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.

Analysis Of Multicenter Clinical Trials With Very Low Event Rates

Nov. 9, 2020

Jiyu Kim, Andrea B. TroxelScott D. HalpernKevin G. Volpp, Brennan C. Kahan, Tim P. Morris, Michael O. Harhay

Abstract [from journal]

Introduction: In a five-arm randomized clinical trial (RCT) with stratified randomization across 54 sites, we encountered low primary outcome event proportions, resulting in multiple sites with zero events either overall or in one or more study arms. In this paper, we systematically evaluated different statistical methods of accounting for center in settings with low outcome event proportions.

Methods: We conducted a simulation study and a reanalysis of a completed RCT to compare five popular

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A Qualitative Study Of Parents With Children 6 To 12 Years Old: Use Of Restaurant Calorie Labels To Inform The Development Of A Messaging Campaign

Nov. 1, 2020

Sophia V. Hua, Kimberly Sterner-Stein, Frances K. Barg, Aviva A. Musicus, Karen Glanz, Marlene B. Schwartz, Jason P. Block, Christina D. Economos, James W. Krieger, Christina A. Roberto

Abstract [from journal]

Background: US law mandates that chain restaurants with 20 or more locations post calorie information on their menus to inform consumers and encourage healthy choices. Few qualitative studies have assessed how parents perceive and use this information when ordering for their children and what types of accompanying messages might increase use of calorie labels when ordering food.

Objective: We aimed to better understand parents' perceptions and use of calorie labeling and the types of messages

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Racial Inequity in Fatal U.S. Police Shootings, 2015–2020

Oct. 27, 2020

Elle Lett, Emmanuella Ngozi Asabor, Theodore Corbin, Dowin Boatright

Abstract [from journal]

Introduction: Violent encounters with police represent a significant cause of morbidity and mortality in the USA, especially among Black, Indigenous, and People of Colour (BIPOC). This study characterises trends in fatal police shootings overall and by armed status and quantifies inequities in mortality burden and years of life lost (YLL) across racial/ethnic groups.

Methods: Longitudinal study of Washington Post data on fatal police shootings in the USA

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Benchmarking Critical Care Well-Being: Before And After The Coronavirus Disease 2019 Pandemic

Oct. 21, 2020

Sofia Gomez, Brian J. Anderson, Hyunmin Yu, Jacob Gutsche, Juliane Jablonski, Niels Martin, Meeta Prasad KerlinMark E. Mikkelsen

Abstract [from journal]

Objectives: Examine well-being, measured as burnout and professional fulfillment, across critical care healthcare professionals, ICUs, and hospitals within a health system; examine the impact of the coronavirus disease 2019 pandemic.

Design: To complement a longitudinal survey administered to medical critical care physicians at the end of an ICU rotation, which began in May 2018, we conducted a cross-sectional survey among critical care professionals across four hospitals in December 2018 to

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Prediction Models For Physical, Cognitive, And Mental Health Impairments After Critical Illness: A Systematic Review And Critical Appraisal

Oct. 15, 2020

Kimberley J. Haines, Elizabeth Hibbert, Joanne McPeake, Brian J. Anderson, Oscar Joseph Bienvenu, Adair Andrews, Nathan E. Brummel, Lauren E. Ferrante, Ramona O. Hopkins, Catherine L. Hough, James Jackson, Mark E. Mikkelsen, Nina Leggett, Ashley Montgomery-Yates, Dale M. Needham, Carla M. Sevin...

Abstract [from journal]

Objectives: Improved ability to predict impairments after critical illness could guide clinical decision-making, inform trial enrollment, and facilitate comprehensive patient recovery. A systematic review of the literature was conducted to investigate whether physical, cognitive, and mental health impairments could be predicted in adult survivors of critical illness.

Data sources: A systematic search of PubMed and the Cochrane Library (Prospective Register of Systematic Reviews ID:

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The Impact of Intentionality of Injury and Substance Use History on Receipt of Discharge Opioid Medication in a Cohort of Seriously Injured Black Men

Oct. 14, 2020

Shoshana V. Aronowitz, Sara F. Jacoby, Peggy Compton, Justine Shults, Andrew Robinson, Therese S. Richmond 

Abstract [from journal]

Black patients are less likely than white patients to receive pain treatment, especially opioids, for both acute and chronic pain. Black men are at higher risk than other populations of being "assumed criminal" regardless of any involvement in criminal activity. Additionally, certain injury and patient characteristics such as intentionality of injury and substance use history may lead providers to suspect criminal involvement and impact pain treatment decisions. The purpose of this study was to describe factors that predict receipt

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"This Could Mean Death For My Child": Parent Perspectives On Laws Banning Gender-Affirming Care For Transgender Adolescents

Amy Hillier, PhD, MSW
Oct. 13, 2020

Kacie M. Kidd, Gina M. Sequeira, Taylor Paglisotti, Sabra L. Katz-Wise, Traci M. Kazmerski, Amy Hillier, Elizabeth Miller, Nadia Dowshen

Abstract [from journal]

Objectives: Numerous U.S. state legislatures have proposed bills to ban gender-affirming medical interventions for minors. Parents and caregivers play a critical role in advocating for and supporting their transgender and gender-diverse youth (TGDY). We aimed to understand parent and caregiver perspectives about this potential legislation and perceived effects on their TGDY's mental health.

Methods: We developed and launched a social-media based, anonymous online survey in February 2020 to

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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

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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

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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

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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

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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

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