The Healthy Nudge

January 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) Mammogram rates increase when patients can schedule themselves

An American Journal of Preventive Medicine paper led by CHIBE-affiliated faculty member Kimberly Waddell, PhD, MSCI, as well as Sae-Hwan Park, PhD; Kristin A. Linn, PhD; Amol Navathe, MD, PhD; Caitlin McDonald, MPH; Catherine Reitz, MPH; Shivan Mehta, MD, MBA, MSHP, et al.

Having the ability to self-schedule mammograms was associated with a 15 percentage point increase following through with getting the screening, according to new research published in the American Journal of Preventive Medicine. Find the press release here.

2) A randomized trial of mailed outreach with behavioral economic interventions to improve liver cancer surveillance

A Hepatology Communications paper led by CHIBE-affiliated faculty member Shivan Mehta, MD, MBA, MSHP; along with Caitlin McDonald, MPH; Catherine Reitz, MPH; et al.

This study, funded by the Roybal pilot program, looked at whether financial incentives and mailed outreach with opt-out framing and a signed order slip could help improve liver cancer surveillance. Find the results here.



3) Remote patient-reported outcomes and activity monitoring to improve patient-clinician communication regarding symptoms and functional status

A JCO Oncology Practice paper led by CHIBE-affiliated faculty member Ravi B. Parikh, MD, MPP; as well as William J. Ferrell, MPH; Michael Kopinsky, BSE; Mohan Balachandran, MA, MS; Mitesh S. Patel, MD, MBA; et al

"Routine collection of patient-generated health data (PGHD) may promote earlier recognition of symptomatic and functional decline. This trial assessed the impact of an intervention integrating remote PGHD collection with patient nudges on symptom and functional status understanding between patients with advanced cancer and their oncology team." Read more here.

4) A randomized, controlled, prehabilitation intervention to maximize early recovery in liver transplantation

A Liver Transplantation paper led by Marina Serper, MD, MS, with CHIBE-affiliated author Peter Reese,MD, PhD, et al

"We conducted a 2-arm patient-randomized pilot trial to evaluate the feasibility and efficacy of a 14-week behavioral intervention to promote physical activity prior to liver transplant. The intervention arm received financial incentives and text-based reminders linked to wearable fitness trackers. End-of-study step counts were nearly 1,000 steps higher for intervention versus control. On average, the intervention group achieved daily step targets 51% of the time. A home-based intervention with financial incentives and text-based nudges was feasible, highly accepted, and increased daily steps in liver transplant candidates with functional impairment and malnutrition." Read more here.

5) Q&A on Penn's Master of Health Care Innovation

A CHIBE blog post featuring project manager Hilena Addis, BA

Interested in learning more about behavioral economics, health equity, health policy, and health care innovation? Consider Penn’s online Master of Health Care Innovation program. "[The program] provided me with a comprehensive understanding of health care, particularly focusing on the systems and structures that present barriers and opportunities for change," Hilena Addis said. "Exploring ways to modify behaviors, assess programs, and address inefficiencies was a highlight. Overall, I think it’s a program that readies its students for leadership roles in health care innovation, equipping them with the network and tools essential to driving positive change in the field." Read the Q&A here.