Behavioral economics and healthy behaviors key concepts and current research

BEHAVIORAL ECONOMICS AND HEALTHY BEHAVIORS The field of behavioral economics can tell us a great deal about cognitive bias and unconscious decision-making, challenging the orthodox economic model whereby consumers make rational and informed choices But it is in the arena of health that it perhaps offers individuals and governments the most value In this important new book, the most pernicious health issues we face today are examined through a behavioral economics lens It provides an essential and timely overview of how this growing field of study can reframe and offer solutions to some of the biggest health issues of our age The book opens with an overview of the core theoretical concepts, after which each chapter assesses how behavioral economics research and practice can inform public policy across a range of health issues Including chapters on tobacco, alcohol and drug use, physical activity, dietary intake, cancer screening and sexual health, the book integrates the key insights from the field to both developed and developing nations Also asking important ethical questions around paternalism and informed choice, this book will be essential reading for students and researchers across psychology, economics, and business and management, as well as public health professionals wishing for a concise overview of the role that behavioral economics can potentially play in allowing people to live healthier lives Yaniv Hanoch is Professor of Decision Science in the School of Psychology, University of Plymouth, UK Andrew J Barnes is Assistant Professor in the Department of Health Behavior and Policy at the Virginia Commonwealth University School of Medicine, Research Associate of Massey Cancer Center, and affiliate faculty in the Center for the Study of Tobacco Products Thomas Rice is Professor in the Department of Health Policy and Management, UCLA Fielding School of Public Health, with a joint appointment in Public Policy This book is a must-have for those who want to understand how the insights from behavioral economics can be applied to the most significant health issues we face, such as smoking, obesity and prevention of HIV Each chapter will change the way you think about health behaviors and provide you with up-to-date research distilled to make it accessible It will be the standard book in behavioral economics and health behaviors for years to come Professor Richard Scheffler, Distinguished Professor of Health Economics and Public Policy, University of California, Berkeley, USA BEHAVIORAL ECONOMICS AND HEALTHY BEHAVIORS Key Concepts and Current Research Edited by Yaniv Hanoch, Andrew J Barnes, and Thomas Rice First published 2017 by Routledge Park Square, Milton Park, Abingdon, Oxon OX14 4RN and by Routledge 711 Third Avenue, New York, NY 10017 Routledge is an imprint of the Taylor & Francis Group, an informa business © 2017 Yaniv Hanoch, Andrew J Barnes, and Thomas Rice The right of Yaniv Hanoch, Andrew J Barnes, and Thomas Rice to be identified as the authors of this work has been asserted by them in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988 All rights reserved No part of this book may be reprinted or reproduced or utilized in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe Library of Congress Cataloging-in-Publication Data A catalog record for this title has been requested ISBN: 978-1-138-63820-4 (hbk) ISBN: 978-1-138-63821-1 (pbk) ISBN: 978-1-315-63793-8 (ebk) Typeset in Bembo by codeMantra CONTENTS Acknowledgments About the Editors and Authors Part I Background material Introduction Yaniv Hanoch, Andrew J Barnes, and Thomas Rice A brief overview of behavioral economics Thomas Rice, Yaniv Hanoch, and Andrew J Barnes Part II Shaping health behaviors The behavioral economics of tobacco products: innovations in laboratory methods to inform regulatory science Warren K Bickel, Lara N Moody, Sarah E Snider, Alexandra M Mellis, Jeffrey S Stein, and Amanda J Quisenberry Understanding alcohol and other drug use via behavioral economics: review and clinical applications Michael Amlung, Joshua Gray, and James MacKillop Behavioral economics: tools for promotion of physical activity Tammy Leonard and Kerem Shuval Using behavioral economics to improve dietary intake: alternatives to regulation, bans, and taxation Marie A Bragg and Brian Elbel Part III Detecting and managing disease Improving medication adherence with behavioral economics Steven E Meredith and Nancy M Petry Integrating principles from behavioral economics into patient navigation programs targeting cancer screening Yan Li, Fernando A Wilson, Roberto Villarreal, and José A Pagán Behavioral economics and HIV: a review of existing studies and potential future research areas Sebastian Linnemayr 10 Behavioral economics and health behaviors among the poor: findings from developing country populations Jill Luoto Part IV The role of providers, insurers, and government 11 Applications of behavioral economics to clinical quality improvement