ArticlePsychology & health2018
Positive affective processes underlie positive health behaviour change.
Article in Psychology & health, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 123 papers, 4 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
123 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- An individual participant data meta-analysis of how physical activity relates to affective well-being in daily life.Nature human behaviour · 2026Pooled it
- Can positive psychological interventions improve health behaviors? A systematic review of the literature.Preventive medicine · 2022Pooled it
- What Intervention Techniques Are Effective in Changing Positive Affective Variables and Physical Activity? A Systematic Review and Meta-Analysis.Frontiers in psychology · 2021Pooled it
- Can Positive Affective Variables Mediate Intervention Effects on Physical Activity? A Systematic Review and Meta-Analysis.Frontiers in psychology · 2020Pooled it
- Evaluating Causal and Noncausal Text Messages to Promote Physical Activity in Adults: Randomized Pilot Study.JMIR formative research · 2025Trial
- Trial
- Laughter yoga as an enjoyable therapeutic approach for glycemic control in individuals with type 2 diabetes: A randomized controlled trial.Frontiers in endocrinology · 2023Trial
- The efficacy and mechanism of positive psychological intervention on well-being for colostomy patients: a randomized controlled trial.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2022Trial
- Effectiveness of a brief hope intervention for chronic kidney disease patients on the decisional conflict and quality of life: a pilot randomized controlled trial.BMC nephrology · 2022Trial
- The effectiveness of an online interdisciplinary intervention for mental health promotion: a randomized controlled trial.BMC psychology · 2021Trial
- Same-day, cross-day, and upward spiral relations between positive affect and positive health behaviours.Psychology & health · 2021Trial
- Behavior change: from neurobiology to behavioral change theories and back - part 2.Arquivos de neuro-psiquiatria · 2026Review
- Positive Psychotherapy for Smoking Cessation Enhanced with Text Messaging: A Randomized Controlled Trial.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2026Article
- The Role of Emotional Entitlement, Gratitude, and Social Support in Psychological Adjustment During Radiotherapy: A Longitudinal Study.Stress and health : journal of the International Society for the Investigation of Stress · 2026Article
- Examining the clustering of lifestyle factors and affect in daily life: An idiographic approach.Applied psychology. Health and well-being · 2026Article
- Navigating prognostic uncertainty with H.O.P.E.: Caring for elderly patients with chronic kidney disease.Patient education and counseling · 2026Article
- Emotional Vitality, Flourishing, and Healthy Lifestyles in Young Adults: A Longitudinal Study.International journal of behavioral medicine · 2026Article
- Disentangling Positive Affect Heterogeneity in a Digital Physical Activity Intervention for Young Adult Cancer Survivors: A Group-Based Multi-Trajectory Modeling Approach.Psycho-oncology · 2026Observational
- Protection from Chronic Musculoskeletal Pain: A Scoping Review.European journal of pain (London, England) · 2026Article
- Chatbot-based interventions for improvement of diet, physical activity, and tobacco use behaviors: protocol for a systematic review.Systematic reviews · 2026Article
63 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
Positive health behaviours such as physical activity can prevent or reverse many chronic conditions, yet a majority of people fall short of leading a healthy lifestyle. Recent discoveries in affective science point to promising approaches to circumvent barriers to lifestyle change. Here, we present a new theoretical framework that integrates scientific knowledge about positive affect with that on implicit processes. The upward spiral theory of lifestyle change explains how positive affect can facilitate long-term adherence to positive health behaviours. The inner loop of this spiral model identifies nonconscious motives as a central mechanism of behavioural maintenance. Positive affect experienced during health behaviours increases incentive salience for cues associated with those behaviours, which in turn, implicitly guides attention and the everyday decisions to repeat those behaviours. The outer loop represents the evidence-backed claim, based on Fredrickson's broaden-and-build theory, that positive affect builds a suite of endogenous resources, which may in turn amplify the positive affect experienced during positive health behaviours and strengthen the nonconscious motives. We offer published and preliminary evidence in favour of the theory, contrast it to other dominant theories of health behaviour change, and highlight attendant implications for interventions that merit testing.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.