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Behavior Analysis Program to Improve Habits of Physical Activity, Eating, and Sleeping

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Behavior Analysis Program to Improve Habits of Physical Activity, Eating, and Sleeping Western Michigan University ScholarWorks at WMU Dissertations Graduate College 8-2015 Behavior Analysis Program to Improve Habits of Physical Activity, Eating, and Sleeping Ivan Noe Martinez Salazar Western Michigan University, [email protected] Follow this and additional works at: https://scholarworks.wmich.edu/dissertations Part of the Applied Behavior Analysis Commons, Clinical Psychology Commons, and the Experimental Analysis of Behavior Commons Recommended Citation Martinez Salazar, Ivan Noe, "Behavior Analysis Program to Improve Habits of Physical Activity, Eating, and Sleeping" (2015). Dissertations. 743. https://scholarworks.wmich.edu/dissertations/743 This Dissertation-Open Access is brought to you for free and open access by the Graduate College at ScholarWorks at WMU. It has been accepted for inclusion in Dissertations by an authorized administrator of ScholarWorks at WMU. For more information, please contact [email protected]. BEHAVIOR ANALYSIS PROGRAM TO IMPROVE HABITS OF PHYSICAL ACTIVITY, EATING, AND SLEEPING by Ivan Noe Martinez Salazar A dissertation submitted to the Graduate College in partial fulfillment of the requirements for the degree of Doctor of Philosophy Department of Psychology Western Michigan University August 2015 Doctoral Committee: R. Wayne Fuqua, Ph.D., Chair Richard W. Malott, Ph.D. Stephanie M. Peterson, Ph.D. Antonio Lopez-Pelaez, Ph.D. BEHAVIOR ANALYSIS PROGRAM TO IMPROVE HABITS OF PHYSICAL ACTIVITY, EATING, AND SLEEPING Ivan Noe Martinez Salazar, Ph.D. Western Michigan University, 2015 An Internet-based five-week duration program to improve “health habits” using behavior analysis principles and eHealth technology was developed and evaluated. The “health habits” include recurring behaviors that impact health status such as eating, sleeping, and physical activity. Ten adult participants were recruited online from Mexico. A multiple baseline design was used and participants were randomly assigned into two different groups (i.e., ABBAA and AABBA groups). Participants received online training using videos describing the characteristics of the program and its components. Each participant recorded selected health behaviors using a Microsoft Excel® tool designed specifically for this program’s goal achievements. Participants reported their performance on a daily basis to their “performance manager” via text messages (i.e., sending a picture of the tool and any preferred tracking device they wanted to use and have access to), which assisted their performance manager in tracking their progress. Goal attainment, as assessed through the text messages, was rewarded by monetary compensation awarded from the performance manager during the two weeks of intervention. During all the experimental phases, participants consulted with their performance manager and set health behaviors improvement goals. These goals were adjusted on a weekly basis. Failure to attain goals resulted in feedback from the performance manager on how to overcome barriers. It was concluded that health behaviors do not increase only under the intervention phases (e.g., money contingencies) but during all the phases. This is explained by the monitoring and feedback procedures. A social validity survey was used to assess participant satisfaction. The participants scored the program and its components as beneficial for the improvement of physical activity, eating, and sleeping habits (4.72/5.0 points). All these “healthy habits” have statistical significant differences (p < 0.05) comparing the results before and after the program. Finally, weight reduction was not statistically significant for all the participants. Nevertheless, this was not the main goal of the program but a secondary benefit for those interested in achieving this goal. A longer duration of the program may be likely to improve weight reduction results. © 2015 Ivan Noe Martinez Salazar ACKNOWLEDGMENTS I would like to begin by acknowledging the U.S.A. and the Mexican governmental authorities for the high distinction I have received as a Fulbright-Garcia Robles scholarship holder. During the past two years at Western Michigan University, I have been able to learn about Behavior Analysis, and I would like to thank Dr. R. Wayne Fuqua for accepting me under his mentorship. I especially thank him for his patience and support. I also would like to acknowledge Dr. Richard W. Malott, whose theoretical concepts were the inspiration for the present dissertation. Thanks to him, I am strongly convinced that it is possible to “Save the World with Behavior Analysis.” I would like to acknowledge Dr. Stephanie Peterson for her kindness and leadership. I would like to deeply thank her, and all the faculty, staff, and students from the Psychology Department who were always willing to support me in the pursuit of my goals. I would also like to thank Dr. Antonio Lopez-Pelaez from Spain for all his support and acknowledge his example as an international professional. Lastly, but always first in my mind, I would like to thank my family. The love, support, trust, and, above all, patience, I have received from my wife Erika and our beloved Christopher and Leonardo made this all worthwhile. Ivan Noe Martinez Salazar ii TABLE OF CONTENTS ACKNOWLEDGMENTS ............................................................................................. ii LIST OF TABLES ......................................................................................................... vii LIST OF FIGURES ........................................................................................................ viii INTRODUCTION ......................................................................................................... 1 Health and Daily Habits ....................................................................................... 1 Health, Behavior and Habits Definitions ............................................................. 1 Effects of Habits on Health and Prevalence of Diseases ..................................... 3 Obesity ........................................................................................................ 3 Habits: Physical Activity ...................................................................................... 5 Definition of Physical Activity: Why Is It Important for Health? .............. 5 Research on Physical Activity .................................................................... 6 Recommendations for Physical Activity .................................................... 9 Habits: Eating Habits ........................................................................................... 10 Definition of Eating Habits: Why Are They Important for Health? ........... 10 Research on Eating Habits .......................................................................... 10 Recommendations for Eating Habits .......................................................... 14 Habits: Sleeping (Sleep Hygiene) ........................................................................ 17 Definition of Sleeping Habits: Why Are They Important for Health? ....... 17 Research on Sleep Hygiene ........................................................................ 19 Recommendations for Sleep Hygiene Habits ............................................. 20 Definition of eHealth and Related Research ........................................................ 25 iii Table of Contents—Continued Behavior Analysis Concepts and Habits Control ................................................. 29 Behavioral Contingencies ........................................................................... 29 Reinforcement ............................................................................................. 30 Punishment by Removal of a Stimulus (Negative Punishment) ................. 33 Avoidance Contingencies ........................................................................... 36 Contingency Contracting (Behavioral Contract) ........................................ 38 Rule-Governed Behavior ............................................................................ 42 Goal Setting and Feedback ......................................................................... 44 Social Validity ............................................................................................ 48 Self-Monitoring and Self-Management ...................................................... 50 The Three-Contingency Model of Performance Management ................... 53 METHODS .................................................................................................................... 57 Subject Recruitment ............................................................................................. 57 Research Procedures ............................................................................................ 60 Phases of the Study ..................................................................................... 60 Randomized Assignment of Group Procedure ........................................... 60 Retrospective Data (Before Phase) ............................................................. 61 Phase A (Baseline and Follow-up) ............................................................. 61 Phase B (Intervention) ................................................................................ 62 General Activities ................................................................................................. 62 Researchers Function as Behavior Managers ......................................................
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