Behavioral Science Research Research Articles

A behavioural science research programme to understand the barriers to achieving recommended LDL cholesterol goals

Background and Aims : Evidence suggests a gap between clinical guideline development and successful real-world implementation, with an estimated 4 out of 10 patients receiving non-evidenced-based care.1 Ensuring research addresses the drivers of this evidence implementation gap is a key health priority. Involving clinicians and patients in research design can help to synthesise existing knowledge and generate key recommendations to guide research. We convened an expert panel, as first step to help guide a 2-year behavioural science research programme - Cardio Connect: which aims to explore barriers to achieving recommended LDL cholesterol goals.Methods: An expert panel of N=4 behavioural scientists, N=5 clinicians (cardiologists and lipidologists) and a patient organisation representative, from Germany, Italy, and UK, attended a 3-hour virtual meeting. Behavioural scientists proposed a mixed-methods research programme and invited discussion.Results: Key research guiding principles emerged from the experts discussion and experience: 1) explore experiences of treatment access inequality, accounting for regional differences; 2) explore ways to better empower patients; 3) understand differences in the application of clinical guidelines between clinical specialties; 4) explore perceptual factors (e.g. clinicians concerns) and practical barriers (e.g. financial restraints) to delivering evidence-based care from patients’ and clinicians’ perspectives. Experts also advised on ways to engage the clinical and patient community: 1) disseminate findings at local and disease specific conferences; 2) engage patient organisations to reach under-served patients.Conclusions: Research is needed to better understand the evidence-implementation gap in dyslipidaemia. This research programme will apply behavioural science and be co-designed with patient and clinical communities. Background and Aims : Evidence suggests a gap between clinical guideline development and successful real-world implementation, with an estimated 4 out of 10 patients receiving non-evidenced-based care.1 Ensuring research addresses the drivers of this evidence implementation gap is a key health priority. Involving clinicians and patients in research design can help to synthesise existing knowledge and generate key recommendations to guide research. We convened an expert panel, as first step to help guide a 2-year behavioural science research programme - Cardio Connect: which aims to explore barriers to achieving recommended LDL cholesterol goals. Methods: An expert panel of N=4 behavioural scientists, N=5 clinicians (cardiologists and lipidologists) and a patient organisation representative, from Germany, Italy, and UK, attended a 3-hour virtual meeting. Behavioural scientists proposed a mixed-methods research programme and invited discussion. Results: Key research guiding principles emerged from the experts discussion and experience: 1) explore experiences of treatment access inequality, accounting for regional differences; 2) explore ways to better empower patients; 3) understand differences in the application of clinical guidelines between clinical specialties; 4) explore perceptual factors (e.g. clinicians concerns) and practical barriers (e.g. financial restraints) to delivering evidence-based care from patients’ and clinicians’ perspectives. Experts also advised on ways to engage the clinical and patient community: 1) disseminate findings at local and disease specific conferences; 2) engage patient organisations to reach under-served patients. Conclusions: Research is needed to better understand the evidence-implementation gap in dyslipidaemia. This research programme will apply behavioural science and be co-designed with patient and clinical communities.

Promoting the Pipeline of Diverse Individuals Within Gastroenterology: Reflections From AGA FORWARD Program Scholars

Promoting the Pipeline of Diverse Individuals Within Gastroenterology: Reflections From AGA FORWARD Program Scholars

Bootstrap confidence intervals for 11 robust correlations in the presence of outliers and leverage observations

Researchers often examine whether two continuous variables (X and Y) are linearly related. Pearson’s correlation (r) is a widely-employed statistic for assessing bivariate linearity. However, the accuracy of r is known to decrease when data contain outliers and/or leverage observations, a circumstance common in behavioral and social sciences research. This study compares 11 robust correlations with r and evaluates the associated bootstrap confidence intervals [bootstrap standard interval (BSI), bootstrap percentile interval (BPI), and bootstrap bias-corrected-and-accelerated interval (BCaI)] across conditions with and without outliers and/or leverage observations. The simulation results showed that the median-absolute-deviation correlation (r-MAD), median-based correlation (r-MED), and trimmed correlation (r-TRIM) consistently outperformed the other estimates, including r, when data contain outliers and/or leverage observations. This study provides an easy-to-use R code for computing robust correlations and their associated confidence intervals, offers recommendations for their reporting, and discusses implications of the findings for future research.