Daniella Meeker and Jason N Doctor 12 Using behavioral economics to improve people’s decisions about purchasing health insurance Andrew J Barnes, Thomas Rice, and Yaniv Hanoch 13 The role of government: how behavioral economics can inform policies to improve health behaviors Aditi P Sen and Richard G Frank Index ACKNOWLEDGMENTS Editing a book requires the efforts of many authors We would first like to thank the authors of this edited volume for their dedication, hard work, and timely submission of their respective chapters Their efforts and willingness to read and comment on others’ chapters is also greatly appreciated Their contribution to the completion of this project was extremely valuable Several external reviewers were kind enough to read and provide excellent comments on various chapters In particular we would like to thank Fred Zimmerman from UCLA, who was supportive of our project from its early stages He provided detailed comments and suggestions about the book proposal as well as on various chapters Jessica Greene, from George Washington University, and Chao Zhou, from the U.S Centers for Disease Control and Prevention, read our chapter on health insurance and gave us excellent suggestions Yaniv Hanoch would like to thank Michaela Gummerum for her ongoing support and excellent ideas; Tom Rice expresses his great appreciation for the continued advice and support from Kate Desmond; and Andrew Barnes would like to thank Kate and Ambrose Barnes for letting him work on this project that brought him so much joy over weekends, holidays, and vacations ABOUT THE EDITORS AND AUTHORS Editors Yaniv Hanoch is Professor of Decision Science in the School of Psychology, University of Plymouth, UK Professor Hanoch is interested in the intersection between decision science, health economics, and psychology His research interests include consumer decision-making (especially with regard to health insurance), communicating (health) risk information, medical decision-making, offenders’ decision-making and risk-taking, and life-span changes in risk-taking He is currently serving as an associate editor of the Journal of Behavioral and Experimental Economics Andrew J Barnes is Assistant Professor in the Department of Health Behavior and Policy at the Virginia Commonwealth University School of Medicine, Research Associate of Massey Cancer Center, and affiliate faculty in the Center for the Study of Tobacco Products His training is in health policy and economics and his research interests include applying behavioral economics to health policies, particularly in the areas of substance use and health insurance Dr Barnes is the co-author of the book Healthcare Systems in Transition: United States of America Thomas Rice is Professor in the Department of Health Policy and Management, UCLA Fielding School of Public Health, with a joint appointment in Public Policy He is a health economist who has studied national health care systems, competition and regulation, behavioral economics, physicians’ economic behavior, health insurance, and the Medicare program The fourth edition of his book, The Economics of Health Reconsidered, was published in 2016 He led a team of researchers that wrote a book published in 2013 about the US health care system, for the European Observatory on Health Systems and Policies Dr Rice served as editor of the journal, Medical Care Research and Review, from 1994 to 2000 Authors Michael Amlung is an Assistant Professor in the Department of Psychiatry & Behavioural Neurosciences in the Michael G DeGroote School of Medicine at McMaster University, Ontario, where he directs the Behavioural Sciences Core of the Peter Boris Centre for Addictions Research A cognitive neuroscientist by training, his research interests include applying behavioral economics and neuroeconomics principles to understand the etiology and treatment of addictive disorders Warren Bickel is the Director of the Addiction Recovery Research Center at the Virginia Tech Carilion Research Institute and Virginia Tech Carilion Professor of Behavioral Health Research Dr Bickel’s research examines the decision-making processes underlying dysfunctional behaviors such as addiction and other poor health behaviors Having co-edited five books and published over 350 papers and chapters, Dr Bickel’s work is frequently cited and receives national and international recognition Marie A Bragg is an Assistant Professor in the Section on Health Choice, Policy and Evaluation at the NYU School of Medicine, with a joint faculty appointment at the NYU Global Institute of Public Health A clinical psychologist by training, Dr Bragg conducts research on environmental and social factors associated with obesity, food marketing, food policy, and health disparities Jason N Doctor is Director of Health Informatics at the Leonard D Schaeffer Center for Health Policy and Economics and Associate Professor in the Department of Pharmaceutical and Health Economics, at the University of Southern California School of Pharmacy A health psychologist by training, his