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New Call for Proposals: Pioneering Use of Behavioral Economics

Mar 4, 2013, 9:00 AM, Posted by Lori Melichar

Lori Melichar Lori Melichar

We have announced our second Call for Proposals in the field of behavioral economics. We’re actively seeking ideas that will help us to better understand how to discourage the consumption of low-value health services — those that provide more harm than benefit or which provide only marginal health benefits. In addition to improving health outcomes, this knowledge could contribute to lowering health care costs for us all.

Behavioral economics is an area of study by which I’ve personally grown increasingly intrigued and in which the Foundation has recently begun to invest.  We all know, for example, that we need to exercise, eat right and be actively engaged in our own health care. But we don’t always do what we know we should do; knowing the “right” decision to make does not guarantee that we make that decision. The goal of behavioral economics is to uncover insights that could enable people to make better — more “rational” — choices for their health.

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Health Games Research Profiled by Inside Healthcare IT

Feb 17, 2012, 12:26 AM, Posted by Pioneer Blog Team

The Pioneer Portfolio is committed to supporting trailblazers who are changing the way we think about health and health care.  Debra Lieberman, PhD, director of Health Games Research, a national program of Pioneer and headquartered at the University of California, Santa Barbara, is breaking ground by using health games to transform the way prevention, self-care, and health care are practiced.

The February 9 issue of Inside Healthcare IT profiles Lieberman’s research on how video games can be used to improve players’ health behaviors and health outcomes, and thereby reduce the cost of care.  After two decades of research on games that improve health behaviors in areas such as smoking prevention, diabetes self-management and asthma self-management, she has found that some games can have a dramatic impact on health.

“Video games can change people in fundamental ways that can lead to better health behaviors,” Lieberman said in the article. “Well-designed games can change people’s perceived risk for experiencing serious health problems, their sense of self-efficacy, or self-confidence, that they can carry out specific health behaviors successfully, and their perceptions of social norms. These and many other changes in people’s attitudes, emotions, understanding, and skills can tip the balance toward behavior change. While games can be fun and can teach health facts, they can do a great deal more to motivate and support better health.”

Check out the article to learn more about Lieberman’s research on health games and tell @pioneerrwjf or @gamesresearch what you think on Twitter.

Decisions, Decisions, Behavioral Economics and Behavioral Change

Oct 13, 2011, 4:33 AM, Posted by Lori Melichar

To improve people’s health, we ask them to change their behavior. Quit Smoking. Eat right. Lose Weight. Take a walk. Get your blood pressure checked. See a doctor. But, as many have noted, making a commitment to do the “right” thing is often easier than following through on that commitment.  In fact, many of the nation’s health epidemics are linked to people doing the “wrong” thing despite their best intentions.  Assuming that people want to feel good and live healthy, productive lives, how can we explain actions that unequivocally threaten that outcome?  As a classically trained economist, I am sorry to say: Classical economics can’t give us an answer to that question.  Wearing the hat of program officer with the Robert Wood Johnson Foundation’s Pioneer Portfolio, I’m charged with searching, often in unexpected places, for pioneering ideas that have the potential to accelerate change and radically improve our health and the health care we receive. This quest has led the Pioneer Portfolio to the doorstep of behavioral economics.

Unlike classical economics, which assumes people act rationally and make choices in their best interest, behavioral economics does not assume that people behave in ways that maximize their income or long term happiness and wellbeing.   Rather, behavioral economist study how various factors such as environment and psychology lead people to sub-optimal outcomes. Pioneer is seeking ideas from this field because we understand that, in addition to the social determinants of health that we cannot individually control, we are constantly making conscious and unconscious decisions that relate directly and indirectly to our health. We choose whether or not to take our medication. We select the foods we eat. We decide whether to take the stairs or go to the gym.  

When we interact with the health care system, our health care providers make decisions that impact our understanding of our health condition and our treatment protocol. Doctors decide whether to use positive reinforcement or fear tactics to motivate a patient, encourage her to stop smoking, or ask her to get a test. Nurses choose whether to speak up during rounds and how to impart knowledge to a patient when he is discharged from the hospital.  Insurers seek to influence our decisions with financial incentives related to choice of physician, care facility and frequency of interaction with the health system. The frequency of these decisions is important because when we – or our providers – make poor decisions, our chances for a long, healthy life are hurt.

The emerging field of behavioral economics is working to discover how people make decisions that can affect their health behaviors and health care, and how we can learn to guide people toward decisions that are in their best interest, even if they are hard, inconvenient or easy to forget. With this knowledge, policymakers and others can design environments, campaigns, messages and tools that make it easier for people to choose what is best for themselves, their families and their communities.

That’s why the Robert Wood Johnson Foundation’s Pioneer Portfolio has issued a call for proposals to identify promising experiments that apply the principles and methods of behavioral economics and choice theory to perplexing health and health care problems. By tapping into the behavioral economics community, we hope to uncover pioneering interventions and policies that will transform the way patients and providers make decisions that affect health for ourselves and our communities.

It is our hope that behavioral economists can help us learn how people think about their health and the decisions they make. Some research we fund will fail, but that’s okay–there will be critical lessons learned from these experiments. The successes and the failures will help to educate our work to transform health and health care for the better.

We’re seeking innovative ideas that apply the field’s principles and theories to perplexing health problems. We are particularly interested in supporting either experiments or secondary data analyses that test innovative solutions to the challenges of obesity and consumer engagement, but any problem can be addressed.

Do you have an idea of how behavioral economics can help change health and health care? Can you think of a health problem that can be transformed by learning more about how patients and providers make decisions about the care they give and receive? If you don’t plan to submit a proposal, leave a comment– I’d love to hear your pioneering ideas.

Register here for an informational web conference on October 19 at 11:00 a.m. Eastern. The Robert Wood Johnson Foundation will discuss and answer programmatic questions about Pioneer's new funding initiative, Applying Behavioral Economics to Perplexing Problems.