Effective Behavioral Interventions Research Articles

Behavioral health services in Urban American Indian Health Programs: Results from six site visits.

This study explores behavioral health services for American Indians and Alaska Natives (AIANs) at six Urban Indian Health Programs (UIHPs).Interviews and focus groups with clinicians and staff inquired about behavioral health treatment available, service needs, client population, and financial and staffing challenges. Resulting site profiles were created based on focused coding and integrative memoing of site visit field notes and respondent transcripts.These six UIHPs evidenced diversity across multiple facets of service delivery even as they were united in their missions to provide accessible and effective behavioral health treatment to urban AIAN clients. Primary challenges to service provision included heterogenous client populations, low insurance coverage, limited provider knowledge, lack of resources, and incorporation of traditional healing.Collaborative research with UIHPs harbors the potential to recognize challenges, identify solutions, and share best practices across this crucial network of health care sites for improving urban AIAN well-being.

Using behavioral interventions to reduce single-use produce bags

Plastic pollution is a major conservation challenge. Current policies have primarily focused on plastic bags but neglected produce bags which are a pervasive source of packaging in grocery stores. To reduce produce bag use, we designed and tested 12 behavioral interventions in a simulated online shopping task. Each intervention reduced produce bag use by 9.2% to 48.7% against the control condition. Among the 12, the most effective interventions included using an indirect incentive or punishment (via donations to an environmental organization), reminding people of the positive consequence of not using produce bags, using normative messaging, drawing attention to the no produce bag option, and reminding or visualizing the negative consequence of using produce bags. These interventions were more effective for liberal participants than conservatives or independents. These findings provide new evidence for effective behavioral interventions and heterogenous effects in encouraging people to reduce produce bag use to curb plastic pollution.

Effects and Social Validation of Remote Parent Training and Implementation of the Cool Versus Not Cool Behavior Intervention

Adolescents with autism spectrum disorder (ASD) often experience challenges with social skill interactions that may affect their quality of life. Given that parents are often the most frequent and constant presence in their child’s life, parents serve a vital role in their child’s social and behavioral development. For this reason, children may substantially benefit from effective and efficient parent-implemented behavior intervention to teach social skills. Using a multiple-baseline design, the Cool versus Not Cool (CNC) behavior intervention was taught via telehealth to three parents of adolescent-aged males with ASD. Parents then subsequently implemented the CNC intervention to teach parent-selected social skills to their children. For all three parent–adolescent dyads, the CNC behavior intervention was implemented with fidelity by parents, and adolescents showed intervention gains. Findings maintained and generalized during probes and social validity outcomes reported by both parents and adolescents were favorable.

Behaviorism and the concepts of influencing the attitudes of patients towards health behaviors

Health professionals in primary care teams need to know how to effectively encourage patients to change health behaviors to achieve treatment goals. Understanding the behavioral patterns and psychological underpinnings of making changes can help healthcare professionals deliver interventions with a higher success rate. The aim of the study was to assess the importance of behavior patterns in shaping patients' health attitudes and behaviors. There are three types of theoretical models that explain how health behaviors are initiated and changed: motivational, post-intentional, and multistage models. Motivation models describe the role of individual cognitive variables in the process of creating the intention to change behavior. Changing habits in the context of health promotion takes place by influencing the perception of patients. This can be achieved using the TRA (Theory of Reasoned Action), TBP (Theory of Planned Behavior) and HBM (Health Belief Model) models by convincing the public about susceptibility to a given disease, disseminating knowledge about effective methods of prevention and generating persuasion, support, admiration or recognition in society after positive behaviors such as smoking cessation or regular physical activity. Post-intentional models indicate factors that increase the chance of translating motivation into action. They commit the individual to a certain action when certain environmental circumstances are met, thus helping to translate the intention of the goal into action. Multi-stage models describe health behaviors as involving several separate stages. These theories are based on the assumption that people at different stages will behave differently, so the types of interventions and information needed to change behavior will vary depending on the stage they are at. Helping patients set realistic goals, such as moving to the next stage, can facilitate the change process. Effective behavioral interventions must be based on changing the approach of medical staff to the interpersonal process with the patient. This approach should be patient-centred and collaborative. Medical staff should assess the importance that the patient attaches to his health and the treatment process, and thus also the willingness and motivation to comply with the recommendations. Merely providing information will not guarantee a change in their behavior. Healthcare professionals should use active listening techniques (using open-ended questions, explanations, reflective and summarizing statements), should encourage patients to express concerns, and should be able to weigh the pros and cons of different treatment approaches.

