The Healthy Nudge

September 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) Sodium reduction is a proven strategy that saves lives—More work is needed to hold industry accountable

A Health Affairs paper by CHIBE affiliate Alyssa Moran, ScD, MPH; Marlene Schwartz, PhD; and CHIBE Associate Director Christina Roberto, PhD

"Setting sodium reduction targets for the food supply is a rare example of a public health policy that reduces health care costs, saves lives, and is even supported by many food companies. In 2016, the FDA embarked on a sodium reduction strategy, only to meet repeated political hurdles. By funding the FDA’s existing work to set sodium reduction targets for the food industry, the White House and Congress could help to bring salt intake to recommended levels, preventing about 450,000 new cases of cardiovascular disease and saving $41 billion in health care costs over 20 years." Read the paper here.

2) Using behavioral science to improve cardiovascular health

A Circulation paper by CHIBE Director Kevin Volpp, MD, PhD

"While clinicians, patients, and health systems all desire to improve patients’ long-term health, objectives only partially overlap. Clinicians may treat patients differently depending on payment incentives. Health systems may respond to underlying incentives by focusing on more profitable patients and balancing margin and mission. Patients may not be able to afford treatments and may struggle with balancing immediate gratification versus long-term health. This highlights that there may be incomplete alignment in what behaviors to nudge depending on the decision makers priorities. Nudging one behavior may, by signaling prioritization, lead to lower performance in other activities." Read the paper here.

3) One minute to save lives: teaming up with pediatricians to secure firearms

A press release and paper by CHIBE affiliate Rinad Beidas, PhD

If it takes a pediatrician less than one minute per visit to talk to parents about how to securely store their firearms and offer a free cable lock, why do only 2% of doctors report routinely doing so? Turns out, they might just need a “nudge” and a little extra support.

This study tested 2 different approaches to implementing secure firearm storage in pediatric primary care, and the researchers were able to show that changing the electronic health record using behavioral economics approaches and providing support to clinics resulted in 49% of pediatricians delivering the program (a brief conversation and offering cable locks). This was done at scale across 30 clinics and 50,000 well-child visits and reflects what is possible when bringing implementation science methods to impactful know-do gaps.

Find the paper here, the press release here, and listen to WBUR's coverage here.

4) Philadelphia-area health experts see shift in attitudes on vaccination in ‘post-COVID’ era

A WHYY story featuring CHIBE Scientific Director Alison Buttenheim, PhD, MBA

Dr. Alison Buttenheim said there’s a lot of research and work being done to figure out how to better address people’s concerns around vaccines for themselves and their children, and how to tailor messaging in the exam room or doctor’s office.

“Even just framing vaccination as like, this is the default, this is the office policy, this is what we do,” she said. “You don’t say, ‘OK, it’s time to talk about vaccines, are you OK with the MMR?’ You’re just like, ‘Baby is due for 5 shots today, the nurse is going to come in and the next thing we’re going to do is give the baby vaccines.’ And then if you get pushback, then that’s a signal that, OK, we need to pivot here.” Read the story here.

5) Study explores willingness to trade-off years of life for an HIV cure

A CHIBE blog post with lead study author Dr. Ilona Fridman

Many people living with HIV desire a cure, even if it means risking their lives. A new study explored whether a psychological phenomenon called “affective forecasting” (where people tend to overestimate the positive impact of future events on their well-being) could be at play and whether this bias could be mitigated. Read the Q&A here.