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AbstractPriming examinees with questions about intended effort prior to testing has been shown to significantly increase examinee expended effort via self-reported effort and response-time effort. However, this question-behavior effect seems to wear off later in a testing session. We examined whether administering a second “dose” of the question-behavior effect could combat the decrease in examinee effort later in a testing session. We randomly assigned examinees to one of three question conditions prior to completing two low-stakes tests: answering three questions about intended effort directly before the first test in a session, answering three questions about intended effort directly before each test in a session, and answering no priming questions (control). Administering a second dose of questions directly before the second test in a session significantly increased response-time effort and self-reported effort for the more difficult test. This simple administration of multiple sets of questions throughout a testing session appears to combat issues with low effort on difficult tests that are administered later in a testing session. [ABSTRACT FROM AUTHOR]

AbstractWe examined the utility of a question-behavior effect (QBE) intervention on test-taking effort. Questioning individuals about future behavior influences the subsequent performance of that behavior. Previous research found this intervention to significantly increase test-taking effort for incoming university students but it was unknown if it would be effective for more advanced college students or differentially effective across gender identities. Thus, 503 more advanced college students were randomly assigned to one of three question conditions prior to completing a low-stakes test: answering five questions regarding intended effort prior to testing, answering five questions regarding intended effort that referenced positive self-identity prior to testing, or a no-question control condition. We then administered a multiple-choice test and collected two measures of test-taking effort: self-reported effort and response time. We found that students identifying as female had significantly and practically higher self-reported effort and response time when in the question conditions compared to the no question condition. There was no effect of condition for students identifying as male for either measure of test-taking effort. Implications for practically increasing motivation on low-stakes tests and surveys, especially for more advanced students, are discussed. Implications for QBE theory, including differential effects related to gender, are discussed. [ABSTRACT FROM AUTHOR]

Questioning individuals about future behavior influences the subsequent performance of that behavior. This question-behavior effect may be enhanced when questions include positive self-identity prompts. To evaluate the effectiveness of this intervention in a testing context, we randomly assigned examinees to one of three conditions prior to completing a low-stakes test: answering five questions regarding intended effort prior to the test, answering five questions regarding intended effort that referenced positive self-identity prior to the test, or a control condition. We then administered two multiple-choice tests and collected two measures of test-taking effort: self-reported effort and response time effort. Answering questions about effort prior to completing the tests resulted in higher self-reported effort and perceived test importance. Moreover, in the question conditions, significantly fewer examinees were identified to be filtered from the dataset due to low effort. The easy strategy of asking examinees to report their intended effort appears to increase test-taking effort. [ABSTRACT FROM AUTHOR]

Older adults process and remember positive information relatively better than negative information, compared with younger adults; this is known as the positivity effect. This study examined whether older adults compared with younger adults also respond differently to positively and negatively framed questionnaire items. Participants (N = 275; age = 18–81 years) were randomly assigned to a positively or negatively framed version of a self-efficacy for physical activity questionnaire. Self-efficacy, physical activity intentions, and planned physical activity in the following week were regressed on experimental group and age, controlling for baseline physical activity and covariates. A significant Age × Frame interaction showed that item framing made a difference in planned physical activity for the oldest age group (+350 min compared with the youngest group). This study provides initial support for the positivity effect in item framing on physical activity plans, but not on intentions or self-efficacy. Item framing should be taken into consideration for accurate measurement, but could also be a simple intervention approach. [ABSTRACT FROM AUTHOR]

Research on pro-environmental behavior (PEB) informs social policies and interventions, so the quality of PEB measurement is critical. Self-reported PEB measures in surveys often contain non-negligible measurement error that can bias estimates and lead to incorrect findings. Given the potential presence of error, we hypothesize that changes to the way self-reported PEB is measured might lead to systematic measurement errors that affect the validity of results. Study 1 (N = 951) showed that priming participants with related scales like environmentalist identity did not substantively change reported behavior (all ds ≤ 0.12). To investigate the possibility of overreporting without priming, Study 2 (N = 385) measured littering prevention behavior using the Unmatched Count Technique. A standard questionnaire format led to much higher reported behavior compared to the more anonymous covert condition, d = 0.53, and this effect appeared driven by participants who reported a stronger environmentalist identity. These results may help to explain some of the observed error in PEB measures. We suggest that researchers could reduce measurement bias with indirect questioning techniques.

