Healthy Behaviors: Research

Loss-Framed Financial Incentives and Personalized Goal-Setting to Increase Physical Activity among Ischemic Heart Disease Patients Using Wearable Devices: The ACTIVE REWARD Trial

Jun. 13, 2018

Neel P. Chokshi, Srinath AdusumalliDylan S. Small, Alexander Morris, Jordyn Feingold, ...

ABSTRACT [FROM JOURNAL] 

Background: Regular physical activity reduces the risk of cardiovascular events, but most ischemic heart disease (IHD) patients do not obtain enough.

Methods and Results: ACTIVE REWARD (A Clinical Trial Investigating Effects of a Randomized Evaluation of Wearable Activity Trackers with Financial Rewards) was a 24‐week home‐based, remotely monitored, randomized trial with a 16‐week intervention (8‐week ramp‐up incentive phase and 8

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Conditional Admission, Religious Exemption Type, and Nonmedical Vaccine Exemptions in California Before and After a State Policy Change

May. 25, 2018

Alison M. Buttenheim, Malia Jones, Caitlin Mckown, Daniel Salmon, Saad B. Omerd

Abstract [from journal]

Recent measles and pertussis outbreaks in the US have focused national attention on state laws governing exemptions from mandatory vaccines for school entry. After several years of increases in nonmedical exemptions in California, the state assembly passed Assembly Bill 2109 in 2012, making

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Trends in P2Y12 Receptor Inhibitor Use and Adherence After Percutaneous Coronary Intervention, 2008-2016

Research Brief
May. 25, 2018

Post-angioplasty, patient adherence to recommended antiplatelet therapy decreased when newer, more expensive drugs were introduced. From 2008-2016, as the use of newer agents increased, the proportion of patients not filling any antiplatelet prescription within 30 days of discharge increased from 6.4% to 19.1%. In the subsequent 12 months, the newer drugs were associated with higher patient costs and lower adherence to recommended therapy.

A Pragmatic Trial of E-Cigarettes, Incentives, and Drugs for Smoking Cessation

Research Brief
May. 25, 2018

In a trial examining five approaches to smoking cessation among over 6,000 U.S. employees, financial incentives combined with free cessation aids were more effective at getting employees to stop smoking than free cessation aids alone. Specifically, the most effective intervention (free cessation aids plus $600 in redeemable funds) helped 2.9% of participants stop smoking through six months after their target quit date; this rate jumped to 12.7% among participants who actively engaged in the trial and were more motivated to quit. For employees with access to usual care (information and a free motivational text messaging service), offering free cessation aids or electronic cigarettes (e-cigarettes) did not help them quit smoking.

Support for Self-Management and Prenatal Health Behavior Change: Implications for Pediatric Promotion of Interconception Care

Apr. 13, 2018

Emily F. Gregory, Charmaine S. Wright, Meredith Matone, ...

Abstract [from journal]

Pediatricians increasingly endorse a dual generation approach to health, in which parental health behaviors are recognized as critical to promoting child health. Positive parental behaviors often emerge during pregnancy, for reasons that remain incompletely described. We surveyed mothers in the immediate postpartum period to identify beliefs about health behavior change and characteristics of prenatal care associated with successful change. Sampling at a tertiary care hospital captured an English-speaking adult population with healthy infants. Respondents (...

Partners and Alerts in Medication Adherence: A Randomized Clinical Trial

Mar. 27, 2018

Abstract [from journal]

Background: Poor medication adherence is common and limits the effectiveness of treatment.

Objective: To investigate how social supports, automated alerts, and their combination improve medication adherence.

Design: Four-arm, randomized clinical trial with a 6-month intervention.

Participants: A total of 179 CVS health employees or adult dependents with CVS Caremark prescription coverage, a current daily statin prescription, a medication possession ratio less than 80%,...

Assaults on Days of Campaign Rallies During the 2016 US Presidential Election

Mar. 20, 2018

Christopher N. Morrison, Benjamin Ukert, Aimee Palumbo, Beidi Dong, Sara Jacoby, ...

In Epidemiology, Christopher Morrison and colleagues, including Benjamin Ukert, Sara Jacoby, and Douglas Wiebe, examine whether the number of assaults increased in cities on days when candidates Donald Trump and Hillary Clinton held campaign rallies leading up to the 2016 Presidential election. Focusing on U.S. cities with populations greater than 200,000, the authors calculated counts of police-reported assaults (aggravated assaults, simple assaults, and/...

