How to create habit formation for behaviors

The Healthy Nudge

December 2019

Welcome to The Healthy Nudge . Each month, we'll get you up to speed on the latest developments in policy-relevant health behavioral economics research at CHIBE. Want more frequent updates? Follow us on Twitter @PennCHIBE and visit our website .

CHIBE hosts Behavioral Science and Health Symposium

Sleep habits, commitment contracts, food choice, and e-cigarettes were some of the various topics discussed at the ninth annual Behavioral Science and Health Symposium ( photos here). This year’s event featured 14 research presentations on behaviorally informed topics as well as keynote presentations by Betsy Levy Paluck, PhD, Professor of Psychology and Public Affairs at Princeton and Deputy Director of the Kahneman-Treisman Center for Behavioral Science & Public Policy, and David Cutler, PhD, the Otto Eckstein Professor of Applied Economics at Harvard. Read a recap of the symposium here.

Mitesh Patel featured on Freakonomics

Mitesh Patel, MD, MBA, MS , director of the Penn Medicine Nudge Unit, was recently featured in a Freakonomics episode called "How to Save $32 Million in One Hour." Read the interview transcript or listen here.

Roundtable: How to create habit formation for behavior

Group gathers for WW roundtable event on habit formation and behavior change

Between 40-50% of premature deaths in the United States are due to behaviors we could change, said Katy Milkman, PhD, at a roundtable discussion on creating habit formation for behaviors. This event, hosted by CHIBE and the Behavior Change for Good Initiative, was sponsored by WW and was designed to form new collaborations and spark new ideas on how to create healthy habits and lasting behavior change. Read the story here.

Alison Buttenheim briefs congressional baby caucus

Alison Buttenheim, PhD, MBA , was invited by Representative Rosa DeLauro to brief the Congressional Baby Caucus on December 4, 2019, on the topic of vaccine hesitancy as a threat to infant health. Rep. DeLauro (D-CT) chairs the Caucus and holds regular briefings for interested members of Congress and their staff on topics relevant to child health and welfare. Read more here.

CHIBE Profile: Jeffrey Kang, MD, MPH

Jeffrey Kang, MD, MPH , is the Founding CEO of WellBe Senior Medical and a new member of CHIBE's External Advisory Board. Read the full Q&A here .

What do you admire about CHIBE, and why did you want to join our external advisory board?

When “consumerism” in health care and individual behavior change was at its height, I was an admirer of CHIBE's work and had the privilege of hearing Dr. Volpp speak several times. So many health care experts default to financial incentives (extrinsic motivators) as the solution to individual behavior change, whereas the historical literature and then all of CHIBE's work point to the science of behavior change as much more complicated than simple financial incentives. The intrinsic motivators to change are frequently much more powerful. CHIBE's work has brought much more clarity to what works and what does not work, and I hope as an advisory board member I am able to contribute in a small way to advancing the science.

What projects are you working on right now?

I am founding CEO of a new company - WellBe Senior Medical. We provide longitudinal geriatric care at home to frail, vulnerable, poly-chronic elderly patients. In order to improve patient outcomes, in addition to individual behavior change, it is just as important, if not more important, to re-engineer the financial incentives of the health care delivery system and the delivery of care.

WellBe's financial model is global capitation; we are responsible and accountable for both the health outcomes and the total cost of care – hospital, specialists, procedures, diagnostics, pharmaceuticals, etc. In this model it is in our interest to improve the patient experience, improve outcomes and access to care, lower total cost of care, and deal with the social determinants of care by bringing longitudinal geriatric care to the patient's home, or wherever they are.

Video: Christina Roberto on sweetened beverage taxes

In this video shown at the Bloomberg American Health Summit, Christina Roberto, PhD, Assistant Professor of Medical Ethics and Health Policy at the Perelman School of Medicine, member of CHIBE, and Director of the PEACH Lab, discusses the dangers of sugary drinks and Philadelphia’s sweetened beverage tax.

