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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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Improving Seriously Ill Patients’ End-of-Life Care by Changing the Default Option in Advance Directives

Principal Investigator: Scott Halpern

This multicenter randomized trial seeks to measure the impacts of default options in advance directives on clinical, economic, and patient- and surrogate-reported outcomes.             

Funder: Moore Foundation

A Day in The Saddle Can Take Its Toll

Principal Investigators: Hengchen Dai, Katherine L. Milkman, Dave Hoffman and Bradley R. Staats

Using longitudinal field observations of over 4,157 caregivers’ in the healthcare industry whose compliance with hand hygiene guidelines was recorded in 35 hospitals on 13.7 million separate occasions, this study tests the hypothesis that the impact of job demands can accumulate quickly – even within the course of a single day. 

The Fresh Start Effect: Breaking Points in Life Motivate Virtuous Behavior

Principal Investigators: Hengchen Dai, Katherine Milkman, Jason Riis

The popularity of New Year’s resolutions suggests that people are more likely to tackle their goals immediately following salient temporal landmarks. We show that Google searches for the term “diet”, gym visits, and commitments to pursue goals all increase following temporal landmarks (e.g., the outset of a new week, month, year, or semester; a birthday; a holiday).

Funder: The Penn Patient Engagement and Communications Small Grants Program (PECO)

Developing a Bilingual Measure of Health Numeracy for Use in Cancer Care

Principal Investigator: Marilyn Schapira

The aim of this study is to develop a test of health numeracy and evaluate its efficacy as a screening tool in the clinical setting with respect to improving the clinician-patient communication process in the cancer consulation.

American Cancer Society Research Scholar Award

Beliefs and Attitudes Toward Scientific Evidence in Health: Development of a Scale to Measure the Impact of Reporting Evidence B Belief in and Attitudes toward Scientific Evidence Information in Health Scale (BASIS-H)

Principal Investigator: Marilyn Schapira

The purpose of this study is to describe and evaluate primary care patients attitudes and beliefs regarding evidence based medicine in health. 

 Robert Wood Johnson Foundation Health & Society Scholars Program

Communication of Evidence and Uncertainty: Advancing Patient Centered Decision Making for Lung Cancer Screening and Treatment

Principal Investigator: Marilyn Schapira

The purpose of this grant is to evaluate patient preferences regarding lung cancer screening and treatment and to incorporate these preferences into the decision making process.

University of Pennsylvania Abramson Cancer Center Pilot Project Grant

Improving Health Numeracy, Medication Adherence and Transitions of Care in Patients with Congestive Heart Failure

Principal Investigator: Marilyn Schapira

The purpose of this grant is to develop and evaluate the efficacy of a health numeracy tutorial on patient outcomes among congestive heart failure patients followed in the VA Patient Aligned Care Teams.

CEPACT Pilot Grant

Improving Consumer Response to Nursing Home Quality Information: An Evaluation of Composite Measures

Principal Investigator: Rachel Werner

 The purpose of this grant is to evaluate the effect of nursing home quality ratings that are available to consumers on choices made and matching between needs and services among nursing homes.

Using Patient Feedback to Explore and Improve the Ways we Communicate Information Regarding Diabetes Control to Patients

Principal Investigator: Anjali Gopalan

To evaluate the efficacy of new formats for the communication of HgbA1C and diabetic control to patients with regard to patient knowledge and motivation to improve diabetic control.

Funded by: Roybal Pilot

Using Patient Feedback to Improve the Ways We Communicate Information Regarding Glycemic Control to Patients with Poorly Controlled Diabetes

Principal Investigator: Marilyn Schapira

The use of mixed methods to develop an effective approach for communicating HgA1C and diabetic control to patients. 

This is a Penn-CMU Roybal Center on Behavioral Economics Health Pilot Project.

Causal Inference in Observational Studies

Principal Investigators: Dylan Small, Paul Rosenbaum

The project goals are to address the hidden biases in observational studies by examining study methodology, specifically focusing on effect modification, the relationship between case definition and sensitivity to unmeasured biases, clustered treatment assignment, and the use of risk set matching to provide finer control of time dependent instrumental variables.  

Funder: National Science Foundation

Tags: Dylan Small

Comparative Efficacy, Acceptance and Effectiveness of Health Incentive Structures

Principal Investigator: Scott Halpern

The goal of the project is to compare different economic incentive structures for smoking cessation to define the mechanisms by which incentives alter behavior and inform the design of smoking interventions.

