels and emphasize the importance of multilevel approaches in combating these challenges as the evidence base regarding medical cannabis and its potential harms and therapeutic benefits continues to accumulate.

The Association of Context with Reported Self-Efficacy for Cancer-Preventive Behaviors and Perceived Cancer Risk in U.S. Adults from the Midlife in the United States (MIDUS) Study.

Background: Cancer is one of the leading causes of death in the United States. It is critical to understand the associations among multilevel determinants of cancer prevention and control behaviors. This study examined associations of neighborhood factors with perceived risk of cancer and self-efficacy for reducing cancer risk. Methods: Cross-sectional analyses included 2324 U.S. adults from the Midlife in the U.S. Wave 3. Participants completed surveys of neighborhood environment (perceived neighborhood trust and safety, built environment conditions, social integration), perceived cancer risk and cancer prevention efficacy. Multivariate linear regressions examined associations of neighborhood context with risk perceptions and self-efficacy. Results: In the model that adjusted for sociodemographic characteristics, better perceived neighborhood trust and safety were associated with lower perceived cancer risk. In fully adjusted models for sociodemographic characteristics and contextual factors, higher perceptions of neighborhood trust and safety were associated with higher cancer prevention self-efficacy. Perceptions of better built neighborhood conditions and higher social integration were significantly associated with lower perceived cancer risk and higher perceived cancer prevention efficacy. Conclusions: Perceptions of neighborhood context may play a role in shaping psychosocial factors such as perceived cancer risk and self-efficacy, even after controlling for robust predictors of these perceptions.

Affective Science Research: Perspectives and Priorities from the National Institutes of Health.

Affective science is a broad and burgeoning field, and the National Institutes of Health (NIH) support research on a similarly broad range of topics. Across NIH, funding is available for basic, translational, and intervention research, including research in non-human animals, healthy populations, and those with or at risk for disease. Multiple NIH Institutes and Centers have specific programs devoted to topics within the affective science umbrella. Here, we introduce the funding priorities of these six: the National Cancer Institute (NCI), National Center for Complementary and Integrative Health (NCCIH), National Institute of Mental Health (NIMH), National Institute on Aging (NIA), National Institute on Drug Abuse (NIDA), and National Institute on Minority Health and Health Disparities (NIMHD). We then discuss overlapping themes and offer a perspective on promising research directions.

SIO-ASCO guideline on integrative medicine for cancer pain management: implications for racial and ethnic pain disparities.

Racial and ethnic disparities in pain management pose major challenges to equitable cancer care delivery. These disparities are driven by complex interactions between patient-, provider-, and system-related factors that resist reductionistic solutions and require innovative, holistic approaches. On September 19, 2022, the Society for Integrative Oncology and the American Society of Clinical Oncology published a joint guideline to provide evidence-based recommendations on integrative medicine for cancer pain management. Integrative medicine, which combines conventional treatments with complementary modalities from cultures and traditions around the world, are uniquely equipped to resonate with diverse cancer populations and fill existing gaps in pain management. Although some complementary modalities, such as music therapy and yoga, lack sufficient evidence to make a specific recommendation, other modalities, such as acupuncture, massage, and hypnosis, demonstrated an intermediate level of evidence, resulting in moderate strength recommendations for their use in cancer pain management. However, several factors may hinder real-world implementation of the Society for Integrative Oncology and the American Society of Clinical Oncology guideline and must be addressed to ensure equitable pain management for all communities. These barriers include, but are not limited to, the lack of insurance coverage for many complementary therapies, the limited diversity and availability of complementary therapy providers, the negative social norms surrounding complementary therapies, the underrepresentation of racial and ethnic subgroups in the clinical research of complementary therapies, and the paucity of culturally attuned interventions tailored to diverse individuals. This commentary examines both the challenges and the opportunities for addressing racial and ethnic disparities in cancer pain management through integrative medicine.

Support-Giving Is Associated With Lower Systemic Inflammation.

