Objective: Contingency management (CM) is often criticized for limited long-term impact. This meta-analysis focused on objective indices of drug use (i.e., urine toxicology) to examine the effects of CM on illicit substance use up to 1 year following treatment. Method: Analyses included randomized trials (k = 23) of CM for stimulant, opioid, or polysubstance use disorders that reported outcomes up to 1 year after the incentive delivery had ended. Using random effects models, odds ratios (OR) were calculated for the likelihood of abstinence. Metaregressions and subgroup analyses explored how parameters of CM treatment, namely escalation, frequency, immediacy, and magnitude of reinforcers, moderated outcomes. Results: The overall likelihood of abstinence at the long-term follow-up among participants who received CM versus a comparison treatment (nearly half of which were community-based comprehensive therapies or protocol-based specific therapies) was OR = 1.22, 95% confidence interval [1.01, 1.44], with low to moderate heterogeneity (I² = 36.68). Among 18 moderators, longer length of active treatment was found to significantly improve long-term abstinence. Conclusions: CM showed long-term benefit in reducing objective indices of drug use, above and beyond other active, evidence-based treatments (e.g., cognitive–behavioral therapy, 12-step facilitation) and community-based intensive outpatient treatment. These data suggest that policymakers and insurers should support and cover costs for CM, which is the focus of hundreds of studies demonstrating its short-term efficacy and, now, additional data supporting its long-term efficacy. (PsycInfo Database Record (c) 2021 APA, all rights reserved) What is the public health significance of this article?—This meta-analysis provides a summary of long-term outcomes of contingency management treatment using objective indices of drug use. Contingency management was found to be more efficacious than either standard care or other evidence-based approaches up to 1 year following the discontinuation of incentives. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

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During the past 50 years, air pollution has become a growing problem throughout the Intermountain West because of increases in personal vehicle ownership and usage. Scientists continue to design interventions to improve air quality by encouraging people to reduce their personal vehicle miles of travel (VMT). However, results of these interventions have only seen modest reductions in VMT because of some methodological and measurement issues. To address these limitations, a 14-week driving reduction intervention was conducted in Cache County, Utah. This intervention employed a prizebased contingency management system within a single-subject, A-B-A withdrawal research design that rewarded participants with prizes if they were able to reduce their VMT below their baseline mean. The VMT was measured each day with an in-car GPS electronic tracking device. Results of this intervention indicate both short- and long-term reductions in VMT as a result of the treatment. Specifically, 6 of the 10 participants showed a statistically significant reduction from the baseline to the intervention stage and maintenance of this reduction during the return-to-baseline stage. The other four participants exhibited a similar pattern but their change in vehicle miles of travel was not statistically significant. Interaction effects were not found between the quo;Choose Clean Airquo; social marketing campaign, gas prices, temperature, and PM 2.5 levels. Despite some problems with the transmission and recording of VMT data, this intervention provides further evidence for the application of prize-based contingency management systems to the reduction of a problematic behavior or encouragement of proenvironmental or pro-social behaviors. The in-car GPS devices improved VMT data collection and quality of the data but hardware and software improvements are still needed to prevent data loss. Further replication is necessary to determine the efficacy of driving reduction intervention that employs prize-based contingency management systems at the community or group level. Future research should also test the possible demographic differences between those that respond favorably to this type of intervention and those that do not, and the differences between prize delivery systems (immediate versus delayed) and prize magnitude (low- versus high-dollar amounts) on driving behaviors.

