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.

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

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What State Legislators Say About Medicaid, and Why It Matters

May. 29, 2018

Medicaid’s federal-state partnership structure has long permitted states to adopt modifications to coverage design, including benefits and cost-sharing. That structure, combined with an Administration signaling its support for greater state flexibility and funding constraints, could produce substantial shifts in state Medicaid policy.

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.

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 (...

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%,...

When Physicians Support Financial Penalties to Reduce Low-Value Care (and When They Don’t)

Dec. 16, 2017

Despite professional consensus, guidelines, and national campaigns, physicians continue to provide many low-value services. These services are defined as having little to no benefit, little benefit relative to their cost, or outsized potential harm compared to their benefit. Policies have tried to promote high-value care by altering physician compensation, but have had limited success in part because they are rarely based on theories of physician behavior.

Using Wearable Devices and Smartphones to Track Physical Activity: Initial Activation, Sustained Use, and Step Counts Across Sociodemographic Characteristics in a National Sample

Dec. 3, 2017

Mitesh S. Patel, Luca Foschini, Gregory W. Kurtzman, Jingsan Zhu, Wenli Wang, Charles A.L. Rareshide, Susan M. Zbikowski

In Annals of Internal Medicine, Mitesh Patel and colleagues describe rates of initial use of activity trackers, sustained use after 6 months, and step counts across different sociodemographic characteristics from a wellness program offered across the United States. Many large employers are using data collected from wearable devices and smartphones in workplace wellness programs; however, the characteristics of persons who use these devices are poorly understood.

Mean daily step count and sociodemographic characteristics between 2014 and 2015 were obtained from Humana for...

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