Four studies demonstrate that people are more likely to buy (but not to buy more) when directly asked how much to buy in response to a set of purchase quantities (0, 1, 2 ... n) than when first asked whether to buy in response to a seemingly innocuous yes/no purchase-interest question. This finding is explained in terms of response-scale partitioning. A purchase-quantity scale has a single negative (0) and multiple (n) positive response options. In contrast, a dichotomous yes/no purchase-interest question has an equal proportion of negative ("no") and positive ("yes") response options, the latter of which subsumes all positive quantity options into one partition. Ascertaining purchase interest using a single negative and multiple positive response options ("no," "mildly," "somewhat," "likely," "very," and "definitely") eliminated the effect. [ABSTRACT FROM AUTHOR]

Abstract: Asking people a question about performing a target behavior influences future performance of that behavior. While contextually robust and methodologically simple, this “question–behavior effect” reveals theoretical complexity as evidenced by the large number of proposed explanations for the effect. Furthermore, considerable heterogeneity exists regarding the “question” used to elicit the effect and the variety of different types of target “behaviors” for which the effect has manifested. A meta‐analytic synthesis of 104 question‐behavior studies across 51 published and unpublished papers is presented. Grouping proposed theories for the effect into four overarching categories, we derive and test systematic predictions regarding potential moderators of conceptual and practical significance. Our findings provide varying degrees of support for four different theoretical mechanisms (attitudes, consistency, fluency and motivations) proposed to underlie the effect. Insights into these mechanisms are presented and outstanding gaps in our understanding are identified as opportunities for future research.

Abstract Background Participation in an assessment may change health behavior. This “mere-measurement effect” may be used for prevention purposes. However, little is known about whether individuals’ characteristics moderate the effect. The objective was to explore whether changes of physical activity (PA) and sedentary time (ST) after a cardiovascular assessment depend on sociodemographic variables and cardiometabolic risk factors. Methods A sample of n = 175 adults aged 40 to 65 received baseline assessment including self-administered PA and ST questionnaires and standardized measurement of blood pressure, waist circumference, and blood parameters. After 5 weeks, participants again reported PA and ST without any prior treatment or intervention. Linear regression models were used to analyze the dependence of five-week changes in PA and ST on baseline sociodemographic and cardiometabolic variables. Results Men increased transport-related PA more than women (b = 9.3 MET-hours/week, P = .031). Men with higher triglycerides increased transport-related PA less than men with lower triglycerides (b = − 5.6 MET-hours/week, P = .043). Men with higher systolic blood pressure reduced ST more than those with lower systolic blood pressure (b = − 35.7 min/week, P = .028). However, this linear association ceased to exist at a level of approximately 145 mmHg (b of squared association = 1.0, P = .080). A similar relationship was found for glycated hemoglobin and ST. Conclusions The findings suggest that sex and cardiometabolic risk factors moderate mere-measurement effects on PA and ST. Researchers and practitioners using mere measurement for prevention purposes may address PA and ST according to these individual characteristics. Trial registration ClinicalTrials.gov NCT02990039 . Registered 7 December 2016. Retrospectively registered.

Abstract Background Measuring physical activity (PA) and sedentary time (ST) by self-report or device as well as assessing related health factors may alter those behaviors. Thus, in intervention trials assessments may bias intervention effects. The aim of our study was to examine whether leisure-time PA, transport-related PA, and overall ST measured via self-report vary after assessments and whether a brief tailored letter intervention has an additional effect. Methods Among a sample of subjects with no history of myocardial infarction, stroke, or vascular intervention, a number of 175 individuals participated in a study comprising multiple repeated assessments. Of those, 153 were analyzed (mean age 54.5 years, standard deviation = 6.2; 64% women). At baseline, participants attended a cardiovascular examination (standardized measurement of blood pressure and waist circumference, blood sample taking) and wore an accelerometer for seven days. At baseline and after 1, 6, and 12 months, participants completed the International Physical Activity Questionnaire. A random subsample received a tailored counseling letter intervention at month 1, 3, and 4. Changes in PA and ST from baseline to 12-month follow-up were analyzed using random-effects modelling. Results From baseline to 1-month assessment, leisure-time PA did not change (Incidence rate ratio = 1.13, p = .432), transport-related PA increased (Incidence rate ratio = 1.45, p = .023), and overall ST tended to decrease (b = − 1.96, p = .060). Further, overall ST decreased from month 6 to month 12 (b = − 0.52, p = .037). Time trends of the intervention group did not differ significantly from those of the assessment-only group. Conclusions Results suggest an effect of measurements on PA and ST. Data of random-effects modelling results revealed an increase of transport-related PA after baseline to 1-month assessment. Decreases in overall ST may result from repeated assessments. A brief tailored letter intervention seemed to have no additional effect. Thus, measurement effects should be considered when planning intervention studies and interpreting intervention effects. Trial registration ClinicalTrials.gov NCT02990039 . Registered 7 December 2016. Retrospectively registered.

