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INTRODUCTION: Internet Gaming Disorder (IGD) according to DSM-5 is a behavioral addiction needing additional study. IGD in youth is correlated with anxiety, depression, attention problems, interpersonal problems, social phobia, behavior problems and low academic achievement. The aim of the present research is to contribute to the understanding of the disorder, by providing preliminary data on the factorial structure of the IGD Questionnaire in the Italian version. PARTICIPANTS: 612 Italian students (323 females), mean of age = 13.94 (SD = 2.44). Instruments: a survey comprising IGD Questionnaire, Internet Addiction Test (IAT), Children's Coping Strategies Checklist (CCSC-R1), Assessment of Interpersonal Relations (AIR), and Child Behavior Checklist (CBCL). RESULTS: 15.2% of participants showed a sub-clinical IGD and 2.1% met the full diagnostic criteria. Participants with IGD showed lower scores in interpersonal relationships, worse coping strategies and higher scores in externalization. The factorial structure of the IGD Questionnaire highlights 4 factors ("addiction", "gaming as coping", "impaired control" and "negative outcomes") that explain 52.14% of the variance. A single-factor solution was also tested and results seem to be coherent with the four-factor solution, explaining less variance. CONCLUSIONS: IGD is a complex clinical condition that can be thought both as a single-factored and as a multi-faceted condition.
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Trastorno de Adicción a Internet , Humanos , Femenino , Masculino , Trastorno de Adicción a Internet/psicología , Italia , Adolescente , Encuestas y Cuestionarios , Niño , Adaptación Psicológica , Psicometría/instrumentación , Análisis Factorial , Juegos de Video/psicología , Conducta Adictiva/psicología , Internet , Relaciones InterpersonalesRESUMEN
OBJECTIVE: Callousness has been identified as a key driver of aggressive and violent behavior from childhood into early adulthood. Although previous research has underscored the importance of the parenting environment in contributing to the development of youth callousness, findings have generally been confined to the between-individual level and have not examined bidirectionality. In the current study, we test whether aspects of parenting are associated with callousness from childhood to adolescence both between and within individuals, examine the temporal ordering of associations, and test whether these relations are moderated by gender or developmental stage. METHOD: Data came from a longitudinal study in which parents of 1,421 youth (52% girls; 62% White and 22% Black) from the second, fourth, and ninth grades were interviewed three times, with one year between consecutive interviews. RESULTS: A random-intercept cross-lagged panel model indicated that elevated youth callousness predicts subsequent increases in parental rejection and decreases in consistency of discipline. Findings were largely similar for boys and girls, but within-individual associations were generally stronger for 4th graders compared to the 2nd and 9th graders. CONCLUSIONS: Callousness and parenting practices and attitudes were related both at the between-individual and within-individual level. These results have implications for the etiology and treatment of children and adolescents who exhibit callousness.
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To address a gap in the literature regarding the development of youth disclosure across the transition to adolescence, the current research uses a cohort-sequential approach to study youth disclosure from middle childhood through adolescence. Longitudinal data from three cohorts of parents were utilized (N = 1359; children at T1 were in grades 2 [M = 8.00 years, SD = 0.57 years, 45% female], 4 [M = 10.12 years, SD = 0.60 years, 45% female], and 9 [M = 15.19 years, SD = 0.57 years, 48% female]). Parents were assessed annually over a 3-year time period. The focal analyses explored contemporaneous associations between characteristics of the parent-youth relationship (specifically, parental rejection and parental consistent discipline) and youth disclosure after accounting for person-specific trajectories of disclosure. Associations of gender, age, and socioeconomic status with disclosure were also assessed. Regarding trajectories of youth disclosure, results indicate that youth disclose less information to their parents about their daily lives as they get older; this trend was consistent across gender and socioeconomic status. In terms of associations with youth disclosure, when parents provided more consistent discipline or engaged in less rejection of their child, youth disclosure increased, even after accounting for their own trajectory of disclosure across time. In addition, the association of consistent discipline with youth disclosure became stronger with increased youth age. Results are discussed in terms of implications for understanding youth autonomy development, and the dyadic and developmental impact of parenting behaviors over time.