Multiphase optimization strategy: How to build more effective, affordable, scalable and efficient social and behavioural oral health interventions.

This commentary introduces the field of social behavioural oral health interventions to the multiphase optimization strategy (MOST). MOST is a principled framework for the development, optimization and evaluation of multicomponent interventions. Drawing from the fields of engineering, behavioural science, economics, decision science and public health, intervention optimization requires a strategic balance of effectiveness with affordability, scalability and efficiency. We argue that interventions developed using MOST are more likely to maximize the public health impact of social behavioural oral health interventions.

Transactional relationships between maternal requesting and responsivity, adolescent compliance, and task demands in fragile X syndrome

BackgroundMales with fragile X syndrome (FXS) may have difficulty with social communication and language in addition to behavioral concerns such as noncompliance to maternal requests. Mothers vary in how they pose requests to their children, and contextual demands may also be a factor in compliance. This study examined the relationships between maternal requesting behaviors, maternal responsivity, child compliance, and task demands in adolescent males with FXS. Methods35 mother-son dyads completed three interactive tasks during in-home visits (puzzle, iPad games, snack). The adolescents also completed assessments of language and autism symptoms. The three interactive tasks were video-recorded, and behavior-by-behavior coding and transcription was completed. ResultsComparing between tasks, mothers requested a behavior most often during the snack task and used a higher proportion of indirect requests during the iPad task. Adolescents were largely compliant across tasks, with average compliance equal to 70%. Adolescent compliance was predicted by maternal request frequency such that mothers who used more requests had adolescent sons who were less compliant. Maternal responsivity was higher for mothers of adolescents with FXS-only compared to those with FXS and high autism symptoms. Conclusions and implicationsTask demands may have influenced maternal requesting, which in turn may have impacted adolescent compliance. Compliance with requests is important for both social and educational aspects of life, and further study of requesting and compliance in FXS is needed to identify effective teaching and behavioral intervention methods.

Digital Health Behavioural Interventions to Support Physical Activity and Sedentary Behaviour in Adults after Stroke: A Systematic Literature Review with Meta-Analysis of Controlled Trials.

Background: As the global prevalence of stroke continues to rise, it becomes increasingly pressing to investigate digital health behaviour change interventions that promote physical activity and reduce sedentary behaviour for stroke patients to support active lifestyles. Purpose: The primary aim of this study is to investigate the effectiveness of digital health interventions in promoting physical activity and reducing sedentary behaviour for stroke patients. The secondary aim is to investigate the intervention components that explain intervention effectiveness to further inform intervention development and policy making. Methods: A systematic search of the literature was conducted in four databases (Scopus, MEDLINE (PubMed), Web of Science, and PsychINFO) to identify the most robust evidence in the form of randomised controlled trials of digital interventions for patients with stroke. A random-effects meta-analysis were utilized to quantify the intervention effects on behaviour change, and subgroup analyses to characterise intervention effective components. Results: In total, 16 RCTs were deemed eligible and included in the systematic review. Meta-analyses suggested significant improvements in physical activity (SMD = 0.39, 95% CI 0.17, 0.61, N = 326, p < 0.001, I2 = 0%), and reductions in time of sedentary behaviour (SMD= -0.45, 95% CI -0.76, -0.14, N = 167, p = 0.00, I2 = 0%) after stroke. The 10 m walk test for physical activity, and the timed up and go test for sedentary behaviour, were the objective outcome measures in the most effective behavioural change interventions. Subgroup analyses found that most effective interventions were underpinned by theories of self-regulation and utilised interactive functions to engage patients with the processes of behaviour change. Conclusions: Digital self-monitoring behavioural interventions are effective in promoting physical activity for stroke patients in adjunct to usual care clinical practice and rehabilitation programmes. Rigorous studies are required to provide evidence to disentangle the most effective intervention components for preventative practices and rehabilitation programs and to inform policymaking for stroke treatment.

