Manifesto for new directions in developmental science.

Although developmental science has always been evolving, these times of fast-paced and profound social and scientific changes easily lead to disorienting fragmentation rather than coherent scientific advances. What directions should developmental science pursue to meaningfully address real-world problems that impact human development throughout the lifespan? What conceptual or policy shifts are needed to steer the field in these directions? The present manifesto is proposed by a group of scholars from various disciplines and perspectives within developmental science to spark conversations and action plans in response to these questions. After highlighting four critical content domains that merit concentrated and often urgent research efforts, two issues regarding "how" we do developmental science and "what for" are outlined. This manifesto concludes with five proposals, calling for integrative, inclusive, transdisciplinary, transparent, and actionable developmental science. Specific recommendations, prospects, pitfalls, and challenges to reach this goal are discussed.

Feasibility and acceptability of intensive, real-time biobehavioral data collection using ecological momentary assessment, salivary biomarkers, and accelerometers among middle-aged African Americans.

Perceived racial discrimination is linked to unhealthy behaviors and stress-related morbidities. A compelling body of research indicates that perceived racial discrimination may contribute to health disparities among African Americans (AAs). The purposes of this study were to describe the study protocol including data collection procedures and study measures and to evaluate the feasibility and acceptability of intensive biobehavioral data collection using ecological momentary assessment (EMA), salivary biomarkers, and accelerometers over 7 days among middle-aged AAs with a goal of understanding the relationships between perceived racial discrimination and biobehavioral responses to stress. Twelve AA men and women participated in the feasibility/acceptability study. They completed surveys, anthropometrics, and received in-person training in EMA and saliva sample collection at baseline. Participants were asked to respond to the random prompt text message-based EMA five times a day, wear an accelerometer daily for 7 days, and to self-collect saliva samples four times a day for 4 consecutive days. The EMA surveys included perceived racial discrimination, affective states, lifestyle behaviors, and social and physical contexts. The mean EMA response rate was 82.8%. All participants collected saliva samples four times a day for 4 consecutive days. About 83% of participants wore the accelerometer on the hip 6 out of 7 days. Despite the perception that the intensive nature of assessments would result in high participant burden, the acceptability of the study procedures was uniformly favorable.

The transtheoretical model is an effective weight management intervention: a randomized controlled trial.

BACKGROUND: Given the current worldwide epidemic of obesity, there is a demand for interventions with higher impact, such as those carried out in the primary health care (PHC) setting. Here we evaluate the effect of intervention performed according to the stages of change of the transtheoretical model (TTM) for weight management. METHODS: This randomized controlled trial in Brazilian PHC offered free physical exercise and nutrition education. The participants were women, aged 20 years or older who were obese or overweight, users in PHC service. The intervention group (IG, n = 51) received the same orientation as the comparison group (CG, n = 35) plus individual health counseling based on the TTM aimed at weight loss, which lasted 6 months. The outcome measures were anthropometric, food, and nutrient profiles. Inflammatory parameters were evaluated in a random subsample. The inter-group and intra-group differences were evaluated using interntion-to-treat analysis, and analysis of covariance (ANCOVA) used to assess intervention effectiveness. RESULTS: There was a difference between groups of - 1.4 kg (CI95%: - 2.5; - 0.3) in body weight after the intervention. About 97% of women in the IG reported benefits of the intervention and presented positive changes in diet, biochemical markers, and anthropometry. The IG showed better body mass index, resistine, and blood glucose results compared to the CG during follow-up. CONCLUSION: The individualized TTM-based intervention, combined with usual care, was an effective strategy in PHC. These results should encourage the use of interdisciplinary practices; nevertheless, research to identify additional strategies is needed to address barriers to weight maintenance among obese low-income women. TRIAL REGISTRATION: The trial is registered with Brazilian clinical trials under the code: RBR-8t7ssv, Registration date: 12/12/2017 (retrospectively registered).

A computational account of threat-related attentional bias.

Visual selective attention acts as a filter on perceptual information, facilitating learning and inference about important events in an agent's environment. A role for visual attention in reward-based decisions has previously been demonstrated, but it remains unclear how visual attention is recruited during aversive learning, particularly when learning about multiple stimuli concurrently. This question is of particular importance in psychopathology, where enhanced attention to threat is a putative feature of pathological anxiety. Using an aversive reversal learning task that required subjects to learn, and exploit, predictions about multiple stimuli, we show that the allocation of visual attention is influenced significantly by aversive value but not by uncertainty. Moreover, this relationship is bidirectional in that attention biases value updates for attended stimuli, resulting in heightened value estimates. Our findings have implications for understanding biased attention in psychopathology and support a role for learning in the expression of threat-related attentional biases in anxiety.