Background: Participation in an assessment may change health behavior. This "mere-measurement effect" may be used for prevention purposes. However, little is known about whether individuals' characteristics moderate the effect. The objective was to explore whether changes of physical activity (PA) and sedentary time (ST) after a cardiovascular assessment depend on sociodemographic variables and cardiometabolic risk factors.Methods: A sample of n = 175 adults aged 40 to 65 received baseline assessment including self-administered PA and ST questionnaires and standardized measurement of blood pressure, waist circumference, and blood parameters. After 5 weeks, participants again reported PA and ST without any prior treatment or intervention. Linear regression models were used to analyze the dependence of five-week changes in PA and ST on baseline sociodemographic and cardiometabolic variables.Results: Men increased transport-related PA more than women (b = 9.3 MET-hours/week, P = .031). Men with higher triglycerides increased transport-related PA less than men with lower triglycerides (b = - 5.6 MET-hours/week, P = .043). Men with higher systolic blood pressure reduced ST more than those with lower systolic blood pressure (b = - 35.7 min/week, P = .028). However, this linear association ceased to exist at a level of approximately 145 mmHg (b of squared association = 1.0, P = .080). A similar relationship was found for glycated hemoglobin and ST.Conclusions: The findings suggest that sex and cardiometabolic risk factors moderate mere-measurement effects on PA and ST. Researchers and practitioners using mere measurement for prevention purposes may address PA and ST according to these individual characteristics.Trial Registration: ClinicalTrials.govNCT02990039. Registered 7 December 2016. Retrospectively registered. [ABSTRACT FROM AUTHOR]

Abstract Asking questions about a behavior has been found to influence subsequent performance of that behavior, a phenomenon termed the question-behavior effect (QBE). The present study addressed two under-researched questions concerning the QBE: (1) Can the QBE be used to change multiple health behaviors, and (2) does enhancing dissonance during questionnaire completion increase the magnitude of the QBE? Participants (N = 1534) were randomized to one of three conditions (dissonance-enhanced QBE; standard QBE; control) that targeted three health-protective behaviors (eating fruit and vegetables, physical activity, dental flossing) and three health-risk behaviors (alcohol intake, sedentariness, unhealthy snacking). The dissonance-enhanced intervention comprised a message designed to pressurize participants into forming healthful behavioral intentions. Behavior was assessed via self-reports at four-week follow up. Findings showed significant overall effects of the QBE both in increasing performance of health-protective behaviors (p =.001) and in reducing performance of health-risk behaviors (p =.04). Compared to the standard QBE condition, the dissonance-enhanced QBE intervention increased performance of health-protective behaviors (p =.04) and marginally reduced performance of health-risk behaviors (p =.07). The dissonance-enhanced QBE intervention outperformed the control condition in all analyses. This is the first report that a brief QBE intervention influences performance of multiple health behaviors. Findings supported the idea that magnifying dissonance increases the impact of the QBE. [ABSTRACT FROM AUTHOR]

