Theoretical underpinnings of a need-supportive intervention to address sustained healthy lifestyle changes in overweight and obese adolescents

ObjectivesRecent figures indicate that nearly a quarter of Australian adolescents are overweight or obese. Despite the well-established role of physical activity and healthy eating in reducing prevalence of obesity, there remains a lack of effective interventions that promote sustained behavior engagement. This paper aims to describe the theory-based integration and implementation of self-determination theory and goal setting theory in a family-based lifestyle intervention. Although these theories have been shown to independently predict motivation for behavior, a limited number of studies have described behavior-change techniques at a level to allow for effective evaluation and replication, and no studies have combined the theories in a healthy lifestyle behavior intervention.MethodsBehavior change techniques and the associated change mediators are described in relation to need-supportive environments provided by instructors and extended to parents in the home environment. Methods for motivating and promoting sustained engagement in adolescent physical activity and healthy eating and parent behaviors to support these lifestyle changes are discussed within the context of need-satisfaction and goal setting.ConclusionsThis study will contribute to understanding processes for developing and implementing behavior-change techniques based on the integration of two theories of motivation. Future interventions aimed at promoting maintenance of physical activity and healthy eating behaviors in overweight and obese adolescents will benefit by being informed of which techniques are effective at enhancing motivation within the intervention context and home environment.     

Relationships between health behaviors,posttraumatic stress disorder,and comorbid general anxiety and depression

Poor health outcomes associated with posttraumatic stress disorder (PTSD) may reflect engagement in unhealthy behaviors that increase morbidity risk and disengagement in healthy behaviors that decrease morbidity risk. Although research supports this pattern, findings are not definitive, particularly for healthy behaviors. Many studies have not controlled for effects of concurrent generalized anxiety and depression, which might explain conflicting findings. To address this limitation, we used an online cross-sectional research design and multivariate multilevel modelling to evaluate associations between a multitude of health behaviors (i.e. sedentary behavior, sleep quality, physical activity, eating habits, alcohol use and substance use) and PTSD, while adjusting for comorbid generalized anxiety and depression, in a sample of trauma-exposed individuals (N = 246). Our results indicate that PTSD and comorbid generalized anxiety and depression symptoms were differentially associated with specific health constructs. Specifically, sedentary behavior and poor sleep quality were associated with PTSD, whereas low physical activity, poor sleep quality, and unhealthy eating habits were associated with depression. Both increased alcohol and substance use were associated with generalized anxiety. Results from our study highlight the need to conceptualize associations between health behaviors and specific psychological symptoms in a comprehensive manner as part of clinical presentations of PTSD.     

Ecobehavioral analysis in the classroom: Review and implications

A rapidly developing area within applied behavior analysis that has implications for classroom instruction and behavior management is ecobehavioral analysis. Ecobehavioral analysis adds to behavior analysis the assessment of situational or contextual factors, such as classroom physical arrangements, instructional materials used by students, and teacher's behavior. Its eventual importance and contribution to behavior analysis and to education, however, has yet to be realized. In fact, it is difficult to find adequate accounts of exactly what ecobehavioral analysis entails (Morris & Midgley, 1990). To date, it has led to a number of interesting contributions. These include the development and validation of specific classroom instructional procedures, the development of a number of approaches to the reduction of challenging behaviors, an improved understanding of the components of effective instruction including the identification of instructional risk factors within regular and special education, as well as providing a better understanding of how the quality of implementation functions as a mediating variable for student outcomes. In this paper, we discuss the theory and principles that support ecobehavioral analysis, review research literature concerning its use in educational settings, describe emerging applications by school personnel (e.g., teachers, school psychologists), and examine a number of future research directions and their implications.     

The five-factor model of personality and physical inactivity: A meta-analysis of 16 samples

A sedentary lifestyle is harmful for health; personality traits may contribute to physical (in)activity. With participant-level data from 16 samples (N > 125,000), we examined the personality correlates of physical inactivity, frequency of physical activity, and sedentary behavior (in a subset of samples). Lower Neuroticism and higher Conscientiousness were associated with more physical activity and less inactivity and sedentary behavior. Extraversion and Openness were also associated with more physical activity and less inactivity, but these traits were mostly unrelated to specific sedentary behaviors (e.g., TV watching). The results generally did not vary by age or sex. The findings support the notion that the interest, motivational, emotional, and interpersonal processes assessed by five-factor model traits partly shape the individual’s engagement in physical activity.     

