Epstein L H, Masek B J
J Appl Behav Anal. 1978 Spring;11(1):1-9. doi: 10.1901/jaba.1978.11-1.
This study examined the effectiveness of several behavioral techniques on compliance of college students taking vitamin C on q.i.d. regimen. Compliance was assessed by a new technique using a variation of the urine tracer procedure designed specifically for this study. Subjects were provided vitamin C tablets, with three tablets per week containing phenazopyridine, a drug that produces a bright red-orange urine discoloration. Subjects were requested to indicate when urine discolorations occurred, and compliance was assessed by comparing the time of their report to the time predicted on the basis of the scheduled sequence of vitamin C and phenazopyridine tablets. Baseline compliance was assessed for 72 subjects over a three-week period, with the 40 most noncompliant subjects randomly assigned to four groups for Treatment I. The groups were: self-monitoring, taste, taste and self-monitoring, and a no-treatment control group. The self-monitoring procedure involved recording the time medicine was taken; the taste procedure involved providing the subjects with flavored tablets to increase the saliency of tablet taking; and the self-monitoring and taste procedure involved providing subjects with flavored tablets and asking them to record the flavor of each tablet they ingested. At the end of six weeks, half the subjects in each of these groups participated in response-cost procedures while the remaining subjects continued with their previous procedures. Response-cost procedures were implemented by returning a portion of the subjects' deposit only if a preset compliance criterion was met. Treatment II procedures were implemented for an additional three weeks. Results indicated the self-monitoring and taste plus self-monitoring procedures were superior during Treatment I. The implementation of response cost during Treatment II was associated with a marked improvement in compliance, independent of the history of noncompliance. The effects of the taste plus self-monitoring procedure were maintained during Treatment II and results obtained by this procedure were not significantly different from effects of response cost.
本研究考察了几种行为技术对服用维生素C的大学生遵守每日四次服药方案的有效性。依从性通过一种新技术进行评估，该技术采用了专门为此研究设计的尿液示踪程序的变体。为受试者提供维生素C片，每周三片含有非那吡啶，这种药物会使尿液变成亮红橙色。要求受试者指出尿液变色发生的时间，并通过将他们报告的时间与根据维生素C和非那吡啶片的预定顺序预测的时间进行比较来评估依从性。在三周时间内对72名受试者的基线依从性进行了评估，将40名最不依从的受试者随机分为四组进行治疗I。这些组分别是：自我监测组、口味组、口味加自我监测组和无治疗对照组。自我监测程序包括记录服药时间；口味程序包括为受试者提供有味道的片剂以增加服药的显著性；口味加自我监测程序包括为受试者提供有味道的片剂并要求他们记录所服用每片药的味道。六周结束时，这些组中的每组一半受试者参与了反应代价程序，而其余受试者继续之前的程序。仅当达到预设的依从性标准时，才返还部分受试者的押金来实施反应代价程序。治疗II程序又实施了三周。结果表明，在治疗I期间，自我监测组以及口味加自我监测组表现更优。治疗II期间实施反应代价与依从性的显著改善相关，与不依从的历史无关。口味加自我监测程序的效果在治疗II期间得以维持，并且通过该程序获得的结果与反应代价的效果没有显著差异。