BACKGROUND: Support-giving has emerged as a health-relevant social behavior, such that giving more support is associated with better physical health. However, biological mechanisms by which support-giving and health are linked remain unclear. Whether support-giving uniquely relates to health relative to other psychosocial factors is also an open research question. PURPOSE: Two studies test the hypothesis that support-giving is uniquely (over-and-above other psychosocial factors) related to lower systemic inflammation, a biological correlate of health. METHODS: Cross-sectional associations of support-giving with markers of systemic inflammation (i.e., interleukin-6 [IL-6], C-reactive protein [CRP]) were examined in two independent samples of midlife adults (Study 1, n = 746; Study 2, n = 350). RESULTS: Consistent with hypotheses, giving to more social targets (to family and friends, and also volunteering for various causes), but not receiving support from similar targets, was associated with lower IL-6. In conceptual replication and extension with a different measure of support-giving, higher frequency of support-giving behavior was associated with lower IL-6, even after adjusting for social network size and individual differences in social desirability. There were no associations between support-giving and CRP in either sample. CONCLUSIONS: Future research needs to establish causality and directly test mechanistic pathways, but together, findings reaffirm the health-relevance of support-giving behavior and shed light on a promising biological mechanism by which such effects may occur.

Support-giving behavior and health are linked such that more support-giving is related to better health and longevity for the person giving. How such a link occurs, however, is an open question for research. Two cross-sectional studies test the hypothesis that support-giving behavior relates to lower systemic inflammation, a potential biological pathway linking supportive behavior with health. Results of Study 1 show that giving to more social targets (to family and friends, and also volunteering) is associated with lower inflammation. Receiving support was not associated with inflammation. In a replication and extension, Study 2 shows that a greater frequency of giving is also related to lower systemic inflammation, over and above the size of one's social network and individual differences in reporting socially desirable responses. Although more research is needed to establish whether support-giving causes systemic inflammation to change, the current findings highlight a promising pathway by which support-giving behavior benefits health.

Sun protection behavior: health impact, prevalence, correlates and interventions.

Sun protection behavior can reduce skin cancer risk. This paper provides an overview of skin cancer risk and the complex behavioral options for sun protection, along with a narrative review of research on determinants of, and interventions to promote, sun protection. Gaps and opportunities for future research are also outlined. Evidence supports the effectiveness of sunscreen use, ultraviolet (UV) protection clothing, and shade seeking. However, these behaviors are complex and are often performed in ways that are inadequate for sun protection. Most research examining and targeting determinants of sun protection behavior has focused on sunscreen use, to the exclusion of other strategies, and has largely ignored the complexity of even sunscreen use. Most research and interventions are theory- driven, drawing on social cognitive constructs, but also considering self and social identity and emotion. Multilevel perspectives considering context, environment, policies, and other structural contexts have also been applied to sun protection behavior, but there is a need to combine psychological constructs with factors at other levels to optimize predictive models and intervention effectiveness. Effective sun protection effectively involves complex behaviors and perceived and actual tradeoffs that should be considered, in combination with multilevel determinants, in research predicting and promoting sun safety.

Responsive social support serves important functions in clinical communication: Translating perspectives from relationship science to improve cancer clinical interactions.

Patient-clinician interactions are critical to patient-centered care, including in cancer care contexts which are often defined by multiple patient-clinician interactions over an extended period. Research on these dyadic interactions has been guided by perspectives in clinical communication science, but the study of clinical communication has not been fully integrated with perspectives on interpersonal interactions from relationship science research. An overlapping concept in both fields is the concept of responsive socialsupport. In this article, we discuss responsiveness as a concept that offers opportunities for connections between these two disciplines. Next, we focus on how relationship science can be applied to research in clinical settings. We discuss how three areas of relationship science define responsiveness and have potential for extension to clinical communication: (1) (in)visibility of social support, (2) attachment orientations, and (3) shared meaning systems. We also discuss how social biases can impede responsiveness and suggest research avenues to develop ideas and understand potential challenges in connecting these two fields. Many opportunities exist for interdisciplinary theory development that can generate momentum in understanding interpersonal processes in cancer care.

Understanding responses to different types of conflicting information about cancer prevention.