research interests include using behavioral economics to improve the quality of care in medicine Brian Elbel is an Associate Professor of Population Health and Health Policy within the Department of Population Health at the NYU School of Medicine, with a joint faculty appointment at the NYU Wagner Graduate School of Public Service Trained in health policy/health economics, Dr Elbel studies how individuals make decisions that influence their health, with a particular emphasis on behavioral economics, evaluation, obesity, and food choice Richard Frank is the Margaret T Morris Professor of Health Economics in the Department of Health Care Policy at Harvard Medical School He has conducted research on how behavioral economics can apply to health insurance arrangements, physician payment systems, and mental health and substance use disorder policy From 2014–2016 he served as Assistant Secretary for Planning and Evaluation at the U.S Department of Health and Human Services Joshua Gray is a doctoral student in the Clinical Psychology Program at the University of Georgia His research seeks to elucidate the neurobiological underpinnings of risk phenotypes for addiction to better prevent and treat addictive disorders Josh has used behavioral economics, neuroimaging, and molecular genetics methodologies to better understand addictive processes Tammy Leonard is Associate Professor of Economics at the University of Dallas She specializes in interdisciplinary applications of public, urban and behavioral economics along with applied spatial and econometric analysis methods Dr Leonard is also co-director of the Community Assistant Research (CARE) initiative, which leverages interdisciplinary relationships between academic researchers and community stakeholders to improve research related to low-income households Yan Li is a Research Scientist at the Center for Health Innovation, The New York Academy of Medicine, and an Assistant Professor in the Department of Population Health Science and Policy at the Icahn School of Medicine at Mount Sinai A biomedical and systems engineer by training, his research interests include simulation modeling, cost-effectiveness analysis, behavioral economics and social determinants of health Working with interdisciplinary teams, he has developed a range of innovative computer simulation models for chronic health conditions such as cardiovascular disease, diabetes, and cervical cancer Sebastian Linnemayr is a Senior Economist at the RAND Corporation in Santa Monica An economist by training, his research interests include the design of incentives for long-term health behavior change Dr Linnemayr is Principal Investigator on several NIH-funded grants in Uganda using behavioral economics to improve medication adherence of clients in HIV care Jill Luoto is an Economist at RAND, a non-profit policy research organization An economist by training, her research interests include labor, health and behavioral economics, with a focus on poverty and individual decision-making Much of her work has focused on developing country populations James MacKillop is the Peter Boris Chair in Addictions Research and Professor in the Department of Psychiatry and Behavioural Neurosciences at McMaster University A clinical psychologist by training, he conducts translational research on addictive behavior, especially the application of behavioral economics and neuroeconomics, to understand alcohol use disorder, nicotine dependence and other addictive disorders Daniella Meeker is an Assistant Professor at the University of Southern California (USC) Keck School of Medicine and an Information Scientist at RAND She directs the Informatics Program for the Southern California Clinical Translational Sciences Institute, a collaboration between Children’s Hospital of Los Angeles, Los Angeles County Department of Health Services, and Keck Medicine of USC Alexandra Mellis is a graduate student in the Translational Biology, Medicine, and Health Ph.D program at Virginia Tech Her research interests include the impact of narratives on health behavior and decision-making Steven Meredith is a postdoctoral fellow at the Calhoun Cardiology Center at the University of Connecticut School of Medicine A behavioral pharmacologist by training, his research interests include behavioral economics interventions to treat substance abuse and other behavioral health problems Lara N Moody is a clinical psychology doctoral student at Virginia Tech Her research interests include improving treatments for substances of abuse, with a particular interest in providing improved treatments to underserved populations José A Pagán is Director of the Center for Health Innovation at The New York Academy of Medicine and Professor in the Department of Population Health Science and Policy at the Icahn School of Medicine at Mount Sinai He is also Adjunct Senior Fellow of the Leonard Davis Institute of Health Economics at the University of Pennsylvania His research interests include systems science, health disparities and population health management