Life expectancy by county, race, and ethnicity in the USA, 2000–19: a systematic analysis of health disparities

There are large and persistent disparities in life expectancy among racial-ethnic groups in the USA, but the extent to which these patterns vary geographically on a local scale is not well understood. This analysis estimated life expectancy for five racial-ethnic groups, in 3110 US counties over 20 years, to describe spatial-temporal variations in life expectancy and disparities between racial-ethnic groups. We applied novel small-area estimation models to death registration data from the US National Vital Statistics System and population data from the US National Center for Health Statistics to estimate annual sex-specific and age-specific mortality rates stratified by county and racial-ethnic group (non-Latino and non-Hispanic White [White], non-Latino and non-Hispanic Black [Black], non-Latino and non-Hispanic American Indian or Alaska Native [AIAN], non-Latino and non-Hispanic Asian or Pacific Islander [API], and Latino or Hispanic [Latino]) from 2000 to 2019. We adjusted these mortality rates to correct for misreporting of race and ethnicity on death certificates and then constructed abridged life tables to estimate life expectancy at birth. Between 2000 and 2019, trends in life expectancy differed among racial-ethnic groups and among counties. Nationally, there was an increase in life expectancy for people who were Black (change 3·9 years [95% uncertainty interval 3·8 to 4·0]; life expectancy in 2019 75·3 years [75·2 to 75·4]), API (2·9 years [2·7 to 3·0]; 85·7 years [85·3 to 86·0]), Latino (2·7 years [2·6 to 2·8]; 82·2 years [82·0 to 82·5]), and White (1·7 years [1·6 to 1·7]; 78·9 years [78·9 to 79·0]), but remained the same for the AIAN population (0·0 years [-0·3 to 0·4]; 73·1 years [71·5 to 74·8]). At the national level, the negative difference in life expectancy for the Black population compared with the White population decreased during this period, whereas the negative difference for the AIAN population compared with the White population increased; in both cases, these patterns were widespread among counties. The positive difference in life expectancy for the API and Latino populations compared with the White population increased at the national level from 2000 to 2019; however, this difference declined in a sizeable minority of counties (615 [42·0%] of 1465 counties) for the Latino population and in most counties (401 [60·2%] of 666 counties) for the API population. For all racial-ethnic groups, improvements in life expectancy were more widespread across counties and larger from 2000 to 2010 than from 2010 to 2019. Disparities in life expectancy among racial-ethnic groups are widespread and enduring. Local-level data are crucial to address the root causes of poor health and early death among disadvantaged groups in the USA, eliminate health disparities, and increase longevity for all. National Institute on Minority Health and Health Disparities; National Heart, Lung, and Blood Institute; National Cancer Institute; National Institute on Aging; National Institute of Arthritis and Musculoskeletal and Skin Diseases; Office of Disease Prevention; and Office of Behavioral and Social Science Research, US National Institutes of Health.

Sexually transmitted infection prevention behaviours: health impact, prevalence, correlates, and interventions

Sexually transmitted infections (STIs) remain a major public health threat, disproportionately affecting young people, and men who have sex with men. In this narrative review of the current state of behavioural science research on STI prevention, we consider the definition, health impacts, correlates and determinants, and interventions to promote STI prevention behaviour. Research on STI prevention behaviour has extended from a focus on abstinence, partner reduction and condom use, to also include novel preventive behaviours, notably treatment-as-prevention, pre-exposure prophylaxis (i.e., the preventive use of medicines by uninfected people), and vaccination for some STIs. Social-cognitive factors specified by, for instance the theory of planned behaviour, are critical proximal determinants of STI prevention behaviours, and related interventions can effectively promote STI prevention behaviours. Social-ecological perspectives highlight that individual-level determinants are embedded in more distal environmental influences, with social stigma especially affecting STI prevention behaviours and requiring effective intervention. Further to providing a major domain of application, STI prevention also poses critical challenges and opportunities for health psychology theory and research. We identify a need for health behaviour theory that addresses the processes linking multiple levels of influence on behaviour and provides practical guidance for multi-level behaviour change interventions adapted to specific contexts.

