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.

Effect of a Game-Based Intervention Designed to Enhance Social Incentives to Increase Physical Activity Among Families: The BE FIT Randomized Clinical Trial

Nov. 8, 2017

Mitesh S. Patel, Emelia J. Benjamin, Kevin G. Volpp, Caroline S. Fox, ...

In JAMA Internal Medicine, Mitesh Patel and colleagues, including Kevin Volpp and Dylan Small, tested the effectiveness of a gamification intervention designed using insights from behavioral economics to increase physical activity. The researchers piloted the Behavioral Economics Framingham Incentive Trial (BE FIT), a randomized clinical trial with a 12-week intervention period and a 12-week follow-up period, among 200 adults (comprising 94 families) enrolled in the Framingham Heart Study.

All participants received daily feedback on whether or not they had achieved their...

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...

Video Analysis of Factors Associated With Response Time to Physiologic Monitor Alarms in a Children’s Hospital

Jul. 11, 2017

Christopher P. Bonafide, A. Russell Localio, John H. Holmes, Vinay M. Nadkarni, Shannon Stemler, Matthew MacMurchy, Miriam Zander, Kathryn E. Roberts, Richard Lin, Ron Keren

In JAMA Pediatrics, Christopher Bonafide and colleagues, including John Holmes and Ron Keren, seek to identify factors associated with nurses' response time to physiologic monitor alarms at the bedside. As nurse response time to bed alarms remains slow, the authors examine patient- and nurse-related factors that affect responses to alarms. The authors video recorded 551 hours of care administered by 38 nurses to 100 children. They find several variables that shorten nurses’ response time to alarms. These include if the patient was on complex care service, if family members were...

Coercion or Caring: The Fundamental Paradox for Adherence Interventions for HIV+ People With Mental Illness

Jul. 3, 2017

Marlene M. Eisenberg, Michael Hennessy, Donna Coviello, Nancy Hanrahan, Michael B. Blank

In AIDS and Behavior, Marlene Eisenberg and colleagues, including Nancy Hanrahan and Michael Blank, examine if a high-intensity HIV-treatment intervention would be perceived as coercive by HIV-positive individuals with serious mental illness. Previous research has shown that potentially coercive mandates during the earliest stages of mental health treatment are associated with later treatment benefits. Furthermore, the prevalence of HIV is significantly higher among populations with mental illness. The authors developed an HIV management regimen that utilized advance practice...

Effect of Electronic Reminders, Financial Incentives, and Social Support on Outcomes After Myocardial Infarction

Jun. 30, 2017

Kevin G. Volpp, Andrea B. Troxel, Shivan J. Mehta, Laurie Norton, Jingsan Zhu, Raymond Lim, Wenli Wang, Noora Marcus, Christian Terwiesch, Kristen Caldarella, Tova Levin, Mike Relish, Nathan Negin, Aaron Smith-...

In JAMA Internal Medicine, Kevin Volpp and colleagues, including Shivan Mehta, Christian Terwiesch, Kristen Caldarella, and David Asch, investigate whether medication reminders, as well as financial and social support, delay re-hospitalization for a vascular event. The authors randomized participants to either a usual care group (the control), or to an intervention using electronic pill bottles, lottery incentives, and social support for medication adherence. The primary measured outcome of this study was time to first vascular-related re-hospitalization or death, but the authors...

Financial Incentives for Adherence to Hepatitis C Virus Clinical Care and Treatment: A Randomized Trial of Two Strategies

Jun. 29, 2017

David A. Wohl, Andrew G. Allmon, Donna Evon, Christopher Hurt, Sarah Ailleen Reifeis, Harsha Thirumurthy, Becky Straub, Angela Edwards, Katie R. Mollan

In Open Forum Infectious Diseases, David Wohl and colleagues, including Harsha Thirumurthy, assess the feasibility of two strategies for financially incentivizing adherence to Hepatitis C (HCV) care among patients with substance use disorders. Previous research has shown that, although rates of a sustained response to the virus (SVR) surpass 90%, patients experiencing substance use disorders may struggle to adhere to HCV care. The authors randomly assigned participants to either a fixed or lottery-based monetary incentive for attending clinic appointments, adhering to medications...