Policy Insights from the Behavioral and Brain Sciences最新文献

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Digital Contingency Management in the Treatment of Substance Use Disorders 药物使用障碍治疗中的数字应急管理

IF 3.8 Q1 EDUCATION & EDUCATIONAL RESEARCH

Policy Insights from the Behavioral and Brain Sciences

Pub Date : 2023-03-01 DOI: 10.1177/23727322221144648

J. Dallery, Anthony Defulio, B. Raiff

Contingency management (CM) provides incentives based on drug abstinence or other treatment goals; it is one of the most efficacious and cost-effective psychosocial interventions for substance use disorders. However, CM remains severely underused in clinical care. Digital methods to deliver CM could dramatically expand access. These methods include information and drug sensing technologies to obtain objective evidence of drug abstinence, authenticate the end-user's identity, and deliver incentives immediately. Digital CM has been applied successfully to cigarette smoking, alcohol misuse, and more recently illicit drug use. Policies should continue to evolve to promote the delivery of digital CM based on decades of research.

应急管理（CM）提供基于戒毒或其他治疗目标的激励措施；它是治疗药物使用障碍最有效、最具成本效益的心理社会干预措施之一。然而，CM在临床护理中的使用仍然严重不足。提供CM的数字化方法可以极大地扩大访问范围。这些方法包括信息和药物传感技术，以获得戒毒的客观证据，验证最终用户的身份，并立即提供激励措施。数字CM已成功应用于吸烟、酗酒和最近的非法药物使用。政策应在数十年研究的基础上继续发展，以促进数字CM的交付。

引用次数: 0

National Health Guidelines for Social Connection: What Is the Evidence in Support and What Might the Guidelines Say? 国家社会联系健康指南：支持的证据是什么？指南可能会说什么？

IF 3.8 Q1 EDUCATION & EDUCATIONAL RESEARCH

Policy Insights from the Behavioral and Brain Sciences

Pub Date : 2023-03-01 DOI: 10.1177/23727322221150204

J. Holt‐Lunstad

National health guidelines provide policy makers and the public with recommendations for various behavioral factors known to promote health and reduce disease risk, such as diet and physical activity. Given public health concerns about social isolation, loneliness, and other forms of lacking social connection, the evidence supports establishing national health guidelines for “social connection.” The aggregate body of scientific evidence demonstrates social connection protects health and reduces health risks, pointing to clear relevance for public health. Taken together with national trends suggesting greater social disconnection, there is a compelling case for national preventative efforts. This article summarizes evidence on the health relevance of social connections, potential opportunities, and challenges in establishing and implementing guidelines, the process of establishing guidelines, and provides illustrative evidence-based examples of potential recommendations.

国家健康指南为决策者和公众提供了关于促进健康和减少疾病风险的各种已知行为因素的建议，例如饮食和体育活动。鉴于公共卫生对社会隔离、孤独和其他形式的缺乏社会联系的担忧，有证据支持为“社会联系”制定国家卫生指南。综合科学证据表明，社会联系可以保护健康并降低健康风险，这表明社会联系与公共卫生有着明确的关联。结合表明社会脱节加剧的国家趋势，有一个令人信服的理由，要求国家采取预防措施。本文总结了社会关系与健康相关的证据、建立和实施指南的潜在机遇和挑战、制定指南的过程，并提供了潜在建议的说明性证据示例。

引用次数: 5

Barriers to Accessing Effective Treatments for Destructive Behavior. 获得破坏性行为有效治疗的障碍

IF 3.4 Q1 EDUCATION & EDUCATIONAL RESEARCH

Policy Insights from the Behavioral and Brain Sciences

Pub Date : 2023-03-01 Epub Date: 2023-03-15 DOI: 10.1177/23727322221144653

Brian D Greer

The field of applied behavior analysis has developed and refined a comprehensive methodology for the assessment and successful treatment of destructive behavior: An individualized approach emphasizes (a) function of responding (or its cause) over its form; (b) objective and reliable measurement of behavior; (c) systematic procedures and their application; (d) rigorous, single-case experimental designs; and (e) determinations of successful intervention judged by improvements in the same individual's performance. Outcomes of this approach are often dramatic and reliably surpass those obtained by alternative means. However, significant barriers limit the accessibility of this proven therapy. Too few intensive behavioral intervention units, diagnosis- and age-dependent insurance authorization and reimbursement practices, long waitlists and slow approval processes, and the possibility of treatment relapse represent a few such barriers. This article describes these barriers and suggests some potential solutions.

