Applied Behavioral Science Goes to Scale: A Review of Biglan’s The Nurture Effect

When the bright-eyed freshman- and sophomore-level undergraduate students at the University of Kansas (KU) decide to pursue a major in Applied Behavioral Science (ABS), they schedule an office-hour appointment with me to discuss the possible career options. Most of these students entered KU hoping to major in social welfare, psychology, or education, but discover ABS through our gateway course—typically taken as an elective by most students—and decide to change gears. The vast majority of these students had never heard of ABS before (let alone, applied behavior analysis [ABA]), so the change to this career path can seem a gamble.

Inevitably, a substantial number of these students follow up with me because their parents are skeptical of this “applied behavioral science” major. These parents know about social welfare, psychology, or education, but ABS remains in the shadows of these larger disciplines. In this sense, their skepticism is justified. These eager students—in an attempt to appease their parents, if not themselves—ask for direction on what to tell their parents about this field (many of whom are funding their education; many of whom are also frustrated their child is switching majors from something “mainstream”). “What can I do with this degree?,” they ask. Another typical question is, “Is there anything behavior analysis has done that my parents might recognize?” Up until this semester, I relied on various websites or peer-reviewed scientific publications as resources. I was never comfortable with doling out these resources, however, because they contain an overwhelming degree of jargon and can easily be misinterpreted as propaganda. Luckily, Anthony Biglan’s new book, The Nurture Effect: How the Science of Human Behavior can Improve our Lives and our World (2015), is now the only resource I will need. I suspect many other behavior analysts will agree.

The Nurture Effect, published by New Harbinger, Inc., offers a cornucopia of what behavioral science has done; more importantly, though, it blueprints what else behavioral science can do for emerging societal problems. The physical appearance of the book is appealing, with a crisp and contemporary look paralleling the kinds of covers used in similar popular press science books. Beyond the cover, the text balances technological language with accessible and engaging writing. The book is, quite simply, appropriate for any reader with an interest in solving cultural issues.

Appropriate Audiences

Thumbing through The Nurture Effect is like scrolling through the timeline of a close friend’s Facebook account; you relive the highlight moments of your relationship and sentimentally reflect on how much you’ve grown together. You also see distal relationships—in this case, broad applications of behavioral science (i.e., taken to national policy scales), informed by, but not always synonymous with, ABA.

Like someone’s Facebook feed, the content of The Nurture Effect is a figurative highlight-reel of behavioral science and ABA. The book covers familiar behavioral examples such as the Good Behavior Game (e.g., Barrish et al. 1969; Embry 2002), Carolyn Webster-Stratton’s Incredible Years program (e.g., Webster-Stratton and Taylor 2001; Webster-Stratton 2003), Direct Instruction (e.g., Adams and Engelmann 1996; Carnine and Engelmann 1984), and Acceptance and Commitment Therapy (ACT; e.g., Hayes et al. 2006, 1999), but also delves into prevention science and health psychology concepts that are often published in non-behavioral outlets. In this sense, many behavior analysts will learn something new.

The inspirational tales of what behavioral science can do at the individual, local, and national level will spark novel ideas in even the most seasoned behavior analyst. In many ways, The Nurture Effect is a rejoinder to Skinner’s Beyond Freedom and Dignity (1971) or Sidman’s Coercion and its Fallout (1989), chronicling the ways humanistic behaviorism can solve today’s problems through a nurturing approach grounded in positive consequences. The positive and nurturing message is highly compatible with Geller’s “Actively Caring for People” (1991, 2014) translation of behavioral science. Only time will tell whether behavioral researchers reading this text will take up the applications Biglan suggests. (I’m not a betting man, but this seems like a sure bet).

For readers aspiring to become behavioral scientists, parents looking for strategies for rearing their children, or those simply interested in reading about an empirically-supported applied science that can, literally, save lives (if not the world), The Nurture Effect is an interweaving tale of the successes of behavioral science. The readability is accessible and the language Biglan uses masterfully captures the technological detail of behavioral science without the use of off-putting jargon. Throughout the book—and including the title—Biglan uses the term “nurture effect,” rather than the precise terms for antecedent- and consequence-based technologies found in our peer-reviewed journals. However, the term “reinforcement” does appear 63 times in the text.