[ES] El ritmo de desarrollo tecnológico actual y la investigación científica están permitiendo alcanzar mayores niveles de automatización en todos los sectores industriales. Uno de los ejemplos más representativos es el uso de aeronaves no tripuladas (UAS) en diferentes aplicaciones. Debido al gran potencial de este tipo de aeronaves, las Autoridades de Aviación Civil están desarrollando un nuevo marco regulatorio que permita integrarlas en el espacio aéreo civil de forma segura. El objetivo consiste en garantizar que la operación con UAS se realice con un nivel de seguridad equivalente al de la aviación tripulada convencional. Para tratar de alcanzar este objetivo, esta tesis propone aumentar el nivel de automatización de un UAS dotando al sistema embarcado con la capacidad de Gestión Automática de Contingencias (ACM). La función del sistema ACM es la de asesorar al piloto en el momento en que se produce una contingencia en vuelo; y en última instancia, tomar el control total de la aeronave si la situación así' lo requiere (por ejemplo, en caso de pérdida del enlace de Comunicación y Control (C2)) o si el piloto delega la resolución del conflicto al sistema automático. Para acreditar que las nuevas funciones no suponen un riesgo añadido para la operación, resultará determinante seguir metodologías de diseño seguro basadas en los estándares de la industria aeroespacial. La tesis propone una solución tecnológica basada en tres pilares: a) una arquitectura software para el sistema automático a bordo de la aeronave que trate de adaptar la trayectoria de vuelo a la condición operacional del vehículo, equilibrando seguridad y robustez; b) una especificación de Plan de Misión novedosa que permita aumentar la predictibilidad de la aeronave tras sufrir una contingencia; y c) un modelo de riesgo que permita determinar la ruta que minimiza el riesgo derivado de la operación. Las diferentes propuestas realizadas en esta tesis se han implementado en un demostrador y se han validado en un entorno de simulación. Los resultados obtenidos apoyan la idea de que dotar al sistema embarcado de mayor grado de automatización puede ser un mecanismo viable hacia la integración segura de UAS en el espacio aéreo civil. En concreto, los resultados muestran que el sistema ACM propuesto es capaz de reducir el riesgo de la operación tras sufrir una contingencia y que, cuando esto ocurre, la respuesta de la aeronave sigue siendo predecible, incluso si el piloto no puede intervenir. / [CA] El ritme de desenvolupament tecnològic actual i la investigació científica estan permetent implementar majors nivells d'automatització a tots els àmbits de la indústria. Un dels exemples més representatius és l'ús d'aeronaus no tripulades (UAS) en diferents aplicacions. Vist el gran potencial d'aquest tipus d'aeronaus, les Autoritats d'Aviació Civil estan tractant de desenvolupar un nou marc regulador que permeta integrar-les en l'espai aeri civil de forma segura. Es tracta de garantir que l'operació d'un UAS es realitza amb un nivell de seguretat equivalent al de l'aviació tripulada convencional. Per tal d'assolir aquest objectiu, aquesta tesi proposa augmentar el nivell d'automatització d'un UAS dotant el sistema embarcat amb la capacitat de Gestió Automàtica de Contingències (ACM). La funció del sistema ACM és assessorar el pilot quan ocorre una contingència en vol; i en última instància, prendre el control total sobre l'aeronau si és necessari (per exemple, en cas de pèrdua de l'enllaç de Comunicació i Control (C2)) o si el pilot delega la resolució del conflicte al sistema automàtic. Per tal d'acreditar que les noves funcions del sistema automàtic no comporten un risc afegit per a l'operació, resultarà determinant emprar metodologies de disseny segur d'acord amb els estàndards de la indústria aeroespacial. La tesi proposa una solució tecnològica basada en tres pilars: a) una arquitectura software per al sistema automàtic a bord de l'aeronau que tracte d'adaptar la trajectòria de vol a la condició operacional del vehicle, equilibrant seguretat i robustesa; b) una especificació de Pla de Missió innovadora que permeta augmentar la predictibilitat de l'aeronau quan ocorre una contingència; i c) un model de risc que permeta determinar la ruta que minimitza el risc derivat de l'operació. Les distintes propostes realitzades en aquesta tesi s'han implementat sobre un demostrador i s'han validat en un entorn de simulació. Els resultats de la investigació recolzen la idea que dotar el sistema embarcat d'un major grau d'automatització pot ser un mecanisme adient per integrar els UAS en l'espai aeri civil de manera segura. En concret, els resultats indiquen que el sistema ACM és capaç de reduir el risc de l'operació quan ocorre una contingència i que en eixe cas, la resposta de l'aeronau segueix sent predicible, fins i tot si el pilot no hi pot intervenir. / [EN] Technological development and scientific research are steadily enabling higher levels of automation in the global industry. In the aerospace sector, the operation of Unmanned Aircraft System (UAS) is a clear example. Given the huge potential of the UAS market, Civil Aviation Authorities are elaborating a new regulatory framework for the safe integration of UAS into the civil airspace. The general goal is ensuring that the operation of UAS has an Equivalent Level of Safety (ELOS) to that of manned aviation. To meet the previous goal, this thesis advocates for increasing the level of automation of UAS operations by providing the automatic system on-board the aircraft with Automated Contingency Management (ACM) functions. ACM functions are designed to assist the pilot-in-command in case a contingency, and ultimately to fully replace the pilot if this is required by the situation (e.g. due to a Command and Control (C2) link loss) or if the pilot decides so. However, in order for automation to be safe, automated functions must be developed following safe design methodologies based on aerospace standards. The thesis develops a technological solution that is based on three pillars: a) a software architecture for the automatic system on-board the aircraft that tries to autonomously adapt to contingencies while still achieving mission objectives; b) a novel Mission Plan specification than increases predictability in the event of a contingency; and c) a probabilistic risk model that ensures that the flight trajectory is optimal from the point of view of the risk exposure. The different proposals are prototyped and validated using a simulation environment. The results obtained support the idea that an increase in the automation level of the aircraft can be an effective means towards the safe integration of UAS into the civil airspace. The proposed ACM functions are proved to reduce the operational risk in the event of a contingency, while ensure that the aircraft remains predictable, even without pilot intervention. / En primer lloc, vull fer constar que aquesta tesi ha estat co-financiada pel Fons Social Europeu 2014-2020 i pel programa VALI+d de la Generalitat Valenciana (expedient número ACIF/2016/197). / Usach Molina, H. (2019). Automated Contingency Management in Unmanned Aircraft Systems [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/130202 / TESIS

