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.

Universal Background Checks For Handgun Purchases Can Reduce Homicide Rates Of African Americans

Elinore Kaufman, U of Penn
Jun. 1, 2020

Elinore J. Kaufman, Christopher N. Morrison, Erik J. Olson, David K. Humphreys, Douglas J. Wiebe, Niels D. Martin, Carrie A. Sims, Mark H. Hoofnagle, C. William Schwab, Patrick M. Reilly, Mark J. Seamon

Abstract [from journal]

Background: Federal law requires background checks for firearms purchased from licensed dealers, but states can extend requirements to private sales of handguns and purchases at gun shows (universal background checks for handguns [UBC-HG]). Although firearm homicide disproportionately affects African Americans, little is known about how UBG-HG impacts African Americans. We hypothesized that implementation of UBC-HG would reduce rates of firearm homicide of African Americans.

Methods: We


Does Implementing A New Intervention Disrupt Use Of Existing Evidence-Based Autism Interventions?

Rinad Beidas, PhD, U of Penn
May. 20, 2020

Melanie Pellecchia, Rinad S Beidas, Gwendolyn Lawson, Nathaniel J Williams, Max Seidman, John R Kimberly, Carolyn C Cannuscio, David S Mandell

Abstract [from journal]

Interventions for children with autism spectrum disorder are complex and often are not implemented successfully within schools. When new practices are introduced in schools, they often are layered on top of existing practices, with little attention paid to how introducing new practices affects the use of existing practices. This study evaluated how introducing a computer-assisted intervention, called TeachTown:Basics, affected the use of other evidence-based practices in autism support classrooms. We compared how


Early Childhood Sleep Intervention In Urban Primary Care: Clinician And Caregiver Perspectives

Alexander G. Fiks, MD, MSCE
May. 20, 2020

Ariel A Williamson, Izabela Milaniak, Bethany Watson, Olivia Cicalese, Alexander G Fiks, Thomas J Power, Frances K Barg, Rinad S Beidas, Jodi A Mindell, Katharine A Rendle

Abstract [from journal]

Background: Despite significant income-related disparities in pediatric sleep, few early childhood sleep interventions have been tailored for or tested with families of lower socio-economic status (SES). This qualitative study assessed caregiver and clinician perspectives to inform adaptation and implementation of evidence-based behavioral sleep interventions in urban primary care with families who are predominantly of lower SES.

Methods: Semi-structured interviews were


COVID-19 Pandemic: Every Day Feels Like A Weekday To Most

Konrad Kording, University of Pennsylvania professor
May. 18, 2020

Tony Liu, Jonah Meyerhoff, David C Mohr, Lyle H Ungar, Konrad P Kording

Abstract [from journal]

The COVID-19 outbreak has clear clinical and economic impacts, but also affects behaviors e.g. through social distancing, and may increase stress and anxiety. However, while case numbers are tracked daily, we know little about the psychological effects of the outbreak on individuals in the moment. Here we examine the psychological and behavioral shifts over the initial stages of the outbreak in the United States in an observational longitudinal study. Through GPS phone data we find that homestay is increasing, while being at work


Annual Prevalence Of Use Of Potentially Inappropriate Medications For Treatment Of Affective Disorders In Parkinson's Disease

May. 18, 2020

Danielle S. Abraham, Thanh Phuong Pham Nguyen, Sean Hennessy, Shelly L. Gray, Dawei Xie, Daniel Weintraub, Allison W. Willis

Abstract [from journal]

Objective: To examine the national prevalence of pharmacological treatment of affective disorders in older adults with Parkinson's disease (PD), and determine the prevalence and risk factors for receipt of an American Geriatrics Society Beers Criteria® defined potentially inappropriate medication (PIM) for affective disorder treatment.

Design: Cross-sectional analysis of 2014 Medicare data.

Setting: Research Identifiable File data from the Centers for Medicare and


Are Sexual Minority Stressors Associated With Young Men Who Have Sex With Men's (YMSM) Level Of Engagement In PrEP?

José Bauermeister
May. 13, 2020

Steven Meanley, Cristian Chandler, Jessica Jaiswal, Dalmacio D. Flores, Robin Stevens, Daniel Connochie, José A Bauermeister

Abstract [from journal]

Sexual minority stressors (community homophobia, sexuality-related discrimination, and internalized homonegativity) are negatively associated with accessing HIV prevention services among men who have sex with men (MSM). Few studies have tested minority stressors' associations with PrEP engagement among high-HIV risk young MSM (YMSM). Therefore, we assessed the associations between PrEP-indicated YMSM's progression along the PrEP continuum and their experiences of minority stress. N = 229 YMSM completed a web-survey on PrEP-related behaviors and minority...

Framing Social Comparison Feedback With Financial Incentives For Physical Activity Promotion: A Randomized Trial

May. 11, 2020

Mitesh S Patel, David A Asch, Roy Rosin, Dylan S Small, Scarlett L Bellamy, Karen Hoffer, David Shuttleworth, Victoria Hilbert, Jingsan Zhu, Lin Yang, Xingmei Wang, Kevin G Volpp

Abstract [from journal]

Background: Social comparison feedback is often used in physical activity interventions but the optimal design of feedback is unknown.

Methods: This 4-arm, randomized trial consisted of a 13-week intervention period and 13-week follow-up period. During the intervention, 4-person teams were entered into a weekly lottery valued at about $1.40/day and contingent on the team averaging ≥7000 steps per day. Social comparison feedback on performance was delivered weekly for 26 weeks, and varied by reference point (50th vs...

