Use Of Behavioral Supports Research Articles

Using the Listening2Faces App with Three Young Adults with Autism: A Feasibility Study

Abstract Objectives Listening2Faces (L2F) is a therapeutic, application-based training program designed to improve audiovisual speech perception for persons with communication disorders. The purpose of this research was to investigate the feasibility of using the L2F application with young adults with autism and complex communication needs. Methods Three young adults with autism and complex communication needs completed baseline assessments and participated in training sessions within the L2F application. Behavioral supports, including the use of cognitive picture rehearsal, were used to support engagement with the L2F application. Descriptive statistics were used to provide (1) an overview of the level of participation in L2F application with the use of behavioral supports and (2) general performance on L2F application for each participant. Results All three participants completed the initial auditory noise assessment (ANA) as well as 8 or more levels of the L2F application with varying accuracy levels. One participant completed the entire L2F program successfully. Several behavioral supports were used to facilitate participation; however, each individual demonstrated varied levels of engagement with the application. Conclusions The L2F application may be a viable intervention tool to support audiovisual speech perception in persons with complex communication needs within a school-based setting. A review of behavioral supports and possible beneficial modifications to the L2F application for persons with complex communication needs are discussed.

Changes in smoker characteristics in England between 2008 and 2017.

AimsAt a time of declining smoking prevalence in England, it is useful to document any changes in the characteristics of smokers. This has implications for targeting tobacco control policies and interventions. This study compared the characteristics of smokers from 2008 to 2017 to assess changes in smoking and quitting patterns and socio‐demographic profile.Design and settingAnalysis of annual trends in results from repeated cross‐sectional surveys of representative samples of the population in England from 2008 to 2017.ParticipantsThe study included 208 813 adults aged 16+.MeasurementsInformation was gathered on age, sex, social grade and region, cigarette consumption, cigarette dependence as measured by time to first cigarette of the day, daily smoking, smoking roll‐your‐own cigarettes, attempts to cut down, use of an e‐cigarette or nicotine replacement therapy, attempts to cut down or quit, use of support in quit attempts and whether the quit attempt was abrupt.FindingsDuring the period, mean daily cigarette consumption [B = –0.30, 95% confidence interval (CI) = –0.33 to −0.27] and the time to first cigarette score decreased (B = –0.03, 95% CI = –0.03 to −0.02). The proportion of smokers attempting to cut down or quit decreased (odds ratio (OR) range = 0.96–0.97, 95% CI range = 0.95–0.97). Use of behavioural support [odds ratio (OR) = 0.89, 95% CI = 0.86–0.92] or no support decreased (OR = 0.98, 95% CI = 0.96–0.99), while use of pharmacological support, including e‐cigarettes, increased (OR = 1.04, 95% CI = 1.02–1.05). There was no significant change in the difference in social grade between smokers and non‐smokers comparing 2008 with 2017. Changes in smoking and quitting behaviour were independent of changes in socio‐demographic characteristics.ConclusionsBetween 2008 and 2017 in England, smokers appear to have become less dependent on cigarettes but less likely to try to quit or cut down. Of those who tried to quit, fewer used behavioural support and more used pharmacological support. The proportion from more disadvantaged backgrounds did not change significantly.

Early Childhood Teachers’ Ratings of Metacognitive Knowledge and Behavioral Support Strategy Use in Classrooms

The purpose of the present study is to investigate if early childhood educators’ behavioral supports for young children are associated with their metacognitive knowledge of general problem-solving strategies. A sample of 175 Korean early childhood educators were surveyed regarding their implementation of behavioral support and meta-cognitive knowledge of five problem-solving (free production, analogy, step by step analysis, visualization, and combining) strategies. In general, early childhood educators who reported frequent implementation of general problem-solving strategies and highly evaluated the applicability and benefits of those strategies also reported active implementation of positive and proactive behavioral supports. In contrast, negative reactive behavioral strategy implementation did not have any association with general problem-solving strategies. Among the five strategies, meta-cognitive knowledge of three strategies (step by step analysis, free production, and analogy) were predictors of their use of behavioral supports in natural settings.

Cold Turkey and Hot Vapes? A National Study of Young Adult Cigarette Cessation Strategies.