In an effort to adapt a prize-based attendance and abstinence reinforcement program to the group therapy modality typically found in community substance abuse treatment, this study applied a contingency management (CM) procedure to behavior outcomes of the group as a whole. An algorithmic shaping percentile schedule was used to establish the outcome criteria determining group access to prize bowl drawings. Both the shaping schedule and hypothesized positive social support secondary to interdependent group contingencies aimed to initiate cocaine abstinence among cocaine abusing methadone-maintained participants having initial low rates of cocaine abstinence. In a multiple baseline across behaviors with reversals design, the procedure was applied to four target behaviors in sequence: incentive group attendance, urinalysis appointment attendance, opiate and cocaine abstinence. Results demonstrated clear improvement in group attendance during the shaping schedules. Effects on opiate abstinence were promising but not definitive; an increase in magnitude of reinforcement yielded a better response. There were no effects on cocaine abstinence using the percentile schedules tried. When shaping was conducted by an experienced psychologist in conjunction with an average 4-fold increase in reinforcer magnitude, 55% achieved some abstinence (compared to 18% in baseline). Participants were monitored for safety due to concern about coercion; no instances of physical violence occurred and infrequent instances of verbal negativity were managed using typical outpatient procedures. Results indicate that interdependent group CM is efficacious for attendance, and a feasible and acceptable procedure with appropriate monitoring. Future studies are needed to determine effective and appropriate shaping and reinforcement schedules in group CM to increase drug abstinence. / Educational Psychology

In the Highway construction project development process, State Highway Agencies (SHA) prepare cost estimates for effective communication to stakeholders and for project cost control. Cost estimates prepared in the planning phase of project development typically in a time range of 10 to 20 years from project letting are characterized by a great deal of uncertainty due to low scope definition. SHAs typically include an amount as contingency in the project cost estimate to cover costs due to unidentified or unquantified risks during project development. However, most of the methods used by SHAs to apply contingency to projects lack consistency in definition and application. This leads to poor communication to stakeholders, project cost escalation and other project control issues due to inaccuracy of baseline cost estimates. This study developed a set of sliding scale contingencies for estimating contingency on highway projects taking into consideration the effect of major factors, such as project complexity that impacts contingency application. Expert opinion was sought through the use of the Delphi technique. Experimental techniques were not suitable for this study due to the exploratory nature of the problem and the lack of data to analyze using empirical methods. The Delphi method typically consists of a series of rounds called questionnaires. Twenty-three professionals with experience in risk assessment and cost estimating agreed to participate in the study. Email was the means of communication using an excel spreadsheet. The assessment was completed in three iterative rounds with controlled feedback to the participants on the panel at the end of each round. Sliding scale contingencies were developed for three levels of project complexity: noncomplex (minor), moderately complex, and most complex (major) projects. The sliding scale contingencies are presented as a final output of this study. This method of estimating contingency provides consistent rationale for estimating contingency. Risks are an inextricable part of the contingency estimating process. Estimators are encouraged to identify and document risks as justification for contingency values applied to a project.

