Jessica A. Nastasi

Despite the increasing number of registered behavior technicians (RBTs) certified yearly, applied behavior-analytic organizations report difficulties in hiring and retaining RBTs in Florida. The current study evaluated RBTs’ work experiences related to the shortage of RBTs in Florida, particularly work concerns that lead to burnout and turnover. Eleven RBTs were interviewed regarding their working conditions and perspectives on the RBT working conditions. A thematic analysis yielded four main themes: (1) challenges establishing and maintaining competency; (2) difficult working conditions; (3) a transient or unheard-of career; and (4) dissatisfaction with pay and benefits. Results suggested that RBTs’ experiences vastly differed across organizations and that a combination of variables impact RBT burnout and turnover, which may contribute to burnout and turnover among RBTs in Florida. Implications for future research on RBT burnout and turnover and recommendations for organizations are discussed.

Background: Approximately half of smokers attempt to quit, but 90% of these attempts fail. Video game–based interventions have the potential to address common barriers to evidence-based smoking cessation treatment, including high cost, lack of health care access, and low engagement. Objective: The purpose of this study was to evaluate the feasibility and acceptability of a video game–based smoking cessation intervention called Inspired and its impact on the 7-day smoking point prevalence at the 30-day follow-up. Methods: US adults (n=48) were recruited via the web to use Inspired on their smartphones for 7 weeks. The object of the game was to defend a healing tree against attackers. Levels of the game were unlocked twice daily when participants self-reported the number of cigarettes they smoked since the previous entry. Completion of the levels awarded players in-game currency, which could strengthen in-game abilities. Participants received additional in-game rewards to aid gameplay by submitting either smoking self-reports only or self-reports indicating abstinence, determined through random assignment. In addition, participants completed a web-based survey at intake, week 4, week 7, and the 30-day follow-up. Results: Of the 48 participants, who had an average age of 39.8 (SD 10.7) years, 27 (56%) were female, 4 (8%) Hispanic, 37 (77%) White, and 27 (56%) employed; 26 (54%) earned <US $40,000 a year; and 14 (29%) lived in nonurban areas (eg, rural and suburban). There were no significant differences between the groups, so all outcome data were combined. Participants averaged 20.6 (SD 15.3) days of gameplay and reached a mean highest game level of 10.7 (SD 8.4), although there was a high degree of variability. Participants reported abstinence on 31.4% (SD 38.2%) of all cessation phase reports and averaged 5.4 (SD 9.8) consecutive abstinent smoke reports. For every 1 SD increase in the highest level achieved, there was a 27% increase in the percentage of abstinent samples and a 405% increase in longest continuous abstinence. At the 30-day follow-up, 23% (11/48) of the participants reported having not taken a cigarette puff in the prior 7 days and 31% (15/48) had spent at least 24 hours without smoking in the prior 14 days. On an 11-point scale, participants rated the intervention moderately favorably: if they had to do it again, they would use Inspired to help them quit (mean 6.4, SD 3.4), and Inspired was helpful in their current attempt to quit (mean 5.4, SD 3.6). Conclusions: These results support the acceptability of Inspired. Although high dropout rates prevent conclusions on feasibility, a subset of the participants responded favorably. Scalable and accessible video game–based smoking cessation interventions could be the key to addressing the foremost cause of preventable morbidity and mortality in the United States. Trial Registration: ClinicalTrials.gov NCT03929003; https://clinicaltrials.gov/ct2/show/NCT03929003

In 2023, the Behavior Analyst Certification Board (BACB) reported that there were over 160,000 registered behavior technicians (RBTs) certified to deliver behavior analytic services. Previous research suggests that RBTs experience varying levels of burnout and turnover intention. Providing employees breaks at work is one strategy that may decrease burnout and turnover. We conducted semi-structured interviews with 15 RBTs working in clinics, schools, and homes to inquire about their experiences with taking breaks at work. The results of the thematic analysis yielded the following themes: (1) breaks are important and necessary; (2) break conditions vary; and (3) support for taking breaks is mixed. The implications of these findings and recommendations for employees, supervisors, and organizations are discussed.