Perhaps the most interesting twist is the bulleted list of “Action Implications” at the conclusion of each chapter. These Action Implications provide brief highlights of the content of each chapter, translating the material into a series of instructions to scale behavioral science to local, regional, and national levels of application. In fact, Biglan specifically groups the bullets at the end of each chapter by audience-type, with parents, policy makers, and citizens appearing most often. As an example, the following two bullets are listed as Action Implications for policy makers in “Chapter 2: Nurturing Families” (p. 65):

1. Require the use of evidence- based programs. I hope I have convinced you to explore the tested and effective programs that can significantly reduce the level of psychological and behavioral problems that are so costly to communities, state, and nation. The Institute of Medicine report on prevention, Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities (IOM and NRC 2009), describes numerous evidence- based programs.

2. Investigate the cost-benefit ratio of interventions. Most of these programs save much more money than they cost. Return on Investment: Evidence-Based Options to Improve Statewide Outcomes (Aos et al. 2011) carefully analyzes the costs and benefits of many programs and indicates that most offer a significant return on investment.

Biglan’s specific appeal to policy makers in The Nurture Effect is a refreshing reminder that our field has remained in a scientific silo for too long. In the mid- to late 1980s, a series of independent papers in The Behavior Analyst addressed the rationale for strategic dissemination of behavioral science to the public, with specific emphasis on policy makers (Morris 1985; Fawcett et al. 1988; Seekins and Fawcett 1986). The gist of the messages in these papers was that, while behavior analysis has the capacity for scalability to improve the human condition, the science of behavior behind these applications can easily be misunderstood by the public.

The strategic delivery of behavioral science research findings is crucial for changing policy. Central to this approach is to render scientific findings and their implications both palatable and convincing (Seekins and Fawcett 1986), while presenting the topics in a personally identifiable manner. Biglan’s writing style is clearly palatable and convincing, and the specific treatise to policy makers in each Action Implications section provides the necessary “elevator speech” highlights for quick talking points. Readers interested in affecting policy change should use these Action Implications whenever engaging with policy makers.

Chapter Highlights

The Nurture Effect contains four parts. Part 1 is titled, “A Science Equal to the Challenge of the Human Condition,” and consists of one chapter on the topic. Part 2 (Chapters 2–5) is titled, “Nurturing Well-Being Through Prevention and Treatment,” and summarizes a number of behaviorally oriented prevention and intervention techniques at the individual or small group level. Part 3 (Chapters 6–9) is titled, “Addressing Well-Being in the Larger Social Context,” and discusses the capacity of behavioral science at the policy level. Finally, Part 4 is titled, “Evolving a Nurturing Society,” and is comprised of two chapters (10 and 11) on the topic of molar contingencies in our society and culture, with Biglan’s innovative vision for how behavioral science can help shape these entities.

Part 1: “A Science Equal to the Challenge of the Human Condition”

Part 1 is the briefest section of the book, containing only one chapter, “A Pragmatic Science of Human Behavior” (pp. 11–37). Despite its brevity, the chapter covers much ground in introducing the rigor and relevance of ABS. Biglan begins the chapter by introducing the reader to evolution and pragmatism as the guiding approaches to the science of behavior. He quickly transitions to discussing how these concepts may be applied to understanding the human condition. He summarizes this view by stating,

When the environment is favorable to the success of coordinated action among multiple units—be they genes, cells, people, or groups of people—those coordinated entities are likely to survive and reproduce. Conversely, when the environment favors individual units, those units will be selected even at the group’s expense. (p. 15)

The goal, then, is to provide nurturing environments that promote behavior the society deems favorable, and to nurture those favorable behaviors as they occur.

On page 20 of The Nurture Effect, Biglan offers his view that successful interventions render environments more nurturing in at least three of the following ways (p. 20):

1. Promoting and reinforcing prosocial behavior

2. Minimizing socially and biologically toxic conditions

3. Monitoring and setting limits on influences and opportunities to engage in problem behavior

4. Promoting the mindful, flexible, and pragmatic pursuit of prosocial values

Indeed, these four approaches to creating a nurturing environment will resonate well with the behavior analytic community, as they are common active ingredients in nearly every behavior change procedure. The reader will note Biglan’s careful use of terminology and lay-language when introducing these concepts. The remainder of Chapter 1 unpacks each of these approaches in greater detail, providing numerous real-life examples.

