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Author Archives: Lori Melichar

Some Unconventional Approaches to Stress: Pioneering Ideas Podcast Episode 7

Jan 29, 2015, 7:00 PM, Posted by Lori Melichar

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A man asking for money on the subway this week told me how Hurricane Sandy led to a series of events that left him stressed out by the challenges of putting food on the table for his children.

Recessions, hurricanes, violence—how many ways can we count that add stress to our lives? Whether dealing with economic stress, the stress of caring for an aging parent, or even the stress of keeping up with email, research shows that all of it affects our health. As Alexandra Drane, a guest in the latest episode of RWJF’s Pioneering Ideas podcast, puts it: “When life goes wrong, health goes wrong.”

This episode of the Pioneering Ideas podcast explores unconventional approaches to tackling stress­—and other health problems—with energizing possibilities that could also transform health and health care. From monitoring electricity use as a way of helping the elderly stay in their homes, to measuring the indirect health effects of social services (what if heating assistance led to greater medication adherence?), these conversations offer cutting-edge ideas for building a Culture of Health.

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Bringing in Diverse Perspectives to Build a Culture of Health

Sep 24, 2014, 9:00 AM, Posted by Lori Melichar

Susannah Fox Susannah Fox, RWJF Entrepreneur in Residence

Entrepreneurs start from a place of passion, then work tirelessly to make others see their vision. I'm excited to announce that Susannah Fox will be pushing all of us at the Foundation to behave more like entrepreneurs.

This month, Fox began a new role as the Foundation's next entrepreneur in residence. She was previously an associate director at the Pew Research Center’s Internet & American Life Project, where she combined traditional survey research with field work in online patient communities. She excels at using data and storytelling to compel policymakers, consumers, and entrepreneurs to understand and discuss key health care issues.

To build a Culture of Health in the United States, we have to consider new approaches and ways of thinking. We need the creativity, imagination, and efforts of people from a range of backgrounds and industries to develop innovative solutions to our most pressing health and health care challenges. A health and technology researcher and trend spotter, Fox will be a valuable asset to these efforts.

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What's Next Health: Jammed Up: Is Too Much Choice Bad for Our Health?

Sep 4, 2014, 2:28 PM, Posted by Lori Melichar

Too Many Choices

Each month, What’s Next Health talks with leading thinkers about the future of health and health care. Recently, we talked with Sheena Iyengar, Inaugural S.T. Lee Professor of Business at Columbia University, about navigating the thousands of choices we make daily – and the stress that comes with making so many decisions. In this post, RWJF Director Lori Melichar reflects on Sheena's visit to the Foundation.

Each of us makes choices constantly and those choices reverberate across other aspects of our lives. By choosing to read this blog, you’ve chosen to place something else on hold.

Depending on the time of day you read this, you have likely made hundreds of distinct choices today...from choosing to hit snooze one...or two, or three times, to choosing what to eat for breakfast, where to park and whether to take the stairs or the elevator in your office or home.

I don't have to tell you that so many of the choices you have made in the last 24 hours already will affect your health, your bodies (those of you who had green smoothies for breakfast are probably feeling a little better than those who, like me, had a muffin), as well as your mental health (how many of you, like me, are regretting your decision to stay up to watch another episode of The Americans instead of getting eight hours of sleep?). Many of the choices you make are simple, but many are extremely complex. 

The emerging science that helps us understand why we make the choices we do—and how to influence those choices—is equally complex.

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In a Culture of Health, People Get the Sleep They Need

Aug 11, 2014, 9:52 AM, Posted by Lori Melichar

sleep

How can we help people get more sleep?

I asked that question in a blog post back in February. Since then, I’ve been actively exploring the area of sleep health. I’ve talked with researchers, behavioral economists, physicians and mindfulness experts. I’ve talked with people who think they get enough sleep, and people who think they don’t. I’ve talked with anyone I can to discover what we need to know and do in order to help Americans sleep.

Sleep has tremendous ripple effects on our overall health and well-being. Lack of sleep affects your brain. There’s evidence that it affects your working memory. And as any new parent will confirm, we don’t need research to tell us that those who are sleep deprived are less able to control their tempers.

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Reflections on TED2014: Ideas Worth Spreading … FASTER!

Apr 18, 2014, 2:11 PM, Posted by Lori Melichar

Pattie Maes on stage at TED2014 (Photo: Bret Hartman) Pattie Maes, MIT Media Laboratory, speaking at TED2014

When people find out I work for the Robert Wood Johnson Foundation, they often want to tell me their idea for solving the problems that keep Americans from being as healthy as they can be. It's one of the pleasures of my job. Some of these ideas are indeed pioneering,  with the potential for breakthrough change.  All of them are helpful in shaping my vision of a path to achieving a Culture of Health.

I heard a lot of ideas last month while representing RWJF at TED2014. If you aren’t familiar, TED is an organization dedicated to spreading ideas through inspiring talks and conversations. Their annual conference is a great place to meet leaders from a variety of disciplines, from science and technology to business and the arts, and it was a privilege to attend.

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How Can We Help People Get More Sleep?

Feb 12, 2014, 8:00 AM, Posted by Lori Melichar

Hairdresser Sleeping Hairdresser takes a break during work. Image courtesy of epSos.de.

How’d you sleep last night?

Like many Americans, I’m a mother of small children. And like many Americans, I have a full time job with a long commute, from New York City to Princeton, New Jersey. Like too many Americans, I don’t always get as much sleep as I need to do a good job as a mother or as a program officer here at the Robert Wood Johnson Foundation.