BACKGROUND The majority of smokers express an interest in quitting and about half make an attempt to quit, but about 90% of these attempts fail. Videogame-based interventions have the potential to address common barriers to evidence-based smoking cessation treatment including cost, lack of access to healthcare settings, and low engagement. OBJECTIVE The purpose of this study was to evaluate the feasibility and acceptability of a videogame-based smoking cessation intervention called InspiredTM. METHODS U.S. adults (n=48) were recruited online to use InspiredTM on their smartphone for 7 weeks (the final 6 of which had a goal of smoking abstinence for all participants). The object of the game was to grow and defend one healing tree per level against attackers. In each level, players allocated different colored gems from their bank to activate either healing or defensive structures. Levels of the game were unlocked twice daily when participants reported the number of cigarettes they smoked since the previous entry. Completion of the levels awarded players in-game currency, which was used to strategically strengthen their structures. Participants received additional in-game rewards from either submitting smoking self-reports (i.e., submission contingent) or for submitting self-reports indicating smoking abstinence (i.e., abstinent contingent), consisting of gem prisms (used to power their structures for longer) and larger amounts of in-game currency. Additionally, participants completed an online survey at intake, week 4, week 7, and during the 30-day follow-up. RESULTS Participants were 56.3% female, 8.3% Hispanic, 77.1% white, 56.2% employed, 54.2% earning less than $40,000 a year, and had an average age of 39.79 (SD=10.72). Geographically, 29.2% of the sample lived in non-urban areas (e.g., rural, suburban). There were no significant differences between groups, so all outcome data are combined. Participants reached a mean highest level of 10.71 in the game (SD=8.43), though there was a high degree of variability. Participants reported abstinence on 31.36% (SD=38.16%) of all cessation phase reports and averaged 5.40 samples of continuous abstinence (SD=9.78). For every one-standard deviation increase in highest level achieved, there was a 27% increase in the percentage of abstinent samples reported and a 405% increase in longest period of continuous abstinence. During the abstinence phase, 52.10% of participants submitted at least one abstinent report. On an 11-point scale, participants rated the intervention moderately favorably: if they had to do it again, they would use Inspired to help them quit (M=6.43, SD=3.44) and InspiredTM was helpful in this current attempt to quit (M=5.37, SD=3.57). CONCLUSIONS These results support acceptability a videogame-based smoking cessation intervention for a geographically diverse population. Though high rates of dropout prevent conclusions on the intervention’s feasibility (possibly due to the game being imbalanced), a subset of the participants responded favorably to the intervention. Scalable and accessible smoking cessation interventions could be the key to addressing the number one cause of preventable morbidity and mortality in the U.S. CLINICALTRIAL ClinicalTrials.gov NCT03929003

The Fair Labor Standards Act suggests that short rest periods of 5–20 min may improve employee productivity, but there is limited experimental research on the topic. The current study compared productivity when breaks were not required (i.e., control session) compared with when breaks were programmed by the experimenter (i.e., experimental session). Sixteen undergraduate students completed two 2‐hr sessions of a simulated check‐processing task. Half of the participants were randomly assigned to receive the experimental session (5‐min breaks every 20 min) first with the control session second, and the other half received the control first and the experimental session second. The results showed that 75% of participants completed more checks during the experimental session than during the control session and the difference was statistically significant. Most participants took more unprogrammed break time during control sessions compared with experimental sessions. Implications for future research and the value of work breaks are discussed.

Background: Smoking is the most prevalent cause of morbidity and mortality in the United States. Although most individuals who smoke express a desire to quit smoking, only a small percentage are successful. Serious games have become popular in health sectors as a potential avenue for delivering a scalable treatment that is both accessible and engaging for the smoking population. Several smoking cessation games have already been developed, but these games feature a broad range of gameplay elements and are not necessarily based on existing video game preferences in the general or smoking population. Objective: To better inform treatment development, this study aims to evaluate video game genre preferences among treatment-seeking individuals who smoke (N=473). Methods: Participants responded to a screening survey to enroll in a larger, serious game intervention for smoking cessation. During this screening survey, participants were asked to disclose their favorite video games, which resulted in 277 unique game titles. These titles were coded for genre categories based on publisher listings and game features. The genres were then analyzed for the frequency of reporting overall and across age groups. Results: Action, Role-Playing, and Action-Adventure were the most reported genres among adults aged ≤34 years; Action, Action-Adventure, and Logic were the most reported genres among adults aged 35-44 years; and Logic and Action were the most reported genres among adults aged ≥45 years. Conclusions: These data indicate that treatment-seeking individuals who smoke have different game preferences across age groups, and the data provide novel information to inform the development of future serious games targeting the smoking population that are tailored to the preferences of their age group. Trial Registration: ClinicalTrials.gov NCT03929003; https://clinicaltrials.gov/ct2/show/NCT03929003

The current set of within-subject, single-case design studies examined how exposure to social comparison information may impact physical activity in sedentary individuals. In Study 1, participants (N = 6) were exposed to two Fitbit challenges, one with a physically active confederate and another with a sedentary confederate. Each challenge phase lasted 7 days, during which participants were able to compare their daily steps to the assigned confederate on a ranked leaderboard, received notifications if their cumulative steps were surpassed by the confederate, and a notification indicating if they won at the conclusion of each challenge (i.e., active confederate in challenge one then sedentary confederate in challenge two, or vice versa). Study 2 replicated the procedures used in Study 1 but controlled for the distance between confederate and participant daily steps (N = 4). In Study 3, participants (N = 4) were exposed to the same confederate twice to evaluate potential order effects. Results showed that physical activity increased for most participants, but the direction and magnitude of effects differed across participants, challenge type, and order of confederate exposure. The factors producing differential responding to the Fitbit challenges, and the implications for future research on the effects of competition and social comparison on behavior, are discussed.

The effectiveness of performance feedback depends on many factors, including accuracy and repeated delivery over time. Previous research has suggested that requiring the delivery of performance feedback may result in less accurate observations and feedback during subsequent observations. The current study evaluated whether different reactions (i.e., positive, neutral, or negative) to feedback would affect the accuracy of subsequent observations or the delivery of feedback. Forty‐five participants were assigned to 1 of 3 reactions groups and they were instructed to observe and record the safety performance of a confederate during a baseline condition. Following 2 baseline sessions, participants were instructed to deliver feedback and the confederate reacted to the feedback according to the assigned condition for 4 sessions. Results provide evidence that positive reactions maintain observation accuracy and the provision of feedback, while both neutral and negative reactions decrease observation accuracy and result in frequent omission of feedback.