A diathesis-stress model of engagement in risky behaviors in Chinese adolescents

The current study examined whether the association between the occurrence of negative events and increased engagement in risky behavior is moderated by maladaptive and/or adaptive coping strategies. At time 1, 411 adolescents (ages 14–19) from Yue Yang, Hunan, completed self-report measures assessing coping strategies, engagement in risky behaviors, and the occurrence of negative events. Once a month for the subsequent 6 months, adolescents completed measures assessing engagement in risky behaviors and the occurrence of negative events. In line with our hypotheses, results of hierarchical linear modeling analyses indicated that adolescents possessing high levels of maladaptive coping strategies reported greater engagement in risky behaviors following the occurrence of negative events than adolescents possessing low levels. In contrast to our hypotheses, the association between the occurrence of negative events and increased engagement in risky behavior was not moderated by adaptive coping strategies.     

Adolescents', parents', and teachers' distress over adolescents' behavior

This study evaluated adolescents', parents', and teachers' self-reported distress and wishes to change adolescents' emotional/behavioral problems in a sample of clinically referred adolescents. Parents reported being bothered more than adolescents or teachers by adolescents' internalizing behavior. Both parents and teachers rated adolescents' externalizing behavior as more bothersome than did adolescents. Adolescents were significantly less likely to want to change their behavior than were parents or teachers. In addition, adolescents were significantly more likely to want to change their internalizing problems than their externalizing problems. For all three informants, being bothered by adolescents' behaviors was strongly associated with a desire to change the behaviors. Clinical implications of these findings are discussed.The authors wish to thank John Iriye and Alisa Waldman for their invaluable help as research assistants.     

The Gap Between Clinical Trial and Application in Health Behavior Counseling: Can Behavioral Medicine Build a Bridge?

Patients desire to have information about health-related behaviors (e.g., exercise) provided to them by their health care provider. Outcomes of clinical trials in physical activity counseling are modest at best and therefore, the degree of effectiveness of physical activity counseling in the primary care setting remains unclear. We describe what may be considered a real-world example of behavior change counseling aimed at primary or secondary risk factor identification and modification for CHD in women. We examined rates of baseline and follow-up physical activity in our sample of midlife Caucasian and African American women (N = 227) participating in a hospital-based CHD-risk screening. Baseline physical activity levels and rates of return for follow-up appointments were quite low with only negligible achievement of behavior change recommendations. In light of these findings, the potential role of behavioral medicine in training and collaboration with health care providers in primary care behavior counseling is discussed.     

A RESPONSE-RESTRICTION ANALYSIS OF STEREOTYPY IN ADOLESCENTS WITH MENTAL RETARDATION: IMPLICATIONS FOR APPLIED BEHAVIOR ANALYSIS

The behavior of 4 adolescents with severe or profound mental retardation was evaluated in the presence of four sets of materials during periods of unstructured leisure activity. Functional engagement with the materials, stereotypic engagement with the materials, stereotypy without interaction with the materials, and other aberrant behaviors were recorded. Across a series of experimental conditions, the number of sets of materials was reduced from four to one by eliminating the set most frequently manipulated in each preceding condition. In the final condition, four sets of materials were again made available for manipulation. The procedures replicated Green and Striefel's (1988) response-restriction analysis of the activity preferences and play behaviors of children with autism. In general, the results of the present experiment replicate those of Green and Striefel in that reallocation of responding was idiosyncratic and unpredictable as sets of materials were removed. Nevertheless, the results provided insight into how responding might be reallocated if it were restricted through behavioral interventions rather than by restriction of access. Thus, the results are discussed with respect to how response-restriction analyses may be useful in identifying topographies of behavior that could be included in differential reinforcement contingencies that are designed to affect stereotypic behavior and in the selection and arrangement of environmental stimuli to minimize the presence of evokers of stereotypy.     

Environmental Behavior of Visitors to a Science Museum

ABSTRACT

Increasingly, informal science and environmental education institutions are addressing conservation messaging and environmental behavior in programming, exhibits, and interpretation. Yet, little is known about what pro-environmental behaviors visitors are currently undertaking, what characteristics those environmental behaviors may have in common, and what differences might exist among visitor populations. This study investigated environmental behaviors and attitudes of visitors (N = 689) to an informal science museum, including separate foci on members and nonmembers based on previous work suggesting differences between the two groups. To improve research, policy, and educational interventions that address environmental behavior, researchers have long sought to uncover relationships among unique environmental behaviors. To this end, the authors explored whether five commonly recommended pro-environmental behaviors shared underlying characteristics that could be used to group those behaviors. They uncovered some dissimilarity in self-reported environmental behaviors among members and nonmembers. Although no single shared construct underlying the behaviors was evident, the authors did find, for nonmember visitors, a suite of three traditional environmental behaviors and, for members, a suite of four contemporary environmental behaviors. They discuss implications for practice and future research.     

