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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

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Developing Interactive Technologies to Improve Research and Health Behavior

Principal Investigators: Asch / Volpp

Co-investigators:  Bellamy, Halpern, Glanz, Goldberg, Groeneveld, Karlawish, Kimmel, Kuna, Loewenstein, Rozin, Shea, Troxel, Zauberman

David A. Asch, MD, MBA and Kevin G. Volpp, MD, PhD are developing IT infrastructure that will deploy clinical and behavioral research studies to advance the science at the intersection of behavioral economics and health.  The project is called Way to Health. For more information see: waytohealth.org

Funded by: National Institutes of Health / National Institute on Aging


Behavioral Economic Approaches to Dietary Control

Principal Investigators: Loewenstein / Volpp / Asch

George Loewenstein, PhD is leading a team in pilot studies to explore different ways of encouraging consumption of healthier food items by framing caloric content using various formats.

 Funded by: Aramark


A Randomized Trial of Cognitive vs. Behavioral Incentives to Induce Sustained Healthy Oral Hygiene Habits and Improve Oral Health

Principal Investigators: Alison Buttenheim, PhD, MBA and Iwan Barankay, PhD

Designing cost-effective, time-limited interventions that lead to persistent healthy habits is a pressing public health challenge. In this planned randomized controlled study, we propose to test and compare the effectiveness of two types of financial incentives-behavioral vs. cognitive-for creating better toothbrushing habits and improving the gingival index, an important measure of oral health.

Funder: NIH: National Institute of Dental and Craniofacial Research


Capturing symptom progression and the physical and cognitive activities of patients daily following concussion using Way To Health

Principal Investigators: Douglas Wiebe, MD; Christina Master, MD; Kit Delgado, MD, MS

Our long term goal is to develop an intervention delivered at the point of care at emergency department or clinic discharge on a smartphone to deliver precise, real-time guidance on activity and rest to optimize post-concussion recovery. The objective of this application is to deploy Way To Health (WTH) as way to enable a robust approach to utilizing remote technologies to monitor symptoms, cognitive rest, and physical rest to carryout critical next studies of concussion. We aim to 1) use WTH to develop a protocol to efficiently recruit and enroll pediatric and adult concussion patients from the ED and monitor patients’ symptoms and activities daily over 3 weeks, and 2) test behavioral strategies to ensure engagement with the study protocol by randomizing patients to different incentive conditions.

Funder: CTSA UL1TR000003 from the National Center for Advancing Translational Science


Increasing physical activity to decrease post-operative morbidity

Principal Investigators: Gregory Tasian, MD and Thomas Guzzo, MD


In this application, we propose a pilot randomized, controlled trial to estimate the effect size of financial incentives on achieving a daily goal of 2000 steps in the hospital and post-discharge for 1 month following radical cystectomy. Secondary outcomes include step count, composite morbidity, and functional decline. Thirty adults with bladder cancer undergoing radical cystectomy at the Hospital of the University of Pennsylvania will be randomized to either control (education of step goal with monitoring and daily feedback) or a gain financial incentive ($1.50 for each day the goal was achieved) combined with a lottery incentive if they achieve 75% of the daily goals during the study period. We will use Fitbit Zips to measure step counts for all participants. This proposal will provide the preliminary data needed to design future, larger trials that will test the effect of financial incentives to increase ambulation on post-operative complications, readmissions, and functional decline.

Funder: CTSA UL1TR000003 from the National Center for Advancing Translational Science


Project LIFT: Lifestyle intervention to promote fitness in transplantation

Principal Investigators: Marina Serper, MD, MS; Iwan Barankay, PhD; Peter Reese, MD

Objectives: 1) To determine whether use of an accelerometer device (Misfit tracker) and financial loss-incentives paired with health trivia information vs. the accelerometer use alone increases walking among kidney and liver transplant recipients, and 2) To evaluate whether the interventions are associated with lower weight and changes in body fat composition.

Funder: CTSA UL1TR000003 from the National Center for Advancing Translational Science


Influence of increased physical activity on patient reported measures of disease activity in inflammatory arthritis

Principal Investigators: Alexis Ogdie-Beatty, MD and Joshua Baker, MD

Rheumatoid arthritis (RA) and psoriatic arthritis (PsA) are two of the most common forms of inflammatory arthritis (IA). Exercise or regular physical activity is a low cost adjunctive therapy for IA that is frequently overlooked due to low adherence rates. We propose a randomized interventional study to examine a) the use of a financial incentive to increase physical activity over 12-weeks and b) the impact of increased physical activity on patient-reported measures of disease activity. This proposed study represents a novel collaboration between rheumatology and behavioral economics at Penn and a novel approach to the management of IA.

Funder: CTSA UL1TR000003 from the National Center for Advancing Translational Science


Pilot trial leveraging smartphone-paired breathalyzers and incentives for reducing binge drinking and drinking and driving

Principal Investigators: Kit Delgado, MD, MS; Henry Kranzler


This project will test the feasibility of implementing a randomized control trial of a behavioral intervention that combines smartphone-paired breathalyzers, financial incentives, and rideshare credits to reduce binge drinking and drinking and driving.