Of the entire book, Chapter 1 contains the most references to behavioral technologies. Thus, I suspect most behavior analysts will agree wholeheartedly with the vast majority of the language in this chapter. The chapter concludes by introducing the role of functional contextualism in language and why this matters for nurturing psychological health. The topic of functional contextualism remains the source of much debate, even in the pages of The Behavior Analyst (e.g., Hayes and Barnes-Holmes 2004; Palmer 2004), and some readers may take issue with how Biglan introduces this discussion:

Behavioral scientists have struggled with how to effectively analyze human language capacities. Behaviorists with a Skinnerian orientation insist it can be understood as simply verbal behavior that is shaped by reinforcing consequences, just as any other behavior is. That view led to considerable success in helping children with developmental disabilities learn how to talk. But it fell short of the goal of a comprehensive understanding of human language. (p. 33)

In all transparency, I agree that functional contextualism is necessary for a “comprehensive understanding of human language.” Despite my agreement, I would also classify myself as behaviorist “with a Skinnerian orientation”—thereby, I am seemingly an oxymoron according to Biglan, but not according to Barnes-Holmes and colleagues (2000). I worry that Biglan’s choice of language frames Skinnerian behaviorists as archaic zealots to the naïve reader, which almost certainly is not the goal of this book. (Later in the book, Biglan makes it clear he adopts a radical behavioral perspective, and views functional contextualism as a complement to radical behaviorism.) The research on relational frame theory (RFT) and ACT is advancing rapidly and growing more recognized by the broader psychological community (Guinther and Dougher 2015); thus, I am ecstatic these topics are featured with such prominence in this book. This minor misstep in language should not detract from the glowing treatment of behavior analysis found throughout the rest of the pages.

Part 2: “Nurturing Well-Being Through Prevention and Treatment”

Chapters 2 and 3 are titled, “Nurturing Families” and “Nurturing Schools,” respectively. In Chapter 2, Biglan reviews the impact of early experiences on child development. The discussion includes examples from Jerry Patterson’s work with families (Patterson 1982; Patterson et al. 2010), Carolyn Webster-Stratton’s parent training successes (Webster-Stratton 1992; Webster-Stratton et al. 2008), and Hart and Risley’s famous study on language acquisition (Hart and Risley 1995). Amidst the scholarly discussion of these seminal works, Biglan peppers in personal stories from his own family and practice. Biglan’s personal perspectives provide face valid examples of how these research findings can be seen in everyday real-world conditions.

Biglan echoes many of his Chapter 2 points in Chapter 3 when discussing quality education. Specific attention is paid to the Good Behavior Game, Positive Action, and Positive Behavioral Intervention and Support (PBIS). Like the inclusion of ACT, the inclusion of PBIS might raise objections from some readers of The Behavior Analyst given the controversy on this topic outlined in the pages of this journal (see Carr and Sidener 2002; Johnston et al. 2006). While the controversy still exists within the field of behavior analysis, the advances in data-based demonstrations of effectiveness and behavioral conceptualizations (e.g., Horner and Sugai 2015) have begun to dampen some of the initial outcries, leading some behavior analysts to question why PBIS remains a controversial subject (e.g., Critchfield 2015; Jarmolowicz and Tetreault 2015). Biglan’s take on PBIS, as well as the Good Behavior Game and Positive Action is relatively agnostic and sticks with the empirical facts of these programs’ successes—he avoids debate over how and whether these programs quality as “behavior analysis.” Rather, Biglan articulates the immense success of these programs in changing education policy.

I found Biglan’s careful injection of policy level implications regarding education to be very well crafted. For example, when discussing the effects of the Good Behavior Game, Biglan seems to directly speak to policy makers:

The kids who had played the [Good Behavior Game]—only for 1 year, in either the first or second grade—were less likely to be addicted to drugs or suicidal and had committed fewer crimes. An independent analysis of the economic benefit of this intervention indicated that for every dollar spent on the Good Behavior Game, about eighty-four dollars could be saved through reduced special education, victim, health care, and criminal justice costs. (p. 74)

Only a small portion of Chapter 3 is spent discussing Direct Instruction, which was surprising. More surprising to me, however, was that only three sentences were devoted to discussing direct instruction’s success in the Project Follow Through study, given the abundance of data that could inform both educational and policy level decisions (Becker and Carnine 1981).