应用行为分析领域已经发展和完善了一种评估和成功治疗破坏性行为的综合方法。这种个性化的方法强调(a)响应(或其原因)的功能而不是其形式;(b)客观可靠的行为测量;(c)系统程序及其应用;(d)严格的单例实验设计;(e)通过个体表现的改善来判断干预是否成功。这种方法的结果往往是戏剧性的，并且可靠地超过其他方法所获得的结果。然而，重大障碍限制了这种经过验证的治疗方法的可及性。强化行为干预单位太少，诊断和年龄相关的保险授权和报销做法，漫长的等待名单和缓慢的批准过程，以及治疗复发的可能性代表了其中的一些障碍。本文描述了这些障碍，并提出了一些可能的解决方案。

引用次数: 0

Heart Rate Variability Biofeedback for Substance Use Disorder: Health Policy Implications. 药物使用障碍的心率变异性生物反馈:健康政策影响

IF 2.3 Q1 EDUCATION & EDUCATIONAL RESEARCH

Policy Insights from the Behavioral and Brain Sciences

Pub Date : 2022-10-01 Epub Date: 2022-09-10 DOI: 10.1177/23727322221113037

Sarah T Wieman, David Eddie

Substance use disorder (SUD) exacts massive individual and public health burdens, in part because of its relapsing nature. First-line SUD treatments aim to strengthen affective and cognitive control to help individuals override impulses to use alcohol and other drugs, yet automatic physiological processes compromised by SUD interact with affective states and the environment, compromising effortful cognitive control and undermining attempts to avoid substance use. While existing first-line SUD treatments may indirectly help offset these vulnerabilities, none target them. Heart rate variability biofeedback (HRVB) involves rhythmic breathing that directly targets these deficits, complementing first-line SUD treatments. HRVB has evolved from a clinic-based treatment to an ambulatory intervention utilizing wearable biosensors and smartphone applications with capacity for just-in-time support of affective and behavioral self-regulation. There is evidence supporting the efficacy of HRVB for SUD, but more research is needed to fully assess HRVB's potential to support SUD recovery and inform policy.

物质使用障碍(SUD)造成了巨大的个人和公共卫生负担，部分原因是其复发性。一线SUD治疗旨在加强情感和认知控制，帮助个体克服使用酒精和其他药物的冲动，然而，SUD损害的自动生理过程与情感状态和环境相互作用，损害了努力的认知控制，破坏了避免物质使用的尝试。虽然现有的一线SUD治疗可能间接帮助抵消这些弱点，但没有针对它们。心率变异性生物反馈(HRVB)涉及有节奏的呼吸，直接针对这些缺陷，补充一线SUD治疗。HRVB已经从基于临床的治疗演变为利用可穿戴生物传感器和智能手机应用程序的动态干预，具有及时支持情感和行为自我调节的能力。有证据支持HRVB对SUD的疗效，但需要更多的研究来充分评估HRVB支持SUD恢复的潜力并为政策提供信息。

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引用次数: 0

Cognition is a Critical Vital Sign for Older Adults: The Need for Early Detection of Cognitive Impairment is Now 认知是老年人的重要生命体征：现在需要早期发现认知障碍

