Learning How Behavioral Economics Impacts Health Decisions

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Center for Health Incentives and Behavioral Economics Research

CHIBE researchers apply concepts from the field of behavioral economics to design, implement, and evaluate interventions that improve health and build knowledge about efficacy, cost and effectiveness. 

Basic Science Core Request for Applications

The Basic Science Core aims to support laboratory or low-cost field studies that will shed light on mechanisms that can generate behavior change.  In contrast to previous large-scale field studies, which have often combined multiple mechanisms into one intervention in order to maximize impact on behavior, basic science projects supported by the Core focus on disentangling and precisely identifying the impacts of individual mechanisms.  CHIBE researchers interested in applying for project support can click here for more information.

 

 

Health Incentives and Behavioral Economics Research Studies

You are viewing 56 posts by the author Dana Gatto

Smarter Big Data for a Healthy Pennsylvania: Changing the Paradigm of Healthcare

Principal Investigators: Polsky / Volpp

The goal of this project is to improve the health of Pennsylvanians at an individual, community, and population level by changing the paradigm of medical care and health care delivery to predicting and preventing onset, exacerbation, and advancement of disease rather than principally reacting to clinical events with expensive treatments. Using medical record data with linkages to administrative claims, wearable monitor data, and social media data, we will develop algorithms to better predict clinical events in the hospital, at home, and in the community. The proposed project will expand an established and highly successful minority health services research training program to provide opportunities for training in big-data research to support the career development of under-represented minorities within the Commonwealth of Pennsylvania.

Funded by: Commonwealth of Pennsylvania


Using Social Forces to Improve Medication Adherence in Statin Users With Diabetes

Principal Investigators: Kevin Volpp, MD, PhD, Judd Kessler, PhD, Peter Reese, MD, MSCE

There is growing evidence of strong associations between a patient’s social environment and health behavior.  Social forces are worth harnessing as a strategy to promote health behaviors because patients usually engage with their physicians and nurses during occasional health system visits, but they interact with their social networks much more frequently. Furthermore, social forces may be particularly effective at building enduring habits for healthy behavior and might be cost effective to implement.  This study proposes to complete a randomized controlled trial of 200 subjects with diabetes and evidence of poor adherence to a statin medication (<70% medication possession ratio determined through pharmacy records). Study subjects will use GlowCaps to store their statin medication. Study subjects will identify potential Medication Adherence Partners (MAPs) who can receive information about their adherence patterns at enrollment. The primary outcome will be the percent of statin doses taken during the study as measured by the GlowCaps. The secondary outcome will be subjects’ statin MPR during the study.

Funder: Merck & Co.


Using Social Comparison to Improve Medication Adherence in Statin Users With Diabetes

Principal Investigators: Kevin Volpp, MD, PhD, Judd Kessler, PhD, Peter Reese, MD, MSCE

This study aims to investigate the association between a patient’s social environment and health behaviors. It has been well documented in non-health domains that providing agents with information about what others are doing can be an effective motivator. Leveraging this social force might be capable of encouraging patients to build habits for healthy behavior and might be cost effective to implement. This study specifically leverages feedback and information about the performance of others to influence individual behavior. An individual can be motivated to improve his performance when he knows he will be receiving feedback about that performance. Additionally, individuals may feel compelled to compete when their performance is compared to the performance of others. This study’s interventions will study the effects of feedback and information about others by varying what individuals are told about their medication adherence and how it compares to other people in the study. 

Funder: Merck & Co.


A Rapid Cycle Approach to Improving Medication Adherence Through Incentives and Remote Monitoring for Coronary Artery Disease Patients

Principal Investigators: Kevin Volpp, David Asch

The goal of this project is to improve medication adherence and health outcomes in post-discharge patients who are recovering from acute myocardial infarctions.  Such patients typically have high rates of poor medication adherence and hospital readmissions and are costly to monitor through intensive case management.  The intervention will increase medication adherence through use of wireless pill bottles, financial incentives, and social incentives. We are conducting this study in 38 states with 5 major insurer partners. The anticipated result will be improved health outcomes and lower cost.

