We can work it out

By Jim Heffernan ('96)

What if you received a cash reward each time you completed a workout or fought the urge to reach for a cigarette? Would you be more inclined to stick with such a program?

The Changing Activity, Substance Use and Health (CASH) lab at JMU develops and tests interventions for health risk behaviors among college students such as alcohol, smoking and inactivity. The lab's researchers, mostly undergraduate psychology majors, employ a practice called contingency management, in which participants receive a series of rewards for adhering to a treatment program. Not surprisingly, cash is a popular incentive.

'One of the barriers to changing behavior is actually initiating that first behavior change.'

"Very often one of the barriers to changing behavior is actually initiating that first behavior change," says the lab's founder and faculty mentor, Dr. Jessica Irons, an experimental health psychologist and associate professor of psychology at JMU. "If you're a smoker and haven't experienced abstinence from smoking in five years, you may not even remember what that feels like not to smoke. So if I say to you, 'Just quit,' then good luck. But if I can engineer something that helps you remember what abstinence feels like, you're more likely to be successful. I may have to pay you a little bit to get you started, but then your natural reinforcers kick in. And as you begin to see results, that becomes your motivation and you don't need the incentive anymore."

With exercise intervention, subjects volunteer to work out in the CASH lab for up to eight weeks under supervision. "We give them a schedule of what they will be doing, and the participant knows they have flexibility and can schedule when they want to come in," Irons says. "We try to remove barriers for them. ... As long as they fulfill their requirements, they will get the cash."

Participants can choose to be paid after each session or receive a lump sum weekly. The amount is nominal —usually $5 or $6 per session.

"There have been a lot of critics [of contingency management] who say, 'Why should I be paying someone to treat a risk behavior that they already shouldn't be doing?'" Irons says. "But in the long run it is so much cheaper, and the reason is because it actually works. The students do it and they engage in it. And it ends up saving [society] money because the health patterns that students establish while in college tend to follow them."