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Revelación , Responsabilidad Parental , Humanos , Niño , Adolescente , Femenino , Masculino , Relaciones Padres-Hijo , Estudios de Cohortes , PadresRESUMEN
Inducing mindfulness has shown a promising effect on reducing aggression in both clinical and nonclinical populations, possibly because mindfulness can improve emotion regulation. The present study examined the association between mindfulness and aggression through potential mediating effects of several emotion regulation strategies. University and community samples of U.S. adults completed questionnaires on mindfulness, emotion regulation strategies, and trait aggression. Results indicate that mindfulness was associated with rumination and expressive suppression, which mediated the mindfulness-aggression relationship. Most facets of mindfulness were unrelated to the use of reflection and cognitive reappraisal. The nonjudging of experience facet of mindfulness was negatively related to hostility through rumination and expressive suppression. In contrast, the observing mindfulness facet was positively related to verbal aggression and hostility; these relations were mediated by rumination and expressive suppression.
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Regulación Emocional , Atención Plena , Adulto , Agresión/psicología , Hostilidad , Humanos , UniversidadesRESUMEN
BACKGROUND: School wellness programming is important for promoting healthy lifestyles and academic achievement in youth; however, research is needed on methods that can help schools implement and sustain such programs on their own. The purpose of this study was to investigate factors within and outside the school environment that influenced school capacity for implementation and potential sustainability of wellness programming. METHODS: As part of the School Wellness Integration Targeting Child Health (SWITCH®) intervention, elementary school wellness teams (N = 30) were guided through a capacity-building process focused on promoting the adoption of healthy lifestyle behaviors in students. Data on implementation were collected through three standardized surveys and interviews (pre-mid-post) and a post-implementation interview. Indicators of organizational capacity were assessed using the School Wellness Readiness Assessment (SWRA). Paired t-tests were run to assess changes in implementation (classroom, physical education, and lunchroom settings), capacity, and stakeholder engagement over time. One-way analysis of variance (ANOVA) tests were run to examine how implementation of best practices (low, moderate, high) explained differences in capacity gains. Qualitative data were analyzed through inductive and deductive analysis, following the Consolidated Framework for Implementation Research (CFIR). RESULTS: Paired t-tests showed non-significant increases in school and setting-specific capacity and implementation of SWITCH best practices over time, in addition to a consistent level of engagement from key stakeholders. ANOVA results revealed non-significant associations between implementation group and gains in school capacity (F [2, 24] = 1.63; p = .21), class capacity (F [2, 24]=0.20 p = .82), lunchroom capacity (F [2, 24]=0.29; p = .78), and physical education (F [2, 24]=1.45; p = .25). Qualitative data demonstrated that factors within the outer setting (i.e., engaging community partners) facilitated programming. Inner-setting factors (i.e., relationships with administration and staff) influenced implementation. Implementation process themes (e.g., planning, adaptation of resources to meet school capacity/needs, and engaging students as leaders) were cited as key facilitators. Schools discussed factors affecting sustainability, such as school culture and knowledge of school wellness policy. CONCLUSIONS: The results from this implementation study document the importance of allowing schools to adapt programming to meet their local needs, and highlight the strengths of measuring multiple implementation outcomes. Increased support is needed for schools regarding the formation and improvement of wellness policies as a means to enhance sustainability over time.