Young adults have high smoking rates and low utilization of evidence-based smoking cessation strategies. We investigated smoking cessation intentions, strategy use, and socioeconomic predictors of strategy use among young adult smokers (age 18-24) and compared patterns with those of older adults (age 25-64). We used a population-based sample from the Population Assessment of Tobacco and Health (PATH) study of young adult (n = 1,881) and older adult (n = 6,366) established smokers of conventional cigarettes at Wave 1 (2013-2014), who were surveyed at Wave 2 (2014-2015). Simple regression analysis compared intentions to quit between age groups. Among Wave 1 smokers who reported a Wave 2 quit attempt (young adults [YA] n = 748; older adults [OA] n = 2,068), bivariate and multinomial logistic regression estimated differences in use of behavioral support, pharmacotherapy, product substitution, and unassisted quit attempts. Interaction terms estimated age-group differences in relationships between predictors and cessation strategy use. Young adults planned to quit on a longer time frame, expressed lower interest in quitting, and were more confident they would be successful, compared with older adults. Young adults were significantly less likely to use pharmacotherapy (adjusted odds ratio: 0.15; confidence interval: 0.09, 0.24; reference: quitting unassisted). Both groups reported using product substitution (YA: 31.6%; OA: 28.5%), primarily with e-cigarettes, more than any evidence-based cessation strategy. Socioeconomic predictors of cessation strategy use did not differ between age groups. More research on why young adult smokers underutilize evidence-based cessation support is needed, as are innovative efforts to increase intentions to quit and utilization of cessation assistance. Young adulthood is a key transition time for tobacco use, and early cessation substantially reduces the risk of morbidity and mortality from smoking. In the context of high e-cigarette and polytobacco use, this study finds young adults have significantly less intention to quit than older adults and are less likely to use evidence-based cessation strategies to help quit. Innovative methods are needed to increase young adult intentions to quit and use of evidence-based cessation assistance.

Use of Smoking Cessation Methods Among Patients Receiving Office-based Buprenorphine Maintenance Treatment.

Provision of smoking-cessation treatment is limited in office-based buprenorphine maintenance treatment (BMT) settings. This study describes smoking and smoking-cessation behaviors among patients receiving office-based BMT. Cross-sectional study of patients receiving office-based BMT at a community health center in the Bronx, NY. We interviewed patients assessing sociodemographic, and substance use and tobacco use characteristics, including methods used for smoking cessation. We reported simple frequencies and explored associations of BMT characteristics with smoking behaviors. Of 68 patients, 87.7% were current cigarette smokers, 7.9% were former smokers, and 4.4% had never smoked. Of lifetime smokers, 83.1% reported at least 1 prior quit attempt, and 78.5% had used medication (75.4% used nicotine replacement therapy, 29.2% varenicline, and 9.2% bupropion). Ten patients (15.4%) reported using electronic cigarettes to try to quit smoking. Stopping "cold turkey" (40.0%) and gradually decreasing the number of cigarettes smoked (32.3%) were nonpharmacological methods of quitting tried most often. Use of behavioral support, including stop-smoking programs and counseling, was low. Higher dose and longer duration of BMT was associated with greater smoking frequency. Patients receiving BMT have a high prevalence of cigarette smoking, though most have tried to quit, and have prior experience with pharmacotherapy for smoking cessation. Efforts to optimize smoking-cessation treatments among BMT patients are needed.

Elementary and Middle School Teachers’ Self-Reported Use of Positive Behavioral Supports for Children With ADHD: A National Survey

This study examined elementary and middle school teachers’ self-reported use of behavioral supports for students with attention-deficit/hyperactivity disorder (ADHD) from a national sample of teachers. This information is important given increased attention and emphasis on universal and targeted strategies within problem-solving models in schools. Participants were teachers surveyed from 26 states across North America about their use of behavioral supports for their students with ADHD. Results are grouped by primary (K–2), intermediate (3–5), and middle (6–8) school levels. Results from this survey demonstrate that teachers report using significantly more universal and targeted strategies in the primary and intermediate school levels than teachers in the middle school level, revealing a reduction of behavioral supports for students with ADHD as they move into the middle school years. These findings have have implications for targeting school-based interventions for students with ADHD as they transition into middle school.

Association between electronic cigarette use and changes in quit attempts, success of quit attempts, use of smoking cessation pharmacotherapy, and use of stop smoking services in England: time series analysis of population trends

Objectives To estimate how far changes in the prevalence of electronic cigarette (e-cigarette) use in England have been associated with changes in quit success, quit attempts, and use of licensed...

