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.

Networked Collective Intelligence Improves Dissemination of Scientific Information Regarding Smoking Risks

Feb. 6, 2020

Douglas Guilbeault, Damon Centola 

Abstract [from journal]

Despite substantial investments in public health campaigns, misunderstanding of health-related scientific information is pervasive. This is especially true in the case of tobacco use, where smokers have been found to systematically misperceive scientific information about the negative health effects of smoking, in some cases leading smokers to increase their pro-smoking bias. Here, we extend recent work on 'networked collective intelligence' by testing the hypothesis that allowing smokers and nonsmokers to collaboratively evaluate anti-smoking

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Validation of a Modified Berger HIV Stigma Scale for Use Among Patients with Hepatitis C Virus (HCV) Infection

John Holmes, PhD
Feb. 5, 2020

M. Elle Saine, Tyler M. Moore, Julia E. Szymczak, Laura P. Bamford, Frances K. Barg, Nandita Mitra, Jason Schnittker, John H. Holmes, Vincent Lo Re III

Abstract [from journal]

Background: Stigma around hepatitis C virus (HCV) infection is an important and understudied barrier to HCV prevention, treatment, and elimination. To date, no validated instrument exists to measure patients' experiences of HCV stigma. This study aimed to revise the Berger (2001) HIV stigma scale and evaluate its psychometric properties among patients with HCV infection.

Methods: The Berger HIV stigma scale was revised to ask about HCV and administered to patients with HCV (n = 270) in Philadelphia,

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Integrating Machine-Generated Mortality Estimates and Behavioral Nudges to Promote Serious Illness Conversations for Cancer Patients: Design and Methods for a Stepped-Wedge Cluster Randomized Controlled Trial

Jan. 23, 2020

Christopher R. Manz, Ravi B. Parikh, Chalanda N. Evans, Corey Chivers, Susan H. Regli, Justin E. Bekelman, Dylan Small, Charles A.L. Rareshide, Nina O'Connor, Lynn M. Schuchter, Lawrence N. Shulman, Mitesh S. Patel...

Abstract [from journal]

Introduction: Patients with cancer often receive care that is not aligned with their personal values and goals. Serious illness conversations (SICs) between clinicians and patients can help increase a patient's understanding of their prognosis, goals and values.

Methods and Analysis: In this study, we describe the design of a stepped-wedge cluster randomized trial to evaluate the impact of an intervention that employs machine learning-based prognostic algorithms and behavioral nudges to prompt oncologists to

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Suicide in Foster Care: A High-Priority Safety Concern

Jan. 10, 2020

Lily A. Brown

Abstract [from journal]

Suicide rates among youths in foster care are among the highest in the United States. Despite this fact, many foster-care agencies do not perform universal suicide-risk assessments as part of routine care. This commentary includes an argument for the importance of implementing universal suicide-risk assessments for youths in foster care. Important contextual information that prevents behavioral-health clinicians from implementing universal suicide screenings of youths in foster care is discussed. Several possible strategies for implementing universal

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Multi-Dimensional Characterisation of Global Food Supply from 1961-2013

Jan. 1, 2020

James Bentham, Gitanjali M. Singh, Goodarz Danaei, Rosemary Green, John K. Lin, Gretchen A. Stevens, Farshad Farzadfar, James E. Bennett, Mariachiara Di Cesare, Alan D. Dangour, Majid Ezzati 

Abstract [from journal]

Food systems are increasingly globalized and interdependent and diets around the world are changing. Characterising national food supplies and how they have changed can inform food policies that ensure national food security, support access to healthy diets and enhance environmental sustainability. Here, we analysed data for 171 countries on availability of 18 food groups from the United Nations Food and Agriculture Organization to identify and track multi-dimensional food supply patterns from 1961 to 2013. Four predominant food group combinations

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Patient Phenotypes Help Explain Variation in Response to a Social Gamification Weight Loss Intervention

Dec. 26, 2019

Jeffrey Lienert, Mitesh Patel

Abstract [from journal]

Purpose: This study aims to determine latent classes of study participants using baseline characteristics, explore the patterns within the groups, and determine whether the intervention had differential effects on weight loss across the groups.

Design: Secondary analysis of a completed randomized clinical trial.

Setting: Participants in a gamification intervention with social incentives who were recruited as

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Association of Cognitive Biases with Human Papillomavirus Vaccine Hesitancy: A Cross-Sectional Study

Dec. 20, 2019

Tiffany D. Poares, Alison M. Buttenheim, Avnika B. Amin, Caroline M. Joyce, Rachael M. Porter, Robert A. Bednarczyk, Saad B. Omer

Abstract [from journal]

Given the link between vaccine hesitancy and vaccine-preventable disease outbreaks, it is critical to examine the cognitive processes that contribute to the development of vaccine hesitancy, especially among parents of adolescents. We conducted a secondary analysis of baseline data from a two-phase randomized trial on human papillomavirus to investigate how vaccine hesitancy and intent to vaccinate are associated with six decision-making factors: base rate neglect, conjunction fallacy, sunk cost bias, present bias

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A Randomized Trial to Encourage Healthy Eating Through Workplace Delivery of Fresh Food

Carolyn Cannuscio, ScD
Dec. 16, 2019

Rachel Feuerstein-Simon, Roxanne Dupuis, Ryan Schumacher, Carolyn C. Cannuscio

Abstract [from journal]

Purpose: This study aimed to increase the consumption of home-cooked meals among employees at a large urban worksite through a fully subsidized Community Supported Agriculture (CSA) program.

Design: Randomized trial.

Setting: Worksite in a large northeast city.

Participants: Employees were recruited through flyers, e-mail listservs, and outreach from departmental

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Modification of Everyday Activities and its Association with Self-Awareness in Cognitively Diverse Older Adults

Jason Karlawish, MD of Penn Medicine
Nov. 7, 2019

Danielle Shaked, Preeti Sunderaraman, Jennifer Piscitello, Sarah Cines, Christiane Hale, Davangere Devanand, Jason Karlawish, Stephanie Cosentino

Abstract [from journal]

Cognitive impairment (CI) in older adults is frequently accompanied by difficulty performing complex everyday activities (e.g., managing finances). However, it is unclear if and how older adults with CI modify their activities (i.e., Do individuals continue, monitor, seek help with, change their approach to, or stop different activities?). In the current study, we examined if older adults with CI are concerned about their ability to carry out complex activities, if and how they modify activities based on their concern, and the factors associated with

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Estimating the Effect of Calorie Menu Labeling on Calories Purchased in a Large Restaurant Franchise in the Southern United States: Quasi-Experimental Study

Oct. 30, 2019

Joshua Petimar, Fang Zhang, Lauren Cleveland, Denise Simon, Steven Gortmaker, Michele Polacsek, Sara Bleich, Eric Rimm, Christina Roberto, Jason Block

Abstract [from journal]

Objective: To evaluate whether calorie labeling of menus in large restaurant chains was associated with a change in mean calories purchased per transaction.

Design: Quasi-experimental longitudinal study.

Setting: Large franchise of a national fast food company with three different restaurant chains located in the southern United States (Louisiana, Texas, and Mississippi) from April 2015 until April 2018.

Participants: 104 restaurants with calorie information added

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