Identification of inflammatory markers suitable for non-invasive, repeated measurement studies in biobehavioral research: A feasibility study.

INTRODUCTION: Studying the role of the immune system in the interaction between mental and physical health is challenging. To study individuals with an intensive, longitudinal study design that requires repetitive sampling in their daily life, non-invasive sampling techniques are a necessity. Urine can be collected in a non-invasive way, but this may be demanding for participants and little is known about fluctuation of inflammatory markers in urine over time. The aim of this study was to investigate the feasibility of non-invasive sampling, and to explore intra-individual differences in inflammatory markers in urine. MATERIALS & METHODS: Ten healthy individuals collected 24-hour urine for 63 consecutive days. In a pilot analysis, 39 inflammatory markers were examined for detectability in urine, stability over time and under storage conditions, and daily fluctuations. Multiplex analyses were used to quantify levels of eight selected markers: C-reactive protein (CRP), Fractalkine, Interleukin-1 receptor-antagonist (IL-1RA), interferon-α (IFNα), interferon-γ (IFNγ), Interferon gamma-induced protein 10 (IP10), Macrophage inflammatory protein-1ß (MIP-1ß), and Vascular Endothelial Growth Factor (VEGF). Cross-correlations were calculated between the overnight and 24-hour samples were calculated, to examine whether 24-hour urine could be replaced by the overnight portion for better feasibility. We examined intra- and interindividual differences in the levels of inflammatory markers in urine and the fluctuations thereof. RESULTS: This study showed that levels of selected inflammatory markers can be detected in urine. Cross-correlation analyses showed that correlations between levels of inflammatory markers in the night portion and the 24-hour urine sample varied widely between individuals. In addition, analyses of time series revealed striking inter- and intra-individual variation in levels of inflammatory markers and their fluctuations. CONCLUSION: We show that the assessment of urinary inflammatory markers is feasible in an intensive day-to-day study in healthy individuals. However, 24-hour urine cannot be replaced by an overnight portion to alleviate the protocol burden. Levels of inflammatory markers show substantial variation between and within persons.

Validación del cuestionario del modelo transteórico del cambio de ejercicio físico / Validation of the questionnaire of the transtheoretical model of change of physical exercice

El objetivo de este estudio fue traducir y validar al español el Cuestionario del Modelo Transteórico del Cambio de Ejercicio Físico de Prochaska y DiClemente (1983). Se utilizó una muestra de 812 personas, entre los 14 y los 88 años (29,5±21,7). Se realizó un análisis factorial confirmatorio, análisis de consistencia interna y validez predictiva. Los resultados del Cuestionario del Modelo Transteórico del Cambio de Ejercicio Físico presentaron valores adecuados (χ2/g.l = 4,3, CFI = 0,92, IFI = 0,92, TLI = 0,90, RMSEA = 0,06, SRMR = 0,05). La consistencia interna mostró valores encima de .70. Se halló una predicción positiva y significativa de los estadios más activos del Modelo Transteórico sobre la intención de ser físicamente activo. Este estudio ha permitido proporcionar un cuestionario válido y fiable para evaluar el estadio en el que se encuentran las personas con respecto a la práctica de ejercicio físico, en el ámbito español

The aim of this study was to translate and validate in Spanish the Questionnaire of the Transtheoretical Model of Change of Physical Exercise, of Prochaska and DiClemente (1983), and also to make adaptations and modifications as needed. The sample was composed of 812 people, aged between 14 and 88 years (29.5+21.7). Confirmative factorial analysis, analysis of internal consistency and of predictive validity were carried out. After the confirmative factorial analysis, the Questionnaire of the Theoretical Model of Change of Physical Exercise showed acceptable results (x2/g.1=4,3, CFI=0,92, IFI= 0.92, TLI = 0.90, RMSEA = 0.06, SRMR = 0,05). Similarly, internal consistency obtained from the respective dimensions showed values above .70. A positive and significant prediction of the most active stages of the Transtheoretical Model (action and maintenance) was found on the 'intention to be physically active'. This study has enabled the provision of a valid and reliable questionnaire

Quantifying the relationship between food sharing practices and socio-ecological variables in small-scale societies: A cross-cultural multi-methodological approach.

