Behavioral Economics / Behavior Change

The application of principles of economics and psychology to examine how individuals make choices in complex contexts--such as personal finances and health--and to improve these decisions and behaviors.

Real-World Experiences With Generating Real-World Evidence: Case Studies From Pcori's Pragmatic Clinical Studies Program

Oct. 7, 2020

Mark D. Neuman, Michael D. Kappelman, Elliot Israel, Susan S. Ellenberg, Cindy Girman, Jess Robb, Allie Rabinowitz, Anne Trontell

Abstract [from journal]

Background: Over the last decade, randomized studies evaluating outcomes of health care interventions conducted in real-world settings-often termed "pragmatic trials"-have come to be seen as an important means of obtaining relevant, actionable evidence to guide health care decisions. Despite extensive writing on methodological considerations in pragmatic trial design, limited information exists regarding the practical and logistical challenges encountered in carrying out rigorous randomized evaluations in highly


Making The News: Victim Characteristics Associated With Media Reporting On Firearm Injury

Elinore Kaufman, U of Penn
Oct. 4, 2020

Elinore J. Kaufman, Jesse E. Passman, Sara F. JacobyDaniel N. Holena, Mark J. Seamon, Jim MacMillan, Jessica H. Beard

Abstract [from journal]

Firearm injury is a public health crisis in the United States. Selective media coverage may contribute to incomplete public understanding of firearm injury. To better understand how firearm injury is communicated to the public, we analyzed media coverage of intentional, interpersonal shootings in 3 U.S. cities. We hypothesized that multiple shootings and fatal shootings would be more likely to make the news, as would shootings affecting children, women, and white individuals. We compared police department data on shootings to media


Jobs For People With Mental Health Conditions: Trends And Prospects

Morgan Shields
Sep. 23, 2020

Richard G. Frank, Sherry A. M. Glied, Morgan Shields

Abstract [from journal]

Objective: For individuals with serious mental illness, work can play an important role in improving quality of life and community integration. Since the 1960s, demand has shifted away from routine cognitive (e.g., clerical work) and manual skills (warehouse picking and packing) toward nonroutine analytical (computer coding), interpersonal (nursing), and manual skills (home health attendant). This study aimed to determine whether individuals with serious mental illness are likely to hold the types of jobs that are in


Political Partisanship Influences Behavioral Responses To Governors' Recommendations For COVID-19 Prevention In The United States

Sep. 15, 2020

Guy Grossman, Soojong Kim, Jonah M. Rexer, Harsha Thirumurthy

Abstract [from journal]

Voluntary physical distancing is essential for preventing the spread of COVID-19. We assessed the role of political partisanship in individuals' compliance with physical distancing recommendations of political leaders using data on mobility from a sample of mobile phones in 3,100 counties in the United States during March 2020, county-level partisan preferences, information about the political affiliation of state governors, and the timing of their communications about COVID-19 prevention. Regression analyses examined how political


Effect Of Peer Mentors In Diabetes Self-management vs Usual Care On Outcomes In US Veterans With Type 2 Diabetes

Judith Long, MD, Penn Internal General Medicine
Sep. 11, 2020

Judith A. Long, Valerie S. Ganetsky, Anne Canamucio, Tanisha N. Dicks, Michele Heisler, Steven C. Marcus

Abstract [from journal]

Importance:  Diabetes is a substantial public health issue. Peer mentoring is a low-cost intervention for improving glycemic control in patients with diabetes. However, long-term effects of peer mentoring and creation of sustainable models are not well studied.

Objective:  Assess the effects of a peer support intervention for improving glycemic control in patients with diabetes and evaluate a model in which former mentees serve as mentors.

Design, Setting, and Participants:  A...

The Impact Of Socially Stigmatized Preexisting Conditions On Outcomes After Injury

Sep. 8, 2020

Lucy W. Ma, Elinore J. Kaufman, Justin S. Hatchimonji, Ruiying Xiong, Dane R. Scantling, Jordan B. Stoecker, Daniel N. Holena

Abstract [from journal]

Background: Socially stigmatized preexisting conditions (SSPECs), including alcohol use disorder (AUD), drug use disorder (DUD), and major psychiatric illness, may lead to provider minimization of patient symptoms and have been associated with negative outcomes. However, the impact of SSPECs on failure to rescue (FTR) has not been evaluated. We hypothesized that SSPEC patients would have increased probability of complications, mortality, and FTR.