Tourist behaviour change for sustainable consumption (SDG Goal12): Tourism Agenda 2030 perspective article

ObjetivoEl objectivo de este documento de perspectiva es llamar la atención sobre cómo la industria del turismo puede tomar las medidas necesarias para contribuir al Objetivo de Desarrollo Sostenible 12 de las Naciones Unidas al alentar a los turistas comportarse de una manera ambientalemente sostenible. La mayoría de las medidas prácticas disponibles son fáciles y económicas de implementar por las pequeñas y medianas empresas turísticas.Diseño/metodología/enfoqueEste documento de perspectiva revisa las pasadas contribuciones al Objetivo de Desarrollo Sostenible 12 de las Naciones Unidas y pide más investigaciones futuras que desarrollen y prueben empíricamente intervenciones efectivas para cambiar los comportamientos.ResultadosLa investigación futura debe centrarse en dos direcciones: (1) el desarrollo y las pruebas empíricas en el campo de nuevas intervenciones de cambio de comportamiento que atraigan a los turistas a comportarse de una manera ambientalmente sostenible, y (2) el desarrollo y despliegue a gran escala de instrumentación asequible para medir de forma automática y continua el desempeño ambiental de las empresas turísticas.Originalidad/valorEste documento de perspectiva sintetiza la literatura y señala puntos importantes para futuras investigaciones. Es la primera síntesis de investigaciones turísticas pasadas que ha desarrollado y probado empíricamente enfoques tangibles que la industria del turismo puede implementar para contribuir al SGD 12.

Knowledge, Attitudes and Practices Towards Covid-19 among Undergraduate Students in University: A Quick Online Cross-Sectional Survey

In Malaysia, the fight against COVID-19 is still going strong. The knowledge, attitude, and practises (KAP) of individuals with regard to COVID-19 may be used to evaluate effective behavioural interventions for containing the epidemic. This study intends to evaluate university students' KAP toward the COVID-19. The demographic data and KAP toward the COVID-19 epidemic were disseminated and discussed in the questionnaire's two portions, which were divided into two categories. An online cross-sectional survey comprising 114 undergraduate students, aged 18 to 36, was carried out from October 2020 to December 2020. Participants conducted an online survey after giving their permission to evaluate socio-demographic factors, perceptions, and KAP towards COVID-19. 83.5 percent of the 114 survey participants were female, and 73 percent were diploma and degree students (26.1 percent ). According to the poll, 95% of participants had more frequent behaviours to avoid COVID-19, and 98% had more positive attitudes and information about the disease. Nearly all (97%) participants agreed that the best course of action to take when they saw they were beginning to exhibit COVID-19 symptoms was to visit the hospital as soon as possible. The majority of participants (97.4%) regularly wash their hands with soap and sanitizer. It is essential to raise KAP among pupils during the fast increase phase of a pandemic epidemic like COVID-19. Therefore, it is necessary to create efficient health education programmes that take KAP-modifying variables into account.

A smartphone intervention that enhances real-world memory and promotes differentiation of hippocampal activity in older adults

The act of remembering an everyday experience influences how we interpret the world, how we think about the future, and how we perceive ourselves. It also enhances long-term retention of the recalled content, increasing the likelihood that it will be recalled again. Unfortunately, the ability to recollect event-specific details and reexperience the past tends to decline with age. This decline in recollection may reflect a corresponding decrease in the distinctiveness of hippocampal memory representations. Despite these well-established changes, there are few effective cognitive behavioral interventions that target real-world episodic memory. We addressed this gap by developing a smartphone-based application called HippoCamera that allows participants to record labeled videos of everyday events and subsequently replay, high-fidelity autobiographical memory cues. In two experiments, we found that older adults were able to easily integrate this noninvasive intervention into their daily lives. Using HippoCamera to repeatedly reactivate memories for real-world events improved episodic recollection and it evoked more positive autobiographical sentiment at the time of retrieval. In both experiments, these benefits were observed shortly after the intervention and again after a 3-mo delay. Moreover, more detailed recollection was associated with more differentiated memory signals in the hippocampus. Thus, using this smartphone application to systematically reactivate memories for recent real-world experiences can help to maintain a bridge between the present and past in older adults.

Heterogeneity thwarts autism explanatory power: A proposal for endophenotypes.

