Value Added: Vicarious-Affirmation Strategies to Enhance Prediabetes Awareness Among High-Risk Hispanics

Reducing the progression of type 2 diabetes mellitus hinges on accurate, timely recognition of prediabetes risk and the ability to make corresponding lifestyle changes. However, this critical step is often hindered by resistance to and avoidance of health information among high-risk individuals. Drawing on self- and vicarious-affirmation (VA) theory, this study experimentally tests a brief, culturally targeted, message-based vicarious-affirmation intervention among Hispanic adults at elevated risk (N = 1,039). Relative to standard messaging, the intervention did not improve primary outcomes; however, VA increased knowledge compared to a no-message control, and mechanism-focused analyses indicated modest sequential indirect effects on knowledge, information seeking, and behavioral intent. While the effect of VA did not vary by cultural attachment, the downstream pathways linking mediators to knowledge did: self-appraisal significantly predicted knowledge alongside message derogation at lower levels of cultural attachment, whereas at moderate to high levels, only message derogation remained significant. These findings advance affirmation theory by specifying mechanisms and boundary conditions tied to cultural identity, and by illustrating how low-burden, scalable messages can exert effects even when direct mean differences on primary outcomes are modest. Results also underscore the need for replication and extension to clarify conceptual distinctions among affirmation approaches.