In Chapter 4, titled, “Peers and Problems,” Biglan hones in on the importance of prosocial relationships as children develop into adults. The chapter begins by describing the seemingly strong social reinforcement adolescents doled out to one another in the form of peer attention for describing deviant acts in the longitudinal Oregon Youth Study (OYS). These findings underscore the potential for delinquency to be shaped by social pressures and social reinforcement. Biglan summarizes Thomas Dishion and colleagues’ findings (see Dishion et al. 1999): “They found that the more laughs a boy got for what he said, the more he talked about that topic” (p. 92). Indeed, two recent matching law analyses of the OYS data in Journal of the Experimental Analysis of Behavior (McDowell and Caron 2010a, b) suggest an operant explanation for these deviant conversations. The chapter concludes by advocating parents and educators nurture peer relationships at young ages (through reinforcement procedures, as well as antecedent approaches such as John Gottman’s emotional coaching [2011]). These early interventions seem to “inoculate” youngsters from the social pressures and reinforcement for delinquency they will most likely encounter in their school-aged years.

While Chapters 2–4 focus on environmental manipulations to nurture appropriate child development and prosocial behavior, Chapter 5, “The Behavioral Revolution in Clinical Psychology,” is exclusively devoted to psychological flexibility and the third wave of behavior therapy: acceptance and commitment therapy (ACT). The chapter begins much like any other introductory ACT chapter by describing the rise of cognitive behavior therapy (CBT) over psychoanalytic approaches. Biglan’s discussion then transitions to reviewing the schism between radical behaviorism and CBT. Here, Biglan explicitly describes his adoption of Skinnerian approaches early in his career, as well as the blowback he received.

Most of the people who embraced the cognitive movement hadn’t read Skinner, but they were comfortable being dismissive of his theories. On more than one occasion, I encountered sneers from other psychologists. I felt a bit like a persecuted minority. (p. 111)

I think readers will enjoy hearing Biglan’s personal stories regarding his formation of the Behavior Change Center and his struggle finding an appropriate therapy for difficult cases involving depression and anxiety. He describes a turning point in his practice, when he realized, “a different underlying process was at work—one in which thoughts, including private thoughts, were a form of verbal behavior” (pp. 111–112). That quote should lay to rest any concerns of Biglan’s appreciation of Skinner’s radical behaviorism.

Biglan introduces contextual behaviorism and ACT by describing a fortuitous moment in his career: Steve Hayes sending him a book chapter on contextual behaviorism in 1986. Interestingly, Biglan recounts, “…to this day, neither [Hayes] nor I know why he sent me the chapter” (p. 112). Hayes’ contextual account of human behavior (Hayes et al. 2001) had a clear and immediate impact on Biglan’s approach to psychological therapy, as well as his general philosophical approach to behaviorism. The remainder of the chapter provides an excellent primer on ACT—using more of Biglan’s personal accounts and case studies—and succinctly reviews the extant literature on its effectiveness. The praise Biglan sings of ACT in this chapter makes it abundantly clear he is a contextual behaviorist. Yet, the acclaim provided in this chapter is not distracting—it results in a highly engaging, yet straightforward and understandable, account of ACT. Having attempted to learn contextual behaviorism in my free time, I must note this chapter is one of the most lucid and accessible descriptions of ACT I have had the pleasure of reading.

Part 3: “Addressing Well-Being in the Larger Social Context”

Beginning with Chapter 6, “From People to Populations,” Biglan turns his focus to the nurturing of meta- and macrocontingencies (Glenn 2004)—but, of course, Biglan refrains from using behavioral jargon and speaks to “society-wide factors” (p. 127) and “cultural change” (p. 128). Toward this end, Biglan introduces the reader to best practices in public health, epidemiology, and prevention science, defining necessary technical terms such as incidence or prevalence along the way. Chapter 6 is mainly a primer on the behavioral science of public health, with Biglan’s personal examples to illustrate the relevance of behavioral science for policy development. Many of the examples surround Biglan’s high-profile and highly successful work on tobacco control. The cataloged success of behavioral science to impact policy level decisions in Chapter 6 is presented as a springboard for affecting this change in areas of social interest and is discussed further in the remainder of the book.

