Putting prospection into practice: Methodological considerations in the use of episodic future thinking to reduce delay discounting and maladaptive health behaviors

Abstract

In recent years, episodic future thinking (EFT) has emerged as a promising behavioral intervention to reduce delay discounting or maladaptive health behaviors; however, considerable methodological heterogeneity in methods for eliciting engagement in EFT has been observed in prior research. In this narrative review, we briefly describe methods for generating EFT cues, the content of EFT cues, common control conditions for experiments utilizing EFT, and considerations for cue delivery and implementation. Where possible, we make suggestions for current best practices in each category while identifying gaps in knowledge and potential areas of future research. Finally, we conclude by using the NIH Stage model to better frame the current state of the literature on EFT and propose gaps to be addressed if EFT is to be both an efficacious and effective behavioral intervention.

Episodic future thinking in type 2 diabetes: Further development and validation of the Health Information Thinking control for clinical trials

“…Participants randomized to the EFT condition generated EFT cues using a self-guided cue generation survey (see Brown & Stein [ 15 ], for details on this method). Participants first identified personally meaningful possible future events using single sentence descriptions (e.g., “In one month, I am celebrating my wife’s birthday”), then rated those events on four dimensions: how much they enjoy the event, how important the event is, how exciting the event is, and how vividly they can imagine experiencing the event.…”

“…HIT participants also rated the information on several dimensions, including how much they liked learning the information, the importance of understanding the information, how exciting it was to learn the information, and how useful it was to learn the information. This approach results in personalized summaries of and reactions to health information, which mirrors common survey-guided EFT cue generation methods [ 15 ]. Additionally, the health-information vignettes may be tailored for a given clinical condition, increasing the likelihood that individuals with said condition will view HIT cues as a relevant intervention component.…”

Acceptability and feasibility of a mobile behavioral economic health intervention to reduce alcohol use in adults in rural areas

“…Herein, we use a participant-centered approach to refine two behavioral economic intervention components to enhance fit for people in rural areas with at-risk alcohol use. The intervention components are: volitional choice (VC), which involves replacing a potentially risky health behavior with an alternative via creation of “if-then” plans ( Armitage and Arden, 2012 , Moody et al, 2018 ), and episodic future thinking (EFT), which involves envisioning future personal experiences in vivid detail ( Brown and Stein, 2022 ). We conducted a pilot randomized controlled factorial trial to assess acceptability and feasibility of the intervention components and trial design.…”