Nancy Petry is Professor of Medicine, and Director of Behavioral Cardiology Prevention and the REWARD Center at the Calhoun Cardiology Center at the University of Connecticut School of Medicine A psychologist by training, her research interests include behavioral therapies for treatment of addictive disorders ranging from substance use to gambling disorders Her work on improving adherence behaviors has extended to diabetes management, weight loss, exercise, and medication adherence Amanda J Quisenberry is a Postdoctoral Associate at the Addiction Recovery Research Center of the Virginia Tech Carilion Research Institute Dr Quisenberry’s training and research interests 235 Glaeser, E.L (2006) “Paternalism and Psychology,” University of Chicago Law Review 73(1): 133–156 Gollwitzer, P.M and Sheeran, P (2006) “Implementation Intentions and Goal Achievements: A Meta-Analysis of Its Effects and Processes,” in M.P Zanna (ed.), Advances in Experimental Social Psychology New York: Academic Press Hanoch, Y., Rice, T., Cummings, J., and Wood, S (2009) “How Much Choice Is Too Much? The Case of the Medicare Prescription Drug Benefit,” Health Services Research 44(4): 1157–1168 Hoch, S.J and Loewenstein, G.F (1991) “Time-Inconsistent Preferences and Consumer SelfControl,” Journal of Consumer Research 17(4): 492–507 Hsu, J., Price, M., Huang, J., Brand, R., Fung, V., Hui, R., Fireman, B., Newhouse, J.P., and Selby, J.V (2006) “Unintended Consequences of Caps on Medicare Drug Benefits,” New England Journal of Medicine 354(22): 2349–2359 ideas42, “Sticking to Statins,” ideas42 Blog Available at http://www.ideas42.org/blog/project/sticking-statins/ (accessed January 1, 2017) Iyengar, S.S and Lepper, M.R (2000) “When Choice Is Demotivating: Can One Desire Too Much of a Good Thing?” Journal of Personality and Social Psychology 79(6): 995–1006 Johnson, E.J and Goldstein, D.G (2003) “Do Defaults Save Lives?” Science 302: 1338–1339 Johnson, E.J., Hassin, R., Baker, T., Bajger, A.T., and Treuer, G (2013) “Can Consumers Make Affordable Care Affordable? The Value of Choice Architecture,” PLOS One 8(12): e81521 Johnson, E.J., Shu, S.B., Dellaert, B.G.C., Fox, C.R., Goldstein, D.G., Häubl, G., Larrick, R.P., Payne, J.W., Peters, E., Schkade, D., Wansink, B., and Weber, E.U (2012) “Beyond Nudges: Tools of a Choice Architecture,” Marketing Letters 23: 487–504 Keller, P.A., Harlam, B., Loewenstein, G., and Volpp, K.G (2011) “Enhanced Active Choice: A New Method to Motivate Behavior Change,” Journal of Consumer Psychology 21: 376–383 King, D., Jabbar, A., Charani, E., Bicknell, C., Wu, Z., Miller, G., Gilchrist, M., Vlaev, I., Franklin, B.D., and Darzi, A (2014) “Redesigning the ‘Choice Architecture’ of Hospital Prescription Charts: A Mixed Methods Study Incorporating In Situ Simulation Testing,” BMJ Open 4(12): e005473 Loewenstein, G (1999) “Is More Choice Always Better?” Social Security Brief No 7, National Academy of Social Insurance Available at https://www.nasi.org/ research/1999/more-choicealways-better (accessed January 1, 2017) Loewenstein, G and Ubel, P (2010) “Economics Behaving Badly,” New York Times Available at http://www.nytimes.com/2010/07/15/opinion/15loewenstein.html?_r=0 (accessed January 1, 2017) Loewenstein, G., Brennan, T., and Volpp, K.G (2007) “Asymmetric Paternalism to Improve Health Behaviors,” Journal of the American Medical Association 298(20): 2415–2417 Loewenstein, G., John, L.K., and Volpp, K.G (2013) “Using Decision Errors to Help People Help Themselves,” in E Shafir (ed.), The Behavioral Foundations of Public Policy Princeton, NJ; Oxford: Princeton University Press Madrian, B.C and Shea, D.F (2001) “The Power of Suggestion: Inertia in 401k Participation and Savings Behavior,” Quarterly Journal of Economics 116(4): 1149–1187 Marr, C and Huang, C (2014) “Higher Tobacco Taxes Can Improve Health and Raise Revenue,” Center on Budget and Policy Priorities Available at http://www.cbpp.org/sites/default/files/atoms/files/6-19-13tax.pdf (accessed January 1, 2017) McWilliams, J.M., Afendulis, C.C., McGuire, T.M., and Landon, B.E (2011) Complex Medicare Advantage Choices May Overwhelm Seniors—Especially Those with Impaired Decision Making Health Affairs Available at http://content.healthaffairs.org/content/early/2011/08/16/hlthaff.2011.0132.full (accessed January 1, 2017) Milkman, K.L., Beshears, J., Choi, J.J., Laibson, D., and Madrian, B (2011) “Using Implementation Intentions Prompts to Enhance Influenza Vaccination Rates,” Proceedings of the National Academy of Sciences 108(26): 10415–10420 Monahan, C.H., Dash, S.J., Lucia, K.W., and Corlette, S (2013) “Realizing Health Reform’s Potential: What States Are Doing to Simplify Health Plan Choice in the Insurance Marketplaces,” Commonwealth Fund Available at http://www.commonwealthfund.org/~/media/Files/Publications/Issue%20Brief/2013/Dec/1720_Mo (accessed January 1, 2017) Newhouse, J (1993) Free for All? Lessons from the RAND Insurance Experiment Cambridge, MA: Harvard University Press Newhouse, J.P and McGuire, T.G (2014) “How Successful Is