The Healthy Nudge

June 2024

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. See our 5 top stories below.

1) How “fresh start” texts could help people living with HIV who missed appointments return to care

A paper published in AIDS led by Christine Njuguna, MCOM, with CHIBE Scientific Director Alison Buttenheim, PhD, MBA; and CHIBE Associate Director Harsha Thirumurthy, PhD, and colleagues

In this study conducted in South Africa, the authors found that "low-cost text messages sent around a 'fresh start' date may increase the likelihood that patients who miss appointments return to care. This study suggests the potential of text messaging for motivating return to care." Read the paper here.

2) Making change for one and all

A PBS show featuring CHIBE affiliate Angela Duckworth, PhD, MA, MSc

"Why has there been a dramatic drop in smoking?" asks Dr. Angela Duckworth. "Was there a dramatic increase in willpower? No. Prices went up for cigarettes. Places where you could smoke went away. And the social norms of what is and isn’t OK and what’s cool and what’s not cool – those shifted. So as a psychologist who’s been studying self-control from day 1 of graduate school, I am coming to the belief that unless we really understand ourselves in context, we end up blaming the victim and we end up blaming ourselves." Watch Dr. Duckworth discuss the factors that affect human behavior here.

3) Many Americans want to eat a healthier diet but face barriers including high costs, study shows

A CBS segment featuring CHIBE Director Kevin Volpp, MD, PhD

CBS covered a new poll from the American Heart Association, which found that many Americans want to eat a healthier diet but face challenges including high costs and lack of knowledge about healthful foods. "We're at a critical juncture here, where if underlying trends continue, we're facing much higher rates of cardiovascular disease and obesity," Dr. Kevin Volpp said. Watch on CBS here.

4) AI intervention reduced end-of-life spending for patients with cancer

A Penn LDI blog post by Christine Weeks featuring CHIBE affiliate Ravi Parikh, MD, MPP, FACP

"Research by Dr. Ravi Parikh has shown that a machine-learning algorithm that identifies patients at higher risk of dying within a shorter time—in combination with behavioral nudges—can increase the rate at which doctors conduct serious illness conversations. Dr. Parikh built on that work in a New England Journal of Medicine AI study that examined how the machine learning-based behavioral intervention designed to motivate serious illness conversations affected health care spending at the end of life among patients who died. Among the 957 patients in the intervention group, the savings amounted to $13,747 for every patient who died, and more than $13 million in cumulative savings." Read the LDI story here.

5) Differential hospital participation in bundled payments in communities with higher shares of marginalized populations

A Journal of General Internal Medicine paper led by Aidan P. Crowley, BS; with CHIBE affiliates Qian (Erin) Huang, MPH; Deborah Cousins MSPH; Torrey Shirk, BA, Jingsan Zhu MS, MBA, Amol S. Navathe MD, PhD, and colleagues

"Medicare’s voluntary bundled payment programs have demonstrated generally favorable results. However, it remains unknown whether uneven hospital participation in these programs in communities with greater shares of minorities and patients of low socioeconomic status results in disparate access to practice redesign innovations." Read the findings of the study here.