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.
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."
Source: AcademyHealth, June 14, 2016
AcademyHealth Announced their 2016 Annual Research Meeting Award Recipients. Kevin Volpp and David Asch received the Article-of-the-Year Award for "Effect of Financial Incentives to Physicians, Patients, or Both on Lipid Levels: A Randomized Clinical Trial."
The Article-of-the-Year Award recognizes the best scientific work that the fields of health services research and health policy have produced and published during the previous calendar year. The award-winning article provides new insights into the delivery of health care and advances the knowledge of the field.
Source: Commonwealth Fund, June 2, 2016
On June 2, 2016, The Commonwealth Fund, Healthcare: the Journal of Delivery Science and Innovation, and The University of Pennsylvania hosted an event at the National Press Club, in Washington, D.C., that explored how leading policymakers, health system executives, and payers are crafting innovative incentive programs to support value-based models of care. The event, MACRA-Economics: Nudging Physicians Toward Value, focused on programs at three regional health systems—Advocate Healthcare in Chicago, Baptist Health System in San Antonio, and Partners HealthCare in Boston—and consider how insights from behavioral economics are shaping new models of provider incentives. Speakers from Penn were Ezekiel Emanuel, M.D., Ph.D. and Amol Navathe, M.D., Ph.D.
The Philadelphia Inquirer featured an article on the FIELDS program, highlighting their current studies and recent publications. FIELDS is " the country's only program devoted to applying the principles of behavioral economics, in essence the study of how people make choices, to end-of-life care," says director Scott Halpern.
The "Behavioral Insights for Health Innovation" (BIHI) initiative between CHIBE and nonprofit behavioral science lab ideas42 will give practitioners and policymakers tools to apply powerful and cost-effective solutions inspired by behavioral science, putting BIHI at the forefront of America’s drive for low-cost innovation and improved health outcomes. The new collaboration will also include a spotlight series of pieces taking a closer look at behavioral solutions to pressing challenges and issues that our healthcare system faces, ranging from over-prescription of pharmaceuticals to smoking cessation to diabetes prevention. This initiative is supported by the Robert Wood Johnson Foundation.
Source: LDI News, May 11, 2016
NEJM Catalyst has appointed national "Lead Advisors" and a committee of "Thought Leaders" in three areas of healthcare delivery. Kevin Volpp was chosen as the Lead Advisor for the Patient Engagement core and David Asch and Scott Halpern were chosen as two of the seven Thought Leaders. The core participated in the NEJM Catalyst Event Patient Engagement: Behavioral Strategies for Better Health at the University of Pennsylvania on February 25, 2016.
Source: Medical Express, May 9, 2016
A study published in JAMA Internal Medicine, led by Mitesh Patel, found that a change to prescription default options in electronic medical records immediately increased generic prescribing rates from 75 percent to 98 percent. Patel commented "Our results demonstrate that default options are a powerful tool for influencing physician behaviors but that they have to be well-designed to achieve the intended goals."
Source: JAMA Pediatrics, May 9, 2016
A JAMA viewpoint article authored by Alison Buttenheim and David Asch identifies several interventions that use behavioral economics to increase vaccine acceptance. These interventions recognize common biases as well as people’s tendency to respond to social cues and salient information.
Two new studies led by Jalpa Doshi have found evidence that cost-sharing arrangements are associated with significant reductions in access to specialty drugs. Both papers are published online in the American Journal of Managed Care.
In the first study, the team conducted a review of the literature and found evidence that high out-of-pocket costs were generally associated with lower use of specialty drugs. In the second study, the team examined Medicare claims data and found that “Part D” (prescription drug plan) co-insurance policies for specialty drugs seem to be reducing or delaying use of a lifesaving class of leukemia therapies.