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Creación de Capacidad/métodos , Salud Infantil , Implementación de Plan de Salud/métodos , Promoción de la Salud/métodos , Servicios de Salud Escolar , Adolescente , Creación de Capacidad/organización & administración , Niño , Política de Salud , Estilo de Vida Saludable , Humanos , Iowa , Masculino , Servicios de Salud Escolar/organización & administración , Instituciones Académicas , Estudiantes/estadística & datos numéricos , Encuestas y CuestionariosRESUMEN
PURPOSE: The risk and protective factors of Internet gaming disorder (IGD) could vary by individual. The identification of more homogeneous subgroups may lead to better understanding of gaming behaviors and their consequences in adolescents. The purpose of this study was to investigate the prevalence of IGD among the subgroups defined by cluster analysis in adolescents. METHODS: A total of 2319 adolescents were enrolled in the Internet User Cohort for Unbiased Recognition of Gaming Disorder in Early Adolescence (iCURE) study at baseline. Self-reported IGD was assessed with a DMS-5 adapted measurement. Smartphone addiction, musculoskeletal discomfort, and dry eye symptoms were evaluated by self-administered questionnaires. Cluster analysis was performed using risk and protective factors of IGD after considering multicollinearity. RESULTS: Three different clusters were identified. Cluster 1 (19.2%) was users with combined potential psychological and social issues. Cluster 2 (32.3%) was users with potential social but no psychological issues. Cluster 3 (45.6%) was users with no potential issues of either a social or psychological nature. Adolescents from both clusters 1 and 2 showed higher degrees of IGD, smartphone addiction, musculoskeletal discomfort, and dry eye symptoms than did those from cluster 3. Also compared with adolescents in cluster 3, those in cluster 1 showed statistically higher risks of IGD (aOR:11.9, 95%CI:7.5-19.9), smartphone addiction (aOR:5.4, 95%CI:4.0-7.2), musculoskeletal discomfort (aOR:2.6, 95%CI:2.1-7.4), and dry eye symptoms (aOR:3.8, 95%CI:3.0-4.9). Those in cluster 2 also showed statistically higher risk of IGD, smartphone addiction, musculoskeletal discomfort, and dry eye symptoms compared with cluster 3 (aOR:4.5, 95%CI:2.8-7.6; aOR:2.8, 95%CI:2.1-3.7; aOR:1.6, 95%CI:1.3-1.9; and aOR:1.9, 95%CI:1.6-2.4, respectively). CONCLUSIONS: Clustering based on the risk and preventive factors of IGD may be suitable for determination of high risk of IGD in adolescents. However, we need to confirm the usefulness and clinical application of the classifications by observing their longitudinal changes.
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Conducta Adictiva , Juegos de Video , Adolescente , Estudios de Cohortes , Humanos , Internet , Encuestas y CuestionariosRESUMEN
BACKGROUND: There is a need to identify strategies that enhance the implementation of evidence-based school wellness intervention programs in real-world settings. The present study evaluates the feasibility of empowering school wellness leaders to deliver an evidence-based, childhood obesity-prevention program called Switch ™. We specifically evaluated the feasibility of a new implementation framework, based on the robust Healthy Youth Places framework, to increase capacity of school leaders to lead school wellness programming. METHODS: The SWITCH (School Wellness Integration Targeting Child Health) implementation process was evaluated in a convenience sample of eight Iowa elementary schools. Teams of three leaders from each school attended an in-person school wellness conference followed by five online webinar sessions delivered by two SWITCH team members. The capacity-building and quality improvement process was designed to empower schools to lead wellness change using methods and concepts from the original 16-week Switch ™ program. School wellness leaders completed checklists on two occasions to assess overall school-level implementation as well as setting-level changes in physical education, classrooms, and the lunchroom. Student acceptability of SWITCH was evaluated by the degree of behavior tracking using an online SWITCH Tracker system that promoted self-monitoring. School acceptability and practicality were assessed through an exit survey completed by school leaders. RESULTS: All school staff reported satisfaction with the SWITCH implementation process. Reports of school- and setting-level implementation were relatively high (2.0 to 2.8 on a 3-point scale) but student engagement, based on use of the online tracking system, varied greatly over time and across schools. Three high implementation schools had average tracking rates exceeding 70% (range: 72-90%) while three low implementation schools had rates lower than 30% (range = 0-23%). CONCLUSIONS: This feasibility study supports the utility of the new implementation framework for promoting school and student engagement with SWITCH. Further testing regarding effectiveness and scale-up of this evidence-based school wellness intervention program is warranted.
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Obesidad Infantil/prevención & control , Servicios de Salud Escolar/organización & administración , Estudiantes/psicología , Creación de Capacidad , Niño , Práctica Clínica Basada en la Evidencia , Estudios de Factibilidad , Humanos , Iowa , Evaluación de Programas y Proyectos de Salud , Estudiantes/estadística & datos numéricos , Encuestas y CuestionariosRESUMEN
The popular press is replete with stories about the effects of video and computer games on the brain. Sensationalist headlines claiming that video games 'damage the brain' or 'boost brain power' do not do justice to the complexities and limitations of the studies involved, and create a confusing overall picture about the effects of gaming on the brain. Here, six experts in the field shed light on our current understanding of the positive and negative ways in which playing video games can affect cognition and behaviour, and explain how this knowledge can be harnessed for educational and rehabilitation purposes. As research in this area is still in its early days, the contributors of this Viewpoint also discuss several issues and challenges that should be addressed to move the field forward.
