Association for Behavior Analysis International

Contingency management is effective for treating a variety of problem behaviors. Incorporating this well-known strategy with technology to increase the number of individuals who can be reached would further its therapeutic impact. Within this session, papers are focused on remotely monitoring behavior using technology-based contingency management interventions for increasing appropriate behavior in teens (e.g., blood-sugar testing) and adults (e.g., purchasing more fresh produce) or decreasing maladaptive behavior in adults (e.g., smoking). In the first presentation, the effects of online peer support on smoking cessation treatment efficacy will be discussed. In the second presentation, the impact of delivering monetary vouchers on adherence with blood sugar testing recommendations will be discussed. In the third presentation, the effects of an intervention for promoting increased consumption of fruits and vegetables by incentivizing their purchase will be discussed. Preliminary data show promising trends that promote contingency management via the Internet as a viable, effective treatment for various problem behaviors.

Social support (e.g., praise) may promote abstinence from cigarette smoking. To combine social support with the monetary consequences of contingency management (CM), we integrated group contingencies of reinforcement and an online discussion forum into an Internet-based intervention to promote smoking cessation. Thirty-six participants were divided into 12 small teams (n = 3 per team). These teams were divided into 2 groups. Participants assigned to the forum group had access to a moderated, online peer support forum through which they could communicate with their teammates. Participants assigned to the no forum group did not have access to this forum. Each participant submitted video recordings of breath carbon monoxide (CO) measurement twice daily via the Internet. Teams were exposed to 3, 5-day conditions in random order. In the independent contingency condition, participants earned vouchers exchangeable for goods contingent on abstinence (CO = 4 ppm; i.e., negative samples). In the interdependent contingency condition, participants earned vouchers only when every member of the team submitted negative samples. In the no contingency condition, no monetary contingency was arranged. Thus far, 12 participants have completed the study. Preliminary results suggest that access to the online peer support forum enhances treatment efficacy.

Diabetes can lead to a number of life-threatening health complications if unmanaged. A critical component of diabetes management, for teens diagnosed with Type 1 diabetes, involves blood sugar testing at least four times per day. The current ongoing clinical trial is designed to evaluate the impact of delivering monetary vouchers contingent (n=4) or non-contingent (n=2) on adherence with blood sugar testing recommendations. Participants submit videos showing them test their blood sugar over a secure, encrypted study website. Although the results are very preliminary due to the early stages of data collection, so far there appears to be a trend towards greater adherence in the treatment, contingent, group relative to the control, noncontingent, group. Contingent participants adhered with the minimum of 4 recommended blood glucose tests per day during a mean of 35% (range 0-70%) of the 20 day treatment, compared to only 12.5% (range 0-25%) in the noncontingent group. In general, participants and their parents, regardless of group assignment, rated the program favorably on a number of dimensions, and parents reported that their children became more independent with their diabetes management as a result of the intervention. The results suggest that Internet-based contingency management interventions are feasible and acceptable, and there is some preliminary evidence that it is also effective, for increasing adherence to blood sugar testing in teens diagnosed with Type 1 diabetes.

Suboptimal diet is associated with 4 of the 10 leading causes of death, and improving dietary choices could reduce the frequency of these afflictions. Eating the minimum recommended servings of produce a day has been found to lower the risk of coronary heart disease and stroke. Despite the increased availability of nutritional information and increased understanding among the public regarding ways to prevent these diseases, only 10% of Americans were classified as having a healthy diet in 2000. We propose to examine the effectiveness and feasibility of an intervention for promoting increased consumption of fruits and vegetables by incentivizing their purchase where the overwhelming majority of food is sold: grocery stores. The primary aim of this project is to generate preliminary evidence of the efficacy of two financial incentive structures in promoting the allocation of a greater percentage of ones grocery budget to the purchase of fresh fruits and vegetables. Thus far, we have recruited five participants (40% Caucasian). We expect recruitment and the study to be completed by the end of February 2012. Thus far this population spends 6.76% of their food money on produce and 42% of their grocery budget comes from food assistance programs like SNAP.