Reducing the risk of bias in health behaviour change trials: Improving trial design,reporting or bias assessment criteria? A review and case study

Objective: It has been suggested that randomised controlled trials (RCTs) of health behaviour change (HBC) interventions are less rigorously designed than – for example– drug trials. This study presents an approach to clarifying whether this is due to poor trial design, incomplete trial reporting and/or the inappropriateness of commonly applied risk of bias assessment criteria.

Design: First, a framework of key sources of bias and common strategies for reducing bias risk is developed based on a literature review. Second, we describe the design of a multi-site RCT evaluating the cost-effectiveness of an HIV-treatment adherence intervention (case study). The choices made by the multidisciplinary team trying to minimise the risk of bias are compared against the risk of bias framework.

Main outcome measures: Implementation of common strategies for reducing the risk of bias in the case study; alternative or additional strategies applied; a justification for each deviation from the risk of bias framework.

Results: Most of the common strategies for reducing the risk of bias could be implemented. Alternative strategies were developed for minimising the risk of performance bias and contamination. Several additional, domain-specific risk of bias strategies were implemented.

Conclusions: The literature provides useful guidance for reducing the risk of bias in HBC trials. Yet, the case study suggests that HBC trial designers may face specific challenges that require alternative/additional measures for reducing the risk of bias. Using the risk of bias justification table (RATIONALE) could lead to better-designed HBC trials, more comprehensive trial reports and the data necessary for evaluating the appropriateness of commonly applied risk of bias assessment criteria to HBC trials.     

On Direct Social Perception

Direct Social Perception (DSP) is the idea that we can non-inferentially perceive others’ mental states. In this paper, I argue that the standard way of framing DSP leaves the debate at an impasse. I suggest two alternative interpretations of the idea that we see others’ mental states: others’ mental states are represented in the content of our perception, and we have basic perceptual beliefs about others’ mental states. I argue that the latter interpretation of DSP is more promising and examine the kinds of mental states that plausibly could satisfy this version of DSP.     

A Duet for one

This paper considers communication in terms of inference about the behaviour of others (and our own behaviour). It is based on the premise that our sensations are largely generated by other agents like ourselves. This means, we are trying to infer how our sensations are caused by others, while they are trying to infer our behaviour: for example, in the dialogue between two speakers. We suggest that the infinite regress induced by modelling another agent – who is modelling you – can be finessed if you both possess the same model. In other words, the sensations caused by others and oneself are generated by the same process. This leads to a view of communication based upon a narrative that is shared by agents who are exchanging sensory signals. Crucially, this narrative transcends agency – and simply involves intermittently attending to and attenuating sensory input. Attending to sensations enables the shared narrative to predict the sensations generated by another (i.e. to listen), while attenuating sensory input enables one to articulate the narrative (i.e. to speak). This produces a reciprocal exchange of sensory signals that, formally, induces a generalised synchrony between internal (neuronal) brain states generating predictions in both agents. We develop the arguments behind this perspective, using an active (Bayesian) inference framework and offer some simulations (of birdsong) as proof of principle.     

Children's Theory of Mind,Self‐Perceptions,and Peer Relations: A Longitudinal Study

This longitudinal study explored Theory of Mind (ToM), self‐perceptions, and teacher ratings of peer relations of 91 children (52 females, ages 6–8 years) drawn from two schools situated in a mainly Euro‐Canadian, middle socioeconomic status, semi‐rural central Canadian context. ToM, self‐perceptions, and teacher ratings of peer relations were assessed at Time 1 (T1, M = 6 y 2 m) and 2 years later at Time 2 (T2, M = 8 y 5 m). Findings showed that ToM scores and perceptions of global self‐worth and physical appearance significantly increased with time across both genders. Positive longitudinal associations were found between teacher ratings of sociable peer relations at T1 and children's T2 moral self‐perceptions. A positive longitudinal correlation was found between T1 ToM and T2 teacher ratings of anxious/fearful peer relations. Individual variation in ToM at age 6 predicted teacher ratings of anxious and fearful behaviours in 8 year olds. In contrast, teacher ratings at age 6 did not predict ToM ability in 8 year olds. Educational implications for social and emotional competencies are discussed. Copyright © 2014 John Wiley & Sons, Ltd.     

