Effective and efficient skill-acquisition procedures must be identified to support individualized behavioral programming for children with autism spectrum disorder (ASD). To do this, practitioners and researchers may use assessment-based instruction. Prompts are a common teaching strategy to promote skill acquisition. The purpose of this applied study was to use assessment-based instruction to evaluate the efficacy and efficiency of within- and extra-stimulus prompts to teach conditional discriminations to two children with ASD. We identified stimulus prompts using a survey of popular children's games and conducted a tablet-based instruction readiness assessment. Stimulus prompts involved motion (within-stimulus) and pointing (extra-stimulus) to evoke correct responses in the presence of a discriminative stimulus. We used an adapted alternating treatments design with a no-treatment control condition to evaluate the effects of both prompt types across multiple sets of stimuli. Both stimulus prompt types were efficacious in facilitating skill acquisition for two of three participants. Little difference was observed in the time to mastery with either prompt. Neither stimulus prompt was efficacious for the third participant. Assessment results will be used to inform clinical programming to teach conditional discriminations to participants and contribute to research on designing and implementing assessments of skill-acquisition procedures.

In the US, rural Native American communities (RNACs) experience excess morbidity in mental health disorders and mortality from opioid use disorder (OUD). This study used mixed methods to evaluate and analyze the primary data from 76 healthcare providers (HPs) from 24 states across the US (physicians = 7%), to identify HP knowledge and training regarding available prevention, treatment, and recovery (PTR) programs in treating OUD, assessment and management skills, and networking and collaboration capacity among the RNACs they serve. The HP completed the Opioid Survey for Health Care Providers online. A majority of HPs reported a need for knowledge and training regarding OUD treatments (92%). Less than half of the HPs provide intensive outpatient treatment; 40% contracted out for medication assisted treatment/medications for opioid use disorder (MAT/MOUD) services. Recovery support was low at 33% for adults and 38% for youth. HPs reported use of Narcan to be effective in reversing overdose (87%). Qualitative responses supported survey findings and described barriers, including lack of resources, inadequate staffing, insufficient funding, lack of training and OUD knowledge, stigma, and lack of tribal involvement and support. The study findings indicate HPs' need for information and training about OUD and networking and collaboration of healthcare …

Due to an increasingly aging population and long-term care available, the number of older adults seeking long-term care facilities is growing. Resident satisfaction indicators have become essential measurements of service quality. However, few studies have investigated the evidence on prevalent resident satisfaction indicators and associated factors. In order to understand what are the types of resident satisfaction measurements utilized in long-term care facilities in the United States and how these types of care services influence resident satisfaction, the researcher conducted the first study, which consists of a systematic scoping review by summarizing the evidence on the types of resident satisfaction indicators utilized in long-term care settings in the United States. The second study completed a further systematic review to summarize how nursing assistants impact resident satisfaction in long-term care settings.The third study aims to translate and validate a Chinese version of the resident satisfaction assessment based on the Ohio Long-term Care Resident Satisfaction Survey (OLCRSS). The fourth study will apply hierarchical regression to predict older adults' satisfaction with individual factors and care services factors in long-term care settings. The dissertation provided a holistic solution to measure resident satisfaction in long-term care settings, assist health providers in meeting the resident`s needs …

The objectives of the present dissertation were: (1) determine the relationships between time use in physical vs social leisure activities (PLA - SLA), and cognitive vs emotional leisure activities (CLA - ELA) by older adults age cohort (60-69, 70-79 and 80-plus yrs.); (2) ascertain the role of sex in moderating the relationship between time use in PLA-SLA and CLA-ELA by older adults age cohort; and (3) assess how employment status mediates the relationship between time use in PLA-SLA and CLA-ELA by older adults age cohort with moderation by sex. Secondary data was obtained from the 2019 American Time Use Survey database. Applying a cross-sectional design, data were analyzed using a linear regression model in SPSS version 27 and PROCESS Macro with Hayes Model 1 and 59. We identified the extent of the conditional indirect moderation effect of sex and the indirect employment status mediation effect moderated by sex in the relationship between PLA-SLA and CLA-ELA by older adult age cohorts. An index of moderated mediation was used to test the significance of each effect. The 80-plus yrs. cohort SLA time use was greater than in PLA across cohorts. Sex moderation showed a stronger effect in men by substantially decreasing their …

