The Step it UP! Game, a modified version of the Good Behavior Game, has been implemented to increase physical activity levels among elementary school children and adults with disabilities. The purpose of the current study was to evaluate Step it UP! Game sessions that differed in duration within a given reinforcement arrangement on steps. Participants included young adults with disabilities (n = 15). Six conditions were alternated randomly within a multielement design: baseline (10, 20, and 40 min) and Step it UP! Game (10, 20, and 40 min). Participants took more steps during the Step it UP! Game relative to baseline, but no clear step differences were observed across game conditions. Pauses in step taking and the percentage of time engaging in moderate-intensity physical activity changed as game duration was manipulated.

Physical inactivity during pregnancy is problematic and associated with adverse health outcomes, including increased blood loss during labor and pre-eclampsia. The purpose of the present study was to apply the behavioral economic framework to understand physical inactivity among pregnant women. We examine the factor structure of a novel hypothetical purchase task for physical inactivity in a cross-sectional survey study, as well as examine differences in the latent variable scores in a convenience sample of two distinct populations (n = 68): pregnant veterans and nonveterans. Results showed that the purchase task was characterized by two latent factors: amplitude (i.e., intensity of demand for physical inactivity, α = 0.5) and persistence (i.e., demand sensitivity regarding physical inactivity, α = 0.9). After controlling for relevant demographic variables using linear regression analysis, veterans—compared to nonveterans—exhibited higher persistence (b = 1.6, p < 0.001) and amplitude scores (b = 1.2, p < 0.001). In summary, this study characterized a new behavioral economic measure of physical inactivity for pregnant women. Furthermore, we suggest that pregnant veterans may value physical inactivity more than pregnant nonveterans.

BACKGROUND:While moral injury is associated with adverse health behaviors among veterans, no studies have examined the association between e-cigarette consumption among women veterans and moral injury. METHODS:Using a nicotine continuum of harm perspective, we recruited women veterans who used e-cigarettes or e-cigarettes + combustible cigarettes (n = 55) via Amazon MTurk and Reddit from June 2023 to September 2024. Women veterans completed the e-cigarette purchase task (e-CPT) assessing the relative reinforcing value (RRV) of e-cigarettes, the e-cigarette Fagerstrom Test for Cigarette Dependence (e-FTCD), and the Moral Injury Symptom Scale (MISS-M-SF). We estimated five e-CPT demand indices and calculated an exponential demand model stratified by moral injury status (i.e., probable vs. unlikely). Comparisons were adjusted for dual user status, length of service, and e-FTCD scores. RESULTS:Those with probable moral injury were more likely than unlikely morally injured veterans to be dual users (p = 0.02). Probable morally injured veterans exhibited significantly higher demand for e-cigarettes than unlikely morally injured veterans (p = 0.01). Average e-cigarette consumption at $0 was significantly higher (M = 118.6 vs. M = 29.9) in probable versus unlikely morally injured veterans (p = 0.03). CONCLUSIONS:This study offers preliminary evidence of the RRV of using e-cigarettes in morally injured women veterans.

The Step it UP! Game, a modified version of the Good Behavior Game (GBG), has previously been shown to increase physical activity levels among elementary school children and adults with disabilities. The purpose of this study was to compare a novel modification of the GBG targeting physical activity, the Don't Stop! Game, with the Step it UP! Game. Participants included 14 young adults with intellectual and developmental disabilities. Three conditions were alternated randomly within a multielement design: baseline, Step it UP! Game (in which the team with the most steps wins a prize), and Don't Stop! Game (in which the team with the fewest demerits for standing still wins a prize). All 14 participants had higher steps per minute during intervention conditions relative to baseline, but the degree of difference between intervention conditions differed across participants. The Don't Stop! Game was preferred by more participants.