BACKGROUND: Individuals are regularly exposed to conflicting information about health; however, understanding of how individuals respond to different types of conflicting information is limited. METHODS: In total, 1027 US adults were randomly assigned to 1 of 8 conflicting information messages about nutrition and cancer risk, depicting 1/4 conflicting information types (conflict in evidence - sources A and B agree the evidence is mixed; conflict between two expert sources - sources A and B present conflicting evidence about nutrition and cancer risk; conflict within the same expert source - source A changes its own recommendation about the evidence; no conflict control) crossed by 1/2 baseline recommendations with which new information conflicted (limit vs. do not limit red meat intake to reduce cancer risk). RESULTS: Compared to the control, each conflicting information type led to lower perceived scientific consensus about how much red meat one should eat (p < .001); conflict in evidence (p = .004) and between sources (p = .006) led to lower trust in scientists. Intentions to consume red meat more frequently were higher in the conflicting information conditions than control in the group initially told to "limit red meat" and lower in the "do not limit red meat" group (p = .022). Conflict within the same source led to higher perceived scientific consensus compared to conflict in evidence (p = .007) and between sources (p = .013); it also lowered intentions to consume red meat more frequently compared to conflict in evidence, but only in the "do not limit red meat" condition (p = .033). Conflict in evidence (p = .007) and within the same source (p = .013) increased cancer fatalism compared to conflict between sources. CONCLUSIONS: Conflict in scientific evidence and conflict arising from the same expert source (e.g., a changing public health guideline) may have pernicious effects. Future efforts could investigate how best to publicly communicate these instances of scientific conflict to minimize negative impact.

Analysis of the components of cancer risk perception and links with intention and behaviour: A UK-based study.

Risk perception refers to how individuals interpret their susceptibility to threats, and has been hypothesised as an important predictor of intentions and behaviour in many theories of health behaviour change. However, its components, optimal measurement, and effects are not yet fully understood. The TRIRISK model, developed in the US, conceptualises risk perception as deliberative, affective and experiential components. In this study, we aimed to assess the replicability of the TRIRISK model in a UK sample by confirmatory factor analysis (CFA), explore the inherent factor structure of risk perception in the UK sample by exploratory factor analysis (EFA), and assess the associations of EFA-based factors with intentions to change behaviour and subsequent behaviour change. Data were derived from an online randomised controlled trial assessing cancer risk perception using the TRIRISK instrument and intention and lifestyle measures before and after communication of cancer risk. In the CFA analysis, the TRIRISK model of risk perception did not provide a good fit for the UK data. A revised model developed using EFA consisted of two separate "numerical" and "self-reflective" factors of deliberative risk perception, and a third factor combining affective with a subset of experiential items. This model provided a better fit to the data when cross-validated. Using multivariable regression analysis, we found that the self-reflective and affective-experiential factors of the model identified in this study were reliable predictors of intentions to prevent cancer. There were no associations of any of the risk perception factors with behaviour change. This study confirms that risk perception is clearly a multidimensional construct, having identified self-reflective risk perception as a new distinct component with predictive validity for intention. Furthermore, we highlight the practical implications of our findings for the design of interventions incorporating risk perception aimed at behaviour change in the context of cancer prevention.

Cancer clinical trial providers' perspectives on communicating goals of care: A key informant study.

Objectives: There has been limited research to date exploring provider communication in the context of cancer clinical trials. To elucidate multidisciplinary care providers' experiences, this qualitative study sought to understand their perspectives and communication patterns around goals of care discussions with patients enrolled in cancer clinical trials. Methods: Semi-structured key informant interviews were conducted with a purposive sample of physicians, nurse practitioners, social workers, chaplains, nurses, and administrative staff in a cancer research hospital (N=19). Data were analyzed and interpreted using thematic analysis. Results: Providers hold varied perspectives on goals of care in cancer clinical trials, highlighting the tension and potential for misalignment between scientific and clinical (patient-centered) goals. Inherent institutional hierarchies may impede some team members from initiating goal discussions. Care transitions (e.g., stopping treatment or initiating hospice) offer critical opportunities for goals of care discussions. Conclusion: Conflicting perspectives among team members, perceptions of provider roles, and communication patterns could help explain some of the communication challenges previously documented in advanced cancer and clinical trial care. Innovation: This qualitative study contributes to the literature on healthcare team communication in the clinical trial context and highlights tangible opportunities to better leverage providers' diverse experience and improve patient-centered care.

Patient Perspectives on the Risk-Based NLST Outcomes Tool for Lung Cancer Screening.