IF 3.8 Q1 EDUCATION & EDUCATIONAL RESEARCH

Policy Insights from the Behavioral and Brain Sciences

Pub Date : 2022-09-10 DOI: 10.1177/23727322221110261

R. Hilsabeck, L. Lacritz, M. Colvin, P. Espe-Pfeifer, S. Sperling, P. Arnett, W. Perry

The number of older adults in America is increasing every year, and in just over one decade, people aged 65 and older will surpass the number of children under age 18 for the first time in history. Along with the aging of America comes increase in the prevalence of cognitive impairment because age is the primary risk factor for neurodegenerative conditions such as Alzheimer disease and related disorders. There is an urgent need to identify cognitive impairment as early as possible so interventions can be deployed to reduce the associated medical, behavioral, and economic burden on patients, families, and society in general. Launching public health campaigns, investing in a workforce that is trained and incentivized to detect and manage cognitive impairment, and leveraging technology to facilitate and improve early detection are a few strategies that may help address this growing healthcare crisis.

美国老年人的数量每年都在增加，在短短十年多的时间里，65岁及以上的人将有史以来首次超过18岁以下的儿童。随着美国的老龄化，认知障碍的患病率也在增加，因为年龄是阿尔茨海默病和相关疾病等神经退行性疾病的主要风险因素。迫切需要尽早发现认知障碍，以便采取干预措施来减轻患者、家庭和整个社会的相关医疗、行为和经济负担。发起公共卫生运动，投资于一支受过培训和激励的劳动力队伍，以检测和管理认知障碍，并利用技术促进和改进早期检测，这些策略可能有助于解决这场日益严重的医疗危机。

引用次数: 1

Behavioral Economic Demand: How Simulated Behavioral Tasks Can Inform Health Policy 行为经济需求：模拟行为任务如何为卫生政策提供信息

IF 3.8 Q1 EDUCATION & EDUCATIONAL RESEARCH

Policy Insights from the Behavioral and Brain Sciences

Pub Date : 2022-09-10 DOI: 10.1177/23727322221118668

Derek D. Reed, Brett W. Gelino, J. Strickland

Consumers decide what to purchase, under conditions of constraint (e.g., commodity price). According to behavioral economic demand, commodity purchase task (CPT) can measure hypothetical decisions about purchases under varied simulated policy conditions (e.g., introduction of new cigarette taxes, happy hour drinking specials). These tasks permit rapid data collection without sacrificing methodological rigor or the validity of conclusions reached. The CPT allows researchers to simulate new policies, to determine their relative risks and benefits, thus offering an opportunity to optimize prior to rollout. Behavioral outcomes related to consumer purchases also make the CPT data readily translatable to policymakers, including constituent health behavior. This article provides a background on CPTs, a review of literature related to policy-aimed CPTs, and a start on best practices for other behavioral scientists interested in applying CPT to inform public policy efforts. It also serves as a primer for policymakers seeking to evaluate usage of this tool.

消费者在约束条件下(如商品价格)决定购买什么。根据行为经济需求，商品购买任务(CPT)可以衡量在不同的模拟政策条件下(例如，引入新的香烟税，欢乐时光饮料特价)关于购买的假设决策。这些任务允许在不牺牲方法严谨性或得出结论的有效性的情况下快速收集数据。CPT允许研究人员模拟新政策，以确定其相对风险和收益，从而提供在推出之前进行优化的机会。与消费者购买相关的行为结果也使CPT数据易于向决策者翻译，包括组成部分的健康行为。本文介绍了CPT的背景，回顾了与政策导向的CPT相关的文献，并为其他有兴趣将CPT应用于公共政策工作的行为科学家提供了最佳实践的开始。它还为寻求评估这一工具使用情况的政策制定者提供了参考。

引用次数: 7

Limitations of the Sum-and-Alpha Approach to Measurement in Behavioral Research 行为研究中Sum和Alpha测量方法的局限性

IF 3.8 Q1 EDUCATION & EDUCATIONAL RESEARCH

Policy Insights from the Behavioral and Brain Sciences

Pub Date : 2022-09-10 DOI: 10.1177/23727322221117144

Daniel M. McNeish

Many behavioral researchers are interested in measuring constructs such as mood, affect, or cognition—all of which cannot be observed directly. Instead, researchers administer items from surveys, tests, or scales to indirectly measure aspects of the construct. Psychometrics is a branch of statistics dedicated to determining whether scores created from item responses are reasonably capturing the intended construct. However, several review papers have shown that behavioral research frequently does not engage with psychometrics and instead creates scores by assigning numerical values to item responses, summing item responses, and reporting reliability of summed scores without any assessment of whether scores are valid. Despite the popularity of this approach, it can limit the informativeness and generalizability of conclusions in behavioral research. The goal of this paper is to raise awareness of these issues with policymakers and other consumers of research and to encourage producers of research to consider readily available, more rigorous approaches.

