title: A randomized trial of computer-based communications using imagery and text information to alter representations of heart disease risk and motivate protective behaviour.
abstract: OBJECTIVE
  Advances in web-based animation technologies provide new opportunities to develop graphic health communications for dissemination throughout communities. We developed imagery and text contents of brief, computer-based programmes about heart disease risk, with both imagery and text contents guided by the common-sense model (CSM) of self-regulation. The imagery depicts a three-dimensional, beating heart tailored to user-specific information.
  
  
  METHODS
  A 2 × 2 × 4 factorial design was used to manipulate concrete imagery (imagery vs. no imagery) and conceptual information (text vs. no text) about heart disease risk in prevention-oriented programmes and assess changes in representations and behavioural motivations from baseline to 2 days, 2 weeks, and 4 weeks post-intervention.
  
  
  METHODS
  Sedentary young adults (N= 80) were randomized to view one of four programmes: imagery plus text, imagery only, text only, or control. Participants completed measures of risk representations, worry, and physical activity and healthy diet intentions and behaviours at baseline, 2 days post-intervention (except behaviours), and 2 weeks (intentions and behaviours only) and 4 weeks later.
  
  
  RESULTS
  The imagery contents increased representational beliefs and mental imagery relating to heart disease, worry, and intentions at post-intervention. Increases in sense of coherence (understanding of heart disease) and worry were sustained after 1 month. The imagery contents also increased healthy diet efforts after 2 weeks. The text contents increased beliefs about causal factors, mental images of clogged arteries, and worry at post-intervention, and increased physical activity 2 weeks later and sense of coherence 1 month later.
  
  
  CONCLUSIONS
  The CSM-based programmes induced short-term changes in risk representations and behaviour motivation. The combination of CSM-based text and imagery appears to be most effective in instilling risk representations that motivate protective behaviour.
authors.affiliation: Department of Psychology, The University of Auckland, Auckland, New Zealand.
authors.forename: Tarryn J
authors.initials: TJ
authors.lastname: Lee
authors.forename: Linda D
authors.initials: LD
authors.lastname: Cameron
authors.forename: Burkhard
authors.initials: B
authors.lastname: Wünsche
authors.forename: Carey
authors.initials: C
authors.lastname: Stevens
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D003194:Computer-Assisted Instruction / Q000379:methods; D054626:Consumer Health Information / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D058015:Health Communication / Q000379:methods*; D006331:Heart Diseases / Q000517:prevention & control* / Q000523:psychology; D006801:Humans; D019018:Imagery, Psychotherapy / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods; D033182:Intention; D020407:Internet; D008297:Male; D009042:Motivation; D009043:Motor Activity; D009520:New Zealand; D010353:Patient Education as Topic / Q000379:methods; D015397:Program Evaluation / Q000379:methods; D012307:Risk Factors; D055815:Young Adult