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PubMed1994

The use of goal setting and contingency contracting for improving children's homework performance.

We examined the effects of goal setting and contingency contracting on children's homework performance. Subjects were 4 parent-child dyads in which the child exhibited substantial homework problems. Using a combination of multiple baseline and reversal (ABAB) designs, goal setting and contingency contracting produced significant improvements in children's homework accuracy. Two of the 4 subjects showed substantial improvements in on-task behavior. Consumer satisfaction with the procedures was supported by parent ratings conducted posttreatment.

Attention↗

PubMed1999

A randomized clinical trial of triazolam in 3- to 5-year-olds.

Triazolam has shown promise as a sedative agent for use in pediatric dentistry. However, the efficacy of triazolam has not been previously examined in a placebo-controlled study. The present clinical trial used a two-group, randomized, double-blind study design to compare the efficacy of oral triazolam with that of a placebo. The primary hypothesis tested was that triazolam would reduce negative behaviors of pediatric dental patients compared with a placebo. A secondary hypothesis was that triazolam would increase the efficiency of dental treatment by reducing the need for time-consuming behavior management by the pediatric dentist. The subjects were 54 3- to 5-year-old children, randomly assigned to the drug and placebo groups. The active drug, 0.03 mg/kg triazolam (Halcion), or lactose placebo was given orally 30 min before dental treatment. Behavior management techniques commonly used in pediatric dentistry were used during dental treatment. A single pediatric dentist provided all of the dental treatment. The procedure included an inferior block anesthesia and careful attention to anesthesia effectiveness. All sessions were video-taped and the tapes coded for child and dentist behaviors by an independent observer. There were no statistically significant differences between the groups with respect to completion of dental treatment. There were no significant differences found in either the total time or the percent of time that the subjects exhibited disruptive movements, verbal or non-verbal distress. The total use of time in the dental chair was slightly higher in the placebo than in the drug group due to more time spent preparing the child. Contrary to preliminary reports in the literature, this investigation found little or no improvement in child behavior when triazolam was used as a sedative compared with a placebo. However, triazolam did shorten the length of dental treatment, primarily by reducing dentist time in preparing the child for the dental procedure (e.g., establishing rapport and shaping behavior).

Administration, Oral↗

PubMed2004

Genetic testing for breast and ovarian cancer susceptibility: evaluating direct-to-consumer marketing--Atlanta, Denver, Raleigh-Durham, and Seattle, 2003.

Breast and ovarian cancer are the second and fifth leading causes of cancer death, respectively, among women in the United States. One in eight women will have breast cancer during their lifetimes, and one in 70 will have ovarian cancer. Mutations in two genes, BRCA1 and BRCA2 (BRCA1/2), are associated with predisposition for inherited breast and ovarian cancer and are identified in 5%-10% of women with breast or ovarian cancer (BOC). Since 1996, genetic testing for these mutations has been available clinically; however, population-based screening is not recommended because of the complexity of test interpretation and limited data on clinical validity and utility. Despite the test's limited applicability in the general population, the U.S. provider of clinical BRCA1/2 testing (Myriad Genetic Laboratories, Inc., Salt Lake City, Utah) conducted a pilot direct-to-consumer (DTC) marketing campaign in two cities (Atlanta, Georgia, and Denver, Colorado) during September 2002-February 2003. Although DTC advertisements have been used to raise consumer awareness about pharmaceuticals, this was the first time an established genetic test was marketed to the public. To assess the impact of the campaign on consumer behaviors and health-care provider practices, CDC and the respective state health departments for the pilot cities and two comparison cities (Raleigh-Durham, North Carolina, and Seattle, Washington) surveyed consumers and providers. This report summarizes results of those surveys, which indicated that consumer and provider awareness of BRCA1/2 testing increased in the pilot cities and that providers in these cities perceived an impact on their practice (e.g., more questions asked about testing, more BRCA1/2 tests requested, and more tests ordered). However, in all four cities, providers often lacked knowledge to advise patients about inherited BOC and testing. These findings underscore the need for evidence-based recommendations on appropriate use of genetic tests and education of providers and the public to achieve maximum individual and public health benefit from genetic testing.