Background: Measuring physical activity (PA) and sedentary time (ST) by self-report or device as well as assessing related health factors may alter those behaviors. Thus, in intervention trials assessments may bias intervention effects. The aim of our study was to examine whether leisure-time PA, transport-related PA, and overall ST measured via selfreport vary after assessments and whether a brief tailored letter intervention has an additional effect. Methods: Among a sample of subjects with no history of myocardial infarction, stroke, or vascular intervention, a number of 175 individuals participated in a study comprising multiple repeated assessments. Of those, 153 were analyzed (mean age 54.5 years, standard deviation = 6.2; 64% women). At baseline, participants attended a cardiovascular examination (standardized measurement of blood pressure and waist circumference, blood sample taking) and wore an accelerometer for seven days. At baseline and after 1, 6, and 12 months, participants completed the International Physical Activity Questionnaire. A random subsample received a tailored counseling letter intervention at month 1, 3, and 4. Changes in PA and ST from baseline to 12-month follow-up were analyzed using random-effects modelling. Results: From baseline to 1-month assessment, leisure-time PA did not change (Incidence rate ratio = 1.13, p = .432), transport-related PA increased (Incidence rate ratio = 1.45, p = .023), and overall ST tended to decrease (b = − 1.96, p = .060). Further, overall ST decreased from month 6 to month 12 (b = − 0.52, p = .037). Time trends of the intervention group did not differ significantly from those of the assessment-only group. Conclusions: Results suggest an effect of measurements on PA and ST. Data of random-effects modelling results revealed an increase of transport-related PA after baseline to 1-month assessment. Decreases in overall ST may result from repeated assessments. A brief tailored letter intervention seemed to have no additional effect. Thus, measurement effects should be considered when planning intervention studies and interpreting intervention effects. Trial registration: ClinicalTrials.gov NCT02990039. Registered 7 December 2016. Retrospectively registered. [ABSTRACT FROM AUTHOR]

Purpose Concern that asking about a specific behavior could elicit that behavior is often cited as a reason that communities and schools should not administer surveys about youth drug use. In this study, we investigated if this question-behavior effect exists related to substance use. We examined if simply asking a student about their current drug use leads to an increase in drug use 1 year later. Method This study tests the validity of the question-behavior effect on youth drug use in a longitudinal panel of 2,002 elementary school students. The sample of students was drawn from the Community Youth Development Study, a community-randomized test of the Communities That Care prevention system. If the prevalence of self-reported drug use in sixth grade in a sample surveyed in fifth and sixth grades was higher than in an accretion sample surveyed only in sixth grade, the difference could indicate a question-behavior effect. Results Results from logistic regression analyses did not provide any evidence of a question-behavior effect on 30-day or lifetime prevalence of alcohol, tobacco, inhalant, or marijuana use reported in sixth grade. Conclusions Asking youth about drug use in a survey did not increase the rates of self-reported drug use measured 1 year later. The absence of evidence of a question-behavior effect should ease concerns of communities and schools when administering surveys asking youth about their drug use. [ABSTRACT FROM AUTHOR]

The current meta-analysis estimated the magnitude of the impact of asking intention and self-prediction questions on rates of subsequent behavior, and examined mediators and moderators of this question–behavior effect (QBE). Random-effects meta-analysis on 116 published tests of the effect indicated that intention/prediction questions have a small positive effect on behavior (d+ = 0.24). Little support was observed for attitude accessibility, cognitive dissonance, behavioral simulation, or processing fluency explanations of the QBE. Multivariate analyses indicated significant effects of social desirability of behavior/behavior domain (larger effects for more desirable and less risky behaviors), difficulty of behavior (larger effects for easy-to-perform behaviors), and sample type (larger effects among student samples). Although this review controls for co-occurrence of moderators in multivariate analyses, future primary research should systematically vary moderators in fully factorial designs. Further primary research is also needed to unravel the mechanisms underlying different variants of the QBE. [ABSTRACT FROM AUTHOR]

Objective: Simply answering questions about a specific behavior may change that behavior. This is known as the mere-measurement or question-behavior effect (QBE). Our objective was to synthesize the evidence for the QBE on health-related behaviors. Method: Included studies were randomized controlled trials that tested the effect of questionnaires or interviews about health-related behaviors and/or related cognitions compared with a no-measurement control condition or another form of measurement. Subgroup analyses were conducted to identify potential moderators. Results: 41 studies were included assessing a range of health behaviors. Meta-analyses showed a small overall QBE effect (SMD = 0.09; 95% Cl [0.04, 0.13]; k = 33). Studies showed moderate heterogeneity, variable risk of bias, and evidence of publication bias. No dose-response relationships were found from studies comparing more with less intensive measurement conditions. There were no significant differences in QBE by behavior, but QBEs for dental flossing, physical activity, and screening attendance were significantly different from 0. Findings were not altered by whether behavior or cognitions were measured, attitudes were or were not measured, studies used questionnaires or interviews, or outcomes were objective or self-reported. Conclusions: There is some evidence for the QBE on health-related behavior. However, risk of bias within studies and evidence of publication bias indicate that the observed small effect size may be overestimated, especially given that some studies included intervention techniques in addition to providing questionnaires. Preregistered high-quality trials with clear specification of intervention content are needed to confirm if and when measurement leads to behavior change. [ABSTRACT FROM AUTHOR]