Turning the tide in HIV through health communication research.

Turning the tide in HIV through health communication research.

Efforts to advance NIH-funded behavioral and social sciences research on structural racism and health.

This commentary provides background and context for the increasing attention to research designed to better understand and address the impact of structural racism on health, with particular attention to the role of the behavioral and social sciences. The manuscript describes the impetus provided to this work by recent public health crises of COVID-19 and the racial justice movement that emerged following the murder of George Floyd in the summer of 2020. A range of initiatives from the National Institutes of Health (NIH) focused on structural racism and health equity are discussed in this context and opportunities and gaps for future research are identified.

What Is Coming across the Horizon and How Can We Handle It? Bitcoin Scenarios as a Starting Point for Rigorous and Relevant Research

The disruptive impact of blockchain technologies can be felt across numerous industries as it threatens to disrupt existing business models and economic structures. To better understand this impact, academic researchers regularly apply well-established theories and methods. The vast majority of these approaches are based on multivariate methods that rely on average behavior and treat extreme cases as outliers. However, as recent history has shown, current developments in blockchain and cryptocurrencies are frequently characterized by aberrant behavior and unexpected events that shape individuals’ perceptions, market behavior, and public policymaking. In this paper, I apply various scenario tools to identify such extreme scenarios and illustrate their underlying structure as bundles of interdependent factors. Using the case of Bitcoin, I illustrate that the identification of extreme positive and negative scenarios is complex and heavily depends on underlying economic assumptions. I present three scenarios in which Bitcoin is characterized as a financial savior, as a severe threat to economic stability, or as a substitute to overcome several shortcomings of the existing financial system. The research questions that can be derived from these scenarios bridge behavioral and design science research and provide a fertile ground for impactful future research.

Developing Cross-Cultural Data Infrastructures (CCDIs) for Research in Cognitive and Behavioral Sciences

Developing Cross-Cultural Data Infrastructures (CCDIs) for Research in Cognitive and Behavioral Sciences

Behavioural insights and the evolving COVID-19 pandemic.

Behavioural sciences have complemented medical and epidemiological sciences in the response to the SARS-CoV-2 pandemic. As vaccination uptake continues to increase across the EU/EEA – including booster vaccinations – behavioural science research remains important for both pandemic policy, planning of services and communication. From a behavioural perspective, the following three areas are key as the pandemic progresses: (i) attaining and maintaining high levels of vaccination including booster doses across all groups in society, including socially vulnerable populations, (ii) informing sustainable pandemic policies and ensuring adherence to basic prevention measures to protect the most vulnerable population, and (iii) facilitating population preparedness and willingness to support and adhere to the reimposition of restrictions locally or regionally whenever outbreaks may occur. Based on mixed-methods research, expert consultations, and engagement with communities, behavioural data and interventions can thus be important to prevent and effectively respond to local or regional outbreaks, and to minimise socioeconomic and health disparities. In this Perspective, we briefly outline these topics from a European viewpoint, while recognising the importance of considering the specific context in individual countries.

Replication of design theories: Reflections on function, outcome, and impact

AbstractThe replication of existing research studies and theories is considered a foundational pillar of knowledge accumulation and an important instrument of discourse across research disciplines. Although replication has a long tradition in natural and behavioural science research, the design science research (DSR) community is yet to adopt it, especially the replication of design theories. However, it is unclear how the DSR community could benefit from the replication of design theories. Similarly, the goal of design theories is to obtain utility instead of truth raises questions regarding the transferability of replication into the DSR domain. Against this background, this study reflects on the function, outcome, and impact of replications, to understand whether the replication of design theories is possible and necessary. The study proposes that replication can be an important catalyst for reuse and knowledge accumulation in DSR because it provides evidence on the boundaries of design theory. Specifically, replication can increase or decrease the level of confidence and projectability associated with design theory.