Adult↗

PubMed1983

Behavioral consequences of consumer dissatisfaction with medical care.

The effects of consumer dissatisfaction with doctors and medical care services on intentions to seek care and subsequent behavior were estimated using data from four general population studies. Satisfaction was linked to reported intentions regarding care-seeking behavior (choices between self-care and seeking care from a regular doctor or emergency room) in response to both minor and serious medical problems. These results were replicated in two populations with diverse sociodemographic characteristics. Satisfaction scales also predicted subsequent changes in medical care providers and disenrollments from prepaid health plans independent field tests. These results suggest that the behavioral consequences of individual differences in satisfaction with doctors and health care services are noteworthy from both clinical and social perspectives.

Consumer Behavior↗

PubMed1995

Aggressivity in adolescent alcohol abusers: relationship with conduct disorder.

Several longitudinal and retrospective studies have documented an association between premorbid aggression and an increased risk for an alcohol-use disorder in adulthood. However, few data are available examining the relationship between trait aggressivity, alcohol use behavior, and the presence of an early-onset alcohol use disorder diagnosis among the adolescent population. To address this deficiency, this study had three goals. First, the relationship between aggressivity and adolescent alcohol consuming behavior was examined. Second, the presence and magnitude of trait aggressivity were determined among adolescents who met psychiatric diagnostic criteria for alcohol abuse/dependence (ALC), while controlling for the presence of a conduct disorder (CD). Third, because CD is overrepresented among adolescent alcohol abuse cases and is a priori defined by the presence of certain aggressive behaviors, the simultaneous contributions of CD and ALC on trait aggressivity were also investigated through structural equation modeling. The results confirm the salience of heightened aggressivity as an essential feature of this early-onset alcohol-abusing population and indicate the importance of addressing this behavioral domain in prevention and treatment efforts.

Adolescent↗

PubMed2001

Social marketing: application to medical education.

Medical education is often a frustrating endeavor, particularly when it attempts to change practice behavior. Traditional lecture-based educational methods are limited in their ability to sustain concentration and interest and to promote learner adherence to best-practice guidelines. Marketing techniques have been very effective in changing consumer behavior and physician behavior. However, the techniques of social marketing-goal identification, audience segmentation, and market research-have not been harnessed and applied to medical education. Social marketing can be applied to medical education in the effort to go beyond inoculation of learners with information and actually change behaviors. The tremendous potential of social marketing for medical education should be pilot-tested and systematically evaluated.

Behavior Therapy↗

PubMed2005

Arousal and consumer in-store behavior.

From a psychophysiological point of view, arousal is a fundamental feature of behavior. As reported in different empirical studies based on insights from theories of consumer behavior, store atmosphere should evoke phasic arousal reactions to attract consumers. Most of these empirical investigations used verbal scales to measure consumers' perceived phasic arousal at the point-of-sale (POS). However, the validity of verbal arousal measurement is questioned; self-reporting methods only allow a time-lagged measurement. Furthermore, the selection of inappropriate items to represent perceived arousal is criticized, and verbal reports require some form of cognitive evaluation of perceived arousal by the individual, who might (in a non-measurement condition) not even be aware of the arousal. By contrast, phasic electrodermal reaction (EDR) has proven to be the most appropriate and valid indicator for measuring arousal [W. Boucsein, Physiologische Grundlagen und Messmethoden der dermalen Aktivität. In: F. Rösler (Ed.), Enzyklopädie der Psychologie, Bereich Psychophysiologie, Band 1: Grundlagen and Methoden der Psychophysiologie, Kapitel, Vol. 7, Hogrefe, Göttingen, 2001, pp. 551-623] that could be relevant to behavior. EDR can be recorded simultaneously to the perception of stimuli. Furthermore, telemetric online device can be used, which enables physiological arousal measurement while participants can move freely through the store and perform the assigned task in the experiments. The present paper delivers insights on arousal theory and results from empirical studies using EDR to measure arousal at the POS.

Arousal↗

PubMed2001

Consumers' convenience orientation towards meal preparation: conceptualization and measurement.