Medicare Advantage?” Milbank Quarterly 92(2): 351–394 O’Donoghue, T and Rabin, M (1999) “Doing It Now or Later,” American Economic Review, 89(1): 103–124 Patel, M.S., Day, S., Howell, J.T., Lautenbach, G.L., Nierman, E.H., and Volpp, K.G (2014) “Using Default Options within the Electronic Health Record to Increase the Prescribing of Generic Equivalent Medications: A Quasi Experimental Study,” Annals of Internal Medicine 161: S44–62 Pauly, M.V (1968) “The Economics of Moral Hazard: Comment,” American Economic Review 58(3): 531–537 Rao, A., White, J., and Allen, K (2015) “2016 Health Insurance Exchanges: The Good, the Bad, and the Ugly: Policy Recommendations to Improve Consumer Choices,” Council for Affordable Health Coverage Available at http://cahc.net/wpcontent/uploads/2016/07/CC2016HealthInsExchangeswebv.pdf (accessed January 1, 2017) Redelmeier, D.A and Shafir, E (1995) “Medical Decision Making in Situations that Offer Multiple Alternatives,” Journal of the American Medical Association 273(4): 302–305 Richburg-Hayes, L., Anzelone, C., Dechausay, N., Datta S., Fiorillo, A., Potok, L., Darling, M., and Balz, J (2014) “Behavioral Economics and Social Policy: Designing Innovative Solutions for Programs Supported by the Administration for Children and Families,” OPRE Report No 2014– 16a, Office of Planning, Research and Evaluation, Administration for Children and Families, U.S Department of Health and Human Services Available at http://www.acf.hhs.gov/sites/default/files/opre/bias_final_execsummary_opre.pdf (accessed January 1, 2017) Royer, H., Stehr, M., and Sydnor, J (2015) “Incentives, Commitments, and Habit Formation in Exercise: Evidence from a Field Experiment with Workers at a Fortune-500 Company,” American Economic Journal: Applied Economics 7(3): 51–84 Rutter, D.R., Steadman, L., and Quine, L (2006) “An Implementation Intentions Intervention to Increase Uptake of Mammography,” Annals of Behavioral Medicine 32(2): 127–134 Sheeran, P and Orbell, S (2000) “Using Implementation Intentions to Increase Attendance for Cervical Cancer Screening,” Health Psychology 19(3): 283–289 Simon, H.A (1955) “A Behavioral Model of Rational Choice,” Quarterly Journal of Economics 69(1): 99–118 Sinaiko, A.D and Hirth, R.A (2011) “Consumers, Health Insurance and Dominated Choices,” Journal of Health Economics 30(2): 450–457 Smith, N.C., Goldstein, D.G., and Johnson, E.J (2013) “Choice Without Awareness: Ethical and Policy Implications of Defaults,” Journal of Public Policy & Marketing 32(2): 159–172 Thaler, R.H and Benartzi, S (2004) “Save More Tomorrow: Using Behavioral Economics to Increase Employee Saving,” Journal of Political Economy 112(1): S164–187 Thaler, R.H and Sunstein, C.R (2003) “Libertarian Paternalism,” American Economic Review 93(2): 175–179 U.K Behavioural Insights Team (UK BIT) (2013) “Applying Behavioural Insights to Organ Donation.” Available at http://www.behaviouralinsights.co.uk/publications/applying-behaviouralinsights-to-organ-donation/ (accessed January 1, 2017) U.S Department of Transportation (US DOT) (2010) “Lives Saved in 2009 by Restraint Use and Minimum-Drinking-Age Laws,” Traffic Safety Facts, National Highway Traffic Safety Administration Available at https://crashstats.nhtsa.dot.gov/Api/Public/ViewPublication/811383 (accessed January 1, 2017) U.S Social and Behavioral Sciences Team (US SBST) (2015) “Annual Report.” Available at https://sbst.gov/assets/files/2015-annual-report.pdf (accessed January 1, 2017) Van der Sijs, H., Aarts, J., Vulto, A., and Berg, M (2006) “Overriding of Drug Safety Alerts in Computerized Physician Order Entry,” Journal of the American Medical Informatics Association 13(2): 138–147 Volpp, K.G., John, L.K., Troxel, A.B., Norton, L., Fassbender, J., and Loewenstein, G (2008b) “Financial Incentive-Based Approaches for Weight Loss,” Journal of the American Medical Association 300(22): 2631–2637 Volpp, K.G., Loewenstein, G., Troxel, A.B., Doshi, J., Price, M., Laskin, M., and Kimmel, S.E (2008a) “A Test of Financial Incentives to Improve Warfarin Adherence,” BMC Health Services Research 8: 272–277 Volpp, K.G., Troxel, A.B., Pauly, M.V., Glick, H.A., Puig, A., Asch, D.A., Galvin, R., Zhu, J., Wan, F., DeGuzman, J., Corbett, E., Weiner, J., and Audrain-McGovern, J (2009) “A Randomized, Controlled Trial of Financial Incentives for Smoking Cessation,” New England Journal of Medicine 360: 699–709 Wansink, B., Payne, C.R., Herbst, K.C., and Soman, D (2013) “Part Carts: Assortment Allocation Cues that Increase Fruit and Vegetable Purchases,” Journal of Nutrition Education and Behavior 45(4): S42 INDEX Abaluck, J 203 abuse liability 34–7 ACA (Affordable Care Act) 197, 201–3, 221 academic detailing 177 accelerometers 81 accountable justifications, antibiotic overprescribing 181 ACF (Administration for Children and Families) 222 action bias 18, 24 addiction 53–62 addictive goods 213–14 adverse selection 212 Ahuja, A 166 alcohol 3, 51 see also addiction alcohol demand 57–58 allowance for errors 131 Amlung, M 57 anchoring 18, 24; physical activity 76 antibiotic