This article presents a cross-cultural study of the relationship among the subsistence strategies, the environmental setting and the food sharing practices of 22 modern small-scale societies located in America (n = 18) and Siberia (n = 4). Ecological, geographical and economic variables of these societies were extracted from specialized literature and the publicly available D-PLACE database. The approach proposed comprises a variety of quantitative methods, ranging from exploratory techniques aimed at capturing relationships of any type between variables, to network theory and supervised-learning predictive modelling. Results provided by all techniques consistently show that the differences observed in food sharing practices across the sampled populations cannot be explained just by the differential distribution of ecological, geographical and economic variables. Food sharing has to be interpreted as a more complex cultural phenomenon, whose variation over time and space cannot be ascribed only to local adaptation.

Extending r/K selection with a maternal risk-management model that classifies animal species into divergent natural selection categories.

Reproduction is a defining process of biological systems. Every generation, across all species, breeding females repopulate ecosystems with offspring. r/K selection was the first theory to classify animal species by linking the rates with which breeding females repopulated ecosystems, to the stability of ecosystems. Here, I introduce a species classification scheme that extends the reach of r-K selection and CSR selection by linking breeder investments in offspring quantity, quality, and diversity to specific natural selection pressures. The species classification scheme is predicated on the assumption that high rates of predation favor breeders that invest more in offspring quantity than quality; and that spatiotemporal scarcity favors breeders that investment more in offspring quality than quantity. I present equations that convert the species classification scheme into a maternal risk-management model. Thereafter, using the equations, I classify eighty-seven animal species into the model's natural selection categories. Species of reptiles, fish, and marine invertebrates clustered in the predation selection category. Species of birds and mammals clustered in the scarcity selection category. Several species of apex predators clustered in the weak selection category. Several species of social insects and social mammals clustered in the convergent selection category. In summary, by acknowledging breeding females as the individuals upon which natural selection acts to repopulate ecosystems with offspring, the proposed maternal risk-management model offers a testable, theoretical framework for the field of ecology.

Change Theory Contributes to Choosing Wisely for Immune Thrombocytopenia.

OBJECTIVES: Despite 2011 guidelines in which it is suggested that treatment of acute immune thrombocytopenia purpura (aITP) is not needed for patients without significant bleeding, only 14% of children treated for aITP have bleeding symptoms. Our aim was to decrease the percentage of children with first-episode aITP who were unnecessarily treated by 50% within 12 months of guideline implementation. METHODS: An intervention was designed by using the precaution-adoption-process model. A standard-of-practice meeting was organized and focused on clinician readiness for change. After education on current evidence and common cognitive errors, consensus clinical guidelines were created. After implementation, an article in a statewide professional newsletter was published to educate community providers. Unnecessary treatment (UT) was defined as treatment of any patient who only had bruising and/or self-resolving nose bleeds. Statistical process control charts were used to track progress, midline shifts were determined by Nelson's rules, and hospital costs were derived from administrative billing data. RESULTS: One hundred children with aITP were seen from January 2013 to September 2018. UT decreased from 70% to a sustained rate of <30% (P = .008), including a mean of 7% over the past 12 months. The admission rate decreased from 100% to 52% (P = .013), and the total percentage of patients treated decreased from 100% to 48% (P = .016), with both numbers continuing to decline. No adverse bleeding events occurred. An estimated 12 admissions, 4 readmissions, and 5 adverse events were avoided annually. CONCLUSIONS: We demonstrated successful improvement in UT of aITP through an educational intervention informed by the precaution-adoption-process model change theory.

Terrain coefficients for predicting energy costs of walking over snow.

BACKGROUND: Predicting the energy costs of human travel over snow can be of significant value to the military and other agencies planning work efforts when snow is present. The ability to quantify, and predict, those costs can help planners determine if snow will be a factor in the execution of dismounted tasks and operations. To adjust predictive models for the effect of terrain, and more specifically for surface conditions, on energy costs, terrain coefficients (ƞ) have been developed. The physiological demands of foot travel over snow have been studied previously, and there are well established methods of predicting metabolic costs of locomotion. By applying knowledge gained from prior studies of the effects of terrain and snow, and by leveraging those existing dismounted locomotion models, this paper seeks to outline the steps in developing an improved terrain coefficient (ƞ) for snow to be used in predictive modeling. METHODS: Using published data, methods, and a well-informed understanding of the physical elements of terrain, e.g., characterization of snow sinkage (z), this study made adjustments to ƞ-values specific to snow. RESULTS: This review of published metabolic cost methods suggest that an improved ƞ-value could be developed for use with the Pandolf equation, where z = depth (h)*(1 - (snow density (ρ0)/1.186)) and ƞ = 0.0005z3 + 0.0001z2 + 0.1072z + 1.2604. CONCLUSION: While the complexity of variables related to characteristics of snow, speed of movement, and individuals confound efforts to develop a simple, predictive model, this paper provides data-driven improvements to models that are used to predict the energy costs of dismounted movements over snow.