A Tax Morale Approach to Compliance: Recommendations for the IRS

This article appeared in the December 31, 2007 Annual Report to Congress of the National Taxpayer Advocate, which commissioned this research. Why do people follow the law? The answer, under the traditional theory of compliance, is fear of detection and punishment. The deterrence model, however, accounts for only a minor portion of actual compliance levels. It has such poor explanatory power because it assumes that the decision to comply is based solely on a rational cost-benefit analysis in which people weigh the benefits of non-compliance against the costs of detection and penalties. Recent literature reveals, however, that the decision to comply is not purely rational. Rather, personal values, social norms, and non-rational cognitive processes also strongly affect the decision. What holds true for law in general holds true for tax compliance specifically. Traditional methods of enforcement through audit and penalties explain only a small fraction of voluntary tax compliance. Theorists and researchers attribute the vast majority of compliance to what they loosely describe as internal motivations or “tax morale.” The field is still young, the subject complex, and some of the empirical data is inconclusive. Nevertheless, the literature clearly indicates that tax morale plays a major role in tax compliance.Although neither the exact components of tax morale nor the precise mechanisms by which they work have yet been fully delineated the literature has identified certain elements. Research shows that tax compliance is affected by (social and personal) norms such as those regarding procedural justice, trust, belief in the legitimacy of the government, reciprocity, altruism, and identification with the group. Cognitive processes, such as prospect theory, also influence an individual’s reaction to tax issues. Studies also indicate that certain demographic factors such as age, gender and education correlate with the tax morale.The components of tax morale, like internal motivators in other areas of the law, are not static. They interact with each other and the environment and are influenced by each individual’s own cognitive framework. Consequently, an external agent, such as the IRS, can influence tax morale norms and thereby tax compliance. It can activate compliance norms in a variety of ways including education, properly framing communications, fair procedures, and a regulatory framework that incorporates current and future findings of tax morale research into its operations and dealings with taxpayers.The Report makes three major recommendations. First, the IRS should establish a department devoted solely to exploring tax morale issues and implementing the findings. Second, the IRS should adopt a tax morale approach to tax compliance that recognizes the importance of taxpayers’ internal motivations and the effects on these motivations of societal conditions and institutions (such as the IRS) that interact with them. Third, using behavioral science research, the IRS should implement ongoing educational (long term and short term) programs and media campaigns. Since the subject of this Report is tax compliance of individual taxpayers, both the literature review and the recommendations focus on individuals. Both the tax morale concept and this Report, however, are relevant for all taxpayers.

Behavioral intervention strategies to nudge hand hygiene

<p id="p00005">Maintaining optimal hand hygiene is an important strategy for infection control and prevention. However, how to increase adherence to hand hygiene practices has been a major challenge to prevent infectious diseases and reduce hospital acquired infections (HAIs), especially in the critical period of COVID-19 epidemic regular prevention and control. There are great differences in the effectiveness between different hand hygiene behavior intervention strategies, and the best hand hygiene intervention practice is still in development and requires further investigation. In order to develop intervention strategies for health care researchers and practitioners, the current research systematically summarizes hand hygiene behavior intervention strategies from the perspective of “nudge” for the first time. Traditional hand hygiene interventions are usually based on knowledge sharing and health education, which only produce weak or modest effects on hand hygiene practices. Recent research in behavioral science provides insights for developing effective behavioral interventions to optimize hand hygiene practices by helping people form better hand hygiene habits. Traditional intervention strategies tend to rely on people’s ability to engage in rational thinking and the availability of cognitive resources, that is, encouraging people to reflect on their hand hygiene behaviors and enhance their handwashing motivation in a rational and conscious way. The influences of external environmental factors are rarely taken into account in traditional intervention strategies. Similarly, the role of personal psychological factors is often ignored, so this kind of hand hygiene intervention strategy often shows limited effectiveness and low sustainability. In addition, there are many other common obstacles such as limited accessibility of hand hygiene products, people's overconfidence in their immune system to prevent infection, inertia, and habitual forgetting. Many research results show that even if traditional intervention strategies can increase risk awareness of poor hand hygiene and enhance hand washing intention in the target population, they may not lead to effective behavior changes in hand hygiene. Inspired by the research from behavioral sciences, researchers have tried to promote experiential, unconscious, and automatically triggered hand hygiene behavior through interventions of specific psychological or external environmental factors, so as to help people overcome the gap between hand washing intention and behaviors. Based on different influential mechanisms, hand hygiene nudging strategies can be classified into four categories and nine subordinate categories, including providing decision information (simplifying information, providing feedback, and harvesting the impact of social norms), optimizing decision options (simplifying options and making original options more attractive), influencing decision structure (increasing the accessibility and visibility of favorable options), and reminding decision direction (direct reminder and environmental hint). Previous studies have shown that behavioral science-based hand hygiene interventions, in general, achieved positive effects at a fairly low cost, which are worthy of further application. However, there are still many disputes concerning ethics and effectiveness for nudging intervention. Among these disputes, the two points often mentioned are whether nudging limits the decision-makers' freedom of independent choice and damages their ability of independent choice. These two disputes may have a relatively small impact on hand hygiene promotion, and the form of nudging intervention is more easily accepted by the public, which may be due to the fact that handwashing behavior essentially has a certain degree of “injunctive norm” tendency (i.e., the vast majority of people agree with maintaining hand hygiene). In addition, previous research on hand hygiene nudging intervention also has many limitations, including low accuracy of the evaluation criteria, sustainability, and generalizability of nudging strategies. Further research is warranted to develop more effective hand hygiene nudging interventions and apply them to diverse social contexts. The effectiveness of multi-facet nudging strategies has also been confirmed in hand hygiene practices, suggesting that another future research direction is to construct a hand hygiene nudging strategy classification system similar to the Behavior Change Technique (BCT) taxonomy, so as to design multi-facet nudging strategies for promoting hand hygiene in a specific social context. Based on China's national conditions, traditional hand hygiene intervention strategies such as health education cannot be completely abandoned. This kind of comprehensive new model of “traditional intervention + nudging strategies” and the personalization and specialization of nudging intervention strategies might be the focus of hand hygiene behavior promotion intervention in the future. However, there is still a lack of hand hygiene nudging intervention in Chinese sociocultural contexts. Another direction for future research is to carry out such nudging interventions in hospitals, schools, communities, and other public places based on the theory of behavioral change, so as to contribute to the prevention and control of infectious diseases and improve public health.