overprescribing 179–83 antihypertensive medication adherence, remote voucher-based 120 antipsychotic medication adherence, cash-based 117 antriretroviral medication adherence, prize-based 118–19 Arrow, Kenneth 211 ART (antiretroviral treatment) 141–3 ART adherence 146–7; HIV (human immunodeficiency virus) 150–1 Ashraf, N 165 asymmetric paternalism, physical activity 77–8 attention, limited attention in health decision-making 165 audit-and-feedback approaches 178 auto enrollment 220 availability 135 Bandiera, O 165 Banerjee, A 165–6 Barberis, N.C 16 Barnes, A 196 barriers to medication adherence 110–11 Becker, Gary 15 behavioral bottlenecks 222 behavioral economics 5; applying to public policy 220–2; decision-making process 15–16; government policies 214–19; limitations of 22–3; overview 14–15; public health in developing countries 162–3; strengthening public policy 219–23 behavioral economics interventions 20–2 behavioral economics models 34 Behavioral Insight Team (BIT) 5, 205, 220–1 behavioral interventions, incorporating behavior economics tools 82–3 behavioral market failures 212, 225 behavioral nudge interventions 96 Bennear, L 160 Berhane Hewan 167 BIAS (Behavioral Interventions to Advance Self-Sufficiency) project 222 biases, cognitive biases 16–19 Bickel, W.K 40 BIT (Behavioral Insight Team) 5, 205, 220–1 BMIs (brief motivational interventions) 60–1 Booth, F.W 72 bounded rationality 5, 15, 24, 214 brief motivational interventions (BMIs) 60–1 cancer, Hispanics 127 cancer screenings 127–37 CAPRISA 007 145 CareLink 131 cash-based reinforcement of antipsychotic medication adherence 117 Cass, A 118 CCT (conditional cash transfer) programs 160–1 cervical cancer screenings, patient navigation programs 133–5 children, token-based reinforcement of isoniazid adherence 118 choice architecture 20–1, 24, 128, 204–5; health insurance plans 194 choice overload 202 choice presentation, antibiotic overprescribing 181–2 choices, health insurance purchasing 202–3 Chou, S.Y 97 chronic disease, medication adherence 110 cigarettes see tobacco clinicians see physicians CM (contingency management) 59–60 Coca-Cola, “Share A Coke” 94 cognitive biases 16–19, 25 Cohen, D 160 colonoscopy screenings, Hispanic men 130–1 colorectal cancer screening cost-effectiveness analysis, patient navigation programs 132–3 commitment savings accounts 164 commitments 21 community reinforcement approach (CRA) 59–60 comparison frictions, reducing 200–1 conditional cash transfer (CCT) programs 160–1 confirmation bias 17, 25 consumer choice health plan 193 consumption 35–7, 56 contingency management (CM) 59–60 convenience, food and beverage industry 96–7 copayments, medication adherence 112 cost of prescription drugs, medication adherence 112 cost sharing, medication adherence 112 cost/benefit, physical activity 75 cost-effectiveness analysis of patient navigation program to increase cervical cancer screenings 136–7 costs of inadequate physical activity levels 72 CRA (community reinforcement approach) 59–60 crime, drug and alcohol misuse 51 cross-price elasticity of demand 36–7 Cummings, J 203 CVS, ReadyFill at Mail 113 Datta, S 168 DD (delay discounting) 52; addiction 53–6 decision fatigue 185–6 decision-making process: behavioral economics 15–16; framing effects 128; limited attention 165; non-standard decision-making 216–17 decision-support tools 220 deductibles 213 default behaviors, physical activity 78 default options 95; promoting healthy food 97 default rules 220 defaults 25; antibiotic overprescribing 182–3; India, fortifying flour with iron 166–7 delay discounting (DD) 52; addiction 53–6 DellaVigna, S 215 demand, addiction 56–7 Department of Health and Human Services 222 detailing strategies 177 developing countries 157–68 Devoto, F 166 Diabetes Prevention Program (DPP) 73 dietary intake 90–9 disulfiram adherence, methadone-based reinforcement of disulfiram adherence 114–16 dominated choices 196 DPP (Diabetes Prevention Program) 73 drug abuse 3, 51 see also addiction drug demand 57 drug holidays 150 drug self-administration, own-price elasticity of demand 35–6 dual-process theory 16, 25 Duflo, E 166 Dunn, K.E 116 Dutch Lottery 22 eating behaviors, behavioral economics 93–5 economic experiments, physical activity 82 economic strategies to increase physical activity 73–4 employment-based reinforcement of naltrexone adherence 116–17 encouraging greater effort to improve health 165–6 energy usage, social comparisons 219 Enthoven, Alain 193 environmental structures, physical activity 78 episodic future thinking 60 ethical issues 23; addiction 61–2; tobacco studies 46 Ethiopia, Berhane Hewan 167 ETM (Experimental Tobacco Marketplace) 44–46 Ferrante, J.M 130 financial incentives: HIV 144–6; physical activity 73–4 food and beverage industry 91–9 food cues 98 food policies 98–9 framing 25, 220; physical activity 80 framing effects 128 Frank, R.G 197 Freeman, H.P 129 Godlonton, S 162 Goldstein, D.G 19 government policies 211–19, 225 government regulation 225 grocery stores, default options 97 Grossman, M 97 Grossman model of