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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 34 posts with the tag Kevin Volpp

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


RCT of Automated Hovering for Congestive Heart Failure

Principal Investigators: David Asch, MD, MBA; Kevin Volpp, MD, PhD

The objective of this study is to conduct a pragmatic, randomized controlled trial testing a new approach to chronic disease management combining wireless monitoring devices and behavioral economic engagement incentives to reduce rehospitalization rates among patients with congestive heart failure (CHF) recently hospitalized at the University of Pennsylvania Health System (UPHS).

Funder: NHLBI/NIH


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


Financial Incentives in Surveys of Healthcare Providers: Lotteries versus Guaranteed Payments

Principal Investigators: Halpern / Volpp 

Co-investigator:  Asch

This study will evaluate the relative efficacy of guaranteed payments (either up-front or conditional on response) vs. lotteries (in which respondents are entered into a random drawing for a larger reward) in increasing healthcare provider response to surveys. This study comprises 3 independent randomized trials of actuarially equivalent payments and lotteries.

Funded by: Greenwall Foundation and University of Pennsylvania, LDI CHIBE Pilot Project


A Randomized Trial of Behavioral Economic Interventions to Reduce CVD Risk

Principal Investigators: Asch / Volpp 

Co-investigators:  Barg, Bellamy, Berger, Gaziano, Glick, Graf, Jones, Lafata, Loewenstein, Metlay, Rosenthal, Shea, Stewart, Troxel, Weiner, Weinstein

This project aims to test whether financial incentives and/or choice architecture improve the uptake of comparative effectiveness research findings related to reducing cardiovascular disease risk among physicians and patients.

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


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


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 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.


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


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


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


Cost Sharing Impact on Uptake and Attendance Among People in a Workplace Weight Watchers Program

Principle Investigator: Kevin Volpp, Leslie John

An important unresolved question in the incentive literature is how to optimally set patient cost-sharing for services that require ongoing patient engagement. Standard economic theory would suggest that lowering prices to zero (or even below zero) would maximize program attendance; however, the goal of the Weight Watchers program is not attendance per se but weight loss and it is possible that people who come to the program because it is lower cost or free will value it less and thereby exert themselves less and be less successful in losing weight. It is also unclear how much attendance would change with changes in price and whether the increased attendance would be worth the cost of the subsidies. Our study will test the uptake of four different cost sharing discounts for enrolling in an employer-based Weight Watchers weight loss program as well as program attendance and weight loss over 12 months among those participants who sign up for the program.

Funded by: Weight Watchers, Inc
 

Tags: Kevin Volpp

Participation in Clinical Management Programs

Principal Investigator: Lindsay Jubelt, Kevin Volpp

A substantial portion of health care costs derives from a relatively small subset of the population. These high-cost members often suffer from multiple chronic conditions and may struggle with behavioral health issues and low health literacy. Given these challenges, these members are vulnerable to the inefficiencies and poor coordination of services in the current fee-for-service health care system.

Disease management and care coordination programs are designed to counter these challenges by engaging members, identifying their needs, and providing additional support, education, and services tailored to the specific goals of the individual. However, the effectiveness of such programs is often compromised by low rates of engagement and ongoing participation. More information is required to understand why certain people never fully participate in disease management programs and why others stop after initially participating. Understanding barriers to enrollment and participation is necessary for such programs to achieve their full potential to improve the health and reduce the health care expenditures of the patients they are serving.

Funder: Humana