Health Behavior & Communication

Incentives and communication strategies that influence behaviors affecting health. LDI Senior Fellows study financial and non-financial incentives that promote healthy behaviors, and how individuals and communities receive and exchange health information.

Effect of a Decision Aid on Access to Total Knee Replacement for Black Patients With Osteoarthritis of the Knee: A Randomized Clinical Trial

Research Brief
Dec. 8, 2016

An educational video on the risks and benefits of total knee replacement increased the rate of surgery among black patients, in a clinical trial of an intervention that could reduce known racial disparities in treatment of osteoarthritis.

Beyond Books: Public Libraries as Partners for Population Health

Nov. 9, 2016

Anna U. Morgan, Roxanne Dupuis, Bernadette D’Alonzo, Andria Johnson, Amy Graves, Kiahana L. Brooks, Autumn McClintock, Heather Klusaritz, Hillary Bogner, Judith A. Long, David Grande, and Carolyn C. Cannuscio

In Health Affairs, Anna Morgan and colleagues, including Judith Long, David Grande and Carolyn Cannusciodiscuss the importance of public libraries in addressing the social determinants of health and improving population health. The qualitative study describes the work of the Healthy Library Initiative, a partnership between the University of Pennsylvania and the Free Library of Philadelphia, which aims at integrating evidence-based health efforts throughout the Free Library’s fifty-four branches. The authors collected information about the Free Library’s latest...

Rationale and design of a randomized trial of automated hovering for post myocardial infarction patients: The HeartStrong program

Sep. 22, 2016

Andrea B. Troxel, David A. Asch, Shivan J. Mehta, Laurie Norton, Devon Taylor, Tirza A. Calderon, Raymond Lim, Jingsan Zhu, Daniel M. Kolansky, Brian M. Drachman, Kevin G. Volpp

In the American Heart Journal, Andrea Troxel and colleagues, including Kevin Volpp, David Asch and Shivan Mehta, discuss the rationale and design of the HeartStrong program, a randomized controlled trial aimed at increasing medication adherence among patients with coronary artery disease. This trial features three main innovations: first, it uses behavioral economics concepts such as intermittent feedback, regret aversion and the entertainment value of a daily lottery; second, it automates procedures using new technology such as wireless pill bottles and remote feedback; and third...

Participation Rates With Opt-out Enrollment in a Remote Monitoring Intervention for Patients With Myocardial Infarction

Sep. 13, 2016

Shivan J. Mehta, Andrea B. Troxel, Noora Marcus, Christina Jameson, Devon Taylor,  David A. Asch, and Kevin G. Volpp

In JAMA Cardiology, Shivan Mehta and colleagues, including Andrea Troxel, David Asch and Kevin Volpp, evaluate whether an opt-out approach to enrollment, which has been shown to be effective in behavioral economics research, increases participation in a remote monitoring intervention among patients with myocardial infarction. This prospective cohort study compared enrollment rates in a remote monitoring intervention for medication adherence, using an opt-in vs an opt-out approach. Opt-in participants were recruited in the 60 days after discharge by sending a recruitment letter to...

The Influence of Sugar-Sweetened Beverage Warnings - A Randomized Trial of Adolescents’ Choices and Beliefs

Sep. 13, 2016

Eric VanEpps and Christina Roberto 

In the American Journal of Preventive Medicine, Eric VanEpps and Christina Roberto measure the extent to which health-related warning labels on sugar-sweetened beverages influence adolescents’ perceptions of different beverages and their choice of beverages. The authors conducted and analyzed an online survey of 2202 demographically diverse adolescents, aged 12-18. Participants were asked to choose a beverage in a hypothetical vending machine task, rate perceptions of different beverages and indicate their interest in coupons for beverages. The participants were randomly assigned...

Using Video from Mobile Phones to Improve Pediatric Phone Triage in an Underserved Population

Aug. 19, 2016

Brandi Freeman, Stephanie Mayne, A. Russell Localio, Anthony Luberti, Joseph J. Zorc, and Alexander G. Fiks

In Telemedicine and Health, Brandi Freeman and colleagues, including LDI Senior Fellow Alexander Fiks, assess the feasibility, acceptability, and utility of videos sent via mobile phones to enhance pediatric telephone triage for an underserved population with asthma. Asthma is a leading cause of childhood hospitalization, disability and healthcare-related cost. Asthma disproportionately affects Black and Hispanic children, and these populations have been shown to be more likely to use the emergency department as a routine source of sick care. Moreover, telephone triage systems...

Adoption of a portal for the primary care management of pediatric asthma: a mixed method implementation study

Aug. 19, 2016

Alexander G. Fiks ; Nathalie Du Rivage ; Stephanie L. Mayne ; Stacia Finch ; Michelle E. Ross ; Kelli Giacomini ; Andrew Suh ; Banita McCarn ; Elias Brandt ; Dean Karavite ; Elizabeth W. Staton ; Laura P. Shone ; Valerie McGoldrick ; Kathleen Noonan ; Dorothy...

In the Journal of Medical Internet Research, LDI Senior Fellows Alexander Fiks and Kathleen Noonan and colleagues evaluate the feasibility of using a patient portal for pediatric asthma in primary care, its impact on management and the barriers and facilitators of implementation success. Patient portals improve communication between families of children with asthma and their primary care providers as well as outcomes. This mixed-methods multi-site (11 states) study used 10 clinician focus groups, 22 semi-structured parent interviews and surveys that were sent to the parents...

What Do Hospitalized Patients Say Would Be Worse Than Death?

Aug. 16, 2016

[cross-posted with the Health Cents blog on philly.com]

In caring for hospitalized patients with serious illnesses, and in evaluating interventions designed to help them, clinicians and researchers often focus on death as the primary outcome to be avoided. We tend to pay less attention to avoiding other outcomes that may be equally or more unacceptable to some patients.

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