Nudging Clinicians Toward Higher-Value Cancer Care

May. 5, 2020

In a new study published in JAMA Oncology, my colleagues and I find that behavioral nudges can promote high-value, evidence-based prescribing of specialty drugs in cancer care. For patients with breast, lung, and prostate cancer with bone metastases, clinicians face a decision between two therapies of comparable effectiveness but dramatically different cost.

Neuropsychiatric Symptom Profiles of Community-Dwelling Persons Living with Dementia: Factor Structures Revisited

May. 4, 2020

Natalie G. Regier, Nancy A. Hodgson, Laura N. Gitlin

Abstract [from journal]

Objectives: Most persons living with dementia (PLWD) will develop neuropsychiatric symptoms (NPS) at some point. NPS are often clustered into subsyndromes with other, related symptoms, but the evidence supporting commonly-used clusters is insufficient. We reexamine behavioral clusters in community-dwelling PLWD, and identify associated risk factors and potential contributors.

Methods: This study used baseline data from a longitudinal behavioral intervention study of 250 community-dwelling older adults with


Attitudes Toward Fertility Preservation Among Transgender Youth and Their Parents

Apr. 29, 2020

Rebecca W. Persky, Siobhan M. Gruschow, Ninet Sinaii, Claire Carlson, Jill P. Ginsberg, Nadia L. Dowshen

Abstract [from journal]

Purpose: While gender-affirming hormones (GAH) may impact the fertility of transgender and gender diverse (TGGD) youth, few pursue fertility preservation (FP). The objective of this study is to understand youth and parent attitudes toward FP decision-making.

Methods: This study is a cross-sectional survey of youth and parents in a pediatric, hospital-based gender clinic from April to December 2017. Surveys were administered electronically, containing 34 items for youth and 31 items for parents regarding desire


Racial and Ethnic Differences in Emergency Department Pain Management of Children With Fractures

Apr. 20, 2020

Monika K. Goyal, Tiffani J. Johnson, James M. Chamberlain, Lawrence Cook, Michael Webb, Amy L. Drendel, Evaline Alessandrini, Lalit Bajaj, Scott Lorch, Robert W. Grundmeier, Elizabeth R. Alpern

Abstract [from journal]

Objectives: To test the hypotheses that minority children with long-bone fractures are less likely to (1) receive analgesics, (2) receive opioid analgesics, and (3) achieve pain reduction.

Methods: We performed a 3-year retrospective cross-sectional study of children <18 years old with long-bone fractures using the Pediatric Emergency Care Applied Research Network Registry (7 emergency departments). We performed bivariable and multivariable logistic regression to measure the association between patient race


Awareness, Attitudes, and Actions Related to COVID-19 Among Adults With Chronic Conditions at the Onset of the U.S. Outbreak: A Cross-sectional Survey

Apr. 9, 2020

Michael S. Wolf, Marina Serper, Lauren Opsasnick, Rachel M. O'Conor, Laura M. Curtis, Julia Yoshino Benavente, Guisselle Wismer, Stephanie Batio, Morgan Eifler, Pauline Zheng, Andrea Russell, Marina Arvanitis, Daniela Ladner, Mary Kwasny, Stephen D. Persell, Theresa Rowe,...

Abstract [from journal]

Background: The evolving outbreak of coronavirus disease 2019 (COVID-19) is requiring social distancing and other measures to protect public health. However, messaging has been inconsistent and unclear.

Objective: To determine COVID-19 awareness, knowledge, attitudes, and related behaviors among U.S. adults who are more vulnerable to complications of infection because of age and comorbid conditions.

Design: Cross-sectional survey linked to 3 active clinical trials and 1 cohort study.


Beliefs Associated with Intention to Use PrEP Among Cisgender U.S. Women at Elevated HIV Risk.

Anne M. Teitelman, PhD, CRNP
Apr. 8, 2020

Anne M. Teitelman, Deepti Chittamuru, Beryl A. Koblin, Annet Davis, Bridgette M. Brawner, Danielle Fiore, Tarashon Broomes, Geneva Ortiz, Debbie Lucy, Hong-Van Tieu 

Abstract [from journal]

Women comprise 19% of those newly diagnosed with HIV in the U.S. There is a wide gap between recommended use of pre-exposure prophylaxis (PrEP) and actual uptake among women who are eligible for PrEP. In order to identify women's beliefs and intentions about starting PrEP, a survey, informed by the reasoned action approach, was administered to 160 cisgender PrEP-eligible women, age 18-55, in Philadelphia and New York City. The mean age was 40.2 years (SD = 11.78), 44% had completed high school, 75% were unemployed, and 85% experienced financial


Applying Behavioral Economics to Enhance Safe Firearm Storage

Mar. 1, 2020

Katelin Hoskins, Unmesha Roy Paladhi, Caitlin McDonaldAlison Buttenheim

Abstract [from journal]

Behavioral economics applies key principles from psychology and economics to address obstacles to behavior change. The important topic of pediatric firearm injuries has not yet been explored through a behavioral economic lens. Pediatric firearm-related injuries are a significant public health problem in the United States. Despite American Academy of Pediatrics guidelines advising that firearms be stored unloaded, in a locked box or with a locking device, and separate from ammunition, estimates suggest that ∼4.6 million children live in homes with at