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The Behavior Change Consortium: setting the stage for a new century of health behavior-change research.

The Behavior Change Consortium (BCC), a collective of 15 National Institutes of Health-funded behavior-change projects, was conceived with the goal of evaluating the efficacy and effectiveness of novel ways of intervening in diverse populations to reduce tobacco dependence, and improve physical activity, nutrition and other health behaviors. The purpose of this article is to provide a general introduction and context to this theme issue by: (1) reviewing the promises and challenges of past efforts related to promoting change for three key health behaviors; (2) reviewing successful intervention strategies and principles of health behavior change; (3) discussing major theoretical approaches for obtaining successful behavior change; (4) setting BCC activities within the context of recent recommendations for the behavioral and social sciences; and (5) providing an organizational framework for describing each of the projects within this consortium. In addition to the rich database on behavioral outcomes for tobacco dependence, physical activity and diet, the BCC represents a unique opportunity to share data and address cross-cutting intervention research issues critical for strengthening the field of behavior change research.

Health Behavior↗

Intrafamily influences on health behavior. A study of interdental cleaning behavior.

The purpose of this study was to assess quantified measures of intrafamily patterns of influence on interdental cleaning behavior based on a conceptual model of family influences on health behavior. Data stemmed from the Norwegian National Health Survey 1985, comprising 295 two-parent families with 2 children above 6 years of age. Analyses were performed with the family as the sampling unit. Logistic regression analyses were applied. The results showed that there were statistically significant associations of interdental cleaning behavior among all pairs of family members, the strongest association being between sibling (OR = 36.6). The multivariate analyses of interdental cleaning behavior of the children showed that the strongest explanatory factor was the interdental cleaning behavior of the mother (OR = 2.4). Thus, the mother seems to play an important rôle in the formation and maintenance of the elder child's interdental cleaning behavior. The highly correlated interdental cleaning behavior of the 2 siblings could be explained by correlated measurement errors as well as equity in rules and parental control and reinforcement of the behavior, in addition to substantive influential effect of the elder sibling's interdental cleaning behavior on that of the younger sibling.

Adolescent↗

Relations between parent- and teacher-reported behavioral inhibition and behavioral observations of this temperamental trait.

This study examined the relation between the Behavioral Inhibition Scale (BIS), a measure that was specifically developed for assessing behavioral inhibition, and behavioral observations of this trait. Children ages 6 to 10 years participated in a series of experimental tasks assessing behavioral features of the inhibited temperament. The parents and teachers of these children completed the BIS. Results showed that the BIS (in particular the parent version) was significantly related to the observational index of behavioral inhibition. An additional aim of the study was to examine the relation between behavioral inhibition as indexed by the BIS and observations, on the one hand, and measures of anxiety symptoms, fear, and behavioral symptoms, on the other hand. As expected, significant correlations between behavioral inhibition indexes and symptoms of anxiety and withdrawal were observed. The BIS is found to be a brief and easy-to-administer instrument, which seems to provide a meaningful first impression of children's level of behavioral inhibition, and this is particularly true when using the parent version of the BIS.

Child↗

Rate dependency, behavioral mechanisms, and behavioral pharmacology.

Behavioral pharmacology has become increasingly independent of the experimental analysis of behavior. At its beginning, behavioral pharmacology was closely related to the experimental analysis of behavior, with developments in each field aiding the other. Early attempts to systematize data in behavioral pharmacology culminated with the development of the rate-dependency concept, but as this principle was found to have more limited generality than originally was hoped, a theoretical void developed. This circumstance was followed by increased reliance on pharmacological theory as a basis for experimentation and interpretation, with an attendant decrease in emphasis on environmental variables and behavioral interpretations. Lack of interplay between behavioral pharmacology and the experimental analysis of behavior is detrimental to both disciplines because each could contribute significantly to the other. The current trend might be reversed if more research were directed at elucidating behavioral mechanisms of drug action.

Animals↗

The theory of planned behavior: a review of its applications to health-related behaviors.

PURPOSE: To review applications of Ajzen's theory of planned behavior in the domain of health and to verify the efficiency of the theory to explain and predict health-related behaviors. METHODS: Most material has been drawn from Current Contents (Social and Behavioral Sciences and Clinical Medicine) from 1985 to date, together with all peer-reviewed articles cited in the publications thus identified. FINDINGS: The results indicated that the theory performs very well for the explanation of intention; an averaged R2 of .41 was observed. Attitude toward the action and perceived behavioral control were most often the significant variables responsible for this explained variation in intention. The prediction of behavior yielded an averaged R2 of .34. Intention remained the most important predictor, but in half of the studies reviewed perceived behavioral control significantly added to the prediction. CONCLUSIONS: The efficiency of the model seems to be quite good for explaining intention, perceived behavioral control being as important as attitude across health-related behavior categories. The efficiency of the theory, however, varies between health-related behavior categories.

