No-choice Group Research Articles

Effects of Participant’s Choice of Different Digital Interventions on Outcomes for Binge-Spectrum Eating Disorders: A Pilot Doubly Randomized Preference Trial

It is unclear whether offering individuals a choice between different digital intervention programs affects treatment outcomes. To generate initial insights, we conducted a pilot doubly randomized preference trial to test whether offering individuals with binge-spectrum eating disorder a choice between two digital interventions is causally linked with superior outcomes than random assignment to these interventions. Participants with recurrent binge eating were randomized to either a choice (n = 77) or no-choice (n = 78) group. Those in the choice group could choose one of the two digital programs, while those in the no-choice group were assigned a program at random. The two digital interventions (a broad and a focused program) took 4 weeks to complete, were based on cognitive-behavioral principles and have demonstrated comparable efficacy, but differ in scope, content, and targeted change mechanisms. Most participants (79%) allocated to the choice condition chose the broad program. While both groups experienced improvements in primary (Eating Disorder Examination Questionnaire global scores and number of binge eating episodes over the past month) and secondary outcomes (dietary restraint, body image concerns, etc.), no significant between-group differences were observed. The two groups did not differ on dropout rates, nor on most indices of intervention engagement. Findings provide preliminary insights towards the role of client preferences in digital mental health interventions for eating disorders. Client preferences may not determine outcomes when digital interventions are based on similar underlying principles, although larger trials are needed to confirm this.

Reaction time asymmetries provide insight into mechanisms underlying dominant and non-dominant hand selection.

Handedness is often thought of as a hand "preference" for specific tasks or components of bimanual tasks. Nevertheless, hand selection decisions depend on many factors beyond hand dominance. While these decisions are likely influenced by which hand might show performance advantages for the particular task and conditions, there also appears to be a bias toward the dominant hand, regardless of performance advantage. This study examined the impact of hand selection decisions and workspace location on reaction time and movement quality. Twenty-six neurologically intact participants performed targeted reaching across the horizontal workspace in a 2D virtual reality environment, and we compared reaction time across two groups: those selecting which hand to use on a trial-by-trial basis (termed the choice group) and those performing the task with a preassigned hand (the no-choice group). Along with reaction time, we also compared reach performance for each group across two ipsilateral workspaces: medial and lateral. We observed a significant difference in reaction time between the hands in the choice group, regardless of workspace. In contrast, both hands showed shorter but similar reaction times and differences between the lateral and medial workspaces in the no-choice group. We conclude that the shorter reaction times of the dominant hand under choice conditions may be due to dominant hand bias in the selection process that is not dependent upon interlimb performance differences.

Providing choice of feedback affects perceived choice but does not affect performance.

BackgroundAutonomy or choice can lead to improved learning in various educational domains. The purpose of this online study was to examine whether giving participants a choice regarding the frequency of their received feedback (either after each individual trial or after a block of trials) in a computerized alternate task-switching task, will affect their performance.MethodsParticipants (n = 148) were randomly assigned to three groups: choice group (n = 49), online feedback group (n = 51), and summary feedback group (n = 48). From those three groups we created two groups: a choice group and a no-choice group (n = 49 in each group). All participants performed eight familiarization trials, a pre-test of 24 trials, five blocks of 24 trials for practice, and a post-test of 24 trials. After completing the task, the participants were asked about their perceived feeling of choice and completed the short form of the International Positive and Negative Affect Schedule.ResultsThe participants in the choice group had higher perceived choice compared with the participants in the no-choice group (8.41 vs 5.47 out of 10, respectively). However, this higher perceived choice did not materialize into better performance during practice or in the post-test.

The Effects of Health Care Chatbot Personas With Different Social Roles on the Client-Chatbot Bond and Usage Intentions: Development of a Design Codebook and Web-Based Study.