许多行为研究人员对测量情绪、情感或认知等结构感兴趣——所有这些都无法直接观察到。相反，研究人员管理调查、测试或量表中的项目，以间接测量结构的各个方面。心理测量学是统计学的一个分支，专门用于确定根据项目反应创建的分数是否合理地反映了预期结构。然而，几篇综述论文表明，行为研究通常不涉及心理测量学，而是通过为项目反应分配数值、对项目反应求和以及报告求和分数的可靠性来创建分数，而不评估分数是否有效。尽管这种方法很受欢迎，但它会限制行为研究中结论的信息性和可推广性。本文的目标是提高决策者和其他研究消费者对这些问题的认识，并鼓励研究生产者考虑现成的、更严格的方法。

引用次数: 3

Increasing Stress Resilience in Difficult Times: Integrating Proven Practices from Biofeedback and Psychotherapy 在困难时期提高抗压能力：整合生物反馈和心理治疗的实践

IF 3.8 Q1 EDUCATION & EDUCATIONAL RESEARCH

Policy Insights from the Behavioral and Brain Sciences

Pub Date : 2022-09-10 DOI: 10.1177/23727322221118936

P. Steffen, D. Bartlett

People across the country are experiencing significant levels of stress across most areas of life, including economic (jobs and inflation), health (epidemics), social and relationship issues, and international conflicts and political strife. People want to cope better but the amount of information available on stress management is staggering, confusing, and sometimes contradictory. Drawing from empirically supported intervention research that integrates biofeedback and psychotherapy approaches, three simple practices can help clients build stress resilience: balancing life demands with equanimity, becoming more aware but less worried, and actively engaging in flexible coping strategies. These three practices are straightforward to learn and easy to do as part of daily life. Although these approaches are typically administered individually in psychotherapeutic settings, there is significant potential in using a community approach to intervention. Most importantly, these techniques are proven, cheap, and have no side effects and can be easily administered using online website instruction and smartphone assessment technology.

全国各地的人们在生活的大部分领域都面临着巨大的压力，包括经济（就业和通货膨胀）、健康（流行病）、社会和关系问题，以及国际冲突和政治冲突。人们希望更好地应对，但关于压力管理的信息数量惊人、令人困惑，有时甚至自相矛盾。根据经验支持的综合生物反馈和心理治疗方法的干预研究，三种简单的做法可以帮助客户建立压力恢复力：平静地平衡生活需求，变得更加清醒但不那么担心，以及积极采取灵活的应对策略。这三种做法学习起来很简单，作为日常生活的一部分也很容易做到。尽管这些方法通常在心理治疗环境中单独使用，但使用社区方法进行干预有很大的潜力。最重要的是，这些技术经过验证，价格低廉，没有副作用，可以使用在线网站指导和智能手机评估技术轻松管理。

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引用次数: 2

Behavior Analysis in the War on Poverty: The Therapeutic Workplace Wage Supplement Program 反贫困战争中的行为分析：治疗性工作场所工资补充计划

IF 3.8 Q1 EDUCATION & EDUCATIONAL RESEARCH

Policy Insights from the Behavioral and Brain Sciences

Pub Date : 2022-09-10 DOI: 10.1177/23727322221119990

Shrinidhi Subramaniam, August F. Holtyn, K. Silverman

Poverty presents a profound burden on health. Financial incentives can shape behavior to benefit individuals living in poverty and to benefit society. As current research shows, large-scale wage supplement programs (i.e., those that provide cash assistance for working) can sometimes increase employment, but tend not to address health problems like addiction. As proof of concept, the Therapeutic Workplace intervention treated addiction, increased employment, and reduced poverty in adults with long-term unemployment and opioid use disorder. The Therapeutic Workplace also developed academic skills, encouraged job readiness, enhanced engagement with employment services, and improved mood and quality of life. Granted, in this and similar trials, some participants did not become employed and many relapsed to drug use or were unemployed after the intervention ended. Continued battles in the war on poverty include identifying evidence-based methods to promote steady employment in high-wage jobs and maintaining positive health outcomes long term.

