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.

Loss-Framed Financial Incentives and Personalized Goal-Setting to Increase Physical Activity among Ischemic Heart Disease Patients Using Wearable Devices: The ACTIVE REWARD Trial

Jun. 13, 2018

Neel P. Chokshi, Srinath AdusumalliDylan S. Small, Alexander Morris, Jordyn Feingold, ...

ABSTRACT [FROM JOURNAL] 

Background: Regular physical activity reduces the risk of cardiovascular events, but most ischemic heart disease (IHD) patients do not obtain enough.

Methods and Results: ACTIVE REWARD (A Clinical Trial Investigating Effects of a Randomized Evaluation of Wearable Activity Trackers with Financial Rewards) was a 24‐week home‐based, remotely monitored, randomized trial with a 16‐week intervention (8‐week ramp‐up incentive phase and 8

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Effect of Social Comparison Feedback on Laboratory Test Ordering for Hospitalized Patients: A Randomized Controlled Trial

May. 31, 2018

Kira Ryskina, C. Jessica Dine, Yevgeniy Gitelman, Damien Leri, Mitesh Patel, Gregory Kurtzman, Lisa Y. Lin, ...

Abstract [from journal]

Background: Social comparison feedback is an increasingly popular strategy that uses performance report cards to modify physician behavior. Our objective was to test the effect of such feedback on the ordering of routine laboratory tests for hospitalized patients, a practice considered overused.

Methods: This was a single-blinded randomized controlled trial. Between January and June 2016, physicians on six general medicine teams at the Hospital of the University of

...

A Pragmatic Trial of E-Cigarettes, Incentives, and Drugs for Smoking Cessation

Research Brief
May. 25, 2018

In a trial examining five approaches to smoking cessation among over 6,000 U.S. employees, financial incentives combined with free cessation aids were more effective at getting employees to stop smoking than free cessation aids alone. Specifically, the most effective intervention (free cessation aids plus $600 in redeemable funds) helped 2.9% of participants stop smoking through six months after their target quit date; this rate jumped to 12.7% among participants who actively engaged in the trial and were more motivated to quit. For employees with access to usual care (information and a free motivational text messaging service), offering free cessation aids or electronic cigarettes (e-cigarettes) did not help them quit smoking.

Conditional Admission, Religious Exemption Type, and Nonmedical Vaccine Exemptions in California Before and After a State Policy Change

May. 25, 2018

Alison M. Buttenheim, Malia Jones, Caitlin Mckown, Daniel Salmon, Saad B. Omerd

Abstract [from journal]

Recent measles and pertussis outbreaks in the US have focused national attention on state laws governing exemptions from mandatory vaccines for school entry. After several years of increases in nonmedical exemptions in California, the state assembly passed Assembly Bill 2109 in 2012, making

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Trends in P2Y12 Receptor Inhibitor Use and Adherence After Percutaneous Coronary Intervention, 2008-2016

Research Brief
May. 25, 2018

Post-angioplasty, patient adherence to recommended antiplatelet therapy decreased when newer, more expensive drugs were introduced. From 2008-2016, as the use of newer agents increased, the proportion of patients not filling any antiplatelet prescription within 30 days of discharge increased from 6.4% to 19.1%. In the subsequent 12 months, the newer drugs were associated with higher patient costs and lower adherence to recommended therapy.

Opioid Discussion in the Twittersphere

Apr. 25, 2018

Rachel L. Graves, Christopher Tufts, Zachary F. Meisel, Dan Polsky, Lyle Ungar, ...

Abstract [from journal]

Background: The rise in opioid use and overdose has increased the importance of improving data collection methods for the purpose of targeting resources to high-need populations and responding rapidly to emerging trends.

Objective: To determine whether Twitter data could be used to identify geographic differences in opioid-related discussion and whether opioid topics were significantly correlated with opioid overdose death rate.

Methods: We filtered approximately 10 billion tweets for keywords...

Attitudes on Technological, Social, and Behavioral Economic Strategies to Reduce Cellphone Use While Driving in Teens

Apr. 25, 2018

Abstract [from journal]

Objective: The majority of U.S. teens admit to handheld cellphone use while driving, an increasingly common cause of crashes. Attitudes towards novel cellphone applications and settings that block use while driving are poorly understood, potentially limiting uptake. We examined teens' willingness to reduce cellphone use while driving and perceptions of potential strategies to limit this behavior.

Methods: Teen drivers (n = 153) aged 16-17 who owned smartphones and admitted to texting while driving completed an online...

Support for Self-Management and Prenatal Health Behavior Change: Implications for Pediatric Promotion of Interconception Care

Apr. 13, 2018

Emily F. Gregory, Charmaine S. Wright, Meredith Matone, ...

Abstract [from journal]

Pediatricians increasingly endorse a dual generation approach to health, in which parental health behaviors are recognized as critical to promoting child health. Positive parental behaviors often emerge during pregnancy, for reasons that remain incompletely described. We surveyed mothers in the immediate postpartum period to identify beliefs about health behavior change and characteristics of prenatal care associated with successful change. Sampling at a tertiary care hospital captured an English-speaking adult population with healthy infants. Respondents (...

Yelp Reviews and Opioids

Apr. 10, 2018

Researchers are discovering that social media offers a window into the lived experience of patients and their caregivers. Using Yelp reviews about US hospitals, our team at Penn’s Center for Health Care Innovation attempted to give voice to these experiences related to pain management and opioids during recent hospital visits.

Partners and Alerts in Medication Adherence: A Randomized Clinical Trial

Mar. 27, 2018

Abstract [from journal]

Background: Poor medication adherence is common and limits the effectiveness of treatment.

Objective: To investigate how social supports, automated alerts, and their combination improve medication adherence.

Design: Four-arm, randomized clinical trial with a 6-month intervention.

Participants: A total of 179 CVS health employees or adult dependents with CVS Caremark prescription coverage, a current daily statin prescription, a medication possession ratio less than 80%,...

A National Survey of Young Women's Beliefs About Quitting Indoor Tanning: Implications for Health Communication Messages

Mar. 21, 2018

Amy Bleakley, Amy Jordan, Morgan E. Ellithorpe, DeAnn Lazovich, Sara Grossman, Karen Glanz

Abstract [from journal]

Indoor tanning is a risk factor for melanoma among young white women. Health communications can be an effective way of reaching this population and promoting behavior change. The purpose of this study was (i) to investigate the associations between intention to quit indoor tanning and attitudes, normative pressure, and efficacy about quitting, and (ii) to identify beliefs about quitting indoor tanning that can be used to design effective health communication messages to reduce skin cancer risk. A national online survey was conducted with 279 non-Hispanic...

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