Integrated Bio-behavioral Approach to Improve Adherence to Pre-exposure Prophylaxis and Reduce HIV Risk in People Who Use Drugs: A Pilot Feasibility Study.

This study reports the feasibility, acceptability, and preliminary efficacy of the bio-behavioral community-friendly health recovery program-an integrated, HIV prevention intervention to improve pre-exposure prophylaxis (PrEP) adherence and HIV-risk reduction behaviors among high-risk people who use drugs. We used a within-subjects, pretest-posttest follow-up design to recruit participants, who were HIV-uninfected, methadone-maintained and reported HIV-risk behaviors and had initiated PrEP (n = 40; males: 55%). Participants were assessed at baseline (T0), immediately post-intervention (4 weeks: T4) and 4 weeks post-intervention (T8). Immediately after completing the four weekly intervention groups, participants underwent a post-intervention assessment including in-depth qualitative interviews. Feasibility was high, assessed by participant willingness to enroll (90.1%) and retention (95%). Results showed that participants were highly satisfied and perceived the intervention as valuable and acceptable [mean: 81.3 (range 0-100)]. Significant enhancements in self-reported PrEP adherence [F(2,74) = 7.500, p = 0.001] and PrEP-related knowledge [F(2,74) = 3.828, p = 0.026] were observed. Drug-related (e.g., injection of drugs, sharing of injection equipment) and sex-related (e.g., number of sexual partners, condomless sex) risk behaviors were reduced, while information, motivation, and behavioral skills (IMB) constructs increased. The results support feasibility and high acceptability and support further examination of the efficacy of this combination bio-behavioral intervention in a prospective clinical trial.

In Vivo Feedback Predicts Parent Behavior Change in the Attachment and Biobehavioral Catch-up Intervention.

Understanding mechanisms and active ingredients of intervention is critical to training clinicians, particularly when interventions are transported from laboratories to communities. One promising active ingredient of parenting programs is clinicians' in vivo feedback regarding parent-child interactions. The present study examined whether a form of in vivo feedback, in the moment commenting, predicted treatment retention and parent behavior change when the Attachment and Biobehavioral Catch-up (ABC) intervention was implemented in a community setting. Observational data were collected from 78 parent-child dyads (96% mothers; M age = 29 years; 81% minority; infants' M age = 12 months; 90% minority) across 640 sessions conducted by 9 clinicians (100% female, M age = 39; 67% minority) in Hawaii. Parental behavior was assessed with a semistructured play task before and after intervention. Clinicians' in-the-moment feedback to parents was assessed from intervention session videos. Clinicians' frequency and quality of in-the-moment feedback predicted change in parental intrusiveness and sensitivity at posttreatment. Frequency of in-the-moment feedback also predicted likelihood of retention. Hierarchical linear modeling demonstrated strong support for these associations at the between-clinician level, and limited additional support at the within-clinician (i.e., between-case) level. Thus, a hypothesized active ingredient of treatment, in-the-moment feedback, predicted community-based ABC outcomes. The results complement lab-based evidence to suggest that in vivo feedback may be a mechanism of change in parenting interventions. Helping clinicians to provide frequent, high-quality in vivo feedback may improve parenting program outcomes in community settings.

Una alternativa actual al dualismo en Psicología: la Ciencia Conductual Contextual / A current alternative to dualism in Psychology: Contextual Behavioral Science

El artículo busca constatar el carácter dualista que aún invade la Psicología, y cómo los problemas pragmáticos y filosóficos de la misma tienen como solución más socorrida el acudir a un monismo materialista, encarnado en la figura del reduccionismo cerebrocentrista. Así mismo, se presentan las características, filosofía y aplicaciones de la CBS (Ciencia Conductual Contextual) en vistas a ofrecer una alternativa dentro de la propia Psicología que supere el dualismo imperante y preserve la independencia de la Psicología como campo autónomo en la ciencia, entre la biología y la sociología

The article tries to verify the dualist character that still invades psychology, and how the pragmatic and philosophical problems of it have as a most useful solution to resort to a materialist monism, embodied in the figure of brain-centered reductionism. Likewise, the characteristics, philosophy and applications of the CBS (Contextual Behavioral Science) are presented in order to offer an alternative within the psychology that overcomes the prevailing dualism and preserves the independence of psychology as an autonomous field in science, among biology and sociology

Behavioral Design Teams: The Next Frontier in Clinical Delivery Innovation?

