conscientiousness) and at family dynamics (e.g. Matthews et al., 1996). There is also
a need to consider the effects of multiple personality traits simultaneously. For example,
little research has attempted to examine the simultaneous influence of the ‘Big Five’
traits even though they show some degree of intercorrelation.
Several other personality traits have been linked to health outcomes (see Ferguson,
2013 for detailed discussion). For example, type D and alexithymia are associated with
increased risk of developing cardiovascular disease (e.g. Denollet et al., 1996; Waldstein
et al., 2002). However, the precise pathways and importance of these variables have
been criticized by other researchers (e.g. see Grande et al., 2012). Other personality
traits may have important implications for health-related communication but have been
less thoroughly investigated. Consideration of future consequences (CFC) has been
identified as being important to people’s understanding of health promotion
interventions. People high in CFC tend to sacrifice immediate benefits in order to
achieve desirable future outcomes, whereas people low in CFC place less value on
long-term outcomes and are more concerned with maximizing immediate benefits.
It is generally found that low CFC individuals prefer options where gains are immediate
and losses occur in the future, while high CFC individuals prefer the opposite, where
losses are immediate and gains occur in the future. Earlier research has indicated that
CFC moderates the persuasive impact of communication messages (Orbell, Perugini
and Rakow, 2004; Orbell and Hagger, 2006). Orbell et al.(2004) manipulated the
time frame in which the costs and benefits of colorectal cancer screening occurred and
found that participants low in CFC had greater intentions to participate when the
positive consequences were short term and negative consequences long term. The
opposite was true for high CFC individuals. Nevertheless, surprisingly little recent
research has examined the role of CFC within the context of conventional health
psychological interventions (e.g. see Covey, 2014). Therefore, there remains an urgent
need to tailor health behaviour interventions to different personality traits and
dispositional factors. Modern technologies such as the Internet and email could be used
to achieve this. For example, future research should focus on developing brief, theory-
driven, inexpensive, web-based interventions. These should be tailored to individual
characteristics, to change health behaviours and to raise awareness of serious health
problems (e.g. high blood pressure).
Research into behaviour change has begun to distinguish between initiation and
maintenance of health behaviours (see Conner and Norman, 2005, 2015). Considerable
research with social cognition models has focused on the initiation of health behaviour
(see Chapter 7). When health benefits are associated with one-off performance (e.g.
immunization) this research is immediately relevant to intervention. However, for
many health behaviour patterns (e.g. healthy eating, exercise) there is little or no health
benefit unless the behaviour is performed and maintained over a prolonged period of
time (Conner and Norman, 2005, 2015). In such cases initiation is necessary, but not
sufficient for health benefits to accrue. Further research on behaviour change
maintenance and habit formation is needed (see Chapter 9). For example, are the
psychological processes that prompt initiation continuous with or distinct from those
sustaining maintenance? The evidence is mixed. In a meta-analytic review of the
protection motivation theory, Floyd et al.(2000) reported that response efficacy and
self-efficacy showed similar sized effects for both initiation and maintenance, although
the number of studies on maintenance was modest. Sheeran, Conner and Norman
258 RELATING TO PATIENTS