Many researchers now believe that autism heterogeneity is likely to include many disorders, but most research is based on samples defined by the DSM-5 Autism Spectrum Disorder (ASD) criteria. However, individuals diagnosed with autism have complex and varied biological causes for their symptoms. Therefore, autism is not a unitary biological entity. And although autism is significantly different from typical development, autism is not a unitary clinical disorder because diagnosed individuals vary in symptom patterns, comorbidities, biomarkers, and gene variants. The DSM-5 ASD criteria were designed to reduce heterogeneity, and there have been many other efforts to reduce autism heterogeneity including using more stringent clinical criteria, dividing autism into low and high functioning groups, creating subgroups, and by studying larger samples. However, to date these efforts have not been successful. Heterogeneity is extensive and remains unexplained, and no autism pathophysiology has been discovered. Most importantly, heterogeneity has hindered the explanatory power of the autism diagnosis to discover drug regimens and effective behavioral treatments. The paper proposes that possible transdiagnostic endophenotypes may reduce autism heterogeneity. Searching for transdiagnostic endophenotypes requires exploring autism symptoms outside of the framework of the DSM-5 autism diagnosis. This paper proposes that researchers relax diagnostic criteria to increase the range of phenotypes to support the search for transdiagnostic endophenotypes. The paper proposes possible candidates for transdiagnostic endophenotypes. These candidates are taken from DSM-5 ASD criteria, from concepts that have resulted from researched theories, and from symptoms that are the result of subtyping. The paper then sketches a possible basis for a future transdiagnostic endophenotypes screening tool that includes symptoms of autism and other neurodevelopmental disorders.

Behavioral Interventions to Improve Sleep Outcomes in People With Multiple Sclerosis: A Systematic Review

<h3>Objective(s)</h3> Sleep disturbances are a common issue for individuals with multiple sclerosis (MS). Evidence suggests behavioral interventions may be effective in improving sleep outcomes. The objective of this systematic review is to determine effective behavioral interventions to improve sleep in people with MS. <h3>Data Sources</h3> Literature searches were performed in October 2021 in Ovid MEDLINE, CINAHL, and Web of Science along with hand searching for grey literature and cited references. Out of the 837 search results, 830 unique references were reviewed after duplicates were removed. <h3>Study Selection</h3> Four reviewers independently screened titles/abstracts and full-texts (two reviewers screened each title/abstract and full-texts) to determine which meet eligibility criteria and a third reviewer resolved discrepancies. Eighty-one articles underwent full-text review, and 38 articles were determined eligible for inclusion in the systematic review. <h3>Data Extraction</h3> Reviewers are currently conducting data extraction and quality appraisals. Relevant data is being extracted from each study by four reviewers (two reviewers for each article) using a standardized data-extraction table and consensus will be achieved for completeness and accuracy. Four reviewers (two for each article) will also conduct a quality appraisal of each article to assess the risk for bias and quality of the articles and consensus will be achieved. <h3>Data Synthesis</h3> Descriptive and statistical measures will be used as appropriate to describe types of interventions studied, sleep outcome measures used and corresponding results, and summarize key components across interventions. <h3>Conclusions</h3> This systematic review will summarize the current state of the literature on behavioral interventions for sleep in individuals with MS. It is anticipated the conclusions will aid in guiding clinical practice and identify opportunities for future research. <h3>Author(s) Disclosures</h3> Catherine F. Siengsukon: Owner and CEO of Sleep Health Education, LLC <h3>David Turkowitch</h3> N/A <h3>Prasanna Vaduvathiriyan</h3> N/A <h3>Silvana Costa</h3> N/A <h3>Sarah Donkers</h3> N/A <h3>Joy Williams</h3> N/A

A Feasibility Study of Individuals Living at Home with Alzheimer's Disease and Related Dementias: Utilization of Visual Mapping Assistive Technology to Enhance Quality of Life and Reduce Caregiver Burden.

Efficacy of assistive technology continues to evolve as a means of helping individuals with cognitive and intellectual disabilities, asserting the importance of its research. We report outcomes of a six-week randomized control feasibility study in a small cohort of 16 family caregivers of individuals living with Alzheimer's disease and related dementias. An experimental group of seven family caregivers used visual mapping software on smart devices (step-by-step pictures, audio, and videos instructing how to complete a task) to support carrying out activities of daily living with their care recipients. In comparison, control group of nine family caregivers used smart devices to access and view educational videos focused on dementia care. After a six-week study, compared to caregivers using educational videos, caregivers using visual maps assistive technology reported higher satisfaction of use and stronger recommendation of use to others. Caregivers using visual maps technology also exhibited more improved quality of life scores and improved completion of activities of daily living for their dementia care recipients, as well as reduced caregiver burden scores compared to the caregivers in the control group. These promising findings show that the use of assistive technology is feasible in the home setting and suggest time is ripe for undertaking systematic studies of assistive technology's potential to advance effective behavioral interventions in dementia home and family settings.