Consumer researchers consider convenience orientation towards meal preparation to be a relevant construct for understanding consumer behavior towards foods. This study set out to conceptualize this construct and to develop a scale that measures it. As examined in two different samples of meal preparers, the resulting scale is reliable, satisfies a unifactorial structure and has satisfactory convergent validity. The scale's nomological validity is supported in that it conforms to expectations regarding various psychographic constructs and various food-related behaviors. Convenience orientation was found to be negatively related to cooking enjoyment, involvement with food products and variety seeking, and to be positively related to role overload. The analyses also suggest that the lack of relation between the meal preparer's working status and convenience food consumption, as found in many studies, is due to convenience food not offering enough preparation convenience. Consuming take-away meals and eating in restaurants appear to satisfy the consumer's need for convenience more adequately.

Adolescent↗

PubMed1997

A proposal for the establishment of scientific criteria for health claims for functional foods.

Functional foods are defined and used differently in different nations. Health claims for these foods influence consumer behavior and potentially affect public health. In an increasingly global economy, health claims for functional foods should meet internationally agreed upon scientific criteria. The concept of health claims as it exists internationally is discussed, and suggestions to assist consumers, government, industry, and academia in deciding on a scientific and ethical basis for international agreement on health claims for functional foods are offered.

Consumer Product Safety↗

PubMed2006

Organic food: buying more safety or just peace of mind? A critical review of the literature.

Consumer concern over the quality and safety of conventional food has intensified in recent years, and primarily drives the increasing demand for organically grown food, which is perceived as healthier and safer. Relevant scientific evidence, however, is scarce, while anecdotal reports abound. Although there is an urgent need for information related to health benefits and/or hazards of food products of both origins, generalized conclusions remain tentative in the absence of adequate comparative data. Organic fruits and vegetables can be expected to contain fewer agrochemical residues than conventionally grown alternatives; yet, the significance of this difference is questionable, inasmuch as actual levels of contamination in both types of food are generally well below acceptable limits. Also, some leafy, root, and tuber organic vegetables appear to have lower nitrate content compared with conventional ones, but whether or not dietary nitrate indeed constitutes a threat to human health is a matter of debate. On the other hand, no differences can be identified for environmental contaminants (e.g. cadmium and other heavy metals), which are likely to be present in food from both origins. With respect to other food hazards, such as endogenous plant toxins, biological pesticides and pathogenic microorganisms, available evidence is extremely limited preventing generalized statements. Also, results for mycotoxin contamination in cereal crops are variable and inconclusive; hence, no clear picture emerges. It is difficult, therefore, to weigh the risks, but what should be made clear is that 'organic' does not automatically equal 'safe.' Additional studies in this area of research are warranted. At our present state of knowledge, other factors rather than safety aspects seem to speak in favor of organic food.

Agriculture↗

PubMed2000

Craving: what can be done to bring the insights of neuroscience, behavioral science and clinical science into synchrony.

Alcohol self-administration behavior is the common thread that is necessary to bring the insights of neuroscience, behavioral science and clinical science into synchrony around the concept of craving. Animal models should address the molecular and cellular changes that take place in behaviorally relevant brain regions of rats consequent to chronic self-administration of ethanol. Animal models can focus on the biology of the anticipatory state in alcohol preferring/consuming rats, as well as studies of the effects of possible medications on this state in the animal model, on actual alcohol consuming behavior, and on the residual effects of chronic alcohol on the non-human mammalian brain. In human studies of craving, cue-reactivity in the absence of the opportunity to drink alcohol does not have the same salience as cue-reactivity in which drinking is possible. Moreover, actual drinking behavior serves to validate self-reports of craving. Studies of limited alcohol self-administration in the laboratory are an essential element in screening new medications for the treatment of alcoholism. Studies to date suggest no adverse reaction to the participation of alcoholic subjects in limited alcohol self-administration studies, but the research community should continue to monitor carefully the outcomes of alcohol-dependent subjects who participate in this type of research, and efforts should always be made to encourage these subjects to enter active treatment. In outpatient clinical trials of new treatments for alcoholism, the assessment of craving should include queries regarding symptoms and signs of protracted abstinence such as sleep disturbances, as well as questions regarding situational craving. Field observations of alcoholics in their favorite drinking environments would contribute greatly to our understanding of the real-world phenomenology of craving.

