Real-time sensing and computing technologies are increasingly used in the
delivery of real-time health behavior interventions. Auditory signals play a
critical role in many of these interventions, impacting not only behavioral
response but also treatment adherence and participant retention. Yet, few
behavioral interventions that employ auditory feedback report the
characteristics of sounds used and even fewer design signals specifically for
their intervention. This paper describes a four-step process used in developing
and selecting auditory warnings for a behavioral trial designed to reduce indoor
secondhand smoke exposure. In step one, relevant information was gathered from
ergonomic and behavioral science literature to assist a panel of research
assistants in developing criteria for intervention-specific auditory feedback.
In step two, multiple sounds were identified through internet searches and
modified in accordance with the developed criteria, and two sounds were selected
that best met those criteria. In step three, a survey was conducted among 64
persons from the primary sampling frame of the larger behavioral trial to
compare the relative aversiveness of sounds, determine respondents'
reported behavioral reactions to those signals, and assess participant's
preference between sounds. In the final step, survey results were used to select
the appropriate sound for auditory warnings. Ultimately, a single-tone pulse,
500 milliseconds (ms) in length that repeats every 270 ms for 3 cycles was
chosen for the behavioral trial. The methods described herein represent one
example of steps that can be followed to develop and select auditory feedback
tailored for a given behavioral intervention.