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Incentives & Health: The Application of Reinforcement in Health Promotion |
Monday, May 25, 2015 |
4:00 PM–4:50 PM |
Texas Ballroom Salon B (Grand Hyatt) |
Area: CBM/BPH; Domain: Applied Research |
Chair: Kenneth Silverman (Johns Hopkins University) |
CE Instructor: Kenneth Silverman, Ph.D. |
Abstract: Incentives have been used to address a range of health problems, but behavior analysts have not been involved in many of these applications, the incentive interventions have frequently failed to employ optimal parameters, and they have not always produced desired outcomes. This symposium will review three behavior-analytic research programs on the use of incentives or reinforcement in health promotion. Silverman will review research on the application of reinforcement in the treatment of heroin and cocaine addiction, and will focus on a recent study that evaluated the effects of employment-based reinforcement in treating out-of-treatment injection drug users. Dallery will review research on the use of technology in health promotion, and will focus on a recent study that evaluated the effects an internet-based contingency management intervention to promote smoking cessation. Madden will review research on the use of reinforcement to encourage children to eat fruits and vegetables, and will focus on recent research that evaluated game-based rewards in promoting fruit and vegetable consumption. These presentations illustrate how behavior analysts have applied reinforcement principles to promote health. Behavior analysts could use similar approaches to address a range of serious health problems. |
Keyword(s): drug addiction, health incentives, healthy eating, smoking |
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The Application of Reinforcement in the Treatment of Heroin and Cocaine Addiction |
KENNETH SILVERMAN (Johns Hopkins University), August F. Holtyn (Johns Hopkins University School of Medicine) |
Abstract: Drug addiction can be a chronic problem that can be difficult to treat. Abstinence reinforcement can initiate drug abstinence, but high magnitude reinforcement is needed to promote abstinence in refractory patients and many patients relapse after the intervention ends. Abstinence reinforcement can be maintained to promote long-term abstinence, but practical means of implementing high magnitude and long-term abstinence reinforcement are needed. The therapeutic workplace was designed to address this practical problem. Under the therapeutic workplace, participants must provide objective evidence of drug abstinence or medication adherence to work and earn wages. Several randomized controlled trials have shown that the therapeutic workplace can initiate and maintain cocaine abstinence in methadone patients, and promote adherence to addiction medications. This presentation will focus on a study that evaluated the effectiveness of the therapeutic workplace in out-of-treatment injection drug users, a population that has been difficult to treat effectively and that is at risk for adverse health outcomes because of their continued drug use, most notably HIV. That study showed that the therapeutic workplace was effective in promoting abstinence from heroin and cocaine in out-of-treatment injection drug users. Workplaces could be effective vehicles for the maintenance of therapeutic reinforcement contingencies including for treatment-refractory individuals. |
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A New Frontier: Integrating Information and Behavioral Technology to Promote Health Behavior |
JESSE DALLERY (University of Florida) |
Abstract: Modifiable behavioral risk factors such as cigarette smoking, physical inactivity, and obesity contribute to over forty percent of premature deaths in the United States. Advances in digital and information technology are creating unprecedented opportunities for behavior analysts to assess and modify these risk factors. Technological advances include mobile devices, wearable sensors, biomarker detectors, and real-time access to therapeutic support via information technology. Integrating these advances with behavioral technology in the form of conceptually systematic and empirically validated procedures could usher in a new generation of effective and scalable behavioral interventions targeting health behavior. In this talk, I will outline a case study in integrating information technology with behavior analytic principles and procedures to promote health behavior. The case study involves an Internet-based contingency management intervention to promote smoking cessation. I will also discuss results from a recent clinical trial involving smokers from across the United States. Technology can substantially increase access to cost-effective, scalable, behavior analytic interventions to promote health. |
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Using Game-Based Non-Tangible Rewards to Improve Dietary Decision-Making |
GREGORY J. MADDEN (Utah State University), Brooke Ashley Jones (Utah State University), Heidi Wengreen (Utah State University), Sheryl Aguilar (Utah State University) |
Abstract: A decade or more of research on the Food Dudes program has demonstrated that tangible reinforcers can produce large increases in healthy eating among elementary school children. Rendering this technology of behavior affordable for US public elementary schools is a challenge. The approach that we explored combines game-design principles (e.g., compelling narrative, autonomy) with behavior-analytic principles (e.g., contingent reinforcement, shaping) so that non-tangible, game-based outcomes can be used to reinforce healthy eating. This talk will summarize the results of two alternating-treatment design studies conducted in public charter schools. In both schools, game-based rewards were contingent upon the school consuming (as a group) more than the 60th percentile of their fruit or vegetable consumption over the last 10 days. In both schools, fruit and vegetable consumption significantly increased when the alternating contingency was placed on the target food (fruit or vegetables). Data collected on individual student’s consumption suggested that those consuming the least in baseline posted the largest increase in healthy eating during the game-based intervention. |
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