Researchers at the NCI have developed the Risk-Based NLST Outcomes Tool (RNOT), an online tool that calculates risk of lung cancer diagnosis and death with and without lung cancer screening, and false-positive risk estimates. This tool has the potential to facilitate shared decision making for screening. The objective of this study was to examine how current heavy and former smokers understand and respond to personalized risk estimates from the RNOT. Individuals who were eligible for lung cancer screening and were visiting Walter Reed National Military Medical Center were invited to participate in a semi-structured interview to assess their experiences with and perceptions of the RNOT. Results were analyzed using template analysis. Participants found their risk of lung cancer death to be lower than anticipated and were confused by changes in risk for lung cancer diagnosis with and without screening. Most participants indicated that the RNOT would be helpful in making screening decisions, despite reporting that there was no maximum risk for a false positive that would lead them to forgo lung cancer screening. Participants provided actionable needs and recommendations to optimize this tool. Risk-based screening tools may enhance shared decision making. The RNOT is being updated to incorporate these findings.

Smoking self-concept moderates the effects of self-affirmation on smoking-related beliefs and behavioral intentions.

OBJECTIVE: Smoking stigmatization has been shown to hinder cigarette smoking cessation, especially among individuals with a strong smoker identity. Self-affirmation, a psychological threat-management coping strategy, can promote smoking cessation, and may mitigate the adverse consequences of stigmatization. DESIGN: Data from an online sample of 1,020 U.S. adult smokers were analyzed using multiple linear regression. MAIN OUTCOME MEASURES: Participants completed a self-affirmation (or no-affirmation control) writing task before viewing a smoking stigma (or non-stigma control) anti-smoking public service announcement video. Participants then reported smoking-related cognitions and behavioral intentions. RESULTS: Among participants with strong-but not weak-ties to a smoker identity (smoking self-concept), self-affirming led to higher quit intentions compared to the control condition. Among participants with weak-but not strong-smoking self-concepts, those who self-affirmed had lower intentions to switch completely to e-cigarettes relative to the control condition. Exposure to stigmatization reduced intentions to seek cessation counseling, particularly among those with weak smoking self-concepts. CONCLUSION: Findings demonstrate the critical role that smoking identity centrality plays in moderating reactions to both affirming and stigmatizing stimuli. Additional research is needed to better understand how self-affirmation and stigma-reduction interventions can be tailored and implemented in natural contexts.

Decision-making about genetic health information among family dyads: a systematic literature review.

Decisions involving two individuals (i.e., dyadic decision-making) have been increasingly studied in healthcare research. There is evidence of bi-directional influences in decision-making processes among spousal, provider-patient and parent-child dyads. Genetic information can directly impact biologically related individuals. Thus, it is important to understand dyadic decision-making about genetic health information among family members. This systematic literature review aimed to identify literature examining decision-making among family dyads. Peer-reviewed publications were included if they reported quantitative empirical research on dyadic decision-making about genetic information, published between January 1998 and August 2020 and written in English. The search was conducted in 6 databases and returned 3167 articles, of which 15 met the inclusion criteria. Most studies were in the context of cancer genetic testing (n = 8) or reproductive testing or screening (n = 5). Studies reported two broad categories of decisions with dyadic influence: undergoing screening or testing (n = 10) and sharing information with family (n = 5). Factors were correlated between dyads such as attitudes, knowledge, behaviors and psychological wellbeing. Emerging evidence shows that dyad members influence each other when making decisions about receiving or sharing genetic information. Our findings emphasize the importance of considering both members of a dyad in intervention design and clinical interactions.

Self-affirmation inductions to reduce defensive processing of threatening health risk information.

OBJECTIVE: Self-affirmation reduces defensiveness toward threatening health messages. In this study, we compared several possible self-affirmation inductions in order to identify the most effective strategy. DESIGN: Women at increased risk for breast cancer (i.e. who drink 7+ drinks per week) were recruited through Amazon Mechanical Turk (N = 1,056), randomly assigned to one of 11 self-affirmation conditions, and presented with an article about the link between alcohol intake and breast cancer risk. MAIN OUTCOME MEASURES: Participants answered questions that measured key indices of message acceptance (risk perception, message endorsement), future alcohol consumption intentions, and action plans to reduce alcohol intake. RESULTS: Participants who affirmed health vs. non-health values did not differ in behavioral intentions or action plans to reduce alcohol intake. General values vs. health essay affirmations led to higher odds of reporting some vs. no action plans to reduce alcohol consumption. Essay- vs. questionnaire-based inductions led to higher breast cancer worry and intentions to reduce alcohol consumption. CONCLUSION: Overall, self-affirmation inductions that include an explicit focus on values (general or health-related) and self-generation of affirming thoughts through essay writing, are most potent in changing behavioral intentions and action plans to change future health behavior.