Longitudinal Assessment of the Relationship Between Physical Self-Concept and Health-Related Behavior and Emotion in Adolescent Girls

This study investigated the changes in and the relationships among body mass index (BMI), global self-esteem, physical self-perceptions, social physique anxiety (SPA), physical activity, and dietary restraint in adolescent females over a 24-month period. Participants (N = 501) completed annual assessments in grade 9, 10, and 11. The results showed moderate covariance stability in all variables. There were several significant time effects (group mean change), with small increases in BMI, moderate decreases in physical activity, and very small changes over time in SPA and physical self-perceptions. Longitudinal analyses indicated that specific physical self-perceptions were important predictors of physical activity, dietary restraint and SPA; however, most of the variance was explained by previous year values. Evidence of bidirectional effects revealed that specific self-perceptions impact specific behaviors and SPA more so than the impact of behavior/emotion on self-perceptions. These results highlight the importance of understanding the physical self and its links to health-related behaviors and emotion in adolescents.     

IMPLICATIONS OF BEHAVIORAL PHARMACOLOGY RESEARCH FOR APPLIED BEHAVIOR ANALYSES: JEAB'S SPECIAL ISSUE CELEBRATING THE CONTRIBUTIONS OF JOSEPH V. BRADY (MARCH 1994)

We review four articles from JEAB's March 1994 issue celebrating the contributions of Joseph V. Brady. These articles have implications for studying private events and for studying multiple operants. We suggest that regularly including self-reports about private events in behavioral pharmacological research has resulted in an accumulated knowledge that has facilitated examination of interesting relations among self-reports, environmental factors, and other observable behaviors. Methodological lessons that behavioral pharmacologists have learned regarding the study of multiple operants are also relayed. We provide examples of how these lessons could be useful to applied behavior analysts studying nonpharmacological issues.     

BEHAVIORAL ASSESSMENT FOR PEDIATRIC INTENSIVE CARE UNITS1

Two studies were conducted to analyze behaviors of staff and patients on a Pediatric Intensive Care Unit (PICU). In the first study, behavioral observation procedures were employed to assess patient state, physical position, affect, verbal behaviors, visual attention and activity engagement, and staff verbal behavior. On the average, one-third of the patients were judged to be conscious and alert but markedly nonengaged with their environment. In the second study, a member of the hospital staff provided alert patients with individual activities to determine whether a simple environmental manipulation could positively affect behavior of children in intensive care. Employing a reversal design, the activity intervention was found to increase attention and engagement and positive affect, and to decrease inappropriate behavior. Both studies demonstrate that behavioral assessment procedures can provide an empirical basis for designing PICU routines affecting children's psychosocial status, and, thus, complement current procedures designed to provide quality medical care.     

Construing action abstractly and experiencing autonomy: Implications for physical activity and diet

Mentally representing action in terms of abstract goals rather than concrete procedures has been found to facilitate self-regulation, including meeting health goals. The present research examined whether autonomous motivation mediates the association between abstract thinking and health behavior engagement. We hypothesized that abstract (vs. concrete) thinking relates to viewing oneself as behaving autonomously, which, in turn, is positively associated with engaging in health behaviors. Two studies tested whether abstract thinking is associated with greater health behavior engagement and whether autonomous motivation statistically mediates this association. In Study 1, abstract thinking was associated positively with physical activity and fruit and vegetable intake. In Study 2, supporting pre-registered hypotheses, there was a significant indirect effect of abstract thinking on vigorous physical activity and fruit and vegetable intake through autonomous motivation. Whereas past research has emphasized that abstract thinking orients attention towards the value of broader goals, this research establishes that autonomous motivation helps explain associations between abstract thinking and health behavior engagement.     

The ecological assessment of an autistic child

The behavior of an autistic child was observed in his natural environment. Observations were made in three settings, over approximately 6 months. Sixteen behaviors of the child and six behaviors of adults and peers were recorded. A cluster analysis was performed to identify response classes within the behavioral structure of the child and to see if correlations existed between response and stimulus events. To examine intra- and intersetting changes, Spearman rank correlations and ttests were also computed. This autistic child exhibited a diversity of behavior over time in a given setting and across settings. He persistently ignored other nonautistic children, although he was responsive to adults. Response classes reflected an inverse correlation between the child's selfstimulatory behaviors and his attentiveness to the environment. Elevated levels of adult attention were consistently related to reduced levels in most self-stimulatory behaviors. Two response classes showed inverse relationships between self-stimulatory behaviors. Reducing the frequency of some self-stimulatory behaviors might cause increases in others.This study is based on a dissertation submitted by the first author to The University of Tennessee in partial fulfillment of the requirements for the Ph.D. degree. The research was conducted under the chairmanship of the second author. The authors wish to express their appreciation to Dr. Edward E. Cureton for his help with the statistical analyses.     