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Conducta/fisiología , Encéfalo/fisiología , Cognición/fisiología , Juegos de Video , Conducta Adictiva/etiología , Humanos , Relaciones Interpersonales , Juegos de Video/efectos adversos , Juegos de Video/psicologíaRESUMEN
Despite recent growth of research on the effects of prosocial media, processes underlying these effects are not well understood. Two studies explored theoretically relevant mediators and moderators of the effects of prosocial media on helping. Study 1 examined associations among prosocial- and violent-media use, empathy, and helping in samples from seven countries. Prosocial-media use was positively associated with helping. This effect was mediated by empathy and was similar across cultures. Study 2 explored longitudinal relations among prosocial-video-game use, violent-video-game use, empathy, and helping in a large sample of Singaporean children and adolescents measured three times across 2 years. Path analyses showed significant longitudinal effects of prosocial- and violent-video-game use on prosocial behavior through empathy. Latent-growth-curve modeling for the 2-year period revealed that change in video-game use significantly affected change in helping, and that this relationship was mediated by change in empathy.
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Agresión/psicología , Empatía/fisiología , Conducta de Ayuda , Medios de Comunicación Sociales/estadística & datos numéricos , Juegos de Video/psicología , Violencia/psicología , Adulto , Comparación Transcultural , Humanos , Estudios Longitudinales , Masculino , Singapur , Adulto JovenRESUMEN
Background and Objectives: As the gaming industry experiences exponential growth, concerns about gaming disorder (GD) also grow. It is crucial to understand the structural features of games that can interact with individual characteristics of gamers to promote GD. This research consolidates the views of an international body of panelists to create an assessment tool for gauging the addictive potential of distinct games. Methods: Utilizing the iterative and structured Delphi method, an international panel of researchers, clinicians, and people with lived experience were recruited to offer a multifaceted viewpoint on the addictive risk associated with specific structural elements in games. Two rounds of surveys facilitated consensus. Results: The panel initially included 40 members-ten from research, eight from clinical settings, and 22 with lived experiences. The second round included 27 panelists-seven from research, eight from clinical settings, and 11 with lived experiences. The study identified 25 structural features that contribute to potentially addictive gaming patterns. Discussion and Conclusions: Consensus was found for 25 features, which were distilled into a 23-item evaluation tool. The Saini-Hodgins Addiction Risk Potential of Games Scale (SHARP-G) consists of five overarching categories: 'Social,' 'Gambling-Like Features,' 'Personal Investment,' 'Accessibility,' and 'World Design.' SHARP-G yields a total score indicating level of addiction risk. A case study applying the scale to three games of differing perceived risk levels demonstrated that that score corresponded to game risk as expected. While the SHARP-G scale requires further validation, it provides significant promise for evaluating gaming experiences and products.
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Conducta Adictiva , Técnica Delphi , Juegos de Video , Humanos , Conducta Adictiva/psicología , Juegos de Video/efectos adversos , Consenso , Medición de Riesgo , Adulto , Masculino , Femenino , Trastorno de Adicción a InternetRESUMEN
Many parents use screens to regulate their young children's emotions. We know very little, however, about how this parenting practice is related to the development of emotional competencies (i.e., emotional reactivity, emotion knowledge, and empathy) over time. The current longitudinal study examined bidirectional associations between media emotion regulation and various emotional competencies across a 1-year period during early childhood (between ages 3.5 and 4.5 on average). Participants included 269 child/parent dyads who completed a number of in-home tasks and questionnaires. Results revealed that higher levels of media emotion regulation were associated with worse emotional knowledge and empathy and higher emotional reactivity at the cross-sectional level. However, early media emotion regulation was associated with higher levels of child empathy 1 year later. We discuss these results in the context of general parenting practices and encourage future research on the topic with a focus on how these processes develop over time. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Regulación Emocional , Niño , Humanos , Preescolar , Regulación Emocional/fisiología , Empatía , Estudios Longitudinales , Estudios Transversales , Emociones/fisiología , Responsabilidad Parental/psicologíaRESUMEN
Recent research reveals that playing prosocial video games increases prosocial cognitions, positive affect, and helpful behaviors [Gentile et al., 2009; Greitemeyer and Osswald, 2009, 2010, 2011]. These results are consistent with the social-cognitive models of social behavior such as the general learning model [Buckley and Anderson, 2006]. However, no experimental studies have examined such effects on children. Previous research on violent video games suggests that short-term effects of video games are largely based on priming of existing behavioral scripts. Thus, it is unclear whether younger children will show similar effects. This research had 9-14 years olds play a prosocial, neutral, or violent video game, and assessed helpful and hurtful behaviors simultaneously through a new tangram measure. Prosocial games increased helpful and decreased hurtful behavior, whereas violent games had the opposite effects.