Background: NHS Health Checks is a new program for primary prevention of heart disease, stroke, diabetes, chronic kidney disease, and vascular dementia in adults aged 40 to 74 years in England. Individuals without existing cardiovascular disease or diabetes are invited for a Health Check every 5 years. Uptake among those invited is lower than anticipated. Method: The project is a three-arm randomized controlled trial to test the hypothesis that enhanced invitation methods, using the Question-Behaviour Effect (QBE), will increase uptake of NHS Health Checks compared with a standard invitation. Participants comprise individuals eligible for an NHS Health Check registered in two London boroughs. Participants are randomized into one of three arms. Group A receives the standard NHS Health Check invitation letter, information sheet, and reminder letter at 12 weeks for nonattenders. Group B receives a QBE questionnaire 1 week before receiving the standard invitation, information sheet, and reminder letter where appropriate. Group C is the same as Group B, but participants are offered a £5 retail voucher if they return the questionnaire. Participants are randomized in equal proportions, stratified by general practice. The primary outcome is uptake of NHS Health Checks 6 months after invitation from electronic health records. We will estimate the incremental health service cost per additional completed Health Check for trial groups B and C versus trial arm A, as well as evaluating the impact of the QBE questionnaire, and questionnaire plus voucher, on the socioeconomic inequality in uptake of Health Checks. The trial includes a nested comparison of two methods for implementing allocation, one implemented manually at general practices and the other implemented automatically through the information systems used to generate invitations for the Health Check. Discussion: The research will provide evidence on whether asking individuals to complete a preliminary questionnaire, by using the QBE, is effective in increasing uptake of Health Checks and whether an incentive alters questionnaire return rates as well as uptake of Health Checks. The trial interventions can be readily translated into routine service delivery if they are shown to be cost-effective. [ABSTRACT FROM AUTHOR]

Objective: This study tested key variations in the question-behavior effect against a control condition or an implementation intention condition on returning to give blood among lapsed donors (individuals who had not given blood in the past 2 years). Design: At baseline, 7,000 lapsed donors were randomized to 1 of 6 experimental conditions or to a control condition. Participants in the experimental conditions were asked to complete a 6-item postal questionnaire assessing intentions only, interrogative intention, moral norm plus intention, anticipated regret plus intention, positive self-image plus intention, or implementation intentions. Objective measures of behavior were obtained 6 and 15 months later. The frequency of registrations to give blood over the next 6 and 15 months was measured. Results: Intention-to-treat analysis of the frequency of registrations (GENMOD procedure, Poisson distribution) indicated main effects for condition (experimental vs. control) at both 6 months, x2(U = 4.64, p < .05, and 15 months, X2(l) = 5.88, p < .05. Positive self-image and implementation intention interventions outperformed the control condition at 6 months. At 15 months, standard intention, interrogative intention, and regret plus intention conditions showed more frequent registrations compared with control and were just as effective as implementation intention formation. Moderation analysis showed that the moral norm and positive self-image conditions were significant for first-time (1 previous donation) but not repeat (2 or more previous donations) donors. Conclusion: The question—behavior effect can be used to reinvigorate blood donation among lapsed donors, and can be as effective as forming implementation intentions. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to assess the effectiveness of survey administration as a population-level intervention to increase blood donation. Methods: Study 1 was a randomized controlled trial of new donors comparing 3,518 who received a questionnaire and 3,490 who did not. Study 2 compared matched, randomly selected samples of active donors; 5,789 received a questionnaire, while 6,000 did not. In both studies, the dependent measure was the proportion of donors who attended a blood donation center to give blood within 6 months of survey posting. Study 3 compared data across five similar trials. Results: No difference in volunteering to give blood was observed between those who did and did not receive a questionnaire among either new or active donors, confirming the findings of two other Canadian trials. Conclusions: Despite earlier optimistic findings, there is little evidence to suggest that survey administration per se will be effective in increasing blood supplies. Implications for behavior change mechanisms are discussed. [ABSTRACT FROM AUTHOR]