Associations between absolute and relative electronic cigarette harm perceptions and information-seeking behaviours among US adult current, former and never smokers.

INTRODUCTION: Electronic cigarette (e-cigarette) harm perceptions and information seeking behaviours are both important antecedents of e-cigarette use, yet the relationship between them has been rarely studied. We assessed how absolute (e-cigarettes are harmful to my health) and relative harm perceptions (e-cigarettes are more/less harmful than cigarettes) were associated with specific e-cigarette information seeking behaviours in a sample of current, former and never cigarette smokers. METHODS: We used data from US adults in two cycles of the Health Information National Trends Survey (HINTS-FDA 2015, n = 3738; 2017, n = 1736). Analyses controlled for socio-demographics, ever e-cigarette use and survey cycle. Data were analysed between January and August 2020. RESULTS: Higher relative harm perceptions were associated with lower odds of having sought any information on e-cigarettes [adjusted odds ratio 0.61, 95% confidence interval (0.48, 0.84)] and on how to use e-cigarettes to quit smoking specifically [adjusted odds ratio 0.59, 95% confidence interval (0.38, 0.91)]. Smoking status did not moderate associations between absolute or relative harm perceptions and information seeking behaviours, nor was it associated with specific information seeking behaviours after adjusting for covariates. DISCUSSION AND CONCLUSIONS: The risks of e-cigarettes relative to combusted cigarettes (as opposed to the absolute risks of e-cigarettes) appear to be more important in individuals' information seeking behaviours about e-cigarettes. Public health messages could ensure that all individuals understand how one's health risk would change if they exclusively used e-cigarettes, switched to e-cigarettes completely or used both products.

Opportunities for theory-informed decision science in cancer control.

Cancer prevention and control involves navigation of complex clinical decisions, often laden with uncertainty and/or intricate interpersonal dynamics, which have implications for both physical health and quality of life. Cancer decision-making research in recent decades has primarily focused on working to improve the quality of decisions by providing patients with detailed information about their choices and through an increased emphasis in medicine on the importance of shared decision making. This emphasis is reflective of a model of decision making that emphasizes knowledge, options, and deliberative synthesis of information as primary to decision making; yet, decades of research in psychology, decision science, and behavioral economics have taught us that our decisions are not influenced only by our objective knowledge of facts, but by our emotions, by the influence of others, and by biased cognitive processes. We present a conceptual framework for a future of research in decision science and cancer that is informed by decision science theories. Our framework incorporates greater recognition of the interpersonal dynamics of shared decision making, including the biases (including cognitive heuristics and race-based bias) that may affect multiple actors in the decision-making process, and emphasizes study of the interaction between deliberative and affective psychological processes as they relate to decision making. This work should be conducted with an eye toward informing efforts to improve decision making across the cancer care continuum, through interventions that are also informed by theory.

Decision Science Can Inform Clinical Trade-Offs Regarding Cardiotoxic Cancer Treatments.

Cancer treatment-related cardiotoxicity (ie, heart failure, coronary artery disease, vascular diseases, arrhythmia) is a growing cancer survivorship concern within oncology practice; heart disease is the leading cause of noncancer death in cancer survivors and surpasses cancer as the leading cause of death for some cancers with higher survival rates. The issue of cardiotoxicity introduces a critical tradeoff that must be acknowledged and reconciled in clinical oncology practice: treating cancer aggressively and effectively in the present vs preventing future cardiotoxicity. Although many cancers must be treated as aggressively as possible, for others, multiple treatment options are available. Yet even when effective and less cardiotoxic treatments are available, they are not always chosen. Wariness to choose equally effective but less cardiotoxic treatment options may result in part from providers' and patients' reliance on "cognitive heuristics," or mental shortcuts that people (including, research shows, medical professionals) use to simplify complex judgments. These heuristics include delay discounting, availability and affect heuristics, and default bias. In the current commentary, we describe relevant research that illuminates how use of heuristics leads to biased medical decision making and translate how this research may apply when the tradeoff between aggressive cancer treatment and preventing future cardiotoxicity is considered. We discuss the implications of these biases in oncology practice, offer potential solutions to reduce bias, and call for future research in this area.