The importance of idiographic and functionally analytic strategies in the unified protocol for transdiagnostic treatment of emotional disorders

Methodology in the behavioral sciences is heterogeneous, and this is particularly true in the application of methodologies in the study of the nature and treatment of psychopathology and related areas of applied behavior change. For this reason, the very thoughtful and thorough report on strategies and tactics of contextual behavioral science (CBS) research to which this commentary is directed (The Report) is very welcome (Hayes et al., 2021). For our part we will focus comments on several key features and recommendations from The Report, with emphasis on intensive dynamic longitudinal and functionally analytic research strategies for studying behavior change with an idiographic focus. We will also underscore our strong agreement with the need for a multilevel focus and will illustrate many of these issues in the context of our ongoing research on developing a deeper understanding of, and new interventions for, the emotional disorders. To this end we will review some of our recent research on the unified protocol for transdiagnostic treatment of emotional disorders (UP), a cognitive behavioral intervention with increasing evidence for efficacy across a wide range of disorders characterized by emotion dysregulation, among other things.

A Scientometric Analysis of Twenty Years Trends in Bring Your Own Device (BYOD) Research

The main objective of this study is to determine a scientometric analysis of twenty years of trends in Bring Your Own Device (BYOD) research. Papers published on 'Bring Your Own Device' or 'BYOD' topics were extracted and analyzed using the Web of Science database. VOSViewer software was used to identify and visualize key trends, influential authors, and journals. The 281 filtered documents were selected based on three main criteria which are (i) Topics on ‘Bring Your Own Device’ or ‘BYOD’, (ii) Type of documents on ‘Article’, and (iii) Year Published within 2000 to 2020. We conducted several types of analyses on the body of research using VOSViewer which are (i) Co-authorship analysis, (ii) Co-occurrence analysis, (iii) Citation analysis, and (iv) Co-citation analysis. The main contribution and motivation for this study is in the form of a conceptual framework of types of BYOD based on user orientation was proposed to guide possible future research in Information Technology or interdisciplinary research in Behavioral Science and support the UN Sustainable Development Goals agenda. The four major keyword clusters concerning user-oriented cluster main themes are (i) consumer-oriented, (ii) organization-oriented, (iii) students-oriented, and (iv) mobile users-oriented.

