Increasing accuracy and decreasing latency during clean intermittent self-catheterization procedures with young children.

We examined the effects of simulation training on performance of clean intermittent self-catheterization procedures with 2 young girls. Simulation training was conducted, after which independent performance was assessed within a multiple baseline design. The training resulted in increased accuracy and decreased latency for both girls.     

BEHAVIORAL CONTROL OF MEDICINE COMPLIANCE

This study examined the effectiveness of several behavioral techniques on compliance of college students taking vitamin C on q.i.d. regimen. Compliance was assessed by a new technique using a variation of the urine tracer procedure designed specifically for this study. Subjects were provided vitamin C tablets, with three tablets per week containing phenazopyridine, a drug that produces a bright red-orange urine discoloration. Subjects were requested to indicate when urine discolorations occurred, and compliance was assessed by comparing the time of their report to the time predicted on the basis of the scheduled sequence of vitamin C and phenazopyridine tablets. Baseline compliance was assessed for 72 subjects over a three-week period, with the 40 most noncompliant subjects randomly assigned to four groups for Treatment I. The groups were: self-monitoring, taste, taste and self-monitoring, and a no-treatment control group. The self-monitoring procedure involved recording the time medicine was taken; the taste procedure involved providing the subjects with flavored tablets to increase the saliency of tablet taking; and the self-monitoring and taste procedure involved providing subjects with flavored tablets and asking them to record the flavor of each tablet they ingested. At the end of six weeks, half the subjects in each of these groups participated in response-cost procedures while the remaining subjects continued with their previous procedures. Response-cost procedures were implemented by returning a portion of the subjects' deposit only if a preset compliance criterion was met. Treatment II procedures were implemented for an additional three weeks. Results indicated the self-monitoring and taste plus self-monitoring procedures were superior during Treatment I. The implementation of response cost during Treatment II was associated with a marked improvement in compliance, independent of the history of noncompliance. The effects of the taste plus self-monitoring procedure were maintained during Treatment II and results obtained by this procedure were not significantly different from effects of response cost.     

Risk perception and conspiracy theory endorsement predict compliance with COVID-19 public health measures

Public health measures such as spatial distancing and physical hygiene have been found effective in mitigating the spread of the coronavirus. However, there is considerable variability in individual compliance with such public health measures and factors contributing to these interindividual differences are currently still understudied. The present study set out to determine the role of risk perception and conspiracy theory endorsement on compliance with COVID-19 public health measures and explored variations in these associations across participant age and the developmental status of a country, leveraging a large multi-national data set (N = 45,772) across 66 countries/territories, collected via online survey during the early phase of the COVID-19 pandemic (between April and May 2020). Human Development Index (HDI), developed by the United Nations Development Program, was used as a proxy of a country's achievement in key dimensions of human development. Overall, higher risk perception was associated with greater compliance, particularly in individuals with greater conspiracy theory endorsement. Specifically, people from more developed countries who perceived themselves less at risk but showed stronger conspiracy theory endorsement reported the lowest compliance with COVID-19 public health measures. Findings from this study advance understanding of the interplay between risk perception and conspiracy theory endorsement in their effect on compliance with COVID-19 public health measures, under consideration of both individual-level and country-level demographic variables and have potential to inform the design of tailored interventions to fight the current and future global pandemics.     

Moralizing the COVID-19 Pandemic: Self-Interest Predicts Moral Condemnation of Other's Compliance,Distancing, and Vaccination

The emergence of the novel coronavirus has put societies under tremendous pressure to instigate massive and rapid behavior change. Throughout history, an effective strategy to facilitate novel behaviors has been to morally condemn those who do not behave in an appropriate way. Accordingly, here, we investigate if complying with the advice of health authorities—for example, to physically distance or vaccinate—has emerged as a moralized issue during the COVID-19 pandemic. In Study 1, we rely on data (N = 94K) from quota-sampled rolling cross-sectional online surveys from eight countries (Denmark, Sweden, Germany, France, Italy, Hungary, the United Kingdom, and the United States). We find that large majorities find it justified to condemn those who do not keep a distance to others in public and around half of respondents blame ordinary citizens for the severity of the pandemic. Furthermore, we identify the most important predictors of condemnation to be behavior change and personal concern, while institutional trust and social distrust also play large but less consistent roles. Study 2 offers a registered replication of our findings on a representative sample of Britons (N = 1.5K). It shows that both moralization and condemnation of both vaccination and general compliance are best predicted by self-interested considerations.     

