Health Behavior & Communication

Incentives and communication strategies that influence behaviors affecting health. LDI Senior Fellows study financial and non-financial incentives that promote healthy behaviors, and how individuals and communities receive and exchange health information.

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


Variability in Clinician Intentions to Implement Specific Cognitive-Behavioral Therapy Components

Dec. 18, 2019

Courtney Benjamin Wolk, Emily M. Becker-Haimes, Jessica Fishman, Nicholas W. Affrunti, David S. Mandell, Torrey A. Creed 

Abstract [from journal]

Background: CBT comprises many discrete components that vary in complexity, but implementation and training efforts often approach CBT as a single entity. We examined variability in clinician intentions to use different structural and interventional components of CBT for three different clinical groups: clients receiving CBT, clients with depression, and clients with anxiety.

Methods: Clinicians (n = 107) trained in


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


Patient Portal Usage and Outcomes Among Adult Patients with Uncontrolled Asthma

Andrea Apter, MD, MA, MSc
Oct. 23, 2019

Andrea J. Apter, Tyra Bryant-Stephens, Luzmercy Perez, Knashawn H. Morales, John T. Howell, Alyssa N. Mullen, Xiaoyan Han, Maryori Canales, Marisa Rogers, Heather Klusaritz, A. Russell Localio 

ABSTRACT [from journal]

Background: Patient-clinician communication, essential for favorable asthma outcomes, increasingly relies on information technology including the electronic heath record-based patient portal. For patients with chronic disease living in low-income neighborhoods, the benefits of portal communication remain unclear.

Objective: To describe portal activities and association with 12-month outcomes among low-income asthma patients formally trained in portal use.

Methods: In a...

Working Memory Development and Motor Vehicle Crashes in Young Drivers

Flaura K. Winston, MD, PhD
Sep. 13, 2019

Elizabeth A. Walshe, Flaura K. Winston, Laura M. Betancourt, Atika Khurana, Kristin Arena, Daniel Romer


Importance: Adolescent drivers have the highest rate of motor vehicle crashes, and among equally novice drivers, crash risk is inversely age graded. Working memory (WM), crucial to driving hazard awareness, is also age graded, with ongoing development into late adolescence. Variability in WM capacity and growth trajectory positions WM as a candidate crash risk factor for study, clinical screening, and possible preventative intervention.

Objective: To test the association between crashes and differential WM development...

Taxes and Front-of-Package Labels Improve the Healthiness of Beverage and Snack Purchases: A Randomized Experimental Marketplace

May. 30, 2019

Rachel B. Acton, Amanda C. Jones, Sharon I. Kirkpatrick, Christina A. Roberto, David Hammond

Abstract [from journal]

Background: Sugar taxes and front-of-package (FOP) nutrition labelling systems are strategies to address diet-related non-communicable diseases. However, there is relatively little experimental data on how these strategies influence consumer behavior and how they may interact. This study examined the relative impact of different sugar taxes and FOP labelling systems on beverage and snack food purchases.

Methods: A total of 3584 Canadians 13 years and older participated in an experimental marketplace study using