The relationship between predictability and problem behavior for students with severe disabilities

Two single-case studies were conducted to examine the extent to which signaled (predictable) and unsignaled (unpredictable) events were associated with changes in the level of problem behavior during instruction. Two students with moderate-to-severe intellectual disabilities and autism participated in the study. Each student was nominated for the study based on a teacher's report that problem behaviors were much more likely when novel or unsignaled events occurred. Functional assessments were conducted with each student and the specific predictability features (signals) associated with low and high levels of problem behavior were identified. Multi-element and reversal designs were employed to examine the extent to which increased predictability was associated with reduced problem behavior. Results supported the use of functional assessment procedures to determine whether signals that provide information about the content, duration, timing, and/or consequences of future events could reduce problem behaviors.     

Mom,you're only remembering the bad behavior! the utility of distributed lag models in single-subject research

The present study examined if prior events/behaviors accounted for variance in parental perceptions of child behavior beyond that accounted for by those events/behaviors occurring simultaneously with the assessment of the parental perception. By utilizing a time-series analysis, this study investigated the relative effects of positive and negative child behaviors, interparental behavior, and intrapersonal behavior/events occurring simultaneously or at an earlier point in time on a mother's daily satisfaction with her clinic-referred child. Using a single-subject methodology with replication, nine mothers served as subjects. Data were collected across 30 days for participants, and subsequently, each mother's data were analyzed by multiple regression techniques. The results indicate the usefulness of distributed lag models for single-case designs in the absence of autocorrelation. Analyses indicate that for some mothers what happens on prior days with her child is as important or more important in determining her satisfaction with the child than what happens on the current day. In particular, mothers tend to carry over previous days' negative child behaviors into the present day's satisfaction rating. Previous days' positive and negative spouse behaviors and daily activities did not consistently contribute to regression equations predicting mothers' daily satisfaction ratings with their children.This research was supported in part by the University of Georgia's Institute for Behavioral Research.Data for this study were collected as part of a project designed to examine correlates of maternal satisfaction with their children. The primary results of the project have been reported by Furey and Forehand (in press). While the method in this study is basically similar to the Furey and Forehand (in press) method, the questions posed in the two studies differed.     

A Review of Determinants of and Interventions for Proenvironmental Behaviors in Organizations

A review of empirical studies on proenvironmental behaviors in organizational contexts is presented. Twenty‐one studies met the inclusion criteria. Quantitative effect sizes were compared where statistics were available and research designs were comparable. Characteristics of the dependent variable and the targeted organizational (sub)populations were systematically examined. With respect to individual‐specific determinants, the results show relatively consistent effects for attitudinal determinants and past behavior. For organization‐specific influences, management and physical facilitation were frequently significant. Findings related to other factors are less conclusive. Given the available evidence and feasibility considerations, it is recommended that interventions focus on physical facilitation, tailored persuasive communication, and active engagement of middle management. It is further recommended that future research integrates the analysis of individual and organizational determinants.     

Dieting and Body Image in the Child's World: Conceptualization and Behavior

The authors examined children's (N = 431, aged 7 years to 10 years 9 months) understanding of and reasons for dieting, to validate recent research indicating that perceived body-image dissatisfaction and restrictive eating behaviors occur in preadolescent populations. Scores on 2 sentence-completion tasks confirmed that the children do have a clear understanding of what dieting means in terms of intent and behavior (defined, in this study, as intentional restrictive eating behaviors). The results indicated that children as young as 7 years of age report dissatisfaction with their current body size and deliberately engage in restrictive eating behaviors. These findings provide validation of previous research and emphasize children's capacity to engage in deleterious health behaviors. Given that extreme dieting behaviors are harmful to a child's physical and psychological well-being, the authors concluded that research exploring (a) the genesis of these attitudes and behaviors and (b) their continuity or discontinuity across childhood is required.     

Post-Visit Reinforcement of Zoo Conservation Messages: The Design and Testing of an Action Resource Website

Wildlife tourism attractions such as zoos are uniquely placed to make an impact on people’s everyday environmentally responsible behaviors. However, research suggests that visitors who leave such sites with a heightened awareness and good intentions rarely translate their intentions into post-visit environmental actions. This article reports on the development of a website-based action resource designed to reinforce, complement, and extend zoos’ on-site conservation messages and support visitors’ translation of environmental behavioral intentions into actions. The effectiveness of the website in encouraging post-visit engagement in environmental behavior was tested using an experimental design with a follow-up sample of 475 zoo visitors across four sites in three countries. The group that had accessed the website scored significantly higher on a behavior change index than the group that had not accessed the website. Website features identified as most effective in engaging visitors and maximizing their uptake of environmentally sustainable behavior are discussed.