A BEHAVIORAL INTERVENTION FOR IMPROVING VERBAL BEHAVIORS OF HEROIN ADDICTS IN A TREATMENT CLINIC

Positively reinforcing appropriate behaviors improved verbal behaviors of opioid-dependent patients in a buprenorphine treatment clinic. During B phases of an ABAB design, clients received stickers for engaging in appropriate verbal or nonverbal behaviors. Each sticker provided a chance of winning $25. No reinforcement was provided during the A phases. Appropriate verbal behaviors increased during reinforcement periods, and inappropriate verbal behaviors decreased.     

The momentum of compliance

Compliance with demanding requests that are normally ineffective may be increased by presenting a series of easy or high-probability (high-p) requests before the more demanding requests. Mace and his colleagues have discussed the effectiveness of the high-p procedure in relation to behavioral momentum—the tendency for behavior, once initiated and reinforced, to persist in the face of a challenge. The high-p procedure differs in several ways from that employed in laboratory research on momentum, and the methods and findings of basic research may not be relevant to applied work on compliance. This article reviews some laboratory procedures used in research on behavioral momentum, summarizes the major findings of that research, and discusses its relevance to the high-p procedure and its outcomes. Increased compliance with demanding requests following the high-p procedure can be understood in relation to the procedures and findings of basic research, but some questions arise in the process of translating research into application via the metaphor of momentum. These questions suggest some new directions for both experimental and applied behavior analysis.     

Antihypertensive treatment,compliance, and quality of life: Review of a little-understood relation

If patients notoriously violate treatment regimens known to effectively control hypertension, then there must be some subjective costs associated with adherence to these regimens. Generally speaking, there must be some reduction in quality of life associated with antihypertensive medication. Unfortunately the concept of quality of life, due to its lack of specificity, is of little help in further investigating the nature of these subjective costs. We developed a simple neuropsychophysiological model based on fundamental psychological and physiological processes: corticoinhibitory effects of phasic blood pressure elevation reduce the aversive or painful qualities of many stressors. This negative reinforcement increases the rate of the reinforced physiological behavior, i.e., phasic analgesic blood pressure increases. Such negatively reinforced operant behavior is known to be extremely resistant to extinction. Counter actions such as taking antihypertensive medication not only lead to reduced quality of life due to their cancellation of the analgesic effect of conditioned blood pressure increase, but also lead to some form of reluctance to comply with treatment. The model not only provides an innovative etiological path to the emergence of neurogenic essential hypertension, but also yields a highly specific and lean concept of quality of life. Furthermore, it supplies the health care community with a concise explanation for the well-known low compliance of patients with their antihypertensive regimens. In addition to its parsimony, the model fits well with various experimental findings and has been operationalized and tested empirically. Specific therapeutic implications can be derived.     

AN EVALUATION OF EVIDENCE‐BASED INTERVENTIONS TO INCREASE COMPLIANCE AMONG CHILDREN WITH AUTISM

We evaluated 4 evidence‐based interventions to increase compliance. Three children with autism who exhibited noncompliance when asked to relinquish a preferred toy were exposed sequentially to interventions that included a reduction in response effort, differential reinforcement, and guided compliance. Results indicated that effort reduction alone was ineffective and that each participant's compliance improved after exposure to a different intervention; these results highlight the need to individualize treatments for compliance.     

An analysis of modifications to the three-step guided compliance procedure necessary to achieve compliance among preschool children

After a 3‐step guided compliance procedure (vocal prompt, vocal plus model prompt, vocal prompt plus physical guidance) did not increase compliance, we evaluated 2 modifications with 4 preschool children who exhibited noncompliance. The first modification consisted of omission of the model prompt, and the second modification consisted of omitting the model prompt and decreasing the interprompt interval from 10 s to 5 s. Each of the modifications effectively increased compliance for 1 participant. For the remaining 2 participants, neither modification was effective; differential reinforcement in the form of contingent access to a preferred edible item was necessary to increase compliance. Problem behavior varied across participants, but was generally higher during guided compliance conditions and lower during differential reinforcement conditions.