The clinician, the clinician-researcher, and the contextual behavioral science research agenda

The research agenda described in the Report of the ACBS Task Force on the Strategies and Tactics of Contextual Behavioral Science Research (Hayes et al., 2021) calls for investigations that address many pressing needs clinicians encounter daily, and I highlight several: the study of assessment methods and tools, the study of interventions, the study of change processes in treatment, and the study of functioning and well-being. I also describe two topics that are important to clinicians that were not featured in the Report: clinical decision-making and the case conceptualization. Finally, I highlight ways the CBS research agenda lends support to clinicians’ efforts to undertake research in their practice settings.

The Essence of Legal Research is to Resolve Legal Problems

Legal research is carried out to resolve legal problems. Since jurisprudence is a prescriptive science, legal research is conducted to produce prescription. The prescription may be the basis of resolving the legal problem. It is different from research for behavioral science or social research which is to verify a hypothesis. Data are needed to verify the hypothesis. On the other hand, legal research does not need data since it is not conducted to verify a hypothesis. Social research is to find coherence truth while, legal research is to discover coherence truth. Despite usage of induction in establishing argument, legal research does not use data to find the truth because the truth found is coherence truth. Legal research may be for practical purpose or for academic activity but is still like any other research and begins with problem, which is a legal problem. Legal problems in legal research should be clearly defined; otherwise, there will be misapplication of law to the problem. Consequently, the problem will not be solved. Legal problems may be causal relationship, functional relationship, or two propositions where the latter proposition gives clear meaning to the first proposition. The type of legal problem should be identified. It is necessary to collect legal research materials, which may be primary legal materials, secondary legal materials, and non-legal materials. The non-legal materials are supporting and complementary materials. Legal research may be carried out by using approaches as necessary. There are five types of approaches, statute approach, case approach, historical approach, comparative approach, and conceptual approach. The respective approach should be used appropriately.

Misconceptions of Upper-Secondary School Students on Doing Behavioral Sciences Research

With its long tradition, research on misconceptions helps to understand how concepts are learned and how learning in the disciplines can be supported. Up to now, research on misconceptions has focused on natural sciences, while research on misconceptions in behavioral sciences is scarce, not to say absent. In this study an attempt was made to reveal upper secondary school students’ misconceptions on doing research in behavioral sciences. The starting point for the study were research proposals of upper secondary school students. As part of a larger study, students were asked to write a research proposal in maximum two pages. A two-steps approach was adopted in the analysis of these research proposals. First, using a codebook containing both deductive and inductive codes, two-pagers were analyzed in order to identify ‘errors’. In a second step, an interpretative analysis aimed at inferring potential misconceptions underlying these errors. The study can be considered as a starting point for research on misconceptions in behavioral sciences which is currently missing in the field.

Group decision making under uncertain preferences: powered by AI, empowered by AI.

Group decision making is an important, long-standing, and ubiquitous problem in all societies, where collective decisions must be made by a group of agents despite individual conflicting preferences. This has been a classical and active topic for research in many disciplines, including economics, political science, cognitive and behavioral sciences, statistics, mathematics, and computer science. In this article, I survey some recent progress in theoretical, algorithmic, and engineering work toward building AI-powered intelligent systems to help agents make group decisions based on uncertain preferences; these systems leverage principles, ideas, and methodologies from multiple disciplines. Empowered by AI, group decision making can handle a broader range of situations at relatively large scales.

Dynamic change meets mechanisms of change: Examining mediators in the latent change score framework

Researchers in behavioral sciences are often interested in longitudinal behavior change outcomes and the mechanisms that influence changes in these outcomes over time. The statistical models that are typically implemented to address these research questions do not allow for investigation of mechanisms of dynamic change over time. However, latent change score models allow for dynamic change (not just linear or exponential change) over time and have flexibility in parameter constraints that other longitudinal models do not have. Developmental researchers also frequently utilize mediation analyses to investigate mechanisms of influence in longitudinal research implemented in path analytic or latent growth curve models. In this article, we provide three examples of how mediation can be tested in the latent change score framework by combining aspects of traditional mediation models with latent change score models of repeated measures outcomes (and mediators and predictors) with more than two timepoints. We also provide the Mplus syntax to complete these analyses and practical considerations of latent change score mediation (LCSM) models.