Association of Spontaneous and Induced Self-Affirmation With Smoking Cessation in Users of a Mobile App: Randomized Controlled Trial.

BACKGROUND: Most smokers attempt to stop using cigarettes numerous times before successfully quitting. Cigarette cravings may undermine perceived competence to quit and thus constitute psychological threats to the individual's self-concept. Self-affirmation may promote smoking cessation by offsetting these threats. OBJECTIVE: This study examines whether self-affirmation is associated with smoking cessation in the context of a cessation app. Two types of self-affirmation are examined: tendency to spontaneously self-affirm, and self-affirmation inductions added to a publicly available smoking cessation app (Smoke-Free Quit Smoking Now). In addition, this study explores whether optimism and emotional states (happiness, anger, anxiousness, hopefulness, sadness) predict smoking cessation. METHODS: All users who met the inclusion criteria, provided consent to participate, and completed a baseline assessment, including all individual difference measures, were randomized to 1 of 4 conditions. Half of the participants were randomly assigned to complete a self-affirmation induction upon study entry. Orthogonally, half of the participants were randomly assigned to receive self-affirming text notifications during their quit attempt or to receive conventional notifications. The induction and the text notifications were fully automated, and all data were collected through self-assessments in the app. Self-reported smoking cessation was assessed 1 month and 3 months following study entry. RESULTS: The study enrolled 7899 participants; 647 completed the 1-month follow-up. Using an intent-to-treat analysis at the 1-month follow-up, 7.2% (569/7899) of participants self-reported not smoking in the previous week and 6.4% (503/7899) self-reported not smoking in the previous month. Greater tendency to spontaneously self-affirm predicted a greater likelihood of cessation (P<.001) at 1 month after controlling for smoking-related variables. Neither self-affirmation induction influenced cessation. In addition, spontaneous self-affirmation did not moderate the relationship between self-affirmation inductions and cessation. Greater baseline sadness was associated with a lower likelihood of reporting successful cessation. Optimism predicted past-week cessation at the 1-month follow-up, and both happiness and anger predicted past-month cessation at the 1-month follow-up; however, none of these potential predictors moderated the relationship between self-affirmation conditions and successful cessation. CONCLUSIONS: Spontaneous self-affirmation may be an important psychological resource for managing threats to self-concept during the smoking cessation process. Sadness may hinder quit attempts. Future research can explicate how spontaneous versus induced self-affirmation can promote smoking cessation and examine boundary conditions for the effectiveness of disseminated self-affirmation interventions. TRIAL REGISTRATION: ISRCTN Registry 56646695; https://www.isrctn.com/ISRCTN56646695.

Greater benefit of self-affirmation for prevention-focused individuals prior to threatening health messages.

OBJECTIVE: Individuals are often defensive toward health messages that suggest they are putting their health at risk because such messages threaten their self-competence and integrity. Although self-affirmation can facilitate prevention behaviors in response to health messages, effects are variable. We examined whether disease prevention focus might strengthen self-affirmation's effects in response to disease prevention messages, given that prevention-focused individuals are likeliest to be persuaded by those messages after self-affirmation attenuates defensiveness. DESIGN: In Study 1, participants were self-affirmed before a message about sexually transmitted infections. In Studies 2 and 3, individuals were self-affirmed prior to a message about alcohol and cancer risk. MAIN OUTCOME MEASURES: Studies assessed intentions to use condoms, intentions to reduce alcohol, and willingness to drink alcohol in specific scenarios. RESULTS: In Study 1, self-affirmation facilitated condom use intentions among those higher in prevention focus. In Studies 2 and 3, self-affirmation facilitated lower willingness to consume alcohol among those high in prevention focus. A meta-analysis across the three studies indicated that self-affirmation improved intentions and willingness under high, but not low, prevention focus (d = 0.20, p = .003). CONCLUSION: These findings demonstrate that health prevention-focus can strengthen self-affirmation's effects, thereby improving responsiveness to health communications about behaviors that increase disease risk.