Alcohol Drinking↗

PubMed2002

A framework for sustainability science: a renovated IPAT identity.

Learning actors' leverage for change along the journey to sustainability requires quantifying the component forces of environmental impact and integrating them. Population, income, consumers' behavior, and producers' efficiency jointly force impact. Here, we renovate the "IPAT Identity" to identify actors with the forces. Forcing impact I are P for population, A for income as gross domestic product (GDP) per capita, C for intensity of use as a good per GDP, and T for efficiency ratios as impact per good. In the "ImPACT Identity," parents modify P, workers modify A, consumers modify C, and producers modify T. Because annual percentage changes in component forces add to a change in national impact, actors' leverage is reflected transparently in consistent units of annual percentage changes that can be compared from force to force. Examples from energy and food, farming and manufacturing, and steel and water show that declining C, called dematerialization, can temper the sustainability challenge of growth (P x A), and that innovation or efficient technology that lowers T can counter rising consumption (P x A x C). Income elasticity can accommodate connections between income and other forces. From rates of change of forces, the identity can forecast impacts. Alternatively, by identifying the necessary change in forces to cause a projected impact, ImPACT can assay the likelihood and practicability of environmental targets and timetables. An annual 2-3% progress in consumption and technology over many decades and sectors provides a benchmark for sustainability.

Agriculture↗

PubMed1980

Patients' rights in decision making: the case for personalism versus paternalism in health care.

The purpose of this presentation is to shine a psychological spotlight on the role of the breast cancer patient in the process of her decision making about her medical care and the specific influence that the nature of the physician-patient interaction has on that behavior. The vision of the parental physician as unilateral authority in decisions about health care is dimming. The picture is being supplanted by a new image that promotes a view of personalism and a concept of "shared responsibility." The wave of consumerism is washing the shores of medical practice, and women are establishing their beachhead. Women are demonstrating their knowledge, their competence, and their responsibility in exercising decisions about their medical treatments and the quality of their survival. Therefore, it is essential to educate patients to exhibit informed consumer behavior and encourage physicians to recognize the value of a patient's participation. Such collaborative endeavors could result in increased patient satisfaction, reduced burdens for the physician, and preserved patients' feelings of individuality, autonomy, and sense of personal dignity.

Breast Neoplasms↗

PubMed1999

Effect of access to a running wheel on behavior of C57BL/6J mice.

BACKGROUND AND PURPOSE: To evaluate how and when mice run on a running wheel and how ad libitum access to the wheel affect behavior, feed intake, and weight gain. METHODS: Seventeen 2-month-old C57BL/6J mice had access to the wheel, whereas 19 control mice did not. After 3 to 6.5 weeks, behavior was video-recorded over 24 h for each mouse. RESULTS: Experimental mice ran an average 2 km/24 h in 114 min. Highest running activity took place at the onset of darkness. Experimental mice spent 22 min more feeding on the cage floor than did control mice. These times were deducted from those for all other behaviors: 74 min from resting time, 39 min from climbing and feeding on the cage lid, 14 min from locomotion on the cage floor, and 10 min from grooming. In relative figures, deduction from sleeping time was only 9%, whereas climbing time was halved. CONCLUSIONS: Climbing on the cage lid has a similar circadian rhythm as does wheel running and high-energy expenditure. Because experimental mice climbed less, their weight gain and feed intake were similar to those of control mice. Thus, wheel running can substitute for other forms of energy-consuming behaviors and vice versa.

Animals↗

PubMed2006

Exploring the public's views on the health care system: a national survey on the issues and options.

Instead of assessing support for specific health reform initiatives, this study examines fundamental attitudes that shape views about the provision and financing of health insurance. We find strong support for equity and expansion of coverage, with few differences across sociodemographic groups, but some support for holding individuals responsible for health-related behavior. Consumers want to retain choice of plans and coverage for routine expense yet not bear additional financial burden. Compared with the rest of the United States, Californians' views exhibit more reliance on individuals and provide additional caution about the difficulty of identifying acceptable trade-offs and reaching consensus.