BackgroundThe working alliance refers to an important relationship quality between health professionals and clients that robustly links to treatment success. Recent research shows that clients can develop an affective bond with chatbots. However, few research studies have investigated whether this perceived relationship is affected by the social roles of differing closeness a chatbot can impersonate and by allowing users to choose the social role of a chatbot.ObjectiveThis study aimed at understanding how the social role of a chatbot can be expressed using a set of interpersonal closeness cues and examining how these social roles affect clients’ experiences and the development of an affective bond with the chatbot, depending on clients’ characteristics (ie, age and gender) and whether they can freely choose a chatbot’s social role.MethodsInformed by the social role theory and the social response theory, we developed a design codebook for chatbots with different social roles along an interpersonal closeness continuum. Based on this codebook, we manipulated a fictitious health care chatbot to impersonate one of four distinct social roles common in health care settings—institution, expert, peer, and dialogical self—and examined effects on perceived affective bond and usage intentions in a web-based lab study. The study included a total of 251 participants, whose mean age was 41.15 (SD 13.87) years; 57.0% (143/251) of the participants were female. Participants were either randomly assigned to one of the chatbot conditions (no choice: n=202, 80.5%) or could freely choose to interact with one of these chatbot personas (free choice: n=49, 19.5%). Separate multivariate analyses of variance were performed to analyze differences (1) between the chatbot personas within the no-choice group and (2) between the no-choice and the free-choice groups.ResultsWhile the main effect of the chatbot persona on affective bond and usage intentions was insignificant (P=.87), we found differences based on participants’ demographic profiles: main effects for gender (P=.04, ηp2=0.115) and age (P<.001, ηp2=0.192) and a significant interaction effect of persona and age (P=.01, ηp2=0.102). Participants younger than 40 years reported higher scores for affective bond and usage intentions for the interpersonally more distant expert and institution chatbots; participants 40 years or older reported higher outcomes for the closer peer and dialogical-self chatbots. The option to freely choose a persona significantly benefited perceptions of the peer chatbot further (eg, free-choice group affective bond: mean 5.28, SD 0.89; no-choice group affective bond: mean 4.54, SD 1.10; P=.003, ηp2=0.117).ConclusionsManipulating a chatbot’s social role is a possible avenue for health care chatbot designers to tailor clients’ chatbot experiences using user-specific demographic factors and to improve clients’ perceptions and behavioral intentions toward the chatbot. Our results also emphasize the benefits of letting clients freely choose between chatbots.

The Effectiveness of an Autonomy-Based Exercise Training on Intrinsic Motivation, Physical Activity Intention, and Health-Related Fitness of Sedentary Students in Middle School

Background: Understanding how to enhance the motivation of inactive students to do physical activity is of great importance for school health. The purpose of the present study was to investigate the impact of an autonomous exercise training intervention on intrinsic motivation, physical activity intention, and health-related fitness of sedentary students in middle schools of Aliabad Katoul city, Golestan province, in 2019. Methods: The present causal-comparative field study was conducted on 45 middle school boys (mean age: 15.08 years) who were sedentary according to Godin-Shephard Questionnaire. The subjects were randomly assigned into three groups: Choice (autonomy training), No-Choice (training without autonomy), and control (no training). Subjects in Choice and No-Choice groups practiced physical fitness items (including flexibility and endurance) for eight weeks, such that the Choice group was allowed to the chosen order of exercises while the No-Choice group was trained in a predetermined order. Intrinsic motivation and physical activity intention were measured by questionnaire and health-related physical fitness components including flexibility, upper-body endurance, and cardiovascular endurance were evaluated by standard tests. One-way and mixed analysis of variance (ANOVA) were used to analyze the data. Tukey test was also used as follow-up test. Results: The participants in the Choice group reported higher intrinsic motivation (6.11±0.53) and physical activity intention (6.20±0.62) scores compared with other groups in post-test. Moreover, the results showed that autonomy training compared with training without autonomy and no training significantly increased intrinsic motivation (F=36.03, P<0.001) and physical activity intention (F=36.68, P<0.001). However, autonomy training did not improve physical fitness components such as flexibility (P=0.847), upper-body endurance (P=0.572), and cardiovascular endurance (P=0.982) more than non-autonomous training. Conclusions: These results may indicate that the feeling of autonomy during exercise training has a greater effect on psychological components (including intrinsic motivation and physical activity intention) compared with physical components (including physical fitness).