The dark side of behavioral science, however, is that it can be used to nurture unhealthy and risky behavior, such as smoking and drinking. Chapter 7, “Harmful Corporate Marketing Practices,” explores the ways corporations are effectively arranging contingencies to market cigarettes to teens, alcohol to adolescents, and junk food to anyone with an appetite. In this discussion, Biglan concedes that it is difficult to access quality data on these practices given the proprietary nature of corporate marketing data. He goes as far as saying,

…there currently isn’t sufficient experimental evidence showing that specific practices in marketing alcohol and food contribute to ill health, injury, and death, although considerable correlational evidence shows that they do. Therefore, experimental studies are needed to determine whether exposure to ads for alcoholic beverages or unhealthful foods increases young people’s motivation to drink or to eat those foods. (p. 156)

However, absent from Biglan’s commentary is contemporary research from behavioral economics on cue-elicited cravings for smoking and drinking suggesting that exposure to cues such as advertisements or merely the presence of stimuli associated with these behaviors can elevate markers of demand (e.g., Amlung and MacKillop 2014; MacKillop et al. 2010, 2012). This omission ironically punctuates Biglan’s concern that the successes of behavioral science are not well marketed; in this case, however, it is Biglan that appears to be unaware of these studies.

The impact of socioeconomics on health and well-being takes center stage in Chapter 8, “Poverty and Economic Inequality.” As Biglan illustrates, no one is immune to poverty conditions: “…even if you are middle-class, should you suffer a heart attack or stroke, between the cost of medical care and an inability to work, you could quickly lose your life savings and your home (p. 160).” Biglan goes on to cite an abundance of data suggesting that the USA has a significant poverty problem. These statistics transition to the litany of health problems associated with poverty and potential for behavioral science to intervene. Large-scale policy initiatives are discussed, such as social programs and tax policies.

To the “in-the-trenches” behavioral scientist, affecting substantial policy change will be nearly impossible. The behavioral science approach to nurturing healthy outcomes out of impoverished conditions seems lost in the discussion, despite highly efficacious programs such as the community-reinforcement approach (e.g., Hunt and Azrin 1973; Meyers et al. 2011) or examples like the Juniper Gardens Children’s Project (Greenwood et al. 1992). Nevertheless, the substantive data reviewed by Biglan illuminate not only the significance of poverty on behavior but also the areas in which behavioral scientists should focus their research and treatment efforts.

Part 3 of the The Nurture Effect concludes with Chapter 9, titled, “The Recent Evolution of Corporate Capitalism.” This chapter takes an evolutionary perspective to contemporary corporate capitalism in the USA. Without using fancy behavioral jargon, Biglan describes the meta- and macrocontingencies operating on both big business and American culture. Biglan skillfully ties contextual behaviorism into his account of this shaping of corporate greed and consumer materialism, providing a functional analysis of sorts to these issues. The chapter is summarized nicely by the quote, “Evidence seems to be converging that, for at least the past 50 years, cultural evolution in the United States has been taking us where we don’t want to go” (p. 186). In sum, the contingencies are nurturing the wrong consumer behavior from a public health perspective.

Biglan goes on to propose some lofty, but wise, shifts in the contingencies. “The government could fine cigarette companies for every smoker under the age of 21 who became addicted to their brand, (p. 187)” he writes. Adding, “Or there could be a fine for every alcohol-related car crash among those under 21, levied against the company that produced the beverage involved in the crash (p. 187).” In the absence of sound experimental work, such policy changes are likely to be met with fierce political opposition. For example, which agency or person should be fined in such an event? What is the magnitude of such fines? Such proposals raise more questions than answers, but at least Biglan’s proposals might promote discussion. Using the example of Mothers Against Drunk Driving (MADD), Biglan proposes that change agents can take a grass-roots advocacy approach to affecting policy change, providing a necessary critical mass or momentum to break through political obstacles associated with lobbyists and governmental regulatory red-tape. The chapter concludes with sage advice that we should advocate for empirical public policy, making sure to sufficiently evaluate both prevention and intervention efforts at even the largest of scales.

Part 4: “Evolving the Nurturing Society”

Part 4 of The Nurture Effect begins with an inspiring quote: “Can we translate all that we have learned about human behavior in the past 40 years into truly revolutionary changes in society? I think we can (p. 193).” The optimism in Biglan’s claim is defended across Chapters 10 and 11, to round out the book. As evidenced by the title of Part 4, these final two chapters provide evidence of and suggestions for a behavioral science approach to enriching the prosociality and health of our culture.