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Conducta del Adolescente/psicología , Agresión/psicología , Conducta Infantil/psicología , Genio Irritable , Socialización , Juegos de Video/psicología , Adolescente , Niño , Femenino , Humanos , Control Interno-Externo , MasculinoRESUMEN
Recent research reveals that playing prosocial video games increases prosocial cognitions and helpful behaviors [Gentile el al., 2009; Greitemeyer and Osswald, 2009; 2010; 2011]. These results are consistent with social-cognitive models of social behavior [e.g., the "General Learning Model," Buckley and Anderson, 2006]. The social-cognitive learning models suggest that in addition to influencing cognitions, media content may also influence affect. However, past studies on prosocial video games have failed to find a significant effect on affective measures [Greitemeyer and Osswald, 2010]. The present research examined the effects of prosocial, neutral, and violent video games on state hostility and positive affect. Also examined were moderating effects of trait aggressiveness, trait altruistic helping, and trait egoistic helping. Prosocial games reduced state hostility and increased positive state affect. Violent video games had the opposite effects. These effects were moderated by trait physical aggression. Altruistic participants reported relatively more positive affect and less state hostility. Egoistic participants reported relatively more aggravated and mean feelings.
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Agresión/psicología , Ajuste Social , Socialización , Estudiantes/psicología , Juegos de Video/psicología , Violencia/psicología , Cognición , Femenino , Humanos , Masculino , Conducta Social , Violencia/prevención & control , Adulto JovenRESUMEN
Past research has shown activation of aggressive cognitions in memory after media violence exposure, but has not examined priming effects of viewing relational aggression in the media. In the current study, 250 women viewed a video clip depicting physical aggression, relational aggression, or no aggression. Subsequent activation of physical and relational aggression cognitions was measured using an emotional Stroop task. Results indicated priming of relational aggression cognitions after viewing the relationally aggressive video clip, and activation of both physical and relational aggression cognitions after viewing the physically aggressive video clip. Results are discussed within the framework of the General Aggression Model.
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Agresión/psicología , Cognición/fisiología , Emociones/fisiología , Relaciones Interpersonales , Violencia/psicología , Adolescente , Femenino , Humanos , Adulto JovenRESUMEN
BACKGROUND: Performing laparoscopic procedures requires special training and has been documented as a significant source of surgical errors. "Warming up" before performing a task has been shown to enhance performance. This study investigates whether surgeons benefit from "warming up" using select video games immediately before performing laparoscopic partial tasks and clinical tasks. METHODS: This study included 303 surgeons (249 men and 54 women). Participants were split into a control (n=180) and an experimental group (n=123). The experimental group played 3 previously validated video games for 6 minutes before task sessions. The Cobra Rope partial task and suturing exercises were performed immediately after the warm-up sessions. RESULTS: Surgeons who played video games prior to the Cobra Rope drill were significantly faster on their first attempt and across all 10 trials. The experimental and control groups were significantly different in their total suturing scores (t=2.28, df=288, P<.05). The overall Top Gun score showed that the experimental group performed marginally better overall. CONCLUSION: This study demonstrates that subjects completing "warming-up" sessions with select video games prior to performing laparoscopic partial and clinical tasks (intracorporeal suturing) were faster and had fewer errors than participants not engaging in "warm-up." More study is needed to determine whether this translates into superior procedural execution in the clinical setting.