Putting prospection into practice: Methodological considerations in the use of episodic future thinking to reduce delay discounting and maladaptive health behaviors.

In recent years, episodic future thinking (EFT) has emerged as a promising behavioral intervention to reduce delay discounting or maladaptive health behaviors; however, considerable methodological heterogeneity in methods for eliciting engagement in EFT has been observed in prior research. In this narrative review, we briefly describe methods for generating EFT cues, the content of EFT cues, common control conditions for experiments utilizing EFT, and considerations for cue delivery and implementation. Where possible, we make suggestions for current best practices in each category while identifying gaps in knowledge and potential areas of future research. Finally, we conclude by using the NIH Stage model to better frame the current state of the literature on EFT and propose gaps to be addressed if EFT is to be both an efficacious and effective behavioral intervention.

Complementary Approaches for Military Women with Chronic Pelvic Pain: A Randomized Trial.

Introduction: Active duty (AD) women suffer with chronic pelvic pain (CPP) while providers tackle diagnoses and treatments to keep them functional without contributing to the opioid epidemic. The purpose of this randomized trial was to determine the effectiveness of noninvasive, self-explanatory mindfulness-based stress reduction (MBSR) or self-paced healthy lifestyle (HL) interventions on CPP in AD women. Methods: A 6-week, interventional prospective study with AD women aged 21-55 years at Mountain Home (MTHM), Idaho, was conducted. Women were randomly assigned to MBSR (N = 21) or HL (N = 20) interventions. The primary outcome was pain perception. The secondary outcomes were depression and circulating cytokine levels. Results: Women in the MBSR group exhibited reduced pain interference (p < 0.01) and depression (p < 0.05) alongside decreased interleukin (IL)-4 (p < 0.05), IL-6 (p < 0.05), eotaxin (p < 0.05), monocyte chemoattractant protein-1 (p = 0.06), and interleukin-1 receptor antagonist (IL-1ra) (p < 0.01) and increased vascular endothelial growth factor (p < 0.05). Women in the HL group did not have changes in pain; however, they did exhibit reduced depression (p < 0.05) alongside decreased granulocyte-macrophage colony-stimulating factor (p < 0.05) and increased tumor necrosis factor alpha (p < 0.05), stromal cell-derived factor-1 (p < 0.01), and IL-1ra (p < 0.01). Conclusions: AD women receiving MBSR or HL had reduced depression scores and altered circulating cytokine levels; however, only those receiving MBSR had reduced pain perception. Findings support MBSR as an effective and viable behavioral treatment for AD women suffering from CPP and provide premise for larger randomized controlled studies. Clinical Trial Registration: MOCHI-An RCT of mindfulness as a treatment for CPP in AD Women NCT04104542 (September 26, 2019).

Integration of implementation science in cardiovascular behavioral medicine.

Cardiovascular behavioral medicine has significantly advanced the knowledge base regarding the mechanisms by which psychological and behavioral factors can impact cardiovascular function and has developed clear links between these factors and cardiovascular health and disease. More recent work has established numerous behavioral interventions that are efficacious, and in several cases demonstrated to be effective. However, despite these significant advances, translation to broad, real-world uptake and utilization has not been well studied, with consequential profound implications for health equity. The purpose of this article is to review what is known about effective implementation strategies to support the uptake of behavioral medicine interventions to improve cardiovascular health, to underscore the potential for developing additional implementation strategies for wide-scale uptake of effective cardiovascular behavioral medicine interventions, and to discuss the potential for developing additional implementation approaches while conducting early stage efficacy studies in this area. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Measuring sensitivity to social distancing behavior during the COVID-19 pandemic

Social distancing remains an effective nonpharmaceutical behavioral interventions to limit the spread of COVID-19 and other airborne diseases, but monitoring and enforcement create nontrivial challenges. Several jurisdictions have turned to “311” resident complaint platforms to engage the public in reporting social distancing non-compliance, but differences in sensitivity to social distancing behaviors can lead to a mis-allocation of resources and increased health risks for vulnerable communities. Using hourly visit data to designated establishments and more than 71,000 social distancing complaints in New York City during the first wave of the pandemic, we develop a method, derived from the Weber-Fechner law, to quantify neighborhood sensitivity and assess how tolerance to social distancing infractions and complaint reporting behaviors vary with neighborhood characteristics. We find that sensitivity to non-compliance is lower in minority and low-income neighborhoods, as well as in lower density areas, resulting in fewer reported complaints than expected given measured levels of overcrowding.