Non-invasive chromosome testing (NUCT) improved in vitro fertilization (IVF) outcomes compared to morphological assessment in single blastocyst transfer (SBT)

Introduction Pre-implantation screening (PGS) has been widely used in assisted reproductive technology (ART) and helped improve in vitro fertilization (IVF) clinical outcomes. However, the invasive blastomere or trophectoderm biopsy process involved in PGS not only could generate potential effects on embryo development but requires skills and experience. Non-invasive chromosome screening (NICS) method, which using MALBAC technique to amplify the genomic DNA secreted into the culture medium and following next generation sequencing (NGS) to analysis ploidy condition of the embryos, had been validated through in vitro study(J. Xu et al. 2016 ). Here we further investigate NICS potentials on IVF. Material & Methods A retrospective observational study from September 2015 to September 2016. A total of 353 frozen-thawed single blastocyst transfer (SBT) cycles were divided into three groups with different blastocyst selection criteria: the first was the No-choice group which had only one blastocyst for transfer for each patient (n=285). The second was the Morphology group. The patients of this group had at least two blastocysts available and blastocysts were selected for single blastocyst transfer on the basis of traditional morphological assessments (n=41); the third was the NICS group that had at least two blastocysts for each patient and the euploid blastocysts were selected using NICS for single blastocyst transfer (n=27). Results The biochemical pregnancy rate in the No-choice group, the Morphology group and the NICS group was 65.3%, 65.9% and 85.2%, respectively (P=0.232). Among three groups, the NICS group had the highest implantation rate (63.0%) (P=0.193), compared with 56.1% and 45.3% in the Morphology group and the No-choice group, respectively. There was no incidence of early miscarriage in the NICS group, while the early miscarriage rate in the No-choice group and the Morphology group was 21.1% and 13.0%, respectively (P=0.094). A significant difference was found in the ongoing pregnancy rate among the three groups, which was highest in the NICS group (63.0%) and lowest in the No-choice group (37.9%) (P=0.016). Conclusions NICS is a novel genetic testing that allows an accurate selection of blastocysts with better developmental potential for transfer and might improve the clinical outcomes.

Do Parent Preferences for Child Conduct Problem Interventions Impact Parenting Outcomes? A Pilot Study in Community Children's Mental Health Settings.

A pilot, doubly randomized preference trial was conducted to investigate the impact of providing parents preferences on parenting outcomes. Families with children having conduct problems were randomly assigned to a choice group in which they received their preferred treatment among the four intervention options or a no-choice group in which they were randomized assigned to one of the four options. Results of mixed-effects models showed that parents in the choice group who selected Parent Management Training-Oregon Model (PMTO) had better parenting outcomes over time compared to parents in the choice group who selected child therapy. It highlights the importance of incorporating parent preferences in the delivery of evidence-based treatments.

Choices Over Feedback Enhance Motor Learning in Older Adults

Granting learners autonomy over certain aspects of the practice context—for example, by providing them with the opportunity to choose when to receive augmented feedback or observe a model—has been consistently shown to facilitate the acquisition of motor skills in several populations. However, studies investigating the provision of autonomy support to older adults remain scarce. The purpose of the present experiment was to investigate the effects of providing choice over feedback on motor learning in older adults. Participants were divided into two groups, choice and no-choice, and practiced 36 trials of a linear positioning task. Before each block of six trials, participants from the choice group were given the choice to control, or not, when to receive feedback in the block. No-choice group participants received feedback according to the same schedule as their choice group counterparts, but they could not choose when to receive it. Two days later, participants of both groups performed retention and transfer tests. The choice group demonstrated lower absolute error scores during transfer compared with the no-choice group. The findings reinforce outcomes of previous autonomy support studies and provide the first evidence that choice over feedback can enhance the learning of motor skills in older adults.