Issue: A deep understanding of human behavior is critical to designing effective health care delivery models, tools, and processes. Currently, however, few mechanisms exist to systematically apply insights about human behavior to improve health outcomes. Behavioral design teams (BDTs) are a successful model for applying behavioral insights within an organization. Already operational within government, this model can be adapted to function in a health care setting. Goal: To explore how BDTs could be applied to clinical care delivery and review models for integrating these teams within health care organizations. Methods: Interviews with experts in clinical delivery innovation and applied behavioral science, as well as leaders of existing government BDTs. Findings and Conclusions: BDTs are most effective when they enjoy top-level executive support, are co-led by a domain expert and behavioral scientist, collaborate closely with key staff and departments, have access to data and IT support, and operate a portfolio of projects. BDTs could be embedded in health care organizations in multiple ways, including in or just below the CEO's office, within a quality improvement unit, or within an internal innovation center. When running a portfolio, BDTs achieve a greater number and diversity of insights at lower costs. They also become a platform for strategic learning and scaling.

Comparing two remote video survey methods for spatial predictions of the distribution and environmental niche suitability of demersal fishes.

Information on habitat associations from survey data, combined with spatial modelling, allow the development of more refined species distribution modelling which may identify areas of high conservation/fisheries value and consequentially improve conservation efforts. Generalised additive models were used to model the probability of occurrence of six focal species after surveys that utilised two remote underwater video sampling methods (i.e. baited and towed video). Models developed for the towed video method had consistently better predictive performance for all but one study species although only three models had a good to fair fit, and the rest were poor fits, highlighting the challenges associated with modelling habitat associations of marine species in highly homogenous, low relief environments. Models based on baited video dataset regularly included large-scale measures of structural complexity, suggesting fish attraction to a single focus point by bait. Conversely, models based on the towed video data often incorporated small-scale measures of habitat complexity and were more likely to reflect true species-habitat relationships. The cost associated with use of the towed video systems for surveying low-relief seascapes was also relatively low providing additional support for considering this method for marine spatial ecological modelling.

Host Distribution Does Not Limit the Range of the Tick Ixodes ricinus but Impacts the Circulation of Transmitted Pathogens.

Ticks, pathogens, and vertebrates interact in a background of environmental features that regulate the densities of ticks and vertebrates, affecting their contact rates and thence the circulation of the pathogens. Regional scale studies are invaluable sources of information about the regulation of these interactions, but a large-scale analysis of the interaction of communities of ticks, hosts, and the environment has been never modeled. This study builds on network analysis, satellite-derived climate and vegetation, and environmental modeling, quantifying the interactions between the tick Ixodes ricinus and the transmitted bacteria of the complex Borrelia burgdorferi s.l. in the Western Palaearctic. We derived the rates of contact of the tick with 162 species of vertebrates recorded as hosts, and the relative importance of each vertebrate in the circulation of the pathogen. We compiled more than 11 millions of pairs of coordinates of the vertebrates, deriving distribution models of each species and the relative faunal composition in the target territory. The results of the modeling of the distribution of the tick and its hosts, weighted by their importance in the circulation of Borrelia captured the spatial patterns of interactions that allow the circulation of the pathogen. Results indicate that both I. ricinus and B. burgdorferi s.l. are supported in the Western Palaearctic by complex communities of vertebrates, which have large distribution ranges. This high functional redundancy results in the pervasiveness of B. burgdorferi s.l., which depends on the gradient of contributions of the large community of vertebrates, instead of relying on a few dominant vertebrates, which was the prevailing paradigm. Most prominent reservoirs of the pathogen are distributed in specific regions of the environmental niche. However, literally dozens of potential reservoirs can colonize many other environmental regions, marginally but efficiently contributing to the circulation of the pathogen. These results consistently point to the need of evaluating the beta-diversity of the community of vertebrates acting as reservoirs of the pathogen to better know the interactions with the vector. They also demonstrate why the pathogen is so resilient to perturbations in the composition of the reservoirs.

Conducting Biobehavioral Research in Patients With Advanced Cancer: Recruitment Challenges and Solutions.