Funder: National Cancer Institute

Individual Differences in Children’s Susceptibility to Overeating

Principal Investigator: Tanja Kral

The aim of this study is to test the effects of portion size and the relative reinforcing value of food on energy intake in 8- to 10-year-old normal-weight and obese boys and girls.

Funder: National Institute of Diabetes and Digestive and Kidney Diseases

Tags: Tanja Kral

Comparison of the Satiating Properties of Egg- versus Cereal Grain-Based Breakfasts for Appetite and Energy Intake Control in 8- to 10-year-old Children

Principle 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.

Funded by: American Egg Board

Tags: Tanja Kral

Evaluating Methods to Use Health Benefits Design to Encourage Employee Weight Loss

Principal Investigators: Kevin Volpp, Mitesh Patel

Employers are increasing looking for opportunities to encourage weight loss among employees. While studies have shown that financial incentives can effectively encourage weight loss, little is known about their use in health benefits design. The goal of this study is to determine whether a financial incentive program for obese University of Pennsylvania Health System employees can effectively encourage weight loss when compared to changes in health benefit design.

Funder: University of Pennsylvania Health System

A Randomized-Controlled Trial on Decision Making Effort and Decision Fatigue

Principal Investigators: Scott Halpern, Mary McKenzie

This Penn-CMU Roybal Center on Behavioral Economics and Health pilot project, guided by lab experiments showing that repeated decision-making increases the risk of developing decision fatigue, aims to evaluate the existence and consequences of decision fatigue in settings of complex medical decision- making by patients and their surrogates and to identify modifiable factors for the severity of decision fatigue among patients with chronic medical conditions.

Funder: National Institute on Aging

Buy 1 Get 1: Role of Grocery Coupons in Promoting Obesogenic Home Food Environments and Eating Behaviors

Principal Investigators: Tanja Kral, Renee Moore

This randomized-controlled trial will test the effects of incentivizing grocery coupon use for the purchase of healthy foods on changes in dietary intake, BMI/waist circumference, home food availability and grocery coupon use among frequent grocery coupon users and non-coupon users. This study is a part of the Penn-CMU Roybal Center on Behavioral Economics and Health pilot projects.

Funder: National Institute on Aging

Tags: Tanja Kral

Effectiveness of Targeted Health Reminders

Principal Investigators: Jonathan Kolstad, Katherine Milkman

This Penn-CMU Roybal Center on Behavioral Economics and Health pilot project aims to assess the relative effectiveness of targeted health reminders. The study will test whether targeted reminder mailings encouraging engagement in various health measures systematically increase individual take-up of a recommended health behavior and whether encouraging engagement in preventative health measures using these reminders leads to improved health and/or lower health costs down the road.

Funder: National Institute on Aging


Testing Behavioral Economic Interventions to Improve Statin Use and Reduce CVD Risk

Principal Investigators: Kevin Volpp, Iwan Barankay, Peter Reese

The application of conceptual approaches from behavioral economics offers considerable promise in advancing health and health care. In patients with suboptimal cholesterol control who are at high risk for CVD, this study will test the effectiveness and cost-effectiveness of different behavioral economic techniques to improve statin adherence following discontinuation of the intervention. Investigative team leaders Iwan Barankay, Kevin Volpp and Peter Reese will use a 4-arm randomized controlled trial to compare the effectiveness and cost effectiveness of alternative approaches to inducing habit formation among CVD patients with poorly controlled cholesterol who have been prescribed statins.

Funded by: NIH/National Institute on Aging

A Randomized Trial of Financial Incentives for Maintenance of Weight Loss

Principal Investigators: Kevin Volpp, Will Yancy

Identifying effective strategies for treating obesity is both a clinical challenge and a public health priority. While a variety of approaches are successful in achieving initial weight loss, techniques for maintenance of initial weight loss have largely been unsuccessful. This randomized controlled trial will compare the relative effectiveness and cost-effectiveness of lottery-based incentives, traditional direct payments, and daily feedback without incentives among patients who successfully lost at least 5 kg over 6 months during participation in Weight Watchers (Pre Phase). Incentives will be provided to some study participants for the following 6 months (Phase I), and subjects will be followed for 6 more months to examine effects following cessation of incentives (Phase II). 

Funder: National Institute on Aging