Ten experimental and 10 control subjects in elementary special education were exposed to a semester of contingency management procedures for up to 6 1/2 hours per day. The experimental group was taught by teachers who were exceptionally well trained and qualified behavior analysts, while the control group was instructed by teachers with varying degrees of expertise in behavioral techniques. Both groups were given the Bender Gestalt as a pretest and posttest to determine the effect of such treatment on the diagnostic indicators of "acting out" tendencies. Furthermore, the rate of actual "acting out" was measured for all subjects by counting the number of verbal corrections resulting in placement in time out and/ or warning of forthcoming time out during 20 class days of baseline and the last 20 days of treatment.

Contingency management has been utilized to improve treatment compliance and attendance in a medical setting. A related question involves the effect of contingency management on attendance in outpatient psychotherapy. Sixty-nine individuals ranging in age from 8 to 50 years agreed to participate in such a study. These individuals agreed to sign a contract specifying consequation for failure to notify the centers 24 hours in advance of an impending absence. Data on attendance and notification of impending absences were collected weekly for five sessions. After five sessions, dropouts and remainers were interviewed and the course of treatment was discussed. For the purpose of this study, a "dropout" occurred whenever an individual terminated therapy by missing an appointment and not rescheduling, or whenever an individual missed three consecutive appointments.

Lesbian, gay, and bisexual (LGB) individuals have elevated rates of substance use disorders and present to treatment with more severe substance use problems. Despite this health disparity, recent reviews highlight the paucity of studies reporting sexual orientation in substance use research (e.g., Flentje, Bacca, & Cochran, 2015). Using data from 5 clinical trials of contingency management (CM), the current study investigated the impact of sexual orientation on 3 substance use outcomes: treatment retention, longest duration of abstinence, and percent negative samples submitted. Participants (N = 912; mean age = 36.6 years; 51.1% female; 45% African American, 42.2% Caucasian) were randomized to standard care in community-based intensive outpatient treatment (IOP) or the same plus CM. Patients identifying as LGB made up 10.6% of the sample. A significant proportion identified as bisexual (8.2% of the total sample). Regardless of sexual orientation, participants receiving CM achieved better treatment outcomes than those receiving IOP alone. There were no statistically significant differences between LGB and heterosexual participants in their response to IOP in general, and CM specifically, across all 3 treatment outcomes (ps < .05). However, equivalence testing revealed that outcomes were not statistically equivalent for LGB and heterosexual participants, with the exception of percentage of negative samples, which was equivalent within the CM group only. Differences in treatment response to CM and standard community-based IOP do not reach the level of statistical significance; however, in most cases, we cannot conclude that treatment response is equivalent for LGB and heterosexual individuals.

Using a multiple baseline across participants with a changing criterion, this study explored and evaluated the effects of the individualized contingency management package (goal-setting, education, etc.) with sedentary typical adults while focusing on the mentoring component and the use of the technology of the exercise tracker to increase and sustain physical exercise to a level that increased health-benefiting physical activity. During initial mentoring meeting prior to the start of baseline, each participant was given a Garmin Viovsmart 3® exercise tracker, educated on the basic components of the device, and connected to the dashboard through the Garmin Connect™ app on their smartphones. Once each participant's activity stabilized, participant began intervention with weekly mentoring meetings focused on immediate feedback (social reinforcement), goal-setting and education. Through the Connect™ app, experimenter gave social reinforcement on a VR3 schedule to each participant, and participants were encouraged to participate by commenting to other participants through a private group set up for this study. The results indicate that the individualized contingency management package was effective for three of four participants whom increased their total activity minutes from pre-intervention range 0-104 min of weekly activity to post-intervention range of 269-404 min weekly. The two participants that completed two- and six-week maintenance checks continued to increase their total weekly activity minutes. Each of the participants showed increases in exercise during baseline that might suggest the wearable itself, along with basic instruction may be responsible for the increase in activity levels. To our knowledge, this is the first study to isolate an exercise tracker. The exercise tracker created social validity and meaningful change as it allowed participants to choose preferred exercises and plan their own exercise schedules. This helped facilitate natural generalization to their environment. Future research in behavioral health paired with technology will be far-reaching now that real-time assessments and adjustments can be made remotely. To effectively help an individual increase one's exercise and in so doing, help them increase health, has far-reaching significance, both to the individual as well to the societal reduction of the pervasive healthcare problem.