Despite significant advances in cancer treatment and symptom management interventions over the last decade, patients continue to struggle with cancer-related symptoms. Adequate baseline and longitudinal data are crucial for designing interventions to improve patient quality of life and reduce symptom burden; however, recruitment of patients with advanced cancer in longitudinal research is difficult. Our purpose is to describe challenges and solutions to recruitment of patients with advanced cancer in two biobehavioral research studies examining cancer-related symptoms. Study 1: Symptom data and peripheral blood for markers of inflammation were collected from newly diagnosed patients receiving chemotherapy on the first day of therapy and every 3-4 weeks for up to 6 months. Study 2: Symptom data, blood, and skin biopsies were collected from cancer patients taking epidermal growth factor receptor inhibitors at specific time points over 4 months. Screening and recruitment results for both studies are summarized. Timing informed consent with baseline data collection prior to treatment initiation was a significant recruitment challenge for both the studies. Possible solutions include tailoring recruitment to fit clinic needs, increasing research staff availability during clinic hours, and adding recruitment sites. Identifying solutions to these challenges will permit the conduct of studies that may lead to identification of factors contributing to variability in symptoms and development of tailored patient interventions for patients with advanced cancer.

Biobehavioral effects of baclofen in anxious alcohol-dependent individuals: a randomized, double-blind, placebo-controlled, laboratory study.

Baclofen has been suggested as a potential pharmacotherapy for alcohol use disorder, but the clinical data are conflicting. Here we investigated the biobehavioral effects of baclofen in a sample of anxious alcohol-dependent individuals. This was a randomized, double-blind, placebo-controlled, human laboratory study in non-treatment seeking alcohol-dependent individuals with high trait anxiety (N=34). Participants received baclofen (30 mg per day) or placebo for at least 8 days, then performed an experimental session consisting of alcohol cue-reactivity followed by alcohol administration procedure (alcohol priming, then alcohol self-administration). Total amount of alcohol self-administered was the primary outcome; alcohol craving, subjective/physiological responses and mood/anxiety symptoms were also evaluated. There was no significant medication effect on the total amount of alcohol consumed during the alcohol self-administration (P=0.76). Baclofen blunted the positive association between maximum breath alcohol concentration during priming and the amount of alcohol consumption (significant interaction, P=0.03). Ratings of feeling intoxicated were significantly higher in the baclofen group after consuming the priming drink (P=0.006). During the self-administration session, baclofen significantly increased ratings of feeling high (P=0.01) and intoxicated (P=0.01). A significant reduction in heart rate (P<0.001) and a trend-level increase in diastolic blood pressure (P=0.06) were also detected in the baclofen group during the alcohol laboratory session. In conclusion, baclofen was shown to affect subjective and physiological responses to alcohol drinking in anxious alcohol-dependent individuals. These results do not support an anti-craving or anti-reinforcing effect of baclofen, but rather suggest that baclofen may act as a substitution medication for alcohol use disorder.

Test-Retest Reliability of Traumatic Brain Injury Outcome Measures: A Traumatic Brain Injury Model Systems Study.

OBJECTIVE: Evaluate the test-retest reliability of measures that comprise the Traumatic Brain Injury Model Systems follow-up data set. PARTICIPANTS: A total of 224 persons with a moderate-severe traumatic brain injury (TBI) enrolled in the Traumatic Brain Injury Model Systems National Database. DESIGN: Following standard administration of the follow-up interview, a second interview was administered 14 to 28 days later using the same interviewer and the same mode of administration. MAIN MEASURES: Traumatic Brain Injury Model Systems follow-up interview that includes 66 variables comprised (a) single item measures of demographics; employment; general health as well as specific health conditions; rehospitalization; tobacco, alcohol, and other drug use; transportation; and mental health and (b) multi-item instruments: FIM; Participation Assessment With Recombined Tools-Objective; Disability Rating Scale; Glasgow Outcome Scale-Extended; Supervision Rating Scale; Satisfaction With Life Scale; TBI Quality of Life Anxiety and Depression items; and The Ohio State University TBI Identification Method. RESULTS: Intraclass correlation coefficient values ranged from 0.65 to 0.99, weighted kappa values ranged from 0.54 to 0.99, and kappa values ranged from 0.43 to 1.00. Four kappa/weighted kappa estimates fell below 0.60: arrested, psychiatric hospitalization, number of days not in good physical health, and rating of general emotional health. CONCLUSIONS: With few exceptions, good to excellent test-retest reliability estimates were obtained. The findings support the use of these measures in prior and future studies and indicate that persons with moderate-severe TBI can provide reliable self-report.