In the Search for Pioneering Ideas, Start With Other Fields

May 9, 2013, 8:00 AM, Posted by Lori Melichar

Lori Melichar Lori Melichar, director

As I prepared for a recent visit from the RWJF Board of Trustees, I reviewed our portfolio of grants that apply behavioral economics to perplexing health and health care challenges and reflected on what is pioneering about this batch.

These projects are all well-designed studies that, when completed, can inform policy development and result in behavior change. In the near future, policymakers, leaders of health care institutions, program officers, and clinicians will benefit from these nuanced findings about the applications of behavioral economics to health and health care.

In 2011, the Pioneer Portfolio, with support from the Donaghue Foundation, engaged in this five-year behavioral economics initiative because applying an emerging—or even well-established—perspective from another field has the potential to uncover game-changing insights that can generate traction in health and health care. Our quest for these transformational ideas continued this spring as we accepted proposals applying behavioral economics to low-value health care services.

In the coming months, we'll share the latest innovative ideas to receive RWJF/Donaghue funding, and we'll announce the results of the first portfolio of grants in the behavioral economics initiative. By September 2013, we will know the answers to a host of important questions about how we can best decrease obesity and increase consumer engagement, including:

Father holding son while son reached for onion
  • How long can we expect the gains from color-coding food choices to last? 
  • Does letting a participant choose an incentive (lottery versus fixed) increase her likelihood of getting a mammogram?
  • In a walking program, is it better to set unattainably high goals or reasonable goals? Is the number of steps one takes before lunch more effective than daily goals or weekly goals?
  • Does feedback about your food choices increase your ability to make good decisions?
  • How does the ability to share your activity through social media increase your adherence to an exercise program?
  • How does notifying your family members increase your adherence to taking your medication? 

I’m excited to share the preliminary results of these projects. However, it’s important to note that, although it is no longer an emerging field (and, as several social psychologists assert, it’s more of a newly labeled field) behavioral economics (BE) has been sparsely applied to health and health care. The results of experiments from other industries may manifest differently for our field of interest. For example, had the courts not struck it down, the BE-inspired policy intended to reduce soda consumption by prohibiting sales of large-sized soft drinks may not have had the desired effect on calorie intake. As Brian Wansink and David Just cautioned in The Atlantic, implementation of a policy that has no effect can have lasting impacts and kill the will to implement similar (even if better-designed) policies in the future.

Behavioral economics is one of a range of disciplines and research fields RWJF is exploring to shed new insight on persistent, perplexing health and health care problems. Look for future posts discussing our experiences applying social network analysis and cost-benefit analysis to health challenges. We will soon launch an initiative that applies an anthropological lens to understand the “maker” mentality, as well as another initiative that encourages academic researchers to think about “data-mining” as an intellectually acceptable way of uncovering knowledge. Finally, I look forward to sharing our early thinking about harnessing the power of big data and applying micro-targeting techniques to increase the Foundation’s impact.