Category Archives: Behavior change
Human Capital News Roundup: Television ads for statins, advanced nursing education, treatment for gunshot wounds, and more.
Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows and grantees. Some recent examples:
In a piece about the growing need for advanced nursing education, Nurse.com interviewed a group of nurse leaders working to fulfill a recommendation from the Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health, which calls for doubling the number of doctorate-level nurses by 2020. Among those quoted: Christine Kovner, RN, PhD, FAAN, co-principal of RWJF’s RN Work Project; RWJF Executive Nurse Fellows alumna Jane Kirschling, RN, DNS, FAAN; and Susan Bakewell-Sachs, RN, PhD, PNP-BC, program director for the New Jersey Nursing Initiative, a program of RWJF and the New Jersey Chamber of Commerce Foundation.
Nurse.com and Infection Control Today report on an RWJF-supported study that finds hospitals that have higher percentages of nurses with baccalaureate degrees have lower rates of postsurgical mortality. The study, published in the March issue of Health Affairs, stems from the Future of Nursing: Campaign for Action. Read more about the study.
“I recently traveled to Singapore, where I met with other doctors and told about being the emergency department (ED) doctor at the University of Colorado Hospital the morning of the Aurora theater shootings on July 20, 2012,” RWJF Clinical Scholars alumna Comilla Sasson, MD, MS, FACEP, writes in an op-ed for the Denver Post. “One thing dawned on me as I spoke: I had seen more gunshot wound victims in that one night than these doctors will see in their entire careers.” Read a post Sasson wrote for the RWJF Human Capital Blog about the Aurora theater shootings, and learn more about her experience talking to the national news media afterward.
Mitesh Patel, MD, MBA, is a Robert Wood Johnson Foundation Clinical Scholar and senior fellow at the Leonard Davis Institute for Health Economics at the University of Pennsylvania. He is a practicing physician at the Philadelphia Veteran Affairs Medical Center; and author of Clinical Wards Secrets, a guide for medical students transitioning from the classroom to the hospital wards. This post is part of the "Health Care in 2013" series.
While most people spend a few hours a year visiting the doctor, they spend another 5,000 waking hours without any direct contact from the U.S. health care system. There has been an increasing amount of attention on how to design systems that encourage healthy behaviors among the population during their everyday activities. Insights from behavioral economics provide opportunities to design systems that monitor, incentivize and provide feedback to encourage these changes.
One proposal to change behavior is to increase price transparency in the U.S, with initiatives at the state and federal levels. Lessons from other industries and concepts from behavioral economics demonstrate that this must be designed carefully to increase the likelihood that price transparency changes behavior.
One example is the use of calorie-labeling in fast food restaurants. While its intended outcome is to reduce consumer consumption, there are several reasons why it has thus far not been very successful. Consumers may not understand the caloric information or the problem may be self-control and not related to information at all.
Using concepts from behavioral economics such as framing the information or making it more salient could improve its impact on reducing calorie consumption.
As the New Year approaches, millions of Americans will make resolutions to improve their diet, increase their exercise, or to quit smoking. Let’s do our part to design systems that help our population meet their goals and increase healthy behavior.
Natasha Dow Schüll, PhD, MA, is a cultural anthropologist and associate professor at the Massachusetts Institute of Technology's Program in Science, Technology and Society. She is an alumna of the Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program (2003-2005). Her recent book, Addiction by Design: Machine Gambling in Las Vegas, examines the ways that the gambling industry has designed gambling machines that encourage addiction.
Human Capital Blog: In your book, you describe how electronic gambling machines—the modern equivalent of slot machines—are designed in such a way that they encourage addiction. Tell us about that, please.
Natasha Dow Schüll: If you have never actually been in a Las Vegas casino and your idea of it comes from a James Bond movie, you'd be surprised by what you'd find. Of course they still have card games and roulette wheels, but most of the money casinos make is from electronic gambling machines, which are amazingly sophisticated versions of the classic three-reel slot machine. Every aspect of their design—the hardware, the software, the math, even the seating components—is carefully designed to keep players at the machine, playing game after game. Play is simple and amazingly fast—it takes only three to four seconds per spin. The machines are programmed so gamblers win every now and then, and they give audiovisual feedback to encourage them to continue. They induce players to gamble quickly and repeatedly, developing a sort of rhythmic flow that can sweep them away. Gamblers talk about getting into a "zone" where everything but the game just drops out of their awareness. After a while, they crave the zone itself, so it stops being about beating the machine and becomes instead about staying on the machine for as long as they can so they can be in that zone. They're addicted, and they develop all the behaviors of an addict as a result.
My point is that it's no accident; the machines are designed to drive the kinds of behavior—playing faster, longer, and more intensively—that turns gamblers into addicts.
New research shows that physicians who exercise and don’t smoke are much more likely to recommend healthy lifestyle changes to their patients than their smoking or non-exercising colleagues.
Researchers surveyed 1,000 primary care physicians and found that the ones who exercised at least once a week or who didn’t smoke were twice as likely to recommend five key lifestyle changes to patients suffering from hypertension: eating a healthy diet, reducing their salt intake, reaching or maintaining a healthy weight, limiting their use of alcohol and exercising regularly.
According to an article in American Medical News, the findings were presented at a March 14 meeting of the American Heart Association (AHA). “Practicing what we preach is important,” Jo Marie Reilly, MD, an associate professor at the Keck School of Medicine at the University of Southern California, is quoted saying. “Physicians are just more aware and better able to counsel patients if they take care of themselves.”
“Physicians who are healthier themselves are more apt to counsel patients about healthy lifestyle and diet,” agrees Ralph Sacco, MD, immediate past president of AHA and chairman of neurology at the University of Miami Miller School of Medicine. “They are more educated, more personally invested in personal health and therefore, better health advocates for their patients.”
Reilly notes that physicians who are not themselves physically fit can still recommend a healthy lifestyle to their patients, using their own experiences to relate to patients’ struggles. “It’s really important that we take that time to counsel patients about how their health habits influence their lives at each visit, and that we look at that as important as any medication,” she says.
What do you think? Does your doctor discuss healthy lifestyles with you? If you’re a health care provider, do you raise the subject with your patients? Register below to leave a comment.