Funder: CTSA UL1TR000003 from the National Center for Advancing Translational Science

Tags: Kit Delgado

Physician Competency in the Use of Choice Architecture

Principal Investigator: Joanna Hart, MD

The overall objective of this project is to obtain preliminary data revealing whether physicians demonstrate skill in the use of choice architecture.

Funder: NIA/NIH P30AG034546 (Roybal Pilot Project)

Tags: Joanna Hart

Choice Architecture and Mailed Outreach for Colorectal Cancer Screening

Principal Investigator: Shivan Mehta, MD

The proposed project will evaluate the effect of mailed colonoscopy outreach, mailed FIT, or mailed FIT with the choice of colonoscopy (active choice). The hypothesis is that offering the choice of mailed FIT or colonoscopy will result in greater screening response than mailed FIT or colonoscopy outreach alone.

Funder: NIA/NIH P30AG034546 (Roybal Pilot Project)

Tags: Shivan Mehta

Communicating the Health Risks of Sugar-Sweetened Beverages

Principal Investigator: Christina Roberto, PhD

This study has two aims: 1) To test the effect of repeated exposure to warning labels on kilocalories purchased over time among older adults; and 2) To demonstrate the feasibility of a novel, online store research protocol that can be used to ship participants’ actual purchases.

Funder: NIA/NIH P30AG034546 (Roybal Pilot Project)


Perspectives on the Intentional Use of Benevolent Deception in Patient—Physician Communication

Principal Investigator: Joanna Hart, MD

The overall objective of this project is to collect pilot data comparing the degree to which the deception of patients by physicians is viewed as appropriate by three groups: (1) patients, (2) actual or potential surrogate decision makers, and (3) physicians who care for seriously ill patients.

Funder: NIA/NIH P30AG034546 (Roybal Pilot Project)

Tags: Joanna Hart

Physician Judgment and Machine Predictions: Understanding and Improving Medical Decisions Using Machine Learning

Principal Investigator: Amol Navathe, MD, PhD

The main objective of this project is to improve upon human judgment in medicine. We will develop a program of research designed to facilitate the adoption of a sophisticated and powerful set of algorithms in clinical settings. Our initial studies will lay the conceptual and technical groundwork for testing and implementing interventions to improve decision making, and measuring the potential benefits including reducing low-value care and health disparities.

Funder: Robert Wood Johnson Foundation


Tags: Amol Navathe

iDiabetes: Influencing DIabetics to Adapt Behaviors related to Exercise and weighT by Enhancing Social incentives

Principal Investigator: Mitesh Patel, MD, MBA, MS

The objective of this study is to use a randomized, controlled trial to test the effectiveness of three interventions using social incentives and gamification to promote physical activity, weight loss, and improved glycemic control among adult type 2 diabetics.  

Funder: Doris Duke Foundation

Tags: Mitesh Patel

Evaluating Connected Health Approaches to Improve the Health of Veterans

Principal Investigator: Mitesh Patel, MD, MBA, MS

Cardiovascular disease is the leading cause of hospitalization, morbidity, and mortality among veterans.  Many of the contributing risk factors are health behaviors that occur outside of the health care system and within their everyday lives of veterans such as physical activity, obesity, smoking, and medication adherence.  Connected health is a model for using mobile technologies to remotely monitor health outcomes and deploy interventions to change behavior. 

Research objectives:  1) Understand veterans’ perspectives of needs, barriers, and opportunities with connected health devices; 2) Evaluate veteran’s experiences with Way to Health, a technology platform already being used at the CMCVAMC in Philadelphia to integrate connected health devices and enable automated deployment of behavioral economic interventions; 3) Use Way to Health to test social and financial incentive-based connected health approaches to increase physical activity among veterans to inform an investigator-initiated research proposal.

Funder: Veterans Affairs Health Services Research and Development Career Development Award

 

	




         
Tags: Mitesh Patel

HMSA Member Consumer Engagement

Principal Investigator: Amol Navathe, MD, PhD

The first objective of the study is to identify key social and behavioral determinants of health of individuals and communities in Hawaii and development an approach to design and test interventions to address gaps and improve patient engagement and health metrics. The second objective is to help HMSA align incentives of members’ health insurance benefit design and the provider payment system that is part of HMSA’s payment transformation.

Funder: Hawaii Medical Services Association


Tags: Amol Navathe

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

Improving Participation in Vector Control Campaigns

Principal Investigators: Alison Buttenheim, PhD, MBA; Joanne Levy, MBA, MCP

Peruvian officials have engaged for years in a vector-control campaign to fight Chagas, a potentially fatal, bug-borne disease common in Latin America. Resistance to the voluntary, door-to-door program in Arequipa, however, threatens to undermine the Ministry of Health's effort in that city.  This project will explore the effectiveness of three behavioral economics interventions in persuading Arequipa residents to allow pesticide treatment in their homes.

Funder: NICHD/NIH


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