Health Behavior↗

[Advances in the experimental analysis of behavior: issues of choice behavior, comparative cognition, and human language].

As the opportunity to contact with related areas has increased, the study of of the experimental analysis of behavior has experienced revolutionary changes. Some of the most active and important areas-studies of choice, comparative cognition, and human language--are reviewed to acquaint readers. Studies of CHOICE have linked to the molar theories of behavioral economics and behavioral ecology, which promoted research of choice by animals under uncertainty conditions. Further approach has been made to integrate the molar and molecular analyses on the basis of the ideas of behavior dynamics. COMPARATIVE COGNITION is a part of a larger field including cognitive science, behavioral neuroscience, and biological science. Recent developments, aided with a comparative perspective, made significant contributions to our understanding of the phylogeny and ontogeny of cognition. Advances in analysis of human behavior provided tools to study behavioral aspects of semantics, syntax, and pragmatics of HUMAN LANGUAGE. Using the paradigm of stimulus equivalence, the emergence of stimulus relations, stimulus-stimulus networks, hierarchical structure of verbal behavior, and other language-related behaviors have been investigated.

Choice Behavior↗

[A study of the relation between providing healthcare information and behavior changes of people in Japan. Parental behavior changes after receiving information about the sudden infant death syndrome].

OBJECTIVE: Considering the lack of evidence concerning the relationship between providing healthcare information and behavior of people in Japan, we utilized a questionnaire to survey the parents of infants to evaluate behavior change after receiving information about the Sudden Infant Death Syndrome (SIDS). METHODS: A questionnaire about SIDS information was administered in 234 municipalities in Niigata, Gifu, Shizuoka, and Hiroshima Prefectures and in Yokohama City in November and December of 1999 to 14,879 parents who visited for the 18-month health examination of their children. The questionnaire did not ask for the participants' names. Logistic regression analysis was used to study the connection between behavior change and SIDS information sources. RESULTS: 10,900 parents returned the questionnaire to give a 73.3% response rate, 19.0% of these receiving information about SIDS risk factors from hospitals or clinics, 3.7% from public health centers, and 9.2% from their friends. More received information from the mass media such as TV programs, which provided the main source for 71.1% of the parents. The degree of behavior change was evaluated after adjustment for variables concerning a variety of information sources and other appropriate factors such as the age and sex of parents and the number of their children. We found that receiving information from hospitals or clinics significantly influences behavior changes for all kinds of risk factors. Information from public health centers, baby-care groups, and friends influenced behavior changes relevant to the risk factors for feeding methods, sleeping position, and parents' smoking. There was no relation between receiving information from the mass media and behavior change of parents. CONCLUSIONS: The mass media provide far more information than do medical facilities, public health centers, baby-care groups and personal contacts but the latter played much more effective roles in making parents change their baby care behavior. These results point to an obvious discrepancy between efficiency in providing information and the degree of behavior change elicited. We should thus take the source of information and the target population into consideration when we examine the best way to provide healthcare information for people in the future.

Adult↗

Relation of the stages of change for exercise behaviors, self-efficacy, decisional-balance, and diet-related psycho-behavioral factors in young Japanese women.

BACKGROUND: A large proportion of young Japanese women is inactive. Exercise has important health benefits, however, abnormal weight/eating concerns and excessive dieting practices among physically active young women also have been reported in many cross-sectional studies. The purpose of this study was to examine the relationships between stages of change for exercise behaviors and exercise/dieting related psycho-behavioral factors using the Transtheoretical Model of behavior change as a theoretical framework. METHODS: A cross-sectional study included 450 young Japanese women aged 18 to 21 (18.4+/-0.67 years). Subjects in precontemplation (n=111, 24.7%), contemplation (n=120, 26.7%), preparation (n=177, 39.3%), action (n=17, 3.8%), and maintenance (n=25, 5.6%) were compared on physique, body composition, current exercise practices, exercise self-efficacy, decisional balance (benefits and costs exercise), as well as dieting behaviors and weight/eating concerns. RESULTS: Stages of change for exercise behaviors were significantly related to exercise self-efficacy and perceived benefits as well as to dieting behaviors and weight/eating concerns. Subjects in the higher stages had higher self-efficacy, perceived benefits of exercise, and healthy dieting behaviors; however, some of them also had unhealthier dietary practices, higher phobia of obesity and obsession with eating than those in lower stages. CONCLUSIONS: These findings provide support for applying the transtheoretical model of exercise behavioral change to Japanese young women. Additionally, it is also important to pay attention to stage specific psycho-behavioral factors related to their dieting.

