Behavioral self–monitoring (SM) procedures, involving individuals repeatedly observing, evaluating, and recording aspects of their own behavior, are widely used for assessment and intervention purposes (Korotitisch & Nelson-Gray, 1999).  Recently SM has been included in occupational safety interventions (e.g., Hickman & Geller, 2003a; 2003b; Krause, 1997; Olson & Austin, 2001; McCann & Sulzer-Azaroff, 1996).  Large companies, such as the United Parcel Service, are now implementing safety SM interventions with isolated workers (J. Ginter, personal communication, October 2005), and Industrial and Organizational psychologists are also increasingly using SM methods, such as diaries and computer-based ecological momentary sampling procedures, to study organizational phenomena.  However, compliance with SM procedures can be highly variable, and there is evidence that greater compliance rates correlate with better results (Cash & Hrabosky 2003).

What can be done to increase compliance with SM? Two low- effort options are to provide reminders and prompts to participants, or to allow participants to choose target behaviors.  Prompting is a reliable method for increasing behavior during relatively brief interventions (e.g., Austin, Alvero, & Olson, 1998; Muller, Moore, Tingstrom, & Doggett, 2002), but has not been tested as a method for increasing compliance with SM.  Allowing participants to select target behaviors has been used in workplace health- promotion interventions (e.g., Kunitsuka, Yamatsu, & Adachi, 2002), but the effects of this practice on intervention compliance and behavior change were not experimentally evaluated.  The current paper reports the results of an experiment evaluating the impact of prompting and choice on compliance with a SM procedure targeting healthful behaviors. 

Method

The study was conducted at a private University in the Western United States.  Undergraduate college students (n=43) enrolled in Psychology courses participated.  The effects of independent variables on participant compliance with a SM procedure were evaluated with a three group design: (1) control condition with no prompting and assigned target behavior; (2) prompt condition with prompting and assigned target behavior; and (3) prompt plus choice condition with prompting and choice of target behavior.  After participants volunteered for the study they were randomly assigned to one of these three conditions.  Each participant then attended an instructional group session with directions that varied according to group membership, followed by ten consecutive days of SM a healthful behavior.

Six healthful target behaviors were selected by the authors based on recommendations from the United States Center for Nutrition Policy Promotion.  These included the consumption of water, sweets, fruits and vegetables, or soda, and the frequency of exercising and hand washing.  The SM procedure was the same for all participants.  Each person received 3 by 5 inch notecards with spaces for counting behaviors as they occurred throughout the day.  They were instructed to carry the card with them and record behavior occurrences for ten consecutive days.  At the end of each day, participants were asked to turn in their cards at a drop box near the Psychology Department followed by an e-mail to researchers indicating that they turned in their data.  In the control condition participants were assigned a target behavior and received no additional contact from researchers over the next ten days.  In the prompt only condition participants were assigned a target behavior and then received daily e-mail prompts to SM, turn in cards, and send compliance e-mails.  In the prompt plus choice condition, participants chose their target behavior and then received the daily e-mail prompts.  In order to control for effects due to the type of behavior being monitored, the prompt plus choice group was run first.  The proportion of each target behavior selected by this choice group was then used to determine the proportion of each behavior that would be randomly assigned to members of the prompt only and control groups.  For each condition, the primary measure of compliance was the number of cards turned in and emails sent by participants during the ten day period.

Results

Both prompting and target behavior choice increased compliance rates, with the combined treatment condition (“prompt plus choice”) resulting in the highest compliance rate assessed using a Multivariate ANOVA.  The effects were more pronounced on the higher effort target behavior of dropping off SM cards than for the low-effort behavior of e-mailing researchers that SM was complete. The compliance rates for daily e-mails and card drop-offs are shown in Figure 1.  Oneway ANOVAs were computed for both dependent measures.  When comparing the Control to the Prompt plus Choice group, the average number of log drop-offs increased from 4.29 to 7.27, F(2,40)=3.36, p=.05. The Prompt group did not significantly differ from either the Control or Prompt plus Choice group, F(2,40)=.33, p=.72.

Figure1.  Average compliance rates for daily e-mail and daily drop-off tasks across all ten days for Control, Prompt, and Prompt plus Choice groups.

Discussion

The results indicate that prompting and choice of target behavior increase compliance with the most effortful aspect of the current behavioral SM procedure (card drops).  However, the absence of a “choice only” condition prevented a full factorial analysis of interactions between the two independent variables.  The effects of prompting alone were small but higher than the control condition for both dependent measures.  In our view, these findings strongly suggest that offering participants choice in target behaviors during SM interventions is a promising technique for increasing compliance with such interventions.  We predict that choice in target behaviors will also encourage longer lasting behavior changes due to improved motivation from individual conditioned reinforcers of the intervention.

References

Austin, J., Alvero, A. M., & Olson, R. (1998). Prompting patron safety belt use at a restaurant. Journal of Applied Behavior Analysis, 31, 655-657.

Cash, T. F., & Hrabosky, J. I. (2003). The effects of psychoeducation and self-monitoring in a cognitive-behavioral program for body-image improvement. Eating Disorders: The Journal of Treatment and Prevention, 11, 255-270.

Hickman, J. S., & Geller, E. S. (2003a).  A safety self-management intervention for mining operations.  Journal of Safety Research, 34 (3), 299-308.

Hickman, J. S., & Geller, E. S. (2003b).  Self-management to increase safe driving among short-haul truck drivers.  Journal of Organizational Behavior Management, 23 (4), 1-20.

Korotitsch, W. J., & Nelson-Gray, R. (1999). An overview of self-monitoring research in assessment and treatment. Psychological Assessments, 11, 415-425.

Krause, T. R. (1997).  Self-observation. The behavior-based safety process: Managing involvement for an injury-free culture (pp. 283-288). New York City, NY: Van Nostrant Reinhold.

Kunitsuka, K., Yamatsu, K., & Adachi Y. (2002). A correspondence behavioral approach for 6 lifestyle’s improvements in a workplace. Nippon Koshu Eisei Zasshi, 49 (6), 525-534.

McCann, K. B., & Sulzer-Azaroff, B. (1996). Cumulative trauma disorders: behavioral injury prevention at work. Journal of Applied Behavioral Science, 32 (3), 277-291.Mueller, M. M., Moore, J. W., Tingstrom,

D.H., & Doggett, R.A. (2002). Increasing seating opportunities using a behavioral prompt. Journal of Organizational Behavior Management, 21, 99-109.

Olson, R., & Austin, J. (2002). Behavior-based safety and working alone: The effects of a self-monitoring package on the safe performance of bus operators. Journal of Organizational Behavior Management, 21, 5-43.

Schreurs, K. M., Colland, V. T., Kuijer, R. G., & DeRidder, D. T. (2003). Development, content, and process evaluation of a short self-management intervention in patients with chronic diseases requiring self-care behaviors.  Patient Education and Counseling, 51, 133-141.