PREDICTORS OF QUIT SUCCESS IN BELGIAN PARTICIPANTS OF A VARENICLINE OBSERVATIONAL SMOKING CESSATION STUDY

Background: We evaluated efficacy, predictors of quitting success and the safety profile of varenicline for smoking cessation in the Belgian participants in an observational, “ real world ” study.Methods: In this post-hoc analysis of a prospective, observational, non-comparative study, participants were adult smokers who were motivated to quit and were prescribed varenicline in accordance with the recommendations of the European Summary of Product Characteristics. The 7-day point prevalence of abstinence at Weeks 12 and 24 was determined based on patient reporting, and these data were further analysed by time to first cigarette on waking and by the use of behavioural support. The safety profile of varenicline was also assessed.Results: Overall, 61.1% of participants (n = 226) successfully quit smoking by the end of Week 12. There was a significant association between abstinence and time to first cigarette on waking (Week 12: OR, 0.69 [95% CI, 0.50–0.94], p = 0.02; Week 24: OR, 0.70 [95% CI, 0.52–0.94], p = 0.02) and the use of behavioural support (Week 12: OR, 6.18 [95% CI, 3.41–11.2], p < 0.01; Week 24: OR, 5.37 [95% CI, 2.89–9.98], p < 0.01). The most frequent treatment- emergent adverse event was nausea (9.3%).Conclusions: In this post-hoc analysis, varenicline was an effective smoking cessation aid with an acceptable safety profile in real world clinical practice in Belgian smokers. Significant predictors of abstinence were time to first cigarette on waking and use of behavioural support.

Cessation assistance reported by smokers in 15 countries participating in the International Tobacco Control (ITC) policy evaluation surveys

To describe some of the variability across the world in levels of quit smoking attempts and use of various forms of cessation support. Use of the International Tobacco Control Policy Evaluation Project surveys of smokers, using the 2007 survey wave (or later, where necessary). Australia, Canada, China, France, Germany, Ireland, Malaysia, Mexico, the Netherlands, New Zealand, South Korea, Thailand, United Kingdom, Uruguay and United States. Samples of smokers from 15 countries. Self-report on use of cessation aids and on visits to health professionals and provision of cessation advice during the visits. Prevalence of quit attempts in the last year varied from less than 20% to more than 50% across countries. Similarly, smokers varied greatly in reporting visiting health professionals in the last year (<20% to over 70%), and among those who did, provision of advice to quit also varied greatly. There was also marked variability in the levels and types of help reported. Use of medication was generally more common than use of behavioural support, except where medications are not readily available. There is wide variation across countries in rates of attempts to stop smoking and use of assistance with higher overall use of medication than behavioural support. There is also wide variation in the provision of brief advice to stop by health professionals.

Behavior Support Strategies in Early Childhood Settings

The current study investigated early childhood professionals' opinions regarding the use of behavioral supports for children with challenging behavior. Participants included early childhood special education teachers, Title I teachers, speech and language pathologists, instructional aids and paraprofessionals, physical therapists, and school psychologists. Participants rated 24 behavioral support strategies on both their importance and their feasibility. Overall, results indicated that early childhood professionals rated the majority of the behavior support items in the mostly important range. Participants did not rate as many items as mostly feasible, and statistical analyses documented a significant difference between overall importance of the items and overall feasibility. Early childhood professionals' characteristics were analyzed to investigate whether groups differed in their perceptions of the importance and feasibility of the behavioral support items. Findings indicated that early childhood special education and Title I teachers rated the support items as more important than did paraprofessionals and instructional aids. Educational level also differentiated groups on importance ratings; professionals with either undergraduate degrees or graduate-level educational experiences rated items as more important than professionals with high school—level educations or some college. Years of teaching experience was not associated with ratings, and no teacher characteristic was associated with the feasibility of behavior supports. The implications of these findings are discussed.

Cost-utility analysis.

Decisions have to be made about allocating health resources. Currently the best economic evaluation method for doing this is cost-utility analysis. This compares the costs of different procedures with their outcomes measured in "utility based" units--that is, units that relate to a person's level of wellbeing. The most commonly used unit is the quality adjusted life year (QALY). QALYs are calculated by estimating the total life years gained from a procedure and weighting each year to reflect the quality of life in that year. To compare outcomes of different programmes the Rosser index is one measure that is widely used to assign quality of life scores to patients. Combined with a measure of life years gained from a procedure, this enables QALYs to be calculated and procedures ranked according to cost per QALY gained. In this article Ray Robinson explains the measures used and discusses how QALY league tables can be used to guide decisions on resource allocation.