Video: David Asch delivers TEDMED talk

David Asch, MD, MBA , Executive Director of the Penn Medicine Center for Health Care Innovation, gives a TEDMED Talk, “Why it’s so hard to make healthy decisions.” This video, which was filmed last year and was just released recently, addresses how we might harness our innate human irrationality to create positive behavior change.

Announcement: Foundations in Behavioral Economics Course

How do people’s actions and biases influence their health behaviors? And how can we influence their choices? Explore the answers with Kevin Volpp, MD, PhD, in this 4-week, online professional development class. His brief lecture videos and your discussions with classmates will prompt you to consider how you can nudge patients, providers, and others to increase treatment adherence, reduce costs, and shape wellness behaviors. Learn more and sign up here. January 14-February 3, 2020 and June 2-29, 2020.

Work-in-Progress Seminar with J. Michael McWilliams

December 12, 12-1:20 PM

Colonial Penn Center, 3641 Locust Walk, Philadelphia, PA 19104

J. Michael McWilliams, MD, PhD, the Warren Alpert Foundation Professor of Health Care and General Internist at Harvard University, Brigham and Women’s Hospital, will speak on “Value-Based Payment: A Work in Progress.” This event is cohosted with LDI.

CHIBE In the News

What Apple Watch can teach you about your heart

How to change your ‘someday’ money mentality

Why group exercise is so effective: The psychology behind working out with others

'Tis the season to shop for health insurance. Here's your checklist

A new center at Penn will study palliative care for people with dementia

Could taxing sugary drinks help combat health problems?

EHR nudges boost cancer screening orders, streamline workflow

Interview with George Loewenstein

Want better forecasting? Silence the noise

New Publications

Bor, J et al. Bridging the Efficacy–Effectiveness Gap in HIV Programs: Lessons From Economics.

Collins, BN et al. Long-term Results From the FRESH RCT: Sustained Reduction of Children's Tobacco Smoke Exposure.

Oakes, AH et al. A Nudge Towards Increased Experimentation to More Rapidly Improve Healthcare.

Parikh, RB et al. Addressing Bias in Artificial Intelligence in Health Care.

Musicus, AA et al. Online Randomized Controlled Trials of Restaurant Sodium Warning Labels.

Hsiang, EY et al. Association of an Active Choice Intervention in the Electronic Health Record Directed to Medical Assistants With Clinician Ordering and Patient Completion of Breast and Colorectal Cancer Screening Tests.

Meindl, P et al. A Brief Behavioral Measure of Frustration Tolerance Predicts Academic Achievement Immediately and Two Years Later.

Venkataramani, AS et al. Moving Toward Evidence-Based Policy.

Liao, JM et al. To Succeed, MIPS Value Pathways Need More Episodic Cost Measures.

Petimar, J et al. Evaluation of the Impact of Calorie Labeling on McDonald’s Restaurant Menus: A Natural Experiment.

Mislavsky, R et al . The Minimum Mean Paradox: A Mechanical Explanation for Apparent Experiment Aversion.

Tsai, AC et al. Stigma as a Fundamental Hindrance to the United States Opioid Overdose Crisis Response.

Kohut, MR et al. The Inconvincible Patient: How Clinicians Perceive Demand for Antibiotics in the Outpatient Setting.

Mayne, SL et al. Clustering of Unhealthy Behaviors in a Nationally Representative Sample of U.S. Children and Adolescents.

Brown, E et al. Understanding Why Urban, Low-Income Patients Miss Primary Care Appointments: Insights From Qualitative Interviews of West Philadelphians.

Navathe, AS et al. Population-Based Primary Care Payment System in Hawaii—Reply.

Guntuku, SC et al. Studying Expressions of Loneliness in Individuals Using Twitter: An Observational Study.

The Center for Health Incentives and Behavioral Economics (CHIBE) at the University of Pennsylvania conducts behavioral economics research aimed at reducing the disease burden from major U.S. public health problems. Originally founded within the Leonard Davis Institute of Health Economics , our mission is to inform health policy, improve health care delivery, and increase healthy behavior.

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