Attitude to Health↗

PubMed1995

Changing diet and exercise behaviors in individuals at risk for weight gain.

To date, there have been very few studies on the primary prevention of obesity and/or weight gain. This paper identifies three times periods that might be appropriate for such efforts at weight gain prevention--the 25 to 35 year age window, the perimenopausal period, and the year following successful weight loss. Research is encouraged that compares these three time periods and various intervention strategies. Several different approaches to primary prevention are identified, including group treatment programs with weekly meetings vs. less intensive, community-based interventions; focusing on those who are currently at ideal body weight vs. including those who are overweight as well; and targeting weight gain prevention per se vs. attempting to produce modest weight losses and/or modify cardiovascular risk factors. This paper suggests that primary prevention efforts should include exercise, changes in quality and quantity of food consumed, behavior modification, and some degree of therapist contact, but the manner in which these changes should be implemented to produce long-term habit change remains unclear.

Adult↗

PubMed2006

Estimated prevalence of compulsive buying behavior in the United States.

OBJECTIVE: Compulsive buying (uncontrolled urges to buy, with resulting significant adverse consequences) has been estimated to affect from 1.8% to 16% of the adult U.S. population. To the authors' knowledge, no study has used a large general population sample to estimate its prevalence. METHOD: The authors conducted a random sample, national household telephone survey in the spring and summer of 2004 and interviewed 2,513 adults. The interviews addressed buying attitudes and behaviors, their consequences, and the respondents' financial and demographic data. The authors used a clinically validated screening instrument, the Compulsive Buying Scale, to classify respondents as either compulsive buyers or not. RESULTS: The rate of response was 56.3%, which compares favorably with rates in federal national health surveys. The cooperation rate was 97.6%. Respondents included a higher percentage of women and people ages 55 and older than the U.S. adult population. The estimated point prevalence of compulsive buying among respondents was 5.8% (by gender: 6.0% for women, 5.5% for men). The gender-adjusted prevalence rate was 5.8%. Compared with other respondents, compulsive buyers were younger, and a greater proportion reported incomes under 50,000 US dollars. They exhibited more maladaptive responses on most consumer behavior measures and were more than four times less likely to pay off credit card balances in full. CONCLUSIONS: A study using clinically valid interviews is needed to evaluate these results. The emotional and functional toll of compulsive buying and the frequency of comorbid psychiatric disorders suggests that studies of treatments and social interventions are warranted.

Adult↗

PubMed2006

Genotrim, a DNA-customized nutrigenomic product, targets genetic factors of obesity: hypothesizing a dopamine-glucose correlation demonstrating reward deficiency syndrome (RDS).

Obesity is the second largest cause of preventable death in the United States. Historically, obesity was considered a behavioral problem that could be simply addressed with behavioral modifications in diet and exercise. As scientific advancements have demonstrated in other neurological healthcare conditions such as alcoholism, there are important biological and genetic components that limit the efficacy of behavioral adjustments alone. In light of data suggesting frequent co-morbidities to obesity, including diabetes mellitus, atherosclerosis, osteoporosis, and potentially others, we hypothesize that the biologic and genetic factors, synergistically with behavioral modifications, must be addressed to adequately treat this disease. We hypothesize that one such genetic factor that influences behavior and thus obesity is a predisposition to glucose craving and the overall effect of dopaminergic activity in the reward center of the brain. This defect drives individuals to engage in activities of behavioral excess, which will increase brain dopamine function, for which we have created the term reward deficiency syndrome (RDS) to categorize such biological influences on behavior. Consuming large quantities of alcohol or carbohydrates (carbohydrate bingeing) stimulates the brain's production of and utilization of dopamine. So too does the intake of crack/cocaine and the abuse of nicotine. We are proposing that a novel approach to nutritional supplementation may be required to target the RDS role in obesity. In this regard, Genotrim, a DNA based customized nutraceutical has been designed and is currently under investigation in several clinical studies. This is the first hypothesis paper whereby this new paradigm shift in thinking about obesity is presented.

Anti-Obesity Agents↗