Answering a question about performance of a behavior influences the probability of a person performing a target action in the future. Although this question–behavior effect has been shown across multiple contexts, several theoretical mechanisms have been suggested to drive the effect. While various explanations have been offered for the question–behavior effect, clear process evidence exists only for the theoretical perspectives of cognitive dissonance and attitude accessibility. In a series of experiments the current research tests the question–behavior effect from these two theoretical perspectives using a set of outcome measures not previously examined. Findings suggest that the act of self-prediction regarding socially normative behaviors generates cognitive dissonance, thereby obtaining greater compliance with subsequent requests to perform the behavior as a dissonance reduction strategy. Implications of the reported findings and directions for future research are provided. [ABSTRACT FROM PUBLISHER]

Objective: To test the efficacy of interventions based on the question-behavior effect in promoting the adoption of disease prevention behaviors. Design: In Study 1, adults from the general public were randomly allocated to complete a questionnaire about health checks (question-behavior effect condition) or not (control) and later received an invitation to attend for screening. In Study 2, health care professionals were randomly allocated to complete a questionnaire about influenza vaccination or not and later had the opportunity to receive a vaccination. Main Outcome Measures: We objectively assessed health check attendance (Study 1) and influenza vaccination (Study 2). Results: In Study 1, intention- to-treat analyses indicated that health check attendance was significantly higher in the question-behavior effect condition (68.3%) compared with the control condition (53.5%). In Study 2, intention-to-treat analyses indicated that influenza vaccination was significantly higher among participants in the question- behavior effect condition (42.0%) compared with the control condition (36.3%), and this effect persisted after controlling for demographic variables. Explanatory analyses indicated that the effects in both studies were attributable to completing rather than merely receiving the questionnaire and were stronger for those with positive attitudes or intentions about the target behavior. Conclusion: The question-behavior effect represents a simple, cost-effective means to increase disease prevention behaviors among the general public and health professionals. Implications for promoting health behaviors are discussed. [ABSTRACT FROM AUTHOR]

The authors comment on an article by author C. Wood and colleagues on impact of self-prediction and intention questions on behavior that was published in the 2015 issue of "Personality and Social Psychology Review." Topics discussed include assessment of possibility of behavior change by asking questions, role of question-behavior effect (QBE) in intervention of public health and social policy, and possibility of a bias assessment in reviewing questions.

Objectives: The question-behavior effect (QBE) refers to whether asking people questions can result in changes in behavior. Such changes in behavior can lead to bias in trials. This study aims to update a systematic review of randomized controlled trials investigating the QBE, in light of several large preregistered studies being published., Study Design and Setting: A systematic search for newly published trials covered 2012 to July 2018. Eligible trials randomly allocated participants to measurement vs. non-measurement control conditions or to different forms of measurement. Studies that reported health-related behavior as outcomes were included., Results: Forty-three studies (33 studies from the original systematic review and 10 new studies) compared measurement vs. no measurement. An overall small effect was found using a random effect model: standardized mean difference = 0.06 (95% CI: 0.02-0.09), n = 104,388. Statistical heterogeneity was substantial (I 2  = 54%). In an analysis restricted to studies with a low risk of bias, the QBE remained small but significant. There was positive evidence of publication bias., Conclusion: This update shows a small but significant QBE in trials with health-related outcomes but with considerable unexplained heterogeneity. Future trials with lower risk of bias are needed, with preregistered protocols and greater attention to blinding., (Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.)

Eliciting different attitudes with survey questionnaires may impact on intention to donate organs. Previous research used varying numbers of questionnaire items, or different modes of intervention delivery, when comparing groups. We aimed to determine whether intention to donate organs differed among groups exposed to different theoretical content, but similar questionnaire length, in different countries. We tested the effect of excluding affective attitudinal items on intention to donate, using constant item numbers in two modes of intervention delivery. Study 1: A multi-country, interviewer-led, cross-sectional randomized trial recruited 1007 participants, who completed questionnaires as per group assignment: including all affective attitude items, affective attitude items replaced, negatively-worded affective attitude items replaced. Study 2 recruited a UK-representative, cross-sectional sample of 616 participants using an online methodology, randomly assigned to the same conditions. Multilevel models assessed effects of group membership on outcomes: intention to donate (primary), taking a donor card, following a web-link (secondary). In study 1, intention to donate did not differ among groups. Study 2 found a small, significantly higher intention to donate in the negatively-worded affective attitudes replaced group. Combining data yielded no group differences. No differences were seen for secondary outcomes. Ancillary analyses suggest significant interviewer effects. Contrary to previous research, theoretical content may be less relevant than number or valence of questionnaire items, or form of intervention delivery, for increasing intention to donate organs., Competing Interests: The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.