贫穷对健康造成严重负担。财政激励可以塑造行为，使生活在贫困中的个人和社会受益。正如目前的研究表明，大规模的工资补助计划(即那些为工作提供现金援助的计划)有时可以增加就业，但往往不能解决成瘾等健康问题。作为概念的证明，治疗性工作场所干预治疗成瘾，增加就业，并减少长期失业和阿片类药物使用障碍的成年人的贫困。治疗工作场所还培养了学术技能，鼓励就业准备，增强了与就业服务的接触，改善了情绪和生活质量。当然，在这个和类似的试验中，一些参与者没有找到工作，许多人在干预结束后再次吸毒或失业。在向贫困宣战的持续战斗中，包括确定以证据为基础的方法，促进高工资工作的稳定就业，并长期保持积极的健康成果。

引用次数: 0

Biofeedback and Health Evidence-Based Biofeedback and Neurofeedback for People with Epilepsy and Seiz 生物反馈与健康基于证据的生物反馈和癫痫患者的神经反馈

IF 3.8 Q1 EDUCATION & EDUCATIONAL RESEARCH

Policy Insights from the Behavioral and Brain Sciences

Pub Date : 2022-06-21 DOI: 10.1177/23727322221108508

Robert P. Turner

Epilepsy is the fourth most common neurological disorder worldwide despite many anti-seizure medications. Biofeedback (BFB) and neurofeedback (NFB) have shown significant promise since the 1960s to improve seizure control, abnormalities in electroencephalography (EEG) and quantitative-EEG, and quality of life. Epilepsy is a disease of brain networks and BFB/NFB is a non-invasive, brain-centered, low-risk, low-cost, and reliable treatment for people with seizures/epilepsy and especially since standard seizure medications and epilepsy surgery often do not result in complete seizure control. Neuroscience healthcare clinician experience and a 60-year literature foundation show that BFB/NFB to improve brain dysregulation and abnormal network dynamics are known to be at the root of seizures/epilepsy. BFB/NFB trains individuals to self-regulate brain activity through real-time performance feedback. An exhaustive literature review for NFB/BFB and seizures/epilepsy (1960s–present) yielded 150 articles documenting improvements in seizures and EEG/QEEG abnormalities. Clinicians, insurers, and the public should support BFB/NFB as a first-line intervention for seizures/epilepsy.

癫痫是世界上第四大最常见的神经系统疾病，尽管有许多抗癫痫药物。自20世纪60年代以来，生物反馈(BFB)和神经反馈(NFB)在改善癫痫发作控制、脑电图(EEG)和定量脑电图(EEG)异常和生活质量方面表现出了显著的前景。癫痫是一种大脑网络疾病，BFB/NFB是一种非侵入性、以大脑为中心、低风险、低成本和可靠的治疗方法，特别是因为标准的癫痫药物和癫痫手术通常不能完全控制癫痫发作。神经科学保健临床医生的经验和60年的文献基础表明，BFB/NFB改善大脑失调和异常网络动力学是已知的癫痫发作/癫痫的根源。BFB/NFB通过实时表现反馈训练个体自我调节大脑活动。对NFB/BFB和癫痫发作/癫痫(20世纪60年代至今)的文献进行了详尽的回顾，得出150篇文章，记录了癫痫发作和EEG/QEEG异常的改善。临床医生、保险公司和公众应该支持BFB/NFB作为癫痫发作/癫痫的一线干预措施。

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