This study aimed to understand subjective cognitive decline (SCD) and functional difficulties in older age cohorts with depressive symptoms, using one scoping review and two empirical studies. We implemented the six steps of Arksey and O'Malley's procedure for the scoping review. We used the population, concept, and context (PCC) inclusion and exclusion criteria in the literature search across MEDLINE via Ebscohost, PubMed, and PsycINFO for articles published on ADL/IADL indicators of SCD in older adults with depressive symptoms and that published in English language journals from January 2011 to November 2021. The two empirical studies used the 2019 wave of the Behavioral Risk Factor Surveillance Survey dataset of older adults aged 65 and ≥ 80 from the Centers for Disease Control and Prevention. We used multiple regression and the bias-corrected percentile bootstrap with 5000 samples using standard path-analytic approaches for the moderated mediation for the two empirical studies. Findings supported that instrumental activities of daily living (IADLs) presented more difficulties for older adults with SCD than the basic activities of daily living (B-ADLs), given that IADLs require more cognitive capabilities than B-ADLs. Environmental factors like healthcare access and subjective functional difficulties predicted SCD by mentally unhealthy day (MUD) mediation and …

Although behavioral science, due to its emphasis on the use of single-subject research design, appears to focus solely on individual behaviors, behavioral scientists have a long history of lamenting the trajectory of humans, societies, and the discipline itself. Some scholars, for instance, called for our attention to expand our focus beyond individual behaviors to generate solutions for societal issues that we face. When we attempt to develop solutions for issues that require multi-level analysis, we must be cognizant of how institutional contingencies operate at the individual level. The current study analyzed triadic interactions using an exchange task in six triads. The result of this study showed that one common pattern of interactions among participants across triads was direct reciprocation between two participants. The implications of such findings, how they inform social behavior and metacontingency experiments, and future directions are discussed.

People with intellectual disabilities (ID) face a high risk of experiencing adverse events including abuse, neglect, and serious medical issues. Access to effective interventions for people with moderate to severe ID is limited because of communication deficits that are characteristic of this population. Some of the negative effects of exposure to trauma for people with ID can include increases in problem behaviors. Behavior analysts have developed robust assessments and treatments to address these problem behaviors for people with ID; however, when these behaviors arise after a traumatic event, specialized assessments may be necessary to ensure effective treatment and decreased risk of re-traumatization. Specifically, if trauma-related stimuli (TRS) differentially affect preferences and functions of behavior, assessments of the effects of these stimuli may be critical to mitigate those effects. In my first experiment I found that TRS differentially affected behavior (including heartrate) during preferences assessments. In my second experiment I found that TRS differentially affected heartrate and the function of problem behavior for two of three participants. I discuss implications of these findings, including 1) that measuring some of the physiological effects of TRS using commercially available heart rate monitors could improve behavior analytic assessments for people with potential trauma histories; …

This dissertation investigates videoconference technology adoption by aging-in-place organizations to facilitate the social engagement of older adults. It comprises three studies that examine the initiation and coordination of technology adoption by aging-in-place organizations and addresses the factors associated with successful adoption of relational videoconference technology by older adults. The first study is a systematic literature review exploring the role of aging-in-place organizations in social engagement of older adults through videoconference technology. The second study is a survey of adult relatives and friends of older adults regarding videoconference technology adoption by older adults during the COVID-19 pandemic and their experience with facilitating resources. It applies technology adoption theory and a structural equation model to characterize the role of aging-in-place organizations. The third study is a pilot test of a new online platform called Circular that is designed to support social engagement of older adults. Through these studies, this research extends the existing body of knowledge regarding modes to facilitate adoption of relational technology by older adults and to empower senior centers and other aging-in-place organizations as they seek to socially engage the aging members of their communities.