In another international collaboration, CHIBE-affiliated faculty member, Heather Schofield, PhD is partnering with the Institute for Financial Management and Research to run a behavioral economics lab in Chennai, India. The lab, co-founded by Dr. Schofield and Frank Schilbach, PhD of the Massachusetts Institute of Technology, investigates the impact of health factors on economic wellbeing and decision-making, ranging from savings rates to consumption patterns. Active research studies examine whether various aspects of health such as chronic pain, malnutrition, or poor sleep may lower incomes and impede decision-making. This could lead to negative feedback loops and the potential for "poverty traps," wherein poor health associated with poverty lowers productivity, earnings, and cognitive function, feeding back into poor health and further poverty.

Schofield's lab conducts randomized trials in Indian workers' natural environments while applying rigorous methodological approaches and precise measurements, combining the benefits of both fieldwork and controlled laboratory settings. For example, her studies examine the relationship between health, productivity, and decision-making among a variety of professions including rickshaw drivers (bike-taxis), flower-stringers (women who string jasmine into garlands), and data entry workers in Chennai. "We refer to this as a 'lab in the field'," says Dr. Schofield. "You have this control that you wouldn't get from a lot of large field experiments, but at the same time, people are doing their normal daily [routine], so you get a lot more external validity."

Similarly, CHIBE's partnership with the Vitality Group in South Africa has created an opportunity to test behavioral economics health interventions in the field while expanding the Center's impact globally. The Vitality Group is an incentive-based wellness program of South Africa's largest private health insurer, Discovery Ltd. In July 2013, CHIBE began a partnership with Vitality to develop new approaches to drive change in health promotion, leading to disease prevention, improved health and reduced medical costs for individuals, businesses and society. As part of a Global Center of Excellence, researchers from CHIBE are working alongside Vitality's team on pilot studies to develop and test solutions to reduce major risks for chronic diseases, with a focus on weight loss, smoking cessation, and medication adherence. "As Vitality continues to innovate in developing its global wellness program, our partnership with CHIBE ensures an evidence-based approach to health behavior change," says Craig Nossel, Head of Vitality Wellness.

This summer, CHIBE's Alison Buttenheim, PhD, MBA, connected Vitality to Stephen Jean, a University of Pennsylvania Master of Public Health student. Jean joined Vitality at their office in Johannesburg, applying CHIBE's evidence base to weight loss rewards and tobacco cessation programs. "They wanted to know how best to deliver these incentives and rewards for their population...how they were going to engage people," said Jean. Jean's main role was in helping Vitality integrate CHIBE's behavioral economic insights into decisions like what incentives to provide to participants, how frequently to generate rewards, and how much and what kind of feedback to give as part of their program. The partnership will ultimately incorporate CHIBE's nuanced and wide-ranging evidence-based strategies into Vitality's wellness programming while pilot studies produce new evidence to inform similar programs globally.

-Melissa Ostroff