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Hand washing is the most important preventative measure for the reduction of contagious disease. Although hand washing is easy to perform, non-adherence is a ubiquitous problem. Several studies have demonstrated the effectiveness of multi-component intervention packages to improve hand washing among employees; however, interventions are limited to acute settings, are often implemented for a short period of time, and rarely, if ever, include information on long-term effectiveness. The purpose of the current study was to utilize a behavior analytic approach to determine the stimulus conditions under which hand washing should occur, and to assess and then implement a long-term monitoring system among direct care workers in a large, non-acute inpatient unit. A single-case repeated measures reversal design was used to evaluate the effectiveness of two interventions aimed at improving hand washing adherence. A lottery was found to be effective in increasing hand hygiene for 2-years with 170 staff.

We reviewed all issues of the Journal of Organizational Behavior Management (JOBM) from 2000 through 2015 to identify the percentage of empirical articles, which utilized some form of preintervention assessment. In addition, we categorized five types of assessment used and compared the number of assessments conducted in each category. Finally, because assessment is considered to be particularly important in the subdiscipline of behavioral safety (McSween, 2003), and prior research has not examined the commonality of assessment in this area, we also analyzed the frequency and type of assessment procedures used in behavioral safety and compared this to the use of assessment in OBM in general. Results indicated that 28% of the empirical articles in JOBM used some form of preintervention assessment. Indirect methods were the most often used type of assessment. In addition, 48% percent of the articles in JOBM, which employed a safety-related dependent variable, included some form of assessment. The mos...

We examined the use of employment-based abstinence reinforcement in out-of-treatment injection drug users, in this secondary analysis of a previously reported trial. Participants (N = 33) could work in the therapeutic workplace, a model employment-based program for drug addiction, for 30 weeks and could earn approximately $10 per hr. During a 4-week induction, participants only had to work to earn pay. After induction, access to the workplace was contingent on enrollment in methadone treatment. After participants met the methadone contingency for 3 weeks, they had to provide opiate-negative urine samples to maintain maximum pay. After participants met those contingencies for 3 weeks, they had to provide opiate- and cocaine-negative urine samples to maintain maximum pay. The percentage of drug-negative urine samples remained stable until the abstinence reinforcement contingency for each drug was applied. The percentage of opiate- and cocaine-negative urine samples increased abruptly and significantly after the opiate- and cocaine-abstinence contingencies, respectively, were applied. These results demonstrate that the sequential administration of employment-based abstinence reinforcement can increase opiate and cocaine abstinence among out-of-treatment injection drug users.

Advancing the education of low-income adults could increase employment and income, but adult education programs have not successfully engaged low-income adults. Monetary reinforcement may be effective in promoting progress in adult education. This experiment evaluated the benefits of providing incentives for performance in a job-skills training program for low-income, unemployed adults. Participants worked on typing and keypad programs for 7 months. Participants randomly assigned to Group A (n = 23) earned hourly and productivity pay on the typing program (productivity pay), but earned only equalized hourly pay on the keypad program (hourly pay). Group B (n = 19) participants had the opposite contingencies. Participants worked more on, advanced further on, and preferred their productivity pay program. These results show that monetary incentives can increase performance in a job-skills training program, and indicate that payment in adult education programs should be delivered contingent on performance in the training program instead of simply on attendance.

During the course of a 6-year behavioral safety consult at a food and drink industry site, data were collected on the number of Occupational Safety Health Administration (OSHA) recordable incidents, number of lost and restricted days, and number of peer safety observations. Employees were trained to identify safe and unsafe behavior, conduct peer observations, and provide peer feedback. Data collected from observations were utilized to deliver graphic feedback. Managers were encouraged to review graphic feedback with employees weekly, provide prompts for observation, and praise employees for conducting observations. A committee composed of employees and managers met monthly to address safety concerns. Reductions in incidents were observed over the course of the behavioral safety intervention, but a reversal to baseline could not be implemented. A negative correlation was observed between number of peer observations and number of recordable incidents. Results suggest that when employees conduct peer observ...

Analyses were conducted to compare rates of employment before, during, and after employment at the therapeutic workplace, which is a novel employment-based treatment for drug misuse. Participants in two clinical trials attended the therapeutic workplace at higher rates than they worked before intake and six months after discharge. These data suggest that unemployed chronic drug misusers will attend work at higher rates at the therapeutic workplace than in the community when paid modest wages, and that the failure of chronic drug misusers to obtain employment in the community may not result from lack of interest in work.

The purpose of the current study was to examine the effects of a multicomponent intervention that included discrimination training, real-time visual feedback, and self-monitoring on postural behavior at a computer workstation in a simulated office environment. Using a nonconcurrent multiple baseline design across 8 participants, the study assessed the effects of the intervention across three postural variables. Following an information phase, the intervention started for the lowest stable postural variable. The intervention led to substantial improvements in safety behavior for most targeted postural variables. A reversal to the information phase for 2 participants did not lead to decreases in safety. Postures self-monitored with high accuracy improved to a greater degree than postures self-monitored with low accuracy.

Determine if employment-based reinforcement can increase methadone treatment engagement and drug abstinence in out-of-treatment injection drug users.This study was conducted from 2008 to 2012 in a therapeutic workplace in Baltimore, MD. After a 4-week induction, participants (N=98) could work and earn pay for 26 weeks and were randomly assigned to Work Reinforcement, MethadoneWork Reinforcement, and Abstinence, MethadoneWork Reinforcement conditions. Work Reinforcement participants had to work to earn pay. MethadoneWork Reinforcement and Abstinence, Methadone,Work Reinforcement participants had to enroll in methadone treatment to work and maximize pay. Abstinence, Methadone,Work Reinforcement participants had to provide opiate- and cocaine-negative urine samples to maximize pay.Most participants (92%) enrolled in methadone treatment during induction. Drug abstinence increased as a graded function of the addition of the methadone and abstinence contingencies. Abstinence, MethadoneWork Reinforcement participants provided significantly more urine samples negative for opiates (75% versus 54%) and cocaine (57% versus 32%) than Work Reinforcement participants. MethadoneWork Reinforcement participants provided significantly more cocaine-negative samples than Work Reinforcement participants (55% versus 32%).The therapeutic workplace can promote drug abstinence in out-of-treatment injection drug users. Clinical trial registration number: NCT01416584.

Drug addiction can be a chronic problem. Abstinence reinforcement can initiate drug abstinence, but as with other treatments many patients relapse after the intervention ends. Abstinence reinforcement can be maintained to promote long-term drug abstinence, but practical means of implementing long-term abstinence reinforcement are needed.We reviewed 8 clinical trials conducted in Baltimore, MD from 1996 through 2010 that evaluated the therapeutic workplace as a vehicle for maintaining reinforcement for the treatment of drug addiction. The therapeutic workplace uses employment-based reinforcement in which employees must provide objective evidence of drug abstinence or medication adherence to work and earn wages.Employment-based reinforcement can initiate (3 of 4 studies) and maintain (2 studies) cocaine abstinence in methadone patients, although relapse can occur even after long-term exposure to abstinence reinforcement (1 study). Employment-based reinforcement can also promote abstinence from alcohol in homeless alcohol dependent adults (1 study), and maintain adherence to extended-release naltrexone in opioid dependent adults (2 studies).Treatments should seek to promote life-long effects in patients. Therapeutic reinforcement may need to be maintained indefinitely to prevent relapse. Workplaces could be effective vehicles for the maintenance of therapeutic reinforcement contingencies for drug abstinence and adherence to addiction medications.