So when WNYC recently asked me to participate in a roundtable discussion about sleep with Dr. Shelby Freedman Harris and Dr. Carl W. Bazil, I hesitated; clearly, I’m no expert on the subject. But I’ve spent a large part of my career in the Foundation’s Department of Research and Evaluation, where we support research into the root causes of poor health and explore how we can accelerate improvements in health and health care. And as I thought about the studies we’ve supported over the years on behavior change and other research I’ve encountered, I realized that much of it might shed light on the national challenge of sleep deprivation.

What follows are the thoughts I shared at the WNYC panel. I’d be thrilled to hear what you think might work.

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Persuading People to be Healthy: Thoughts from a Healthspottr Innovation Salon on Microtargeting

Jan 24, 2014, 8:00 AM, Posted by Lori Melichar

Lori A. Melichar Lori Melichar, director

If we're going to create a Culture of Health in this country, then we need to re-examine our influence strategies. In other words: We need to get better at delivering the exact right message or intervention that is most likely to get someone to take action that improves their health, their family or friends' health or the healthiness of their community. And that means we need to get better at microtargeting—applying the vast amounts of data available about people's habits and preferences to identify who is most persuadable.

I recently co-hosted an RWJF-funded Healthspottr Innovation Salon focused on the subject of microtargeting, where I met Ricky Gonzales of Enroll America and Erek Dyskant of BlueLabs, both of whom were on the Obama campaign's data analytics team. They talked about how they used microtargeting during the campaign and how those innovations may apply to health, something you can read more about in articles from The New York Times, Mother Jones, and the Wall Street Journal, among other sources. When I observed that several approaches they described might have applications for health and health care, Dyskant said, "Influencing people to make healthy decisions is much harder than getting someone to vote in a single election."

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We Need to Be the Change We Wish to See

Dec 17, 2013, 8:00 AM, Posted by Lori Melichar

Lori A. Melichar Lori Melichar, director

Those of us working to achieve a Culture of Health in this country need to practice the healthy habits we preach.

In Danielle Ofri’s recent New York Times op-ed, Why Doctors Don’t Take Sick Days, she describes a problem that’s persisted for ages, but that no one has created systems to solve: doctors refusing to call in sick. “From day one in medical training,” she writes, “the unspoken message is that calling in sick is for wimps.”

Her message hit home. Despite working for the country’s largest health foundation, I’m also guilty of coming to work sick, and of sending my kids to daycare sick, on days when I feel it would be disruptive to reschedule a day’s worth of meetings. 

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Spurring Open Source Health Innovation

Nov 21, 2013, 3:00 PM, Posted by Lori Melichar

Lori A. Melichar Lori Melichar, director

I recently learned to Code… in a Day.

Why, you might ask, would a labor economist at a health foundation want to acquire programming skills that didn’t relate to statistical analysis? Well, for one thing, I was curious—I wanted to understand the magic that turns letters and numbers into apps with the power to make our lives easier, and our health better. And as a program officer tasked with funding transformative innovations, I wanted to gain perspective on the world of apps, mHealth and the culture of innovation associated with the Silicon Valley tech scene.

To be clear, here at Pioneer, we’re interested in innovations of all shapes in sizes—not just those that are technical in nature. We’ll take a low-tech approach that truly disrupts business-as-usual over a high-tech incremental improvement any day of the week. That said, considering the volume of proposals we receive that involve creating an app or online platform of some kind, it seemed like boosting my literacy in this area couldn’t hurt. (Though I’m fortunate to have colleagues like Steve Downs, the Foundation’s Chief Technology and Information Officer, to fill in gaps in my technical expertise.)

So I learned to code in a day, and I left the class with an app of my own creation. Even more valuable, I learned about developers’ habits and culture…“the developers’ code,” if you will.  And I saw a lot that I’d like to emulate.

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Six Ideas for Reducing the Use of Low-Value Health Care

Oct 17, 2013, 8:00 AM, Posted by Lori Melichar

Lori A. Melichar Lori Melichar, director

Two years ago, my colleagues and I knew very little about how to use behavioral economics to improve health care decisions. Today, we know more. We also know how much there is to learn and do in this field.

That’s why we’re excited to announce six new grantees who will continue to build on the work we’ve funded over the last two years to apply principles from behavioral economics to challenges in health care.

The new grantees are as follows:

  • Amber Barnato and Rebecca Sudore, University of Pittsburgh and University of California, San Francisco, Consumer-directed financial incentives to increase advance care planning among Medicaid beneficiaries
  • Jeremiah Schuur, Brigham and Women's Hospital, Inc., Decision Fatigue in the Emergency Department and the Use of Hospital Services
  • Jeffrey Kullgren, University of Michigan Medical School, Decreasing Overuse of Low-Value Health Care Services through Physician Precommitment
  • Mark Vogel and Scott Halpern, Genesys Health System and University of Pennsylvania, BEACON -  Behavioral Economics for Advanced Care OptioNs
  • Richard Frank and Abigail Friedman, Harvard Medical School, Behavioral Experiments in Improving Medicare Coverage Choice
  • Mark Schlesinger and Rachel Grob, Yale University and University of Wisconsin – Madison,  Precommitment, Provider Choice, and Forgoing Low-Value Health Care

If you’re curious about why we’re funding these particular projects at this specific moment in time, read on.

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