The Step it UP! Game, a modified version of the Good Behavior Game, has been used to increase physical activity among elementary school children and adults with disabilities. One important benefit of the Step it UP! Game is that it can be implemented by a single staff member for many clients simultaneously. To date, previous implementations of the Step it UP! Game have only been facilitated by researchers. The purpose of the present study is to determine whether staff members could be trained to proficiently implement the Step it UP! Game with adults with disabilities and determine if a staff-implemented Step it UP! Game could increase the mean steps per min of adults with disabilities. Three staff members (N = 3) were trained to implement the Step it UP! Game using video modeling and behavior skills training (BST). The percentage of correct implementation was evaluated using a concurrent multiple baseline design across participants. The baseline percentage of correct implementation was M = 38.75

College vaping has increased four-fold during 2017-2019. This study aimed to examine the attempts to quit vaping among undergraduate students and provide insights into interventions. A random sample of undergraduate students completed an anonymous Qualtrics survey (N = 543). Utilizing discriminant function analysis (DFA), regular vapers were categorized into three cessation interventions, based on their readiness and preferred strategies for quitting: Complete Cessation (i.e. quit within a few months); Alternative Strategies (i.e. alternative stress management and/or socializing techniques), Availability Reduction (i.e. reducing vape products availability). Of ever-vapers (n = 270), 44% regularly vape; 76% of regular vapers have attempted to quit (2.5 attempts/participant). The most prevalent method was abrupt cessation, followed by gradual reduction. DFA assigned students to three interventions with 67% accuracy, underscoring the need for personalized interventions. Cessation attempts among youth who are motivated to quit are often unsuccessful, whereas success is multifactorial. Therefore, customized, data-driven, youth-friendly cessation interventions are urgently needed.

The Step It UP! Game, an interdependent group contingency, is an effective intervention package for increasing the step counts of adults with disabilities (Seward & Redner, 2023). To identify appropriate generalization procedures for the Step It UP! Game that will result in meaningful long-term behavior change, the components of the Step It UP! Game necessary to maintain treatment effects should be identified. To date, the components of the Step It UP! Game have not been evaluated independently. Therefore, it is unclear which components are necessary to produce an effect. We utilized an additive component analysis to evaluate the components of the Step It UP! Game among adults with disabilities. Results indicate that the entire Step It UP! Game treatment package is necessary to yield substantial increases in the level of physical activity among adults with disabilities.

OBJECTIVE:Examine nationally representative U.S. data to determine trends in cigarette smoking, nicotine dependence, and quit ratios among females by rurality and veteran status between 2002 and 2023. METHODS:Data were obtained from the 2002-2023 files (N = 454,981) of the National Survey on Drug Use and Health. Adult female respondents were categorized by rural/urban residence and veteran/nonveteran status to examine smoking outcomes across 3-year intervals. To adjust for non-response, selection probability, and post-stratification, analyses were conducted using survey weighted logistic regression models controlling for socio-demographic covariates. RESULTS:Smoking prevalence was higher among rural versus urban residents (aOR = 1.55, 95 %CI = 1.43, 1.67) and veterans versus nonveterans (aOR = 1.72, 95 %CI = 1.36, 2.17). Nicotine dependence was higher among rural versus urban residents (aOR = 1.84, 95 %CI = 1.66, 2.03) and veterans versus nonveterans (aOR = 1.49, 95 %CI = 1.08, 2.06). Quit ratios were lower in rural versus urban residents (aOR = 0.70, 95 %CI = 0.63, 0.78), but not among veterans (aOR = 0.83, 95 % CI = 0.62, 1.10). Rates of decline over time in smoking prevalence and nicotine dependence, as well as increases in quit ratios, were lower among rural residents (p's < 0.001) whereas changes by veteran status did not interact with time. CONCLUSIONS:Results across 21 years from a nationally representative US survey substantiate a growing rural-urban disparity in smoking that disproportionately impacts rural females. We also identified a disparity that disproportionately impacts veteran compared to nonveteran females. Thus, rural and veteran female populations need targeted treatment interventions.