Measuring work styles: Towards an understanding of the dynamic components of the theory of work adjustment

Work styles are an important yet largely unexplored component of the theory of work adjustment (TWA), describing a dynamic component of how individuals maintain and adjust fit with their work environment. The active work style (AWS) scale is the first attempt to develop a specific self-report measure of work styles suitable for longitudinal research. Results from three studies support Dawis and Lofquist's (1984) proposed four factor structure, but these factors are related through a second-order factor describing a person's generalised level of work activity and effort across time. The AWS scale demonstrated good evidence for reliability and validity, and strong measurement invariance across time signifying its suitability for longitudinal research. In line with expectations, overall work style was positively related to conscientiousness and work engagement yet unrelated to stress. When controlling for these variables, AWS was positively related to demands–abilities fit, but not needs–supplies fit. Limitations and possibilities for future research are also discussed.     

What Not to Multiply Without Necessity

The Razor commands us not to multiply entities without necessity. I argue for an alternative principle—The Laser—which commands us not to multiply fundamental entities without necessity.     

Using a metaperspective to clarify the structural-narrative debate in family therapy

The debate in family therapy between structural and narrative therapists often seems irreconcilable. Drawing from work in theoretical sociology that identifies the basic structure of existing social theory, a metaperspective is introduced to clarify a discussion between leading figures in the debate. Disparate views of family interactions are examined in terms of more fundamental disagreements about the center of attention in therapy. Narrative and structural modes of presentation are examined as separate traditions that could not be further apart conceptually. Efforts to identify common ground are discussed in terms of more significant differences that are minimized by drawing out similarities. This analysis provides a framework for standing outside entrenched arguments to see more clearly the unique contributions of each approach.     

Two Theories of Just War

As it is traditionally conceived, Just War Theory is not well suited for dealing with nation vs non-nation wars. It thus makes sense to create a second Just War Theory to deal with these wars. This article explores the differences and similarities between the two theories.

Modeling college women's perceptions of elite leadership positions with Social Cognitive Career Theory

The utility of Social Cognitive Career Theory (SCCT; Lent, Brown, & Hackett, 1994) for predicting college women's interests and goals for positions of elite leadership was examined with 156 undergraduate women at a public university. They completed measures of elite leadership self-efficacy expectations, outcome expectations, interests, and goals. Results supported SCCT as a theoretical framework for understanding internal factors that may contribute to women's elite leadership interests and goals. Self-efficacy and outcome expectations for elite leadership positions related positively to interests and goals for such positions, and self-efficacy and outcome expectations each contributed unique variance to the prediction of elite leadership interests. Outcome expectations partially mediated the relation between elite leadership self-efficacy and interests, interests partially mediated the relation between elite leadership outcome expectations and goals, and the combination of elite leadership interests and outcome expectations completely mediated the relation between self-efficacy for elite leadership positions and elite leadership goals.     

Did she mean to do it? Acquiring a folk theory of intentionality

The ability to both identify and explain others’ intentional acts is fundamental for successful social interaction. In two cross-sectional studies, we investigated 3- to 9-year-olds’ (n = 148) understanding of the folk concept of intentionality, using three types of intentionality measures. The relationship between this type of reasoning and false belief and interpretive mind understanding was also examined. Judgment of the appropriateness of an explanation was based on adult responses (n = 20). Overall, the results indicated that the ability to both identify and appropriately explain a range of intentional acts does not fully emerge until 7 years of age or later. The pattern of explanations revealed the gradual development of a folk concept of intentionality. Preschool- and early school-age children focused on the protagonists’ desires and actions, whereas 8- and 9-year-olds and adults were more likely to reference the protagonists’ awareness and skills.