Testing autonomous motivation as a mechanism of anticipated regret intervention techniques for seasonal flu vaccination

Background Anticipated regret is associated with vaccination. However, gaps in understanding mechanisms of anticipated regret and how to intervene using anticipated regret limit its use as an intervention to promote vaccination. Purpose Address gaps in anticipated regret interventions to promote seasonal flu vaccination. In a randomized intervention, we tested the novel hypothesis that autonomous motivation is a target mechanism of anticipated regret and the effects of 2 techniques to elicit anticipated regret: self-generated and mere measurement. Methods College students (N = 263) were randomized to complete (1) an open-ended anticipated regret prompt (self-generated), (2) anticipated regret questions (mere measurement), or (3) no anticipated regret questions or prompts. Participants then completed measures of motivation and vaccination intentions. The following spring, participants reported their vaccination status. Analyses were guided by the experimental medicine approach. Results Self-generated anticipated regret led to greater autonomous motivation for vaccination (d = 0.39), evidence of target mechanism engagement. Self-generated anticipated regret also had a significant indirect effect on intentions (estimate = 0.335, 95% CI = 0.117-0.55) and vaccination (estimate = 0.035, 95% CI = 0.008-0.08) through autonomous motivation, evidence of target mechanism validation. However, neither anticipated regret intervention technique had a direct effect on intentions or vaccination. Conclusions Autonomous motivation is a viable target mechanism of anticipated regret interventions to promote seasonal flu vaccination, and self-generated anticipated regret is an effective technique to engage autonomous motivation. Findings provide ample evidence for testing autonomous motivation as a mechanism of anticipated regret interventions in other contexts.