Improving Health-Related Decision Making Through Anticipation of Future Emotions: A Unified Approach

People often make short-sighted decisions or decide not to do things they should, like getting vaccinated against influenza or responding to an invitation for a screening appointment.? Indeed, a major public health challenge is to support people to make better decisions.?
We will integrate two different approaches to helping people make healthful decisions. One approach asks people to imagine their personal future experiences in rich and detailed ways. This ‘pre-experiencing’ of the future is known as Episodic Future Thinking (EFT).? Psychological studies consistently show that encouraging people to engage in EFT results in less shortsighted decision-making. There is currently substantial interest in whether such an approach can be scaled up into interventions that help real-world health-related decisions. However, we do not yet understand why EFT works.?
The other approach asks people to anticipate the unpleasant regret they might feel about making a specific decision, such as deciding to forgo vaccination. A long history of such work contains both successful and unsuccessful attempts to use anticipated regret to support healthful decisions. Unfortunately, we do not yet understand why such interventions sometimes fail.
This project will put these two approaches together within a new framework for explaining how future-related thinking supports decision making. This framework will help researchers (1) understand when, why, and for whom such approaches work, and (2) inform the design of more effective interventions to improve healthful decision-making.
The central idea is that people may anticipate a range of emotions occurring at various points along a timeline in the future and weigh them in decision-making, and that EFT can enhance such anticipation. In the context of a set of health-related decisions, including decisions about health screening, vaccination, and cancer checks, our studies will test whether (1) prompting the anticipation of decision-related emotions is most effective when people are encouraged to episodically imagine the emotional experiences, and (2) one reason EFT is beneficial is because it can facilitate the anticipation of emotions that occur after (as well as before or during) an outcome. Such emotions include not just regret: we hypothesise that imagining the pleasurable emotion of relief might be also effective, although little is currently known about relief anticipation.?
The studies will also test whether cognitive differences between people’s ability to think in ways that underlie EFT or the anticipation of emotions such as regret and relief determine effectiveness.
Finally, because both good and bad health-related decisions may have emotional consequences at various points along a future timeline, we will study the spontaneous future thinking that people engage in when making health-related decisions, helping us to identify the emotions and time-points it is most beneficial to anticipate. We will use this information to pilot a novel intervention combining EFT and anticipated emotion designed to direct decision-makers’ attention towards particular periods along a timeline into the future as they make decisions about their health.?
Our project should have very significant theoretical implications as it seeks to situate and extend EFT and anticipated emotion interventions for decision-making in a novel and integrated theory. We also anticipate that our findings will deliver the basis for a whole series of novel interventions for healthful behaviour. We will make links with practitioners and applied psychologists with the aim of developing future collaborations so that our discoveries can be scaled up for real world application.