Noninvasive chromosome screening improves the clinical outcomes in frozen-thawed single blastocyst transfer cycles

To perform a clinical evaluation of the efficacy of single embryo transfer at blastocyst stage selected using the noninvasive chromosome screening (NICS) assay, which involves the sequencing of free genomic DNA in the culture medium of individual blastocysts for obtaining chromosomal ploidy information. A retrospective observational study from September 2015 to September 2016. A total of 353 frozen-thawed single blastocyst transfer (SBT) cycles were divided into three groups with different blastocyst selection criteria: the first was the No-choice group which had only one blastocyst for transfer for each patient (n=285). The second was the Morphology group. The patients of this group had at least two blastocysts available and blastocysts were selected for single blastocyst transfer on the basis of traditional morphological assessments (n=41); the third was the NICS group that had at least two blastocysts for each patient and the euploid blastocysts were selected using NICS for single blastocyst transfer (n=27). The biochemical pregnancy rate in the No-choice group, the Morphology group and the NICS group was 65.3%, 65.9% and 85.2%, respectively (P=0.232). Among three groups, the NICS group had the highest implantation rate (63.0%) (P=0.193), compared with 56.1% and 45.3% in the Morphology group and the No-choice group, respectively. There was no incidence of early miscarriage in the NICS group, while the early miscarriage rate in the No-choice group and the Morphology group was 21.1% and 13.0%, respectively (P=0.094). A significant difference was found in the ongoing pregnancy rate among the three groups, which was highest in the NICS group (63.0%) and lowest in the No-choice group (37.9%) (P=0.016). NICS is a novel genetic testing that allows an accurate selection of blastocysts with better developmental potential for transfer and might improve the clinical outcomes.

Not all choices are created equal: Task-relevant choices enhance motor learning compared to task-irrelevant choices.

Lewthwaite et al. (2015) reported that the learning benefits of exercising choice (i.e., their self-controlled condition) are not restricted to task-relevant features (e.g., feedback). They found that choosing one's golf ball color (Exp. 1) or choosing which of two tasks to perform at a later time plus which of two artworks to hang (Exp. 2) resulted in better retention than did being denied these same choices (i.e., yoked condition). The researchers concluded that the learning benefits derived from choice, whether irrelevant or relevant to the to-be-learned task, are predominantly motivational because choice is intrinsically rewarding and satisfies basic psychological needs. However, the absence of a group that made task-relevant choices and the lack of psychological measures significantly weakened their conclusions. Here, we investigated how task-relevant and task-irrelevant choices affect motor-skill learning. Participants practiced a spatiotemporal motor task in either a task-relevant group (choice over feedback schedule), a task-irrelevant group (choice over the color of an arm-wrap plus game selection), or a no-choice group. The results showed significantly greater learning in the task-relevant group than in both the task-irrelevant and no-choice groups, who did not differ significantly. Critically, these learning differences were not attributed to differences in perceptions of competence or autonomy, but instead to superior error-estimation abilities. These results challenge the perspective that motivational influences are the root cause of self-controlled learning advantages. Instead, the findings add to the growing evidence highlighting that the informational value gained from task-relevant choices makes a greater relative contribution to these advantages than motivational influences do.

Influence of choice on vegetable intake in children: an in-home study

Children's vegetable consumption is still far below that recommended, and stimulating their intake is a challenge for caregivers. The objective of this study was to investigate whether choice-offering is an effective strategy to increase children's vegetable intake in an in-home situation. Seventy children (mean age 3.7; SD 1) randomly assigned to a choice or a no-choice condition, were exposed 12 times to six familiar target vegetables at home during dinner. In the choice group, two selected vegetables were offered each time, whereas the no-choice group only received one vegetable. Vegetable intake was measured by weighing children's plates before and after dinner. A mixed linear model with age, gender, and baseline vegetable liking as covariates was used to compare intake between the choice and the no-choice group. Mixed linear model analysis yielded estimated means for vegetable intake of 48.5 g +/− 30 in the no-choice group and 57.7 g +/− 31 for the choice group (P = 0.09). In addition, baseline vegetable liking (P < 0.001) and age (P = 0.06) predicted vegetable intake to be higher when the child liked vegetables better and with older age. These findings suggest that choice-offering has some, but hardly robust, effect on increasing vegetable intake in children. Other factors such as age and liking of vegetables also mediate the effect of offering a choice.

