Developing and Selecting Auditory Warnings for a Real-Time Behavioral Intervention.

John Bellettiere,Sandy Liles,T Tracy Allen,Melbourne F Hovell,Elaine Blumberg,Neil E Klepeis,Suzanne C Hughes,Saori Obayashi,Marie Boman-Davis,Vincent Berardi,Jeff Mills

doi:10.12691/ajphr-2-6-3

Abstract

Real-time sensing and computing technologies are increasingly used in the delivery of real-time health behavior interventions. Auditory signals play a critical role in many of these interventions, impacting not only behavioral response but also treatment adherence and participant retention. Yet, few behavioral interventions that employ auditory feedback report the characteristics of sounds used and even fewer design signals specifically for their intervention. This paper describes a four-step process used in developing and selecting auditory warnings for a behavioral trial designed to reduce indoor secondhand smoke exposure. In step one, relevant information was gathered from ergonomic and behavioral science literature to assist a panel of research assistants in developing criteria for intervention-specific auditory feedback. In step two, multiple sounds were identified through internet searches and modified in accordance with the developed criteria, and two sounds were selected that best met those criteria. In step three, a survey was conducted among 64 persons from the primary sampling frame of the larger behavioral trial to compare the relative aversiveness of sounds, determine respondents' reported behavioral reactions to those signals, and assess participant's preference between sounds. In the final step, survey results were used to select the appropriate sound for auditory warnings. Ultimately, a single-tone pulse, 500 milliseconds (ms) in length that repeats every 270 ms for 3 cycles was chosen for the behavioral trial. The methods described herein represent one example of steps that can be followed to develop and select auditory feedback tailored for a given behavioral intervention.

Highlights

Devices that provide real-time feedback are becoming increasingly affordable, accurate, and widely used
The four-step process presented above represents the first model for developing auditory warnings for use as real-time feedback in a behavioral intervention intended for residential settings
Warning sounds are increasingly used as real-time feedback in behavioral interventions, yet are often not subject to the same systematic scrutiny as the individual and group therapy models these warnings complement or sometimes replace

Summary

Introduction

Devices that provide real-time feedback are becoming increasingly affordable, accurate, and widely used. Real-time sensor and computing technology can be used to instantly detect behaviors and trigger audio (or visual) feedback that immediately follows. These auditory warnings can be engineered to shape behavior independent of, or synergistically with, brief coaching and education. [4,9,13,14] auditory warnings have not been evaluated for use in behavioral interventions Considering that they can and do function to modify behavior, auditory warnings should be subject to the same scientific investigation as the coaching and therapy models they complement or replace [15,16,17]

Methods

Discussion

Conclusion