Incentive Design and Quality Improvements: Evidence from State Medicaid Nursing Home Pay-for-Performance Programs

Feb. 1, 2018

R. Tamara Konetzka, Meghan M. Skira and Rachel M. Werner

In the American Journal of Health Economics, Rachel Werner and colleagues analyze how incentive design affects quality improvements in the nursing home setting, where several state Medicaid agencies have implemented pay-for-performance (P4P) programs that vary in incentive structure. Using the Minimum Data Set and the Online Survey, Certification, and Reporting data from 2001 to 2009, the authors examine how the weights put on various performance measures that are tied to P4P bonuses, such as clinical outcomes, inspection deficiencies, and staffing levels, affect improvements in...

Using Wearable Devices and Smartphones to Track Physical Activity: Initial Activation, Sustained Use, and Step Counts Across Sociodemographic Characteristics in a National Sample

Dec. 3, 2017

Mitesh S. Patel, Luca Foschini, Gregory W. Kurtzman, Jingsan Zhu, Wenli Wang, Charles A.L. Rareshide, Susan M. Zbikowski

In Annals of Internal Medicine, Mitesh Patel and colleagues describe rates of initial use of activity trackers, sustained use after 6 months, and step counts across different sociodemographic characteristics from a wellness program offered across the United States. Many large employers are using data collected from wearable devices and smartphones in workplace wellness programs; however, the characteristics of persons who use these devices are poorly understood.

Mean daily step count and sociodemographic characteristics between 2014 and 2015 were obtained from Humana for...

The Short- and Long-Term Effects of Smoking Cessation on Alcohol Consumption

Dec. 1, 2017

In the International Journal of Health Economics and Management, Benjamin Ukert examines short- and long-term effects of quitting smoking on alcohol consumption. Most interventions have focused on reducing either cigarette or alcohol consumption to address the severe health and economic consequences of both risky behaviors, while ignoring how they interact.

To estimate the relationship between smoking and alcohol consumption, the author utilizes data from the Lung Health Study (LHS), a randomized smoking...

Ridesharing and Motor Vehicle Crashes in 4 US Cities: An Interrupted Time-Series Analysis

Oct. 30, 2017

Christopher N. Morrison, Sara F. Jacoby, Beidi Dong, M. Kit Delgado, Douglas J. Wiebe 

In the American Journal of Epidemiology, Christopher Morrison and colleagues, including Sara Jacoby, M. Kit Delgado, and Douglas Wiebe, investigated if ridesharing, specifically if using Uber, reduces the rate of motor vehicle crashes.

The authors conducted an interrupted time series analyses using weekly counts of injury crashes and the proportion that were alcohol-involved in four US cities where Uber had piloted, abruptly ceased operations, and then abruptly resumed (Las Vegas, NV; Portland, OR; Reno, NV; San Antonio, TX). The authors hypothesized that Uber’s resumption...

Community Health Worker Support For Disadvantaged Patients With Multiple Chronic Diseases: A Randomized Clinical Trial

Research Brief
Aug. 21, 2017

Community health worker interventions hold promise for improving outcomes of low-income patients with multiple chronic diseases.

Active Choice and Financial Incentives to Increase Rates of Screening Colonoscopy – a Randomized Controlled Trial

Jul. 26, 2017

Shivan J. Mehta, Jordyn Feingold, Matthew Vandertuyn, Tess Niewood, Catherine Cox, Chyke A. Doubeni, Kevin G. Volpp, David A. Asch

In Gastroenterology, Shivan Mehta and colleagues, including Chyke Doubeni, Kevin Volpp, and David Asch, examine various behavioral economics approaches to increase uptake for colorectal cancer screening. The authors assigned 2,245 individuals, all employees of a large academic health system, to one of three interventions: an e-mail containing a phone number for scheduling (control), an e-mail with the active choice to opt in or opt out (active choice), or the active choice e-mail plus a $100 incentive (financial incentive). Participants were followed to determine whether they got...

Calorie Underestimation When Buying High-Calorie Beverages in Fast-Food Contexts

Jul. 14, 2017

Rebecca L. Franckle, Jason P. Block, Christina A. Roberto

In American Journal of Public Health, Rebecca Franckle and colleagues, including Christina Roberto, assess calorie estimation, particularly in high-calorie beverages, among adolescents and adults visiting fast-food restaurants. Previous research has shown that people eating at fast-food restaurants underestimate the caloric content of their purchases, but little is known about whether purchasing beverages affects calorie estimates. Because beverages are generally not the central focus of a meal and can be consumed quickly and with little effort, it is possible that people fail to...

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