Increasing water intake and walking with a self-management intervention using negative and positive reinforcement

Introduction
This study compared the effectiveness of different types of reinforcement (positive, negative, and a combination of both) in a self-management intervention program designed to increase water intake and walking.

Methods
Four university students participated in a self-management program to increase water intake and walking. Multiple baseline design across behaviors that included baseline (A) condition, positive reinforcement (B) condition, negative reinforcement (C) condition, and combination of both (B + C), was introduced. The participants received $2 every day they met the criteria during the positive reinforcement condition and no consequence if they failed to meet the criteria. In the negative reinforcement condition, $2 was subtracted for each day that the participant did not meet the criteria from the total amount of money available to the participant during that phase of the study. During the condition with positive and negative reinforcement, the participants received $2 every day they met the criteria. However, $2 was subtracted from the total for every day they did not meet the criteria.

Results
There was a clear increase from baseline to the first intervention phase across all the behaviors and participants, and the increase was maintained throughout the study. There were no differences in the effectiveness of different types of reinforcement applied in self-management intervention programs.

Conclusions
The study did show that implementing a relatively low-cost reinforcement contingency increased both exercise and water drinking. The results suggest that there are no consistent differences in the effectiveness of positive or negative reinforcement contingencies in self-management intervention.