Materials and methods: We performed a


Self-Efficacy Of Family Caregivers Of Older Adults With Cognitive Impairment: A Concept Analysis

Sep. 4, 2020

Tarik S. Khan, Karen B. Hirschman, Matthew D. McHugh, Mary D. Naylor

Abstract [from journal]

Background: Research demonstrates that increased self-efficacy can help family caregivers of older adults with Alzheimer's and other types of cognitive impairment experience lower burden and depressive symptom severity.

Aims: The purpose of this concept analysis is to address fundamental gaps in the understanding of self-efficacy in family caregivers of older adults with cognitive impairment, including updating the 26-year-old concept analysis with a contemporary definition.


Evaluating The Quality Of Research Ethics Review And Oversight: A Systematic Analysis Of Quality Assessment Instruments

Holly Fernandez Lynch 160
Aug. 21, 2020

Holly Fernandez Lynch, Mohamed Abdirisak, Megan Bogia, Justin Clapp

Abstract [from journal]

Background: Research ethics review committees (RERCs) and Human Research Protection Programs (HRPPs) are responsible for protecting the rights and welfare of research participants while avoiding unnecessary inhibition of valuable research. Evaluating RERC/HRPP quality is vital to determining whether they are achieving these goals effectively and efficiently, as well as what adjustments might be necessary. Various tools, standards, and accreditation mechanisms have been developed in the United States and


Neither Mad Nor Bad? The Classification Of Antisocial Personality Disorder Among Formerly Incarcerated Adults

Jason S. Schnittker, PhD
Aug. 17, 2020

Jason Schnittker, Savannah H. Larimore, Hedwig Lee

Abstract [from journal]

Using the National Comorbidity Survey, this study explores the presence and symptoms of antisocial personality disorder (ASPD) among people with varying degrees of contact with the criminal justice system. The study finds an elevated prevalence of ASPD among formerly incarcerated persons, but also that ASPD is not a simple linear function of actual or potential contact with the criminal justice system. For example, among people who have been arrested the prevalence of ASPD is not much greater than among those who committed a crime


Do Physician Incentives Increase Patient Medication Adherence?

Aug. 1, 2020

Edward Kong, John Beshears, David Laibson, Brigitte Madrian, Kevin Volpp, George Loewenstein, Jonathan Kolstad, James J. Choi

Abstract [from journal]

Objective: To test the effectiveness of physician incentives for increasing patient medication adherence in three drug classes: diabetes medication, antihypertensives, and statins.

Data sources: Pharmacy and medical claims from a large Medicare Advantage Prescription Drug Plan from January 2011 to December 2012.

Study design: We conducted a randomized experiment (911 primary care practices and 8,935 nonadherent patients) to test the effect of paying physicians for


The Landscape Of Cardiovascular Clinical Trials In The United States Initiated Before And During COVID-19

Jul. 27, 2020

Senthil Selvaraj, Stephen J. Greene, Sameed Ahmed M. KhatanaAshwin S. Nathan, Scott D. Solomon, Deepak L. Bhatt

Abstract [from journal]

The Coronavirus Disease 2019 (COVID-19) pandemic has taken an unprecedented toll on the American healthcare system and economy. While numerous COVID-19 clinical trials have been initiated in hopes of curtailing its impact, most pre-existing clinical trials have been forced to suspend or limit activity, which itself can have significant consequences. Missed or postponed trial-related assessments may hinder data quality, and heterogeneity in data collection both across the country and over time introduces bias. In addition, COVID-19


The Psychological Benefits Of Marriage And Children In Rural Malawi

Iliana Kohler
Jul. 27, 2020

Shelley Clark, Cassandra Cotton, Rachel Margolis, Hans-Peter Kohler

Abstract [from journal]

Despite an extensive literature on the psychological rewards of marriage and children in high-income countries, research on these relationships in low-income countries remains limited. This paper draws on data from 4,133 adult women and men interviewed in the Malawi Longitudinal Study of Families and Health to examine how marital status, categorized as never, formerly, monogamously, and polygynously married, and number of children are associated with psychological well-being. With respect to marital status, we find that women in


Identifying Risk Factors For Suicidal Ideation Across A Large Community Healthcare System

Jul. 18, 2020

Emily Schriver, Shari Lieblich, Reem AlRabiah, Danielle L. Mowery, Lily A. Brown

Abstract [from journal]

Background: Suicide is the tenth leading cause of death in the United States. Several studies have leveraged electronic health record (EHR) data to predict suicide risk in veteran and military samples; however, few studies have investigated suicide risk factors in a large-scale community health population.

Methods: Clinical data was queried for 9,811 patients from the Penn Medicine Health System who had completed a Patient Health Questionnaire-9 (PHQ-9) documented in the EHR between January