Choice-offering as a strategy to stimulate vegetable intake in young children. An in-home study

Poor vegetable intake in children is a persistent problem, despite increased awareness of the importance of vegetable consumption in our obesogenic environment. Encouraging children's feeling of autonomy by offering a choice can stimulate children's vegetable intake, according to self-determination theory. The objective of this study was to investigate whether choice-offering is an effective strategy to increase children's vegetable intake. Children (Mage 3.7; SD 1; n?=?70) were randomly assigned to either the choice or the no-choice condition. Each child was exposed 12 times to six familiar target vegetables in both groups at home during the evening meal. In the choice group, two selected vegetables were offered each time, whereas in the no-choice group only one vegetable was offered. Vegetable intake was measured by weighing children's plates before and after dinnertime. A mixed linear model with age, gender, and baseline vegetable liking as covariates was used to compare intake between the choice and the no-choice group. Baseline vegetable liking predicted vegetable intake during the intervention (P?

The effect of choice between test anxiety treatment options on treatment outcomes

Evidence regarding the effect of clients' choice of treatment on treatment outcome is inconsistent. This possible effect was examined by presenting participants with two treatments of test anxiety: advanced muscle relaxation and changing of internal dialogue. Clients (N=73) were allocated to three groups: choice (participants chose their preferred treatment), no choice (participants were assigned to their preferred treatment but were led to believe they couldn't choose the treatment they were assigned to), and wait-list control (participants received no treatment until the end of the study). There was a significant linear pattern, with the choice group performing better than the no-choice group with no feeling of control, which in turn performed better than the control group. Limitations and suggestions for future research are discussed.

Choice of Treatment Improves Quality of Life

Quality of life (QOL) is an important measure of the success of medicine. Choice of treatment is an important variable influencing QOL. We studied QOL in patients undergoing treatment for end-stage renal failure. Until June 1993 our patients needing dialysis could freely choose continuous ambulatory peritoneal dialysis (CAPD); however, since that time most patients have been forced to undergo CAPD because the hemodialysis program is full. We compared QOL in patients accepted before or after June 1993. Forty-five patients undergoing CAPD were studied during the period of choice compared with 44 who had no choice. Quality of life was studied by Bradburn Affect Scale, Mental Health Scale, Campbell Life Satisfaction, Perceived Health, Karnofsky Scale, Activity Scale, Physical Symptoms Scale, and desire for treatment change. The patients undergoing CAPD in the no-choice group had a lower score than the choice population in 4 of the 7 QOL scales. The Mental Health Scale mean score was 18.4 compared with 15.5, and the patients ranking highest on the Mental Health Scale decreased from 33% to 18%, while those ranking lowest increased 7-fold from 2% to 14% comparing choice with no-choice group. The Bradburn Affect Scale score was +0.7 in the choice group compared with -0.3 in the no-choice group. There were no differences in age, sex, race, or treatment that explained the difference. Influence of other time-related factors is unlikely as there were no similar lower scores with time in the QOL reported by patients in the in-center or assisted self-care hemodialysis or transplant groups. Once the freedom of choice of treatment is gone from the patients undergoing CAPD their psychological QOL deteriorates.

Effects of Choice of Instructional Methods on Verbal Learning Tasks

62 children in Grades 2 through 5 were matched on the variables of sex, race, and age. Each member of the matched pairs was randomly assigned to a choice (treatment) or no-choice (control) group. Subjects in the choice group were asked to choose between individualized and group instructional methods; those in the control were assigned the methods by a teacher. Two verbal tasks and measures were administered to all subjects. A 2 (choice) × 4 (age) factorial analysis of variance yielded a significant difference in the predicted direction for choice. The results substantiate current practices.

Effects in extinction, with and without free choice, of degree of experience with stimuli associated with both partial and continuous reinforcement

The effect of two degrees of training of rats to both arms of a T-maze, one associated with partial reinforcement and the other with continuous, were investigated. Animals were permitted free choice of arms in extinction trials, and extra training did not diminish the strong preference for CRF. In a third, no-choice group, animals were extinguished in one arm or the other, but not both: extinction took as long to CRF- as it did to PR-associated stimuli.