health investment 73–4 Gruber, G 203 guidelines for physical activity 70–1 gym memberships 79–80 Hanoch, Y 202 Hawley, J.A 72 health, encouraging greater effort to improve health 165–6 health behaviors 212–19 Health Insurance Act (Netherlands) 197 health insurance literacy 195–6 Health Insurance Marketplaces 221–2 health insurance plans 193–8 health insurance purchasing 198–205 health promotion in developing countries 159–62, 168–9 heuristics 15, 25 Hibbard, J.H 201 Hispanics, cancer 127, 130–5 HIV (human immunodeficiency virus) 141–3; ART adherence 146–7, 150–1; behavioral economics 147–51; male circumcision 149–50; overview 151–2 HIV prevention 144–9 HIV testing 145–6 Ho, P.M 110 homo economicus 5, 15, 26, 176 HPTN 065 146 HPTN 068 144 Huberman, G 202 Huskamp, H.A 112 hypothetical purchase task, tobacco 40–2 immediate gratification 94 immunizations, developing countries 165 implementation intentions 96 impulsive DD 58–61 incentives: for healthy behaviors (developing countries) 160–1; for physical activity 78–9 incorporating behavioral economics tools within behavioral interventions 82–3 increasing: medication adherence 111–20; physical activity 80–3 India, public health, fortifying flour with iron 166–7 information, framing 220 information provision, economic policy 212–14 informational interventions, public health in developing countries 160 instant rewards, food 94 internal cues, dietary intake 98 intertemporal choices 112; physical activity 77 interventions, reinforcement-based interventions see reinforcement-based interventions isoniazid adherence in children (token-based reinforcement) 118 Iyengar, S.S 202 Jack, B.K 165 Jalan, J 160 Jiang, W 202 Johnson, E.J 19 judgements: about physical activity 75–7; unrealistic optimism 128 just-in-time education, health insurance purchasing 203 Kahneman, Daniel 16 Katzmarzyk, P.T 72 Kling, J.R 201 Kohler, H.P 145 Kremer, M 160 Lagarde, M 162 Lako, C.J 197 Lamiraud, K 197 legislation, public health in developing countries 162 Let’s Move! 79 libertarian paternalism 19, 26 Liebson, I.A 114 limitations of behavioral economics 22–3; health insurance purchasing 204–5; public policy 223–4; quality improvement programs 183–4; tobacco studies 46 limitations of traditional economic policy 212–14 limited attention, health decision-making 165 linkage to care (HIV) 146 Liu, P.J 98–9 Loewenstein, G 22 loss aversion 17–18, 26 lotteries 22; HIV prevention 149 Luoto, J 166 MacKillop, J 40–1, 57, 58 Madajewicz, M 160 Malawi 162 male circumcision 149–50 managed competition model, health insurance plans 194–7 mandates, public health in developing countries 162 marketing influences, physicians 177 Marketplaces (ACA) 221–2 marriage, Ethiopia (Berhane Hewan) 167 Marshall, A 56 mass defaults 94 Massachusetts Health Connector 201 McCormack, L.A 20 McDonalds 19–20; food cues 98 measuring behavioral economics constructs, physical activity 81–2 Medicare Advantage 200 Medicare Part D 197–8 Medicare’s Hospital Compare website 20 medication adherence 109–21; ART (antiretroviral treatment) 150–1 MEMS (medication event monitoring system) 118–19 menu effects 216 Meredith, J 160 MET (metabolic equivalent task) 71–2 methadone-based reinforcement of disulfiram adherence 114–16 Mexico, excise tax on sugar sweetened beverages 161 micro-incentives, present bias 164–5 Miguel, E 160 misestimation of probabilities 18–19 Mitchell, M.S 79 modifiers, physical activity behaviors 83 moral hazard 211–12 MSM (men who have sex with men) 141–3 Mullainathan, S 168 Murphy, Kevin 15, 58 naltrexone adherence, employment-based reinforcement 116–17 National Cancer Institute, Center to Reduce Cancer Health Disparities 130 National Institute on Alcohol Abuse and Alcoholism (NIAAA) 62 naturalistic demand assessment, tobacco 42–4 NCDs (non-communicable diseases) 157 neighborhood walkability 78 neoclassical rational model 159–60 NESARC (National Epidemiologic Survey on Alcohol and Related Conditions) 51 Netherlands, health insurance 195–9 new policy tools 220 NIAAA (National Institute on Alcohol Abuse and Alcoholism) 62 nonadherence, medication 109 non-communicable diseases (NCDs) 157 non-standard beliefs 215–16 non-standard decision-making 216–17 non-standard preferences 217–18 North, J 97 novel interventions, addiction 60–1 nudge 19, 26, 92; behavioral nudge interventions 96 Nudge Unit see Behavioral Insight Team Obama Administration, health insurance purchasing 205 obesity 4, 90–3 O’Hagen, S 57 Okeke, E 162 Oliver, Adam 23 operant behavior, medication adherence 113 operant self-administration, tobacco 37–40 opiod prescribing 184–5 opt in 19–20 optimism bias 18, 26 overvaluation, addiction 56 own-price elasticity of demand 35–6 Painter, J.E 97 Paterson, D.L 109 patient navigation programs 127–37 Patient Navigation Research Program (PNRP) 130 pay-for-performance, physicians 176–7 peer recognition, Zambia 164–5 personalized defaults 94 Petry, N.M 40, 120–1 Pettifore, A 144 physical activity 70–9; increasing 80–3 physicians: antibiotic overprescribing 179–84; decision fatigue 185–6; marketing influences 