A study lead by Mitesh Patel, published in Annals of Internal Medicine, gave 281 overweight and obese participants a goal of 7,000 steps per day for 13 weeks. Participants were randomized to one of three incentive groups with daily feedback, a gain incentive ($1.40 for each day goal was met); lottery incentive (daily eligibility if goal was achieved); or loss incentive ($42 allocated monthly upfront and $1.40 removed each day goal was not achieved) or a control group with daily feedback. They found that financial incentives framed as a loss were most effective for achieving physical activity goals.
Source: Forbes, October, 25, 2016
In an op-ed for Forbes, Mitesh Patel, MD, MBA, MS discusses the application of behavioral economics principles to electronic health records (EHRs), particularly in relation to generic prescriptions in light of increasing drug costs.
Dr. Patel says "Because EHRs have become ubiquitous, how they are designed impacts people across the country—for better or for worse. Behavioral modifications to the EHR interface can ensure that more patients are prescribed the lower-cost generic option when it is available."
Source: CHOP Cornerstone
The CHIBE-developed mobile health platform, Way to Health, was featured in two recent mHealth project showcases held at the Children's Hospital of Philadelphia. CHOP Cornerstone reports:
"The Way to Health platform made multiple appearances at the mHealth Project Showcase. This Penn-developed technology includes a mobile-friendly web-based platform that automates healthy behavior interventions, leverages remote monitoring technology, and capitalizes on behavioral economics principles. The technology is in use in studies assessing text-message reminders for adherence to asthma medication (tracked via a smart sensor on the inhaler), a study of post-operative walking in adults (tracked with a wearable fitness tracker), and the BE in CONTROL study of glycemic control behaviors of youth with Type 1 diabetes. Way to Health continues to take on new projects and studies and is expanding into the clinical realm."
In a study published in the Journal of Health Economics this year, George Loewenstein, Joseph Price and Kevin Volpp presented findings from a field experiment testing whether short-run incentives can create habit formation in children. Over a 3- or 5-week period, students received an incentive for eating a serving of fruits or vegetables during lunch. The study found that providing small incentives doubled the fraction of children eating at least one serving of fruits or vegetables. Two months after the end of the intervention, the consumption rate at schools remained 21% above baseline for the 3-week treatment and 44% above baseline for the 5-week treatment. These findings indicate that short-run incentives can produce changes in behavior that persist after incentives are removed.
Source: US News & World Report, October 13, 2016
CHIBE's Mitesh Patel, MD, MBA, MS comments in U.S. News & World Report about a recent study showing that watch-like wristbands that monitor heart rate may not offer true readings during exercise. Patel, who was not involved in the research, said, "further study is needed to determine which devices are more reliable for use in clinical care."
Source: Huffington Post, September 29, 2016
In a Huffington Post blog, CHIBE Fellow Joshua Liao, MD discusses his recent JAMA article on the value of using medical professional norms as a context for social comparisons between physicians. "Because patients can be negatively affected when doctors are compared to each other, leaders and policymakers should guard against unintended consequences in all circumstances by contextualizing comparisons within a set of values that reflect appropriateness and patient well-being," says Liao.
In interviews with NPR and Men's Journal, Mitesh Patel, MD, MBA, MS comments on a recent study at the University of Pittsburgh, which found that a group of people who were given fitness trackers while dieting and exercising lost more weight than a group who self-reported their activity - even though their activity levels were equivalent. "There aren't many — if any — long-term studies of wearable tech," Dr. Patel told NPR. This study is the longest yet, "and that's why this research is important. We need more studies like this to show what wearable tech can and can't do."
Source: Forbes, New York Daily News, Philly.com, U.S. News & World Report, Knowledge@Wharton Radio, Times of India, American Heart Association, Nutrition Insight, Penn Medicine News, Health Day, Daily Mail, Healthy Food America, PreventObesity.Net, ElEconomista.es, Pourqui Docteur, AJMC, India TV News, Medical Xpress, Beverage Daily, LDI Health Policy$ense, September 8, 2016
Teens are more than 15 percent less likely to say they would purchase soft drinks and other sugary drinks that include health warning labels, according to a new CHIBE study conducted by Christina Roberto, PhD and Eric Van Epps, PhD of the Psychology of Eating and Consumer Health Lab. The study, published in the American Journal of Preventive Medicine, is among the first to examine how warning labels on sugary drinks influence teens, and builds upon research published by the team earlier this year which showed that parents were less likely to select sugary beverages for their kids when labels warning about the dangers of added sugar – which can contribute to obesity, diabetes and tooth decay – were present.
Source: Penn LDI eMagazine, August 2016
Penn LDI reports: "In a new international partnership, the University of Pennsylvania's LDI Center for Health Incentives and Behavioral Economics (CHIBE) and the National University of Singapore (NUS) will jointly conduct a series of behavioral economics studies.
CHIBE Director Kevin Volpp said 'The similarity between the issues faced in Singapore and in the US in terms of switches in provider payment toward value and concerns about the role of non-communicable diseases such as obesity and diabetes as a major driver of health costs and poor outcomes is remarkable. We are excited about the possibility of this collaboration.'
