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| Applied Behavior Analysis in Integrative Healthcare |
| Saturday, May 28, 2022 |
| 12:00 PM–12:50 PM |
| Meeting Level 1; Room 103 |
| Area: CBM; Domain: Applied Research |
| Chair: Matthew P. Normand (University of the Pacific) |
| CE Instructor: Matthew P. Normand, Ph.D. |
| Abstract: Because being healthy typically involves behaving healthy, healthcare professionals and applied behavior analysts have much in common, and there is great potential for collaboration in integrated healthcare settings. In this symposium, we present three studies that explore different applications of behavior analysis to two such areas of healthcare: health coaching to increase physical activity, and physical therapy to increase mobility. First, we present two single-case design studies that evaluate variations of goal setting and client-centered components of health coaching, respectively, to increase physical activity in adults in a telehealth format. Next, we present a group design study that evaluated a behavior-analytic technology in comparison with standard physical therapy protocols to address barriers that impede neuromuscular retraining following total knee arthroplasty. Results of these three studies suggest directions for the application of behavior analysis to health coaching and physical therapy. Implications for applied behavior analysis in integrated healthcare will be discussed. |
| Instruction Level: Intermediate |
| Keyword(s): Health Coaching, Healthcare, Physical Activity, Physical Therapy |
| Target Audience: Intermediate level behavior analysts. The target audience has an intermediate knowledge of applied behavior analytic interventions and health care settings. |
| Learning Objectives: At the conclusion of the presentation, participants will be able to: (1) Identify applications of behavior analysis to integrated healthcare settings; (2) describe the effects of an electromyography and gamification technology on neuromuscular retraining, and (3) describe the effects of various health coaching interventions on physical activity of adults. |
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| Evaluating the Effects of Nondirective and Directive Health Coaching Packages on Physical Activity |
| HAILEY EVELYN DONOHUE (University of the Pacific), Matthew P. Normand (University of the Pacific) |
| Abstract: Physical inactivity is a worldwide public health problem. Applied behavior analysis has demonstrated success in this area; interventions such as goal setting, self-monitoring, and feedback have produced increases in physical activity of adults. Nevertheless, strategies with a more nondirective approach, such as health coaching, are gaining increased traction in healthcare settings. We do not know about the relative effects of nondirective approaches and the established, directive interventions in applied behavior analysis, or about client preference for nondirective and directive approaches. The present study employed a multiple baseline across participants design to evaluate a largely nondirective, client-centered health coaching approach for increasing physical activity of adults and the subsequent introduction of a directive coaching approach to goal setting and feedback components. Four adult females participated in the study remotely via telehealth. Active zone minutes were the primary dependent variable in the present study, and physical activity metrics were measured by the Fitbit Inspire 2. Meaningful increases in active zone minutes were observed for 1 of 4 participants, and preference for nondirective and directive coaching styles varied across participants. |
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| Evaluating the Effects of Client-Set Versus Coach-Set Goals in the Context of a Health Coaching Intervention for Physical Activity |
| J. LOGAN GIBSON (University of the Pacific), Matthew P. Normand (University of the Pacific) |
| Abstract: Health coaching is a relatively new integrated health role in which practitioners use a combination of behavioral interventions to evoke health-related behavior changes; however, there is a lack of valid evidence to support health-based claims. We investigated the effect of an approximation of a health coaching intervention on three college students' number of steps per day. We provided participants with weekly tele-health coaching sessions focused on goal-setting and feedback and used Fitbits to track the results. We used a multiple baseline across participants design to compare daily steps across four phases; self-monitoring, self-monitoring with experimenter-set goals and feedback, self-monitoring with participant-set goals and feedback, and finally, a choice phase in which participants could continue to set their own goals or have the experimenter set goals for them. All experimenter-set goals were selected using a weekly percentile schedule. In aggregate, all participants took more steps in the goal-setting phases than during the self-monitoring only phase. However, we cannot determine why, as there is no notable difference between self-set goals and experimenter-set goals. When offered, all participants chose to continue the intervention for an additional one to two weeks. |
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| The Role of Applied Behavior Analysis in Healthcare: Examples from Physical Therapy |
| BRENNAN PATRICK ARMSHAW (University of North Texas), Manish Vaidya (University of North Texas) |
| Abstract: Problems that characteristically fall within the domains of medicine and healthcare have behavioral components. These components contribute to the prognosis of the condition. Applied behavior analytic techniques can optimize these behavioral components which can improve the prognosis of various medical conditions. We adopted this strategy to interpret osteoarthritis and recovery from total knee arthroplasty (Vaidya & Armshaw, 2021; Armshaw & Vaidya, in prep). Specifically, we identified some contingencies that might lead to reduced use and atrophy of a muscle group important for typical knee extension and flexion required for many activities. Additionally, we identified features such as loss of proprioception that hinder the neuromuscular retraining necessary to regain functional use of the knee. We then developed a technology using surface electromyography and gamification to address some barriers that impede neuromuscular retraining. Results with healthy participants suggested that the technology worked. In this presentation, we present data from 18 participants who had undergone total knee arthroplasty. In a group design, participants were exposed to either our technology or the standard physical therapy protocols. We will describe and discuss the results in the context of a renewed role for applied behavior analysis in healthcare and medicine. |
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