177; pay-for-performance 176–7 PNRP (Patient Navigation Research Program) 130 policy tools 19–22 poor, developing countries see developing countries portion sizes 97 pre-commitment, physical activity 79–80 predicting treatment response, addiction 57–9 preference for alternatives, tobacco 38–40 premiums 216 present bias 17, 26; commitment savings accounts 164; HIV prevention 148; micro-incentives 164–5 present-biased preferences 94, 217 preventative behaviors, HIV (human immunodeficiency virus) 143, 148–9 price setting, economic policy 212–14 pricing interventions, public health in developing countries 161 private commitments 21 prize-based reinforcement of antiretroviral medication adherence 118–19 promoting health in developing countries, behavioral economics 163–7 Prospect Theory 16, 18, 26–7 psychiatric illness, cash-based reinforcement of antipsychotic medication adherence 117 public commitments 21; antibiotic overprescribing 179–80 public health in developing countries 157–63 public health strategies to improve physical activity 73–4 public policy 211–12; applying behavioral economics to 219–23 purchase tasks 56 purchasing tobacco 42–6 Purnell, J.Q 128 QALYs (quality-adjusted life-years) 133 quality improvement programs 177–84 Ramsey, S 130 RAND Health Insurance Experiment 213 randomized controlled trial (RCT) 151 Ranganathan, M 162 RAP (Rewarding Adherence Program) 151 RCT (randomized controlled trial) 151 ReadyFill at Mail 113 recall bias 18–19, 27 reducing comparison frictions, health insurance purchasing 200–1 reducing effort needed to improve health 166 reference-dependent utilities 218 reframing information 220 regulations, food policies 98–9 reinforcement-based interventions 114–17 reinforcement-based treatment, addiction 59–60 remote voucher-based reinforcement of antihypertensive medication adherence 120 research, reinforcement-based interventions 121–2 restaurants, default options 97 Rewarding Adherence Program (RAP) 151 Rice, T 203 risk, physical activity 76 risk preferences, physical activity 81–2 Rodriguez, R.L 129 Rosen, M.I 119 Rosenau, P.V 197 safe water behaviors 166 Saffer, H 97 salience 17, 27; HIV prevention 148 satisficers 15 satisficing 27 SBST (Social and Behavioral Sciences Team) 5, 206, 220–1 schools, food policies 98–9 Schwartz, Barry 15 self-reporting physical activity 81 Shafir, Eldar 168 Silverman, K 116 Simon, Herbert 5, 15 smart defaults 11; health insurance purchasing 198–200 smoking 3, 211 social and cultural norms 128 social comparisons 219 social norms 135 socially motivated performance reporting, antibiotic overprescribing 180–1 Sokol, M.C 110 Somanathan, E 160 sponsors, health insurance plans 195 SSB (sugar-sweetened beverage) tax 91 Stackelberg game, policy process 215 Stanger, C 58 state-based influences on demand 57 status quo bias 17–18, 27 status quo framing 95 steeper DD 58 stickk.com 21 strengthening public policy with behavioral economics 219–23 substance demand 52 sugar-sweetened beverage tax (SSB) 91 Sugary Drinks Portion Cap Rule 95 Sunstein, Cass 19, 92 switching health insurance plans 197 System 16, 183; eating behaviors 93 System 16, 183–4; eating behaviors 93 Tarozzi, A 164 taxes, sugar-sweetened beverage tax (SSB) 91 TGW (transgender women) 141–2 Thaler, Richard 19, 92 Thornton, R.I 145 time preferences, physical activity 81–2 time-inconsistent preferences 218 tobacco 37–46 tobacco control 33 token-based reinforcement of isoniazid adherence in children 118 traditional economic approaches: addiction 52–3; ART adherence 146–7; health promotion in developing countries 159–62; HIV 144–6; improving effectiveness with behavioral economics 219–20; increasing medication adherence 112–13; linkage to care (HIV) 146 traditional economic policy, limitations of 212–14 trait-based demand 56 Tversky, Amos 16 UHS (University Health System) 131 UK, Behavioral Insight Team 220–1 uncertainty, physical activity 76 unprotected sex, HIV prevention 144–5 unrealistic optimism 128, 131 US: health insurance plans 195; SBST (Social and Behavioral Sciences Team) 220–1 Van Winssen, K.P.M 199 VBIDs (value-based insurance designs) 112 Veblen, Thorstein 15 VERB 79 visceral factor 94–5 Vivotrol 116–17 Von Korff, M.R 184 Wansink, B 97 want/should, physical activity 77 Washio, Y 58 water, safe water behaviors 166 well-established reinforcement-based interventions for addiction 59–60 Wells, K.J 130 working memory training 60 Zambia, peer recognition 164–5 Zhang, Y 198 ... Health Economics and Public Policy, University of California, Berkeley, USA BEHAVIORAL ECONOMICS AND HEALTHY BEHAVIORS Key Concepts and Current Research Edited by Yaniv Hanoch, Andrew J Barnes, and. .. Stein, and Amanda J Quisenberry Understanding alcohol and other drug use via behavioral economics: review and clinical applications Michael Amlung, Joshua Gray, and James MacKillop Behavioral economics: ... Villarreal, and José A Pagán Behavioral economics and HIV: a review of existing studies and potential future research areas Sebastian Linnemayr 10 Behavioral economics and health behaviors among