The new CHIBE/NUS project will launch a number of pilot studies in various areas of population health including better management of diabetes, medication adherence, the promotion of healthier lifestyles, and the use of wearable monitoring devices for chronic disease management."
A CHIBE study published today in Health Affairs found that a refill synchronization program – in which patients received all prescription refills at the same time – increased medication adherence by an average of three to five percent compared to a control group. Researchers found that refill synchronization had the greatest impact on patients who were least likely to take their medication before the intervention, increasing medication adherence in this subgroup by nine to thirteen percent over the control group. “The logistical challenges involved with keeping track of remaining pills and obtaining timely refills and renewals are magnified for patients who need to take multiple medications, and often create an obstacle to medication adherence,” said lead author Jalpa A. Doshi, PhD. The results of the study suggest that syncing prescription refills may be an effective strategy for reducing these obstacles.
Research from CHIBE's Fostering Improvement in End-of-Life Decision Science (FIELDS) program was highlighted in The Economist after the publication of a JAMA Internal Medicine article entitled, "States Worse Than Death Among Hospitalized Patients with Serious Illnesses."
The magazine wrote: "Asking people approaching, or threatened with death, how they feel about it, and the moment at which they would like it to come, is a welcome development. Both sides of the doctor-assisted-dying debate should pay attention to it."
The New York Times profiled CHIBE's study, "Advance Ordering for Healthier Eating? Field Experiments on the Relationship Between the Meal Order–Consumption Time Delay and Meal Content," recently published in the Journal of Marketing Research.
CHIBE Postdoctoral Fellow Eric VanEpps told the Times, "If a decision is going to be implemented immediately, we just care about the immediate consequences, and we discount the long-term costs and benefits. In the case of food, we care about what’s happening right now – like how tasty it is – but discount the long-term costs of an unhealthy meal.”
A new CHIBE research study published in American Journal of Health Promotion found that comparing performance to average peers and offering financial incentives was the most effective method for increasing physical activity among teams of employees. "Many employers are using workplace competitions and financial incentives to encourage physical activity and other healthy behaviors among their employees," says Mitesh Patel, MD, MBA, MS, lead author of the study. The research team's findings demonstrate that these efforts can be successful when behavioral economics principles are applied.
Source: NPR. July 7, 2016
NPR health news featured research that can raise the odds of making positive behavior changes. Kevin Volpp discusses the use of commitment contracts and Katherine Milkman's "temptation bundling" concept was also mentioned.
Source: Reuters, July 7, 2016
Researchers at Independence Blue Cross compared workplace walking programs with and without "enhanced" features and found participants in the enhanced programs logged more steps, lost more weight and reported more improvement in energy and mood. Kevin Volpp commented that "it’s hard to know which part of the program was really the key ingredient to improvement. The challenge with these interventions is to disentangle the pieces of the intervention, to figure out which components, like feedback and incentives, had an impact.”
Source: The Economist, July 2, 2016
An Economist article discussing Ramadan's negative economic effect on Muslim countries mentions Heather Schofield's research suggesting that Muslims are less productive during Ramadan. The study found that fasting by Indian agriculture workers led to a 20-40% drop in productivity when the holy month fell in the planting or harvesting season. Office workers are said to put off meetings and decisions until after Ramadan, during which trading activity tends to decline on stockmarkets in the Middle East.
Shivan Mehta, Associate Chief Innovation Officer at the Center for Healthcare Innovation, commented on a study conducted in Australia that suggests text messages could reduce one’s odds of a second heart attack. Mehta noted that the length of the Australian study was important because earlier studies have been conducted over a period of three months or less and the first six months after a heart attack are a high-risk period during which new health habits are formed. He also commented that the Australian study targeted multiple risk factors concurrently—smoking, exercise, diet and general cardiovascular awareness, rather than focusing on a single behavior.
Source: Money Magazine, June 22, 2016
Money Magazine’s Get Healthy, Get Wealthy issue features Kevin Volpp's research on the role wearable fitness devices play in motivating people to start or improve an exercise routine. Wearable devices can be helpful if they spark an exercise habit, Volpp says, but “once the novelty wears off, many people stop using them.”
A recent study published in the the Journal of Public Policy & Marketing by CHIBE Postdoctoral Fellow Eric VanEpps and colleagues at Carnegie Mellon University, involving online workplace lunch orders, found that each of three types of calorie labeling conditions – numbers alone, traffic lights alone, or both labels together – reduced calories ordered by about 10 percent, compared to orders involving no calorie labels. “The similar effects of traffic light and numeric labeling suggests to us that consumers are making decisions based more on which choices seem healthier than on absolute calorie numbers,” VanEpps said.
Source: Bench to Bedside (CHOP), June/July 2016
Researchers from CHIBE and the Children's Hospital of Philadelphia (CHOP) are collaborating with the goal of improving teens' glycemic control through behavioral economics. Their research has been made possible through the use of CHIBE's innovative Way to Health platform. CHOP reports: "The platform automates many of the research functions necessary to perform these sorts of behavioral economic randomized controlled trials using devices such as wireless activity trackers and other mobile health applications."