Assessing the Testability of the Multi-Theory Model (MTM) in Predicting Vaping Quitting Behavior among Young Adults in the United States: A Cross-Sectional Survey.

Purpose: Given the increased exposure to e-cigarettes and nicotine among young adults, difficulty in quitting vaping is likely, which supports the need for effective behavioral interventions. Therefore, this cross-sectional study aims to assess the testability of the contemporary multi-theory model of health behavior change in predicting the vaping quitting behavior among young adults in the United States. Methods: A nationally representative sample of 619 young adults engaged in vaping behavior and aged 18–24 years was recruited to complete a 49-item web-based survey. A structural equation model was used to test relationships between MTM constructs. Hierarchical multiple regression was utilized to predict the variance in the initiation and sustenance of vaping quitting behavior by predictor variables, such as demographic characteristics, history of behaviors, and MTM constructs. Results: Of 619 respondents, over 75% were White and nearly 70% had educational attainment equal to high school or some college. In total, 62% of respondents were using nicotine, followed by 33.3% were using cannabis. About 80% of the respondents reported being engaged in drinking alcohol, and nearly 45% were engaged in cigarette smoking. The predictive effect of all MTM constructs on vaping quitting initiation (adjusted R2 = 0.417, F (23, 595) = 20.215, p < 0.001) and sustenance (adjusted R2 = 0.366, F (23, 595) = 16.533, p < 0.001) was statistically significant. Conclusions: The findings of this study point to the usability and applicability of MTM in operationalizing and developing vaping quitting behavior interventions targeting young adults.

Using the Theory of Planned Behavior to Explain and Predict Areca Nut Use Among Adolescents in India: An Exploratory Study.

ContextAreca nut, used alone or in combination with tobacco, contributes to the high oral cancer burden in India. Used widely by adolescents, who perceive it as a harmless substance, areca nut is addictive and considered a precursor to tobacco use. Given its serious implications for addictiveness and physical health, urgent preventive interventions for areca nut use are required in India and South-East Asia. Studies examining the role of health behavior theory in explaining and predicting areca nut use and for development of its prevention among adolescents are scarce.AimThis study explored the role of the components of Theory of Planned Behavior (TPB) such as attitudes, subjective norms, perceived behavioral control, and intention in predicting areca nut use among adolescents.Settings and DesignObservational study with cross-sectional design conducted with 1884 male and female adolescents attending low-income schools in Mumbai, India.Methods and MaterialSelf-administered surveys were used to gather data on age, gender, behavioral factors and areca nut use.Statistical Analysis UsedChi-square and Mann Whitney test for bivariate and logistic regression for multivariate analysis.ResultsAround 27.2% of 1884 participants were areca nut users. The mean age of users was 13.75 years. Intention-to-use and perceived behavioral control were statistically significant predictors of actual areca nut use (p<0.001). The components of TPB such as attitude, perceived subjective social norms, and perceived behavioral control had a statistically significant effect on the intention-to-use areca nut (p<0.05).ConclusionThis exploratory study indicates that constructs from TPB could help us understand and predict areca nut use. However, more rigorous future research is required to generate insights that help craft effective theory-based behavioral interventions for areca nut prevention and cessation in adolescents.

A Brief History and Future of the Traffic Light Diet

Abstract The Traffic Light Diet is a commonly used component of many behavioral treatment programs for pediatric obesity. Vorland, Brown, Cardel and Brown (1) raise some interesting and important issues related to the Traffic Light Diet. This commentary is designed to provide a background on the history and purpose of the Traffic Light Diet, to indicate the Traffic Light Diet is only one component of effective Family-Based Behavioral Treatments for pediatric obesity, and to support an idea for future directions for the Traffic Light Diet based on unique dietary and nutritional requirements for specific diseases.