Date of Award


Degree Name

Doctor of Philosophy



First Advisor

Dr. Linda A. LeBlanc

Second Advisor

Dr. James E. Carr

Third Advisor

Dr. R. Wayne Fuqua

Fourth Advisor

Dr. Leilani Feliciano


Older adults and their caregivers generally prefer behavioral interventions over medications in treatment acceptability studies (Osterkamp, Mathews, Burgio, & Hardin, 1997). However, previous acceptability studies have primarily examined ratings, which did not force the responder to select between treatment options. Additionally, recent advances in behavioral treatment technologies (Carr & LeBlanc, 2003) and pharmacotherapy (Schneider, 1999) warrant revisiting treatment acceptability for older adults. The present investigation examined treatment acceptability of behavioral, pharmacological, and sensory interventions using a treatment acceptability rating scale, treatment selections, and direct report of treatments used in a six-month window. Fifty-six staff from nursing homes in the Mid-West United States who actively participate in treatment decisions (e.g., directors of nursing, program directors) participated in the study. One-way ANOVAs indicated no significant differences in acceptability ratings for three interventions. Treatment selections were significantly different (f = 33.485, p < .000), with behavioral, sensory, and pharmacological selections being selected significantly more often than referral and selecting no treatment. Pearson-Product Moment Correlations indicated that ratings and selections were significantly related for behavioral r = 0.298 (p = .035) and medical r = 0.304 (p = .028). Additionally, ratings for question 2 of the TEI-SF and treatment selections were significantly correlated for behavior r = 0.296 (p = .037) and for medical r = .274 (p = .050). Point Bi-Serial correlations indicated behavioral selections (but not ratings) were significantly correlated with using a second behavioral intervention if the first behavioral intervention was ineffective (r = 0.430, p = 0.016). Thus, unlike previous research, treatment ratings did not result in significant differentiation between treatments and this finding was confirmed with treatment selections. Ratings were correlated with selections, though the clinical significance of such relations is discussed, as well as the clinical significance of selecting referral and no treatment during selection. Although this study does not permit an analysis of ratings versus selections as a better predictor of treatment adoption, these results provide initial evidence that treatment ratings, hereto a staple of treatment acceptability and treatment adoption research, may not be an accurate measure of the behaviors they are employed to sample.

Access Setting

Dissertation-Open Access