Funder: Center for Medicare and Medicaid Innovation


Transforming Provider Payments

Principal Investigators: Emmanuel / Volpp

 

The goal of this partnership is to provide guidance and to conduct research for the roll-out of a new HMSA provider payment initiative that will fundamentally change the way primary care providers are paid in Hawaii.

 

Funded by: Hawaii Medical Services Association

Tags: Kevin Volpp

The Impact of Nonlinear Pricing on Portion Size of Unhealthy Food Purchases

Principal Investigators: Julie Downs, PhD; George Loewenstein, PhD 

This study will test the differential impact of nonlinear pricing on (over) consumption of healthy versus non-healthy food items. 

Funder: NIA Penn Roybal Center on Behavioral Economics and Health


A Randomized Trial of Expanded Choice Sets to Increase Completion of Advance Directives

Principal Investigator: Scott Halpern, MD, PhD

This study will examine whether expanding choice sets can increase the completion of and choices within advance directives among patients with end-stage renal disease (ESRD) presenting at DaVita Dialysis Centers in Philadelphia, PA. 

Funder: Medical Ethics and Health Policy, CHIBE


Choice Architecture and Organ Donation

Principal Investigators: Judd Kessler, PhD; Alvin Roth

This project will investigate how choice architecture affects decisions to register as organ donors among a representative sample of residents from the state of Massachusetts.

Funded by: Medical Ethics and Health Policy

 

Tags: Judd Kessler

The Fresh Start Effect: Temporal Landmarks Motivate Healthy Behaviors

Principal Investigators: Katherine Milkman, PhD; Jason Riis, PhD; Hengchen Dai

This project will determine what types of life transition and calendar events or temporal landmarks are most likely to motivate healthy behaviors and how to leverage these temporal landmarks to enhance peoples’ engagement in healthy activities.

Funder: NIA Penn Roybal Center on Behavioral Economics and Health


Incentives, Information, and Impulse: A Field Experiment on Food Choice

Principal Investigator: Saurabh Bhargava, PhD

The research objective of the study is to understand the factors that influence how families choose the food they consume and to identify strategies that can be used to improve such choices.  While existing research has been largely limited to short-run assessments in experimental restaurants and the laboratory, this project aims to investigate the economic and psychological determinants of food choice using a large and novel panel dataset of actual food purchases and a series of randomized experiments on real-world consumers through collaboration with the world’s largest online food delivery firm.  Specifically, the project seeks to understand the role of financial stress on food choice through analysis of archival data, and the role of (i) Incentives, (ii) Information (and the context within which such information is provided), and (iii) Impulsivity on food choice through a series of field experiments.

Funder: NIA Penn Roybal Center on Behavioral Economics and Health


Eating Phenotypes for Childhood Obesity in the Context of Familial Obesity Risk

Principal Investigator: Tanja Kral

The aim of this study is to test the effects of three different types of breakfast on appetite, food intake, and cognitive performance in 8- to 10-year-old children. Using an integrated approach, this research aims to study multiple child eating traits concurrently under states of hunger and satiety. It will examine the impact of short-term appetite and intake regulation on longer-term energy intake control and weight development in a cohort of ethnically diverse normal-weight and obese boys and girls with different familial predispositions to obesity.

Funder: NIH/NIDDK

Tags: Tanja Kral

Effects of Commercial Insurer Payment Policy on Chemotherapy Use and Costs

Principal Investigator: Justin Bekelman

Over the past several years, a large, national commercial insurer implemented reimbursement changes to incentivize the use of generic chemotherapies, presenting a natural experiment which we will leverage to examine the effects of chemotherapy reimbursement policy changes on treatment patterns, quality and costs.

Funder: American Cancer Society


Understand Health Insurance and Policy Using Massachusetts Health Reform

Principal Investigator: Jonathan Kolstad

Understand Health Insurance and Policy Using Massachusetts Health Reform

Funder: Robert Wood Johnson Foundation

 


The Role of Behavioral Economic Incentive Design and Demographic Characteristics in Financial-Incentive Based Approaches to Changing Health Behaviors

Prinicpal Investigators: Nancy Haff, Mitesh Patel, Kevin Volpp

Financial incentives are increasingly being used to promote health behavior change.  The role of participant demographic characteristics and incentive structure has not been well studied.  In this meta-analysis, participant-level data was pooled from previously published studies using financial incentives to promote health behavior change and associations between the effectiveness of financial incentives, demographic characteristics, and incentive structure were evaluated.


