Applications of operant demand to treatment selection II: Covariance of evidence strength and treatment consumption

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Evidence-based practices (EBPs) are a critical component of effective and ethical service delivery. Clinicians in the behavioral sciences regularly advocate for the use of therapies and interventions based on the strength and breadth of scientific evidence. However, caregiver choices related to specific behavior therapies are seldom based solely on the degree (or the presence) of scientific evidence. This study applied methods from the Operant Demand Framework to characterize caregiver choices when concurrently available behavior therapies varied in terms of unit price and levels of evidence. Four Hypothetical Treatment Purchase Tasks were designed to evaluate how relative differences in scientific evidence between behavior therapies influenced the demand for, and substitutability of, EBPs. Results from 106 caregivers recruited from the Amazon Mechanical Turk platform indicated that low-, moderate-, and high-evidence treatment choices all functioned as substitutes for a high-evidence (i.e., well-established) behavior therapy. A main effect was observed for the level of evidence, whereby the strength of evidence appeared to moderate the degree to which respective treatments functioned as substitutes. These results extend the literature on the factors associated with treatment choices, and specifically, highlight how differences in the degree of scientific evidence influence choice when deciding between behavior therapies. These results are discussed in the context of more effectively advocating for the use of EBPs with mainstream and lay audiences.

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Journal of the experimental analysis of behavior

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