Alison M. Buttenheim, PhD, MBA, is a public health researcher and behavioral epidemiologist who combines her interest in behavioral economics with a focus on improving child health on a global level. She has designed and evaluated interventions to improve parental and family decisionmaking across a broad range of topics, including food access in low-income neighborhoods, childhood obesity, vaccine hesitancy, and participation in large-scale vector control programs .
A New York Times article on a measles outbreak in California several years ago prompted Dr. Buttenheim to look more closely at the factors that influence parents' decisionmaking when it comes to their children's health. "You could really move the needle by paying attention to how parents are making those decisions," she notes.
Household health behavior decisions
Dr. Buttenheim's most recent research focuses on how health behavior decisions are made within households and how socioeconomic and cultural conditions shape those decisions. Her work is designed to provide new insights to help parents make better choices for their children, and to improve take-up of evidence-based preventive services.
An evaluation expert, Dr. Buttenheim has published or consulted on several international evaluations, including school feeding schemes in Laos, household sanitation in Bangladesh, national family planning strategies in Niger and Jordan, and global tobacco surveillance strategies.
Her international work has taken her to Arequipa, Peru, on an NIH-funded project to find new ways to increase participation in a large-scale public health campaigns to control the spread of Chagas disease, an insect-borne disease that affects as many as eight million people in Latin America. Dr. Buttenheim and her colleague, Dr. Michael Z. Levy, have studied the willingness of families in Arequipa to participate in a door-to-door public health campaign to eliminate the parasites that spread Chagas disease.
"Chagas disease is a really, really nasty disease and there's no cure for it once you have it," says Dr. Buttenheim. "So it's really all about prevention." The primary prevention strategy is to spray insecticide inside infested homes. Although more than 5% of children are infected with Chagas disease in some neighborhoods in Arequipa, parents are often reluctant to let public health workers into their homes to spray the insecticide, a practice has proven to be effective.
The research team conducted a 5,000-household randomized trial of three different behavioral economic interventions, with the Ministry of Health's regular public health campaign serving as the control. The interventions included a lottery-based financial incentive, opinion leaders, and logistical assistance and organizations tools to help family schedule and manage sprayings.
Potential global implications
Analyses of the effectiveness and cost-effectiveness of the interventions are ongoing. Findings could contribute to other global health and safety issues in which a family's buy-in is critical, such as bed bug control, fire safety and poisoning prevention.
Dr. Buttenheim is an Associate Professor in the Department of Family and Community Health at the Penn's School of Nursing and an Associate Professor in the Department of Medical Ethics and Health Policy at Penn's Perelman School of Medicine. She graduated magna cum laude from Yale University with a BA in History, earned an MBA from the Stanford University Graduate School of Business and a PhD in Public Health from the University of California, Los Angeles, where she majored in Community Health Sciences and minored in Sociology/Demography. She also completed a postdoctoral fellowship at the Office of Population Research at Princeton University and was a Robert Wood Johnson Foundation Health & Society Scholar at Penn.
You can listen to her describe some of her work here: https://tradeoffs.org/2020/03/12/cc-buttenheim/