Framing Financial Incentives For the Overweight & Obese – PRC Director Kevin Volpp, MD, PhD

A study by PRC Director Kevin Volpp, MD, PhD, and other health behavior researchers at the University of Pennsylvania shows that financial incentives for increasing physical activity are highly effective among the population of overweight and obese.

“Most workplace wellness programs typically offer the reward after the goal is achieved,” said senior author Kevin G. Volpp, MD, PhD. “Our findings demonstrate that the potential of losing a reward is a more powerful motivator and adds important knowledge to our understanding of how to use financial incentives to encourage employee participation in wellness programs.”

The study was reported on in the Knowridge Science Report and was published in the Annals of Internal Medicine.

 

 

NEJM Patient Engagement Insights Report: Kevin Volpp, MD, PhD

 

University of Pennsylvania PRC Director Kevin Volpp, MD, PhD, and Namita S. Mohta, MD of Brigham and Women’s Hospital, analyze the second NEJM Catalyst Insights Council Survey on Patient Engagement.

The majority of the respondents to the online survey sent in July 2016 were clinicians (53%), with executives (22%) and clinician leaders (25%) nearly evenly split.  Most describes their organizations as hospitals or health systems.

“Nearly half of respondents say their patient engagement initiatives are having a major (14%) to moderate (34%) impact on quality outcomes,” said Volpp. “That’s pretty remarkable considering we are still in the earlier stages of patient engagement and that many potential approaches have yet to be fully scaled and integrated into practice. Interestingly, clinical leaders (60%) feel more strongly than executives (47%) and clinicians (43%) that their efforts to engage patients are working.”

Volpp and Mohta note that with the shift to value-based payment models, there may be more of an imperative to design and test new ideas to engage patients between visits that will improve both cost and quality.

 

 

 

 

Does Competition Positively Impact Physical Activity? : PRC Researchers Kevin Volpp and David Asch

PRC Director Kevin Volpp, MD, PhD, and PRC Researcher David Asch, MD, MBA, compare the effectiveness of different combinations of social comparison feedback and financial incentives to increase physical activity in a study in the July/August issue of the American Journal of Health Promotion.

In one of the first randomized trials to test different combinations of social comparison feedback and financial incentives, the researchers found that social comparison to the median with financial incentives was more effective than social comparison to the top quartile without incentives.  In the social comparison condition, participants, grouped by team,  were provided with feedback on their performance and the performance of other teams.  “By focusing social comparison feedback on performance relative to other teams,” the researchers suggest, “we leverage individuals’ competitive drive to motivate behavior change.” These findings may help to guide larger evaluations of interventions to increase physical activity using social comparison feedback and financial incentives.

 

Read more about this study at LiveScience.

AcademyHealth Article-of-the-Year Award: PRC Director Kevin Volpp and PRC Researcher David Asch

PRC Director Kevin Volpp, MD, PhD, and PRC Researcher David Asch, MD, MBA, were recognized for their significant contribution to the fields of health services research and health policy with the AcademyHealth Article-of-the-Year Award.

Volpp, MD, PhD, is the founding Director of LDI’s Center for Health Incentives and Behavioral Economics (CHIBE), a Professor of Medicine and Vice Chairman for Health Policy of the Department of Medical Ethics and Health Policy at Penn’s Perelman School of Medicine, and a Professor of Health Care Management at the Wharton School.

Asch, MD, MBA, is Executive Director of the Penn Medicine Center for Health Care Innovation, a Co-Director of the National Clinical Scholars Program, and a Professor of both Medicine at Penn’s Perelman School of Medicine and Health Care Management at the Wharton School.

Originally published in the Journal of the American Medical Association (JAMA) in November of 2015, the winning paper and its study were the latest to address the issue of how best to improve patient outcomes via financial incentives. The project’s different tack was to test pay-for-performance incentives on just doctors, just patients and then on doctors AND patients together.

The award, which recognizes the year’s “best scientific work in the fields of health services research and health policy” was presented at AcademyHealth’s Annual Research Meeting in Boston on June 28 .

 

 

 

 

 

 

 

 

 

 

On NPR: PRC Director Kevin Volpp and New Strategies For Health Behavior Changes

On NPR’s Health News, PRC Director, Kevin Volpp, MD, discussed new strategies for changing health behaviors.

 

 

Volpp suggests that “commitment contracts” produce better results than traditional workplace rewards programs when it comes to tying financial incentives to goals. Reward programs usually offer a lump payment at the end of a full year.  Commitment contracts involve an upfront investment which participants recoup if they meet self-designed goals and forfeit if they do not.  Volpp and colleagues at the Center for Health Incentives and Behavioral Economics have found that short-term goals are more successful than long-term, when it comes to health behavior changes, and that immediate financial loss has greater impact than far-in-the-future financial gain.

 

 

 

 

 

Philadelphia Inquirer Tracks Incentives Research

The Philadelphia Inquirer: Feb. 16, 2016

The latest in a series of studies from behavioral economists at the University of Pennsylvania reported an example on Monday: promising people a monthly pot of money to increase their physical activity, but then deducting some every day they missed the goal led to a 50 percent jump in successful days – far better than simply paying them to exercise more.

More than 80 percent of large employers offer some kind of incentive to get workers to take up healthier habits, on the theory that this will improve well-being and reduce health-care costs.

But the trend has grown faster than research into what works best. Commonly offered “hidden” incentives, such as lower insurance premiums the next year, don’t “engage” employees enough for them to change their lives, said Mitesh S. Patel, lead author of the new study and one of 50 faculty, along with UPenn PRC Director, Kevin Volpp, MD, PhD, affiliated with Penn’s Center for Health Incentives and Behavioral Economics.

 

 

 

 

