Using the Default Effect to Promote Healthy Behavior

使用默认效果促进健康行为

基本信息

批准号：
8299053
负责人：
GRETCHEN B CHAPMAN
金额：
$ 22.13万
依托单位：
RUTGERS, THE STATE UNIV OF N.J.
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-07-15 至 2014-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8299053
关键词：
Adherence Adult Aging American Appointment Appointments and Schedules Attention Behavior Behavioral Calories Chronic Chronic Disease Clinic Coffee Communicable Diseases Consent Country Cream Decision Making Diabetes Mellitus Diet Disease Economics Elderly Enrollment Epidemic Gifts Health Health behavior Heart Diseases Individual Influenza Influenza vaccination Lead Life Manuals Measures Medical Milk Morbidity - disease rate Organ Donations Outcome Outpatients Participant Patient Appointment Patients Persons Pharmaceutical Preparations Pharmacologic Substance Pharmacy facility Policies Presumed Consent Psychology Public Health Research Risk Schedule Series Source System Testing Vaccinated Vaccination aging population compliance behavior drinking field study flu mortality preference prevent programs public health relevance seasonal influenza sugar

项目摘要

DESCRIPTION (provided by applicant): Research in behavioral economics has indicated that subtle changes in how a choice is presented can have profound effects on the health decisions that people make. One such result is the default effect. For example (Johnson & Goldstein, 2003), organ donation rates are much higher in an opt-out system (presumed consent unless person says otherwise) than in an opt-in system (explicit consent required). Both systems give decision makers the autonomy to choose according to their preferences, but the opt-out system provides a "nudge" (Thaler & Sunstein, 2008) toward donation. The objective of the current research is to examine the use of default options as a mechanism to encourage healthy behavior in three aging-relevant domains: (i) influenza vaccination, (ii) dietary choices, and (iii) pharmaceutical prescription refills. Field studies in each domain will examine real-life health behavior under both opt-in and opt-out defaults. In the flu shot study, outpatients will be automatically scheduled for a flu shot appointment (with the option to opt out) or not scheduled but have the option to opt in. Actual vaccination status will be tracked, with the prediction that vaccination rates will be higher in the opt-out condition. The dietary choice study will examine coffee purchases in cafis that use different defaults for type of milk. In one sub-study, participants will be given a gift card that pictures either a cappuccino with nonfat milk or a cappuccino with whole milk and sugar syrup. The card serves as the customer's default order: the server will provide that drink unless the customer requests something else. Actual purchases will be observed. In the prescription study, prescriptions at a pharmacy will either be enrolled in an automatic refill program (where the prescription is automatically refilled when it is due) or remain in the usual state where the patient must request a refill from the pharmacy. Timeliness of patient refill pick-ups from the pharmacy will be assessed. These studies may demonstrate that simple changes in how health options are presented can have major effects on health behavior and hence on public health. PUBLIC HEALTH RELEVANCE: The health behavior of individuals has a critical impact on health outcomes such as infectious disease epidemics and chronic diseases including heart disease and diabetes. Older adults are at increased risk for morbidity and mortality from each of these diseases. Simple and subtle changes in the way that health options are presented can have important influences on the health behaviors that individuals choose and hence on public health outcomes.

描述（由申请人提供）：行为经济学的研究表明，提出选择的细微变化会对人们做出的健康决策产生深远的影响。一个结果是默认效果。例如（Johnson＆Goldstein，2003年），在退出系统中，器官捐赠率（假定同意，除非人说另有说）要高于选择加入系统（需要明确同意）。这两种系统都为决策者提供了根据他们的喜好选择的自主权，但是退出系统为捐赠提供了“轻推”（Thaler＆Sunstein，2008年）。当前研究的目的是检查使用默认选项作为鼓励与三个相关的领域健康行为的一种机制：（i）流感疫苗接种，（ii）饮食选择，以及（iii）药物处方重新填充。每个领域中的现场研究将检查选择加入和退出默认值下的现实健康行为。在Flu Shot研究中，门诊患者将自动安排以进行流感射击预约（可以选择退出）或不安排，但可以选择选择。实际疫苗接种状态将被跟踪，预测疫苗接种率在选择退出条件下会更高。饮食选择研究将检查在CAFI中购买的咖啡购买，这些咖啡使用不同的默认牛奶类型。在一个子研究中，将为参与者提供一张礼品卡，以贴上含有非脂肪牛奶的卡布奇诺咖啡或带有全牛奶和糖浆的卡布奇诺咖啡。该卡作为客户的默认订单：服务器将提供该饮料，除非客户要求其他东西。将观察实际购买。在处方研究中，药房的处方要么将参加自动补充计划（在应付时会自动补充处方），要么保留在通常的状态下，患者必须在该状态下要求药房重新填充。将评估药房的患者补充接收器的及时性。这些研究可能表明，对健康方案的提出方式的简单变化可以对健康行为产生重大影响，从而对公共卫生产生重大影响。公共卫生相关性：个体的健康行为对健康结果（例如感染性疾病流行病和慢性疾病）具有关键影响，包括心脏病和糖尿病。这些疾病中的每一种都有发病率和死亡率的风险增加。简单而微妙的变化在提出健康方案的方式上可能会对个人选择的健康行为产生重要影响，从而对公共卫生结果的影响。