Adolescent↗

Downregulation of stereotyped behavior and production of latent locomotor behaviors in mice treated continuously with quinpirole.

D1 and D2 dopamine receptors mediate different behavioral effects in animals. We have attempted to selectively modulate dopamine-mediated behaviors by continuously administering D2 agonists to mice. Acute administration of the D2 agonist quinpirole caused dose-related stereotyped effects; no locomotor or grooming behavior was apparent. Continuously infusing quinpirole with implanted Alzet minipumps initially produced stereotyped behavior, but this stereotypy decreased by 2 hours, and was completely absent from 3 hours to 6 days of infusion. Within 1 day after implanting quinpirole, there appeared a significant locomotor behavior that continued for the 6 days of infusion. Acute challenge doses of quinpirole given either 6 days after infusing quinpirole or 12 hours after removing the quinpirole implant failed to elicit any stereotyped behavior and did not alter the locomotor behavior. By contrast, acute challenge injections with the D1 agonist SKF 38393 administered 12 hours after removing the quinpirole implant produced a characteristic grooming response. In an attempt to learn the mechanism of the behavioral effects induced by the continuous administration of quinpirole, the actions of relatively selective D1 and D2 antagonists were examined. The D2 antagonist sulpiride inhibited the stereotypy but not the locomotion induced by quinpirole. By contrast, the D1 antagonist Sch 23390 blocked the locomotion but not the stereotypy induced by quinpirole. These results indicate that chronic administration of quinpirole causes two separate behavioral effects: (1) a downregulation of stereotypy, perhaps by downregulating D2 receptors; and (2) the development of locomotion, which appears to involve both the downregulation of D2 receptors and an activation of D1 dopaminergic mechanisms.

2,3,4,5-Tetrahydro-7,8-dihydroxy-1-phenyl-1H-3-ben↗

Applied behavior analysis for behavior problems in Alzheimer's disease.

While psychoactive drugs are the usual treatment choice for problem behaviors in individuals with Alzheimer's disease (AD), non-drug treatments are increasingly sought. This article describes applied behavior analysis, the predominant nondrug treatment approach for behavior problems in people with cognitive impairments associated with developmental disabilities. Applied behavior analysis identifies the causes of an individual's problem behavior through "functional assessment" and then employs treatment methods that address those causes. Functional assessment seeks information on environmental and internal factors influencing a problem behavior, emphasizing the function or purpose the problem behavior serves for the individual. Applied behavior analysis merits further investigation as a treatment approach to behavior problems in AD.

Alzheimer Disease↗

Facilitation of sexual behavior and enhanced dopamine efflux in the nucleus accumbens of male rats after D-amphetamine-induced behavioral sensitization.

Behavioral sensitization caused by repeated and intermittent administration of psychostimulants, such as cocaine and D-amphetamine, is accompanied by enhanced function in limbic-motor circuitry that is involved in the generation of motivated behavior. The present microdialysis study investigated the effect of D-amphetamine-induced sensitization on dopamine (DA) efflux in the nucleus accumbens (NAC) of male rats during sexual behavior. Male rats were given one injection of D-amphetamine (1.5 mg/kg, i.p.) or saline every other day for a total of 10 injections. Three weeks after discontinuation of drug treatment, rats were tested for sexual behavior during a test in which microdialysis was performed. There was an augmented efflux of DA in the NAC of D-amphetamine-sensitized rats compared with nonsensitized control rats when a receptive female was present behind a screen (35 vs 17%). Sensitized rats exhibited facilitated sexual behavior when the screen was removed, as indicated by a significantly shorter latency to mount and an overall increase in the amount of copulatory behavior. Although there was a significant increase in NAC DA concentrations from baseline in both sensitized and nonsensitized rats during copulation, there was a greater increase in DA efflux in the NAC of sensitized rats during the first 10 min copulatory sample (60 vs 37%). These results demonstrate that behavioral sensitization caused by repeated psychostimulant administration can "cross-sensitize" to a natural behavior, such as sex, and that increased NAC DA release may contribute to the facilitation of appetitive and consummatory aspects of this behavior.

Animals↗

The co-morbidity of violence-related behaviors with health-risk behaviors in a population of high school students.