In Chapter 10, “In Caring Relationships with Others,” Biglan summarizes the problems with coercive behavior management practices, clearly echoing Skinner (1971) and Sidman’s (1989) messages on this issue. The behavioral-science suggestions from Part 2 of the book are not only succinctly revisited but also reinvigorated in the form of rah-rah-ing behavior analysts to take up the flag for “cultivating forbearance and forgiveness” (p. 201) through the strategic use of positive consequences and enriched environments (aka, nurturing). The inspirational tone of the writing picks up pace, motivating the reader to become excited about how close we are to achieving a more positive culture through behavioral science. Of course, ACT is again implicated in the message, with Biglan challenging the reader to be mindful of the contingencies in the environment, as well as exercising psychological flexibility to accept the negativity of the world around us—don’t suppress it—and commit to sound, empirically based, behavioral science to improve those conditions.

The final chapter (Chapter 11, “Evolving the Society We Want”) begins with an idyllic view of the future in the year 2042. In this fictional future, public health has improved dramatically, there is bipartisan support for social issues, and advocacy groups are making meaningful differences on the political landscape. This is an optimistic view of the future of the USA. However, as Biglan suggests, such “optimism is not a substitute for action (p. 212).” Chapter 11 is about creating the requisite action to evolve towards such a society.

Throughout Chapter 11, Biglan continues his crusade-inspiring cheerleading that began in Chapter 10, directing the reader to adopt “creative epidemiology” (p. 214) to frame public health data with in-your-face metrics that cannot be ignored or misunderstood. In that respect, Biglan also encourages the reader to promote the empiricism of behavioral science with such creativity. There are no Action Implications to conclude Chapter 11, as the entire chapter is chock full of action suggestions to make possible all the good that The Nurture Effect promises in Biglan’s vision of a sustainable, nurturing world. The chapter ends with an uplifting personal statement from Biglan to the reader: “I hope you’ll join me in working toward realizing this vision” (p. 225). If you read The Nurture Effect and appreciate empiricism and behavioral science, you can’t help but answer, “I’m in.”

Summary

Take Baer, Wolf, and Risley’s dimensions of behavior analysis (1968), sprinkle in Wolf’s social validity (1978), garnish with Hayes’ ACT (2004) while taking it to scale using Seekins and Fawcett’s recommendations (1989) and you get The Nurture Effect. If that’s not a recipe for a behavior analytic homerun, I clearly don’t understand behavior analysis. Anthony Biglan has cooked up this recipe—adding his own public health and prevention science zest—throughout his career. The resulting compendium of his work is impressive to any social scientist, public health advocate, or epidemiologist. It is thereby a treat to read Biglan’s account and views on the shaping of our culture and what must be done to turn degeneration around to a prosocial and healthy evolution. We have the science, the data, and the know-how to make big changes to our lives and our world.

The Nurture Effect is perfect for inclusion in any survey level behavioral science course, and would make for a great resource in advanced courses on community interventions or behavioral systems. Likewise, this book is a strategic way to introduce someone to the field of behavioral science, if not ABA. (As I indicated at the beginning of this review, I will be suggesting that students hoping to pursue a career in our field share this book with their family and friends.) The accessible writing, colorful examples, and personal descriptions of behavioral science paint our field in a way we have not yet seen in a popular press book.

If there are any regrets regarding the book, it is simply that “behavior analysis” was not specifically referenced. Outside of the terms “Association for Behavior Analysis” or “Journal of Applied Behavior Analysis,” “behavior analysis” appears only once in the 226 pages of Biglan’s text. Moreover, Biglan references Journal of Applied Behavior Analysis only three times in the entire book. Counting the frequency of the term, “behavior analysis,” may seem petty, but the low occurrence is unfortunate, as a large and diverse audience will likely read this book. The Nurture Effect is nevertheless very supportive of behavior analysis—Biglan is a behavior analyst, after all—but naïve readers won’t associate the content with this term. Nonetheless, Skinner advocated that we teach function before form (1957); hooking readers with the promise of behavioral success would be a fantastic outcome of The Nurture Effect. Only time will tell whether this outcome is realized.

With The Nurture Effect, Biglan has provided the perfect primer for the rest of us to launch behavioral science beyond the pages of our safe and friendly behavioral journals. Let’s do our best—and our part, as behavior analysts—to nurture the momentum from this book to improve lives, as well as the world.