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Laparoscopía , Juegos de Video , Adulto , Femenino , Humanos , Laparoscopía/educación , Masculino , Técnicas de Sutura/educación , Análisis y Desempeño de TareasRESUMEN
Many studies have shown that media violence has an effect on children's subsequent aggression. This study expands upon previous research in three directions: (1) by examining several subtypes of aggression (verbal, relational, and physical), (2) by measuring media violence exposure (MVE) across three types of media, and (3) by measuring MVE and aggressive/prosocial behaviors at two points in time during the school year. In this study, 430 3rd-5th grade children, their peers, and their teachers were surveyed. Children's consumption of media violence early in the school year predicted higher verbally aggressive behavior, higher relationally aggressive behavior, higher physically aggressive behavior, and less prosocial behavior later in the school year. Additionally, these effects were mediated by hostile attribution bias. The findings are interpreted within the theoretical framework of the General Aggression Model.
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Agresión/psicología , Medios de Comunicación de Masas , Estudiantes/psicología , Violencia/psicología , Niño , Docentes , Humanos , Relaciones Interpersonales , Estudios Longitudinales , Grupo Paritario , Instituciones Académicas , Conducta SocialRESUMEN
Despite the escalating public concern about pathological use of the Internet among youth, little research has investigated the longitudinal trajectory of the problem and the role of peer support in it. This study aimed to determine the growth trajectory of pathological Internet use (PIU), identify latent subgroups presenting heterogeneous growth trajectories of PIU, and examine the initial status of and the rate of change in peer support as predictors of the growth trajectory of PIU among children and adolescents. Using four-wave longitudinal data from 3,079 Singaporean youth at ages 7-19, we performed Latent Growth Curve Modeling, Latent Class Growth Analysis and Latent Growth Mixture Modeling. Results revealed a downward trajectory of PIU among youth. We identified six latent subgroups, three of which were in pathological status for at least a year. The more rapid improvement in peer support, but not the initial level of peer support, predicted the faster reduction of PIU symptoms during the 3-year period. Findings suggest that although the symptoms of PIU among children and adolescents would decline over time, improving peer support could further alleviate youth PIU. We recommended that intervention programs include a peer support component to mitigate PIU among youth.
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Conducta del Adolescente , Conducta Adictiva , Trastorno de Adicción a Internet/psicología , Uso de Internet , Influencia de los Compañeros , Factores Protectores , Adolescente , Niño , Femenino , Humanos , Análisis de Clases Latentes , Masculino , Singapur , Adulto JovenRESUMEN
Parents regularly use media to help regulate their child's difficult emotions, particularly for those with a more difficult temperament. However, no research has examined how this may be related to the development of problematic (or addictive-like) media use in early childhood. The purpose of the study was to examine associations between temperament, parental media emotion regulation, and problematic media use in young children, using both questionnaires and observational data. Participants included 269 toddlers (2-3 years old) and their parents, who completed several observational tasks and questionnaires. Analyses revealed that higher levels of media emotion regulation was associated with more problematic media use and more extreme emotions when media was removed in toddlers. Additionally, temperament (specifically negative affect and surgency) was related to problematic media and extreme emotions and was mediated by media emotion regulation. Parents should avoid using media as a primary way of regulating their children's emotions as this may be related to the development of problematic media strategies during infancy.
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Background: The purpose of this study was to evaluate the implementation and effectiveness of an ecological, multi-component adolescent obesity prevention intervention called School Wellness Integration Targeting Child Health-Middle School (SWITCH-MS). Methods: Following the effectiveness-implementation hybrid type 3 quasi-experimental design, seven middle schools (377 students) in Iowa, United States, were stratified into "experienced" (n = 3; 110 students) or "inexperienced" (n = 4; 267 students) groups to receive the 12-week SWITCH-MS intervention. To evaluate implementation, school informants (n = 10) responded to a survey and students completed behavioral tracking in the classroom on a website. For effectiveness evaluation, students in 6th, 7th, and 8th grades completed a validated questionnaire before and after intervention, to measure behaviors of physical activity (PA; "Do"), screen-based activity ("View"), and fruits and vegetable consumption ("Chew"). Results: The two groups of schools showed similar levels of implementation for best practices, awareness, and engagement. Behavioral tracking rate favored the experienced schools early on (47.5% vs. 11.7%), but differences leveled off in weeks 3-12 (sustained at 30.1-44.3%). Linear mixed models demonstrated significant time effects for "Do" (at school and out of school; p < 0.01) and "View" behaviors (p = 0.02), after controlling for student- and school-level covariates. Conclusions: This study demonstrates that prior experience with SWITCH-MS may not be a prominent factor for implementation and effectiveness, although greater experience is associated with favorable behavioral tracking when the intervention is first launched.