PURPOSE: To describe the frequency of violence-related behaviors and their association with other health behaviors among high school students. METHODS: The Youth Risk Behavior Survey was administered to all ninth and eleventh graders (n = 2075) of a school district in Texas. It provided information regarding violence-related behaviors and other health behaviors. Students were classified into four mutually exclusive, violence-related categories according to whether they were involved in a physical fight and/or carried a weapon. RESULTS: Overall, 20% of the students were involved in a physical fight but had not carried a weapon, 10% carried a weapon but had not been involved in a physical fight, and 17% had been involved in a physical fight and had carried a weapon. Prevalence of weapon-carrying and fighting were higher among males than females, and among ninth graders than eleventh graders. Among males, 48% had carried a weapon the month prior to the survey. Students who both fought and carried a weapon were 19 times more likely to drink alcohol six or more days than students who did not fight nor carried a weapon. Logistic regression analyses showed that drinking alcohol, number of sexual partners, and being in ninth grade were predictors of fighting. These three variables plus having a low self-perception of academic performance and suicidal thoughts were predictors of fighting and carrying a weapon. CONCLUSIONS: The data indicate that violence-related behaviors are frequent among high school students and that they are positively associated with certain health behaviors. Interventions designed to reduce violence should also address coexisting health-risk behaviors and target high-risk groups.

Adolescent↗

A framework for modeling health behavior protocols and their linkage to behavioral theory.

With the rise in chronic, behavior-related disease, computerized behavioral protocols (CBPs) that help individuals improve behaviors have the potential to play an increasing role in the future health of society. To be effective and widely used CBPs should be based on accepted behavioral theory. However, designing CBPs while at the same time specifying their linkages to behavioral theory and developing reusable CBP components (interventions) are challenges to developers of CBPs. Having an ontology with which to describe CBPs could help with these issues. As a first step towards creating such an ontology, we modeled PACE-Adolescent, a theory-based behavioral protocol that uses the Stages of Change Model and Social Cognitive Theory, using PROTEGE-2000, an ontology editor and knowledge acquisition system. We created a three-part knowledge model. Two sub-ontologies described behavioral interventions and psychological theories. The third component, implemented using Guideline Interchange Format (GLIF3), provided a way to describe the structure of a protocol and to link intervention resources and groups of actions to elements of psychological theory. Using this framework, we formally described the PACE-Adolescent protocol. Creating knowledge models such as this may lead to improvements in the design and evaluation of computerized health behavior protocols.

Adolescent↗

Blueprints for behavior: genetic specification of neural circuitry for innate behaviors.

Innate behaviors offer a unique opportunity to use genetic analysis to dissect and characterize the neural substrates of complex behavioral programs. Courtship in Drosophila involves a complex series of stereotyped behaviors that include numerous exchanges of multimodal sensory information over time. As we will discuss in this review, recent work has demonstrated that male-specific expression of Fruitless transcription factors (Fru(M) proteins) is necessary and sufficient to confer the potential for male courtship behaviors. Fru(M) factors program neurons of the male central and peripheral nervous systems whose function is dedicated to sexual behaviors. This circuitry seems to integrate sensory information to define behavioral states and regulate conserved neural elements for sex-specific behavioral output. The principles that govern the circuitry specified by Fru(M) expression might also operate in subcortical networks that govern innate behaviors in mammals.

Animals↗

The behavior analytic perspective: its nature, prospects, and limitations for behavior therapy.

Behavior analysis is defined as a natural science approach to behavior--with both basic and applied branches--and contrasted with cognitive psychology. Behavior analysis is described as an integrated science that views a person's interactions with the environment as selecting certain behaviors--or rather, environment-behavior relations--making them more probable, given certain subsequent stimulus situations. It seeks an understanding that promotes effective action, which fits the clinical interests of behavior therapy. It promotes persistent searching for environmental causes, which has resulted in a remarkable range of successes, clinical and other. We explore the reasons that all behavior therapists are not behavior analysts and suggest needed future developments.

Behavior Therapy↗

Behavioral and sociocognitive correlates of ratings of prosocial behavior and sociometric status.

Although peers' and teachers' evaluations of children's prosocial behavior and peers' sociometric ratings frequently have been used in studies of social development, the validity of young children's ratings of others has been questioned, as has that for teachers' ratings of prosocial behavior. In this study, preschoolers' ratings of peers' sociometric status and prosocial behavior, as well as teachers' ratings of children's prosocial dispositions, were obtained. These were correlated with children's naturally occurring prosocial or social behavior; ratings of prosocial behavior also were correlated with children's prosocial moral reasoning and prosocial self-attributions. Peers' sociometric ratings were positively related to children's sociability whereas prosocial ratings were related to helping (but not sharing) behavior. Teachers' ratings of prosocial behavior were not related to frequency of prosocial behaviors, but were positively related to developmentally mature moral judgments and self-reported motives.

Child Behavior↗