An abolishing operation reduces the value of a particular kind of reinforcer (e.g., food) and the likelihood of occurrence of responses that historically produced such reinforcers. We examined in rats whether (a) arranging an abolishing operation, pre-session feeding, would produce resurgence when the alternative response continued to be reinforced and (b) whether this abolishing operation would affect resurgence produced by extinction. Rats were exposed to three sequential phases: (a) variable-interval 30-s food reinforcement for pressing a target lever press, with some sessions including 15 hrs of pre-session feeding; (b) variable-interval 30-s food reinforcement for an alternative lever press with extinction of the target response, also with some sessions of pre-session feeding; (c) extinction for both responses, with one group of rats receiving pre-session feeding before sessions. In Phases 1 and 2, pre-session feeding reduced response rates on the active lever. Pre-session feeding during Phase 2 did not increase target responding, indicating that our abolishing operation did not produce resurgence. In Phase 3, rats that were not pre-fed showed resurgence of the target response, whereas pre-fed rats did not, indicating that the abolishing operation mitigated resurgence. These findings are the first examining how changing motivation affects resurgence and we suggest that further research adding this topic is merited.

Cell phones in the college classroom can be used to increase interaction between students and the professor; they can also distract from academic tasks and decrease academic performance. To decrease task-switching in the classroom, researchers have suggested the use of “technology breaks” (TB), in which students are provided periodic breaks to use cell phones throughout class. The purpose of the present study was to evaluate the use of technology breaks in a college classroom (N = 21). Cell phone use was evaluated over 22 class periods. Observers recorded how many students were using cell phones every 10 s. Three experiment conditions were alternated with yoked controls in a multi-element design: (A) 1 min technology breaks, (B) 2 min technology break, and (C) 4 min technology break. The control condition [question breaks, (QB)] provided breaks for students to ask the professor questions regarding class materials. No penalties or punishers were delivered for cell phone use under any conditions. The average rate of cellphone use in QB was 0.53 responses per min (range = 0.06–1.02), while the average rate for TB was 0.35 responses per min (range = 0.20–0.74). Overall, the study found that technology breaks were a promising way to utilize reinforcement-based strategies to reduce classroom cell phone use, though variability in the data weakened conclusions regarding the utility of technology breaks.

The use of online instruction has increased substantially in the last few years. An important aspect of remote instruction that has received some attention via survey-based research is student webcam usage. There are few empirical strategies to increase students’ webcam usage. In the present study, we replicated a prior study by providing students with points contingent on webcam usage during remote college instruction. An alternating treatments design was used to assess the influence of the contingent point delivery on webcam usage. Twenty-four undergraduate students in a psychology course participated. The contingency enhanced webcam usage and the points served as effective reinforcers. A simple reinforcement contingency can improve webcam usage in a college classroom, but outcomes can likely be enhanced by including additional antecedent operations.

The phenomenon of extinction-induced resurgence is well established, but there is comparatively little experimental evidence for punishment-induced resurgence. Punishment-induced resurgence can by tested by contingent shocks following the alternative response. The purpose of Experiment 1 was to test whether low-intensity shocks, that do not decrease rate of reinforcement, result in resurgence. Four rats served as subjects. Rats were exposed to three sequential conditions: (a) variable-interval (VI) 30-s food delivery for a lever press (target response); (b) VI 30-s food delivery for a nose poke (alternative response) and extinction of the lever press; (c) VI 30-s reinforcement for a nose poke with superimposed VI 60-s shock delivery. In the final condition, shocks increased gradually from 0.1 to 0.5mA. Experiment 2 evaluated whether an abrupt introduction of a high-intensity shock would result in resurgence. Three rats served as subjects and were exposed to three sequential conditions: (a) VI 30-s food delivery for a lever press; (b) VI 30-s food delivery for a nose poke and extinction of the lever press; (c) continued VI 30-s reinforcement for a nose poke with superimposed VI 60-s 0.6mA shock delivery. Resurgence was observed in all subjects, including in situations in which rate of responding, but not rate of reinforcement, decreased. The present study provides additional evidence for punishment-induced resurgence, but future studies are warranted to determine the extent to which punishment can produce resurgence with or without decreases in rates of reinforcement.

