Behavior analysts in the war on poverty: Developing an operant antipoverty program.

Silverman, Kenneth; Holtyn, August F.; Subramaniam, Shrinidhi

doi:10.1037/pha0000230

Cited by 20 publications

(23 citation statements)

References 51 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Most abstinence-contingent wage supplement participants, who could earn incentives for working with the employment specialist, worked with the employment specialist consistently, whereas most usual care control participants stopped working with the employment specialist shortly after randomisation. This is consistent with prior studies demonstrating the utility of incentives in promoting attendance and performance in job skills training programmes for unemployed adults with substance use disorders 40. Those studies have shown that unemployed adults will attend a job skills training programme primarily when offered incentives for attendance36 41 42; and they will work on training programmes, but primarily when offered incentives based on their performance on the training programmes 43 44…”

Section: Discussionsupporting

confidence: 88%

“…The development of interventions that can address the inter-related problems of substance use and poverty is among the most important challenges in substance abuse treatment research. The therapeutic workplace could be an ideal intervention for individuals with substance use disorders who live in poverty because it includes both a proximal intervention to promote drug abstinence and a distal intervention to promote employment 1 40. It also provides an opportunity to arrange special contingencies that may be needed to promote skill development, job search behaviours and employment in this population.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Abstinence-contingent wage supplements to promote drug abstinence and employment: a randomised controlled trial

Holtyn

Toegel

Subramaniam

et al. 2020

J Epidemiol Community Health

Self Cite

View full text Add to dashboard Cite

BackgroundPoverty, unemployment and substance abuse are inter-related problems. This study evaluated the effectiveness of abstinence-contingent wage supplements in promoting drug abstinence and employment in unemployed adults in outpatient treatment for opioid use disorder.MethodsA randomised controlled trial was conducted in Baltimore, MD, from 2014 to 2019. After a 3-month abstinence initiation and training period, participants (n=91) were randomly assigned to a usual care control group that received employment services or to an abstinence-contingent wage supplement group that received employment services plus abstinence-contingent wage supplements. All participants were invited to work with an employment specialist to seek employment in a community job for 12 months. Abstinence-contingent wage supplement participants could earn training stipends for working with the employment specialist and wage supplements for working in a community job, but had to provide opiate and cocaine-negative urine samples to maximise pay.ResultsAbstinence-contingent wage supplement participants provided significantly more opiate and cocaine-negative urine samples than usual care control participants (65% vs 45%; OR=2.29, 95% CI 1.22 to 4.30, p=0.01) during the 12-month intervention. Abstinence-contingent wage supplement participants were significantly more likely to have obtained employment (59% vs 28%; OR=3.88, 95% CI 1.60 to 9.41, p=0.004) and lived out of poverty (61% vs 30%; OR=3.77, 95% CI 1.57 to 9.04, p=0.004) by the end of the 12-month intervention than usual care control participants.ConclusionAbstinence-contingent wage supplements can promote drug abstinence and employment.Trial registration numberClinicalTrials.gov NCT02487745.

show abstract

Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Abstinence-contingent wage supplements to promote drug abstinence and employment: a randomised controlled trial

Holtyn

Toegel

Subramaniam

et al. 2020

J Epidemiol Community Health

Self Cite

View full text Add to dashboard Cite

show abstract

“…At the conceptual and intervention levels, these macrolevel factors have not yet played prominent roles in ABA scholarship related to health behavior (cf. Hovell et al, 2002, Silverman et al, 2018. Examining these factors may reveal the proximal contingencies responsible for unhealthy behavior (e.g., living in a food desert increases response effort to obtain healthy food and decreases modeling and reinforcement for healthful eating).…”

Section: A Cohesive Conceptual Systemmentioning

confidence: 99%

Leveraging applied behavior analysis research and practice in the service of public health

Normand

Dallery

Slanzi

2021

J of App Behav Analysis

View full text Add to dashboard Cite

Human behavior plays a central role in all domains of public health. Applied behavior analysis (ABA) research and practice can contribute to public health solutions that directly address human behavior. In this paper, we describe the field of public health, identify points of interaction between public health and ABA, summarize what ABA research has already contributed, and provide several recommendations for how ABA research and practice could continue to promote public health outcomes. A clearer focus on behavior and widespread adoption of research designs and interventions informed by the ABA literature could lead to better public health outcomes. Reciprocally, better integration of public health goals and strategies into ABA research, harnessing of technology, and more collaboration would help diversify and disseminate our applied science and could yield more effective and scalable interventions to prevent and treat public health problems.

show abstract

“…Research examining the utility of operant conditioning in moving people out of poverty has been limited. Two types of research have been conducted in this area: Large-scale anti-poverty interventions that use incentives to increase education and employment in low-income adults (Holtyn, Jarvis, & Silverman, 2017); and the systematic application of incentives to promote skill development in unemployed adults with long histories of drug addiction (Silverman, Holtyn, and Subramaniam, 2018).…”

Section: Distal Interventions To Reduce Povertymentioning

confidence: 99%

The Utility of Operant Conditioning to Address Poverty and Drug Addiction

2019

Self Cite

View full text Add to dashboard Cite

Poverty is associated with poor health. This article reviews research on proximal and distal operant interventions to address drug addiction and poverty. Proximal interventions promote health behaviors directly. Abstinence reinforcement, a common proximal intervention for the treatment of drug addiction, can be effective. Manipulating familiar parameters of operant conditioning can improve the effectiveness of abstinence reinforcement. Increasing reinforcement magnitude can increase the proportion of individuals that respond to abstinence reinforcement, arranging long-term exposure to abstinence reinforcement can prevent relapse, and arranging abstinence reinforcement sequentially across drugs can promote abstinence from multiple drugs. Distal interventions reduce risk factors that underlie poor health and may have an indirect beneficial effect on health. In the case of poverty, distal interventions seek to move people out of poverty. The therapeutic workplace includes both proximal and distal interventions to treat drug addiction and poverty. In the therapeutic workplace, participants earn stipends or wages to work. The therapeutic workplace uses employment-based reinforcement in which participants are required to provide drug-free urine samples or take scheduled doses of addiction medications to work and/or maintain maximum pay. The therapeutic workplace has two phases, a training and an employment phase. Special contingencies appear required to promote skill development during the training phase, employment-based reinforcement can promote abstinence from heroin and cocaine and adherence to naltrexone, and the therapeutic workplace can increase employment. Behavior analysts are well-suited to address both poverty and drug addiction using operant interventions like the therapeutic workplace.

show abstract

Behavior analysts in the war on poverty: Developing an operant antipoverty program.

Cited by 20 publications

References 51 publications

Abstinence-contingent wage supplements to promote drug abstinence and employment: a randomised controlled trial

Abstinence-contingent wage supplements to promote drug abstinence and employment: a randomised controlled trial

Leveraging applied behavior analysis research and practice in the service of public health

The Utility of Operant Conditioning to Address Poverty and Drug Addiction

Contact Info

Product

Resources

About