|Recent Advances in Contingency Management Research I: Incentivizing Healthy Choices|
|Sunday, May 27, 2012|
|10:30 AM–11:50 AM |
|602 (Convention Center)|
|Area: CSE/CBM; Domain: Applied Research|
|Chair: Steven E. Meredith (University of Florida)|
|Discussant: Pauline Horne (Bangor University)|
Contingency management is efficacious in promoting desirable behavior change across a variety of behavior. The treatment strategy has also been used as a tool to help isolate the effects of a number of variables on behavior change. This symposium highlights3 unique studies in which contingency management is used to incentivize healthy choices and dissociate the effects of several independent and predictor variables on treatment outcomes. The first paper examines the effects of incentive type and treatment fidelity on outcome measures in a contingency management program designed to increase children's fruit and vegetable consumption. The second paper examines whether patterns of voucher reimbursement predict treatment success in a contingency management program to promote abstinence among pregnant smokers. The third paper investigates the effects of percentile schedules on the number of steps taken per day in a prize-based contingency management program designed to increase physical activity among healthy adults. These studies demonstrate that contingency management is a promising treatment model for applications designed to promote a diverse group of healthy behaviors and for laboratory investigations of the effects of various independent variables on treatment outcomes.
|Keyword(s): contingency management, decision-making, health, incentives|
|Incentivizing Children’s Fruit and Vegetable Consumption: Examination of Incentive Type and Treatment Fidelity|
|BROOKE ASHLEY JONES (Utah State University), Gregory J. Madden (Utah State University), Heidi Wengreen (Utah State University), Sheryl Aguilar (Utah State University)|
|Abstract: A pilot study on the efficacy of the Food Dudes healthy-eating program was completed in one elementary school in Logan, UT with promising results, including a 0.49-cup increase in fruit and vegetable (F/V) consumption for children who consumed no F/V initially. These results reproduce previous findings on the efficacy of the Food Dudes program. An additional USDA grant allowed for a larger project to be introduced in 6 elementary schools in the same area. In addition to efficacy, we are examining the effects of (a) tangible rewards and (b) treatment fidelity on child outcomes. In the current study, two of the 6 participating schools will receive the full Food Dudes program (Incentive schools), two schools will receive the Food Dudes program but use praise/social recognition instead of tangible rewards (Social Recognition schools), and two schools will receive default F/V provision only (Control schools). Treatment fidelity will be assessed via (a) a secure website accessed by teachers to complete pre-lunch program components and (b) product measures of remaining tangible rewards (Incentive) or teacher report (Social Recognition) for post-lunch components. Results may have implications for both the necessity of tangible incentives and the importance of good treatment fidelity in this program.|
Differentiating Abstinent and Nonabstinent Pregnant Smokers Using Patterns of Voucher Reimbursement and Impulsivity Measures
|DIANN GAALEMA (University of Vermont), Stephen Higgins (University of Vermont), Alexa A. Lopez (University of Vermont), Kathryn Saulsgiver (The University of Pennsylvania), Sarah Heil (University of Vermont), Ira Bernstein (University of Vermont)|
In contingency management (CM) objectively verified target behaviors are reinforced with vouchers that can be redeemed for goods or services. One use of this treatment approach has been to encourage pregnant smokers to abstain during their pregnancy. The voucher redemption records of 174 pregnant women enrolled in a voucher-based smoking cessation treatment were examined to see if patterns of voucher redemption or other measures of impulsivity (e.g. delay discounting, Barratt Impulsiveness Scale) could predict treatment success. Women were classified as high (n=71) or low (n=103) abstinence based on whether greater than or fewer than 50% of their urine samples during the course of their treatment were cotinine negative. Frequency of redemption between high and low abstinence groups did not differ significantly. However, significant differences were found between the groups when examining the percentage of earnings that had been spent at different time points in treatment. Voucher redemption patterns may serve as a naturalistic measure of impulsivity in this population.
Using Percentile Schedules to Increase Steps Taken in Adults
|WENDY DONLIN WASHINGTON (University of North Carolina, Wilmington), Kelly Wall (University of North Carolina, Wilmington), Amanda L. Gibson (University of North Carolina, Wilmington), David King (University of North Carolina, Wilmington), Brian Coleman (University of North Carolina, Wilmington)|
The CDC (2010) recommends that adults engage in a minimum two hours of intense activity per week. Research shows a positive relationship between physical activity and overall health, but most Americans are not physically active. Hindrances to working out include unrealistic expectations and physical discomfort or pain. The current study incentivizes increases in physical activity. Healthy adults were recruited to wear a Fitbit computerized pedometer for up to six weeks. During a baseline period, steps per day were measured, prize draws were earned for wearing the Fitbit. Prizes varied in value from $2 to $150, with a 50% probability of winning each draw. During an intervention phase, daily criterion for draws was set at a percentile of recent steps. Criterion required current steps exceed 4, 5 or 6 of the previous 7 days steps. Finally, a return to baseline required only wearing the Fitbit to earn draws. Preliminary results show significant increases in steps in half of the participants, with those individuals with the lowest baseline rates of stepping showing the greatest increases during intervention.