OBJECTIVES:Unlike the United States general population, veteran women - as opposed to veteran men - have greater smoking prevalence; yet, little is known regarding factors that influence smoking in veteran women. The purpose of this study was to begin examining the relationship between a psychological concept known as moral injury and demand for cigarettes among veteran women. METHODS:Veteran women who smoke (n = 44) were recruited for this cross-sectional study from Amazon MTurk, Reddit, and a veteran-serving non-profit organization in June-July 2023. Consenting participants received $2 for completing the cigarette purchase task (CPT), Fagerstrom Test for Nicotine Dependence (FTND), and the military version of the Moral Injury Symptom Scale (MISS-M-SF). We examined five CPT demand indices and calculated a modified exponential demand model stratified by moral injury severity status (i.e., probable vs. unlikely). RESULTS:Probable morally injured women exhibited significantly higher relative reinforcing value (RRV) for smoking than unlikely morally injured women (F1, 920 = 9.16, p = 0.003). Average cigarette consumption at $0 (i.e., Q0) was 48.56% higher (M = 22.24 vs. M = 13.55) in probable compared to unlikely morally injured women (p = 0.04, Hedge's g = 0.74). FTND scores were significantly correlated with Pmax (i.e., demand elasticity point) and Omax (i.e., maximum expenditure) values in both populations (rs = 0.42-0.68, ps < 0.05). CONCLUSIONS:We provide preliminary evidence of the relatively high RRV of smoking in morally injured veteran women. Continued research is needed to refine the characterization of this relationship.

Hypothetical purchase tasks offer effective and efficient methods to assess the reinforcing value of various substances, including cigarettes. The purpose of the present study is to examine the validity and reliability of the Cigarette Purchase Task (CPT) in an experimental arrangement in which participants were receiving free cigarettes. Critical to the validity of the CPT is that those who smoke can accurately estimate how much they would smoke under varying economic constraints. Participants (N = 9) were provided free study cigarettes for 8 weeks. Participants completed the CPT once weekly. To examine the validity of the five CPT demand indices (i.e., demand intensity, P-max, O-max, breakpoint, and alpha), we used a simple linear regression stratified by session number to model which of the five CPT demand indices were associated with the number of cigarettes smoked per day during Week 1 of the experiment. Significant associations in the hypothesized direction were noted across the five CPT indices, with the evidence for validity greatest for intensity, followed by O-max, P-max, breakpoint, and alpha. To examine CPT test-retest reliability, we estimated interclass correlation coefficients between Sessions 1 and 4 and Sessions 5 and 8. All but one interclass correlation coefficient supported "good" or "excellent" reliability, with the only exception seen with the alpha index between Sessions 1 and 4, which was moderate reliability. Collectively, these results provide evidence supporting the construct validity and temporal stability/reliability of the CPT demand indices under conditions of limited economic constraint.

Objectives: We are in the midst of an overdose epidemic that has grown during the concurrent COVID-19 pandemic. In Wisconsin, overdose deaths increased 11-fold from 2000 to 2020, with over 1200 deaths in 2020. Because of disparities in substance use initiation, relapse, and treatment success among racially minoritized women, this study's purpose was to investigate overdose death rates among Black and Indigenous women in Wisconsin from 2018 to 2020. Methods: Overdose death rates were examined under the following parameters: sex, race (Black, Indigenous, White), age, year, and manner of death. Logistic regression analysis was also conducted looking at death count data, with race, age, and year as potential predictor variables. Results: Death rates (per 100,000) in 2018 were 14.1 (12.6-15.5) for White women, 20.8 (14.7-26.9) for Black women, and 26.5 (10.0-42.9) for Indigenous women; these rates increased in 2020 to 16.4 (14.8-17.9), 32.5 (25.0-40.0), and 59.9 (35.8-84.0) for White, Black, and Indigenous women, respectively. Regression findings illustrated that being Black or Indigenous and aged 15 to 44 or 45 to 64 years were significantly more likely to die from most causes of death (any drug, any opioid, prescription opioid, heroin, synthetic opioids, and cocaine; adjusted odds ratios > 1.25, Ps < 0.001). Conclusions: This study confirms that deaths in Wisconsin are disproportionately higher in female minoritized populations. Understanding the complex intricacies between the impacts of the COVID-19 pandemic coupled with barriers to treatment access or acceptability in these populations is urgently needed. It will take a multipronged approach to address the overdose epidemic and better serve these marginalized, vulnerable populations.