Using Smartphones to Track Health Data: A Qualitative Analysis

Principal Investigator: Mitesh Patel

Smartphones and wearable devices are increasingly being used by individuals to track health data such as physical activity.  In this study, over 1000 participants who used a smartphone to track step counts for three months were asked to report their perceptions on using these devices to track health data.

Funder: NIH Institute on Aging

 

Tags: Mitesh Patel

Team-Based Approaches for Physical Activity to Compare Social Norms Feedback With and Without Forgiveness: A Randomized, Controlled Trial

Principal Investigators: Mitesh Patel, David Asch, Kevin Volpp

Increased physical activity has been found to be associated with lower rates of all-cause mortality, cardiovascular disease, type 2 diabetes, hypertension, and stroke.  Yet, more than 50% of adults in the United States do not meet the national guidelines for minimum levels of physical activity to achieve health benefits.  This randomized, controlled trial enrolled teams of four members each who were given the goal of walking at least 7,000 steps per day.  Each team received different types of social norms feedback on their performance and outcomes were compared for groups that received feedback that accounted for all seven days of the week or forgave the two lowest days of activity, counting only 5 of 7 days per week.

Funder: NIH Institute on Aging


 


Team-Based Approaches for Physical Activity Using Financial Incentives and Social Norms Feedback: A Randomized, Controlled Trial

Principal Investigators: Mitesh Patel, David Asch, Kevin Volpp

Increased physical activity has been found to be associated with lower rates of all-cause mortality, cardiovascular disease, type 2 diabetes, hypertension, and stroke.  Yet, more than 50% of adults in the United States do not meet the national guidelines for minimum levels of physical activity to achieve health benefits.  This randomized, controlled trial enrolled teams of four members each who were given the goal of walking at least 7,000 steps per day.  Each team received different types of social norms feedback on their performance and outcomes were compared with and without financial incentives.

Funder: NIH Institute on Aging

 


CDC Prevention Research Center

Directors: Karen Glanz, PhD, MPH; Kevin Volpp, MD, PhD

A five-year, $4,350,000 grant from the Centers for Disease Control and Prevention has established a Prevention Research Center (PRC) at the University of Pennsylvania. The PRC, one of 26 in the nation, will conduct innovative public health and disease management research aimed at preventing chronic disease and reducing health disparities in Southeastern Pennsylvania. This will be the first PRC in Philadelphia.

Among other initiatives, the PRC will conduct a workplace weight loss study to evaluate environmental change strategies and incentives for decreasing obesity and preventing cardiovascular disease in employees of the City of Philadelphia, Independence Blue Cross, and the Southeastern Pennsylvania Transportation Authority (SEPTA).


Process Versus Outcomes Incentives for Lipid Management

Principal Investigators: Peter Reese, MD; Kevin Volpp, MD, PhD

Financial incentives have been shown to be effective at improving patient health behaviors including medication adherence in a wide variety of contexts. The delivery of such incentives has been enhanced by the recent development of new wireless technologies that facilitate the measurement of daily medication adherence and the provision of incentives in an automated fashion. However, the relative effectiveness of incentives based on process (e.g. statin adherence) versus outcome (e.g. improvements in LDL cholesterol) is unknown.This is a randomized controlled trial to evaluate the relative effectiveness and cost-effectiveness of improving cholesterol levels among participants who are at high risk of CVD and who have elevated LDL cholesterol levels by testing process versus outcomes financial incentives. 

Funder: National Heart, Lung and Blood Institute


Donor Registration Trial

Principal Investigator: Peter Reese, MD

This Roybal pilot is a randomized, controlled trial to compare the effects of four interventions on the rate of organ donor registration by members of the general public who visit the DMV website for business unrelated to organ donor registration.

Funded by: Roybal P30 Pilot