The purpose of the present experiments was to systematically replicate Step it UP! Game interventions with adults with disabilities. Participants were divided into two competing teams, and the team with the highest step count participated in a prize drawing. Experiment 1 (N = 9) evaluated the efficacy of an extended version of the Step it UP! Game that included additional and longer sessions. Experiment 2 (N = 8) evaluated the addition of contingent experimenter attention during the Step it UP! Game. Baseline, Step it UP! Game, and Step it UP! Game plus interaction sessions were evaluated in a multielement design. The Step it UP! Game was effective with additional and longer sessions, and all participants took more steps during Step it UP! Game sessions. Adding experimenter interaction to the Step it UP! Game did not increase the efficacy of the intervention.

Pay disparities have numerous adverse effects upon organizations, employees, and clients, which can affect the organization's ability to deliver services, including culturally responsive services. Evidence is accumulating that pay inequity, particularly among females and males, is present within the field of behavior analysis (Li et al., 2018; Vance & Saini, 2022). The purpose of the present study was to examine the annual income of Board Certified Behavior Analysts (BCBA) and doctoral-level BCBAs (BCBA-Ds) who work with children, with a particular focus on the impact that salary practices have on the provision of services to this age group. A survey was distributed to collect information regarding annual income, demographics, and various aspects of service delivery. The sample included 236 (96.7%) BCBAs and eight (3.3%) BCBA-Ds who had been in the field an average of 11.3 years (N = 244). Annual income for female BCBAs and male BCBAs was $74,888 and $79,140, respectively. For those who served children and adolescents, female respondents earn an annual average of $75,840, while male respondents earn an average of $74, 673. The annual incomes of female BCBAs that served urban, rural, and combined rural and urban regions were $76,931, $69,198, and $77,199, respectively. The observed differences between service regions were statistically significant, whereas the difference observed between females and males was not. Considering this, females made less than male counterparts in nearly every comparison, which is alarming. The present study adds to the growing list of observations indicating that a change in salary practices is needed to improve behavior-analytic service delivery to clients.

A national survey of United States veterans was conducted, yielding 252 veterans with Traumatic Brain Injury (TBI) and 1235 veterans without TBI. Participants were asked questions about moral injury, suicidality, substance use, and other sociodemographic variables. Multivariable linear regression analysis was used to examine the previously described relationships. Increasing severity of moral injury was associated with higher scores on the substance use tool (b = 0.02, p = 0.04), although the magnitude of effect was not different from those without TBI (Z = − 0.57, p = 0.72). Increasing severity of moral injury was positively associated with suicidal behavior scores (b = 0.10, p < 0.01). The strength of this relationship was stronger in veterans with TBI than those without TBI (Z = 1.78, p = 0.04). Rehabilitation programs that treat veterans for TBI may need to consider the evaluation of moral injury given its association with adverse events in this population.

Objective: The purpose of this study was to validate the Moral Injury Purchase Task, a novel behavioral economic tool, and to understand military recruits’ sensitivity to morally injurious events. Methods: Participants (N = 26) read a scenario that could prompt hypothetical feelings of moral injury and then reported the number of years they would purchase services – at varying price points – to help forget their experiences in war. Participants also completed the Moral Injury Events Scale (MIES). We calculated various demand indices and developed demand curves for military recruits and service/members veterans using Koffarnus et al’s equation. Results: Results showed that the demand curves for the 2 populations were not significantly different (F1, 438 = 5.30, p = .07) and the coefficient of determination was satisfactory when modeled on the entire sample (R2 = .90). MIES scores were positively associated with participants’ Pmax values (p = .03), providing preliminary evidence of convergent validity. Conclusions: This study provides initial evidence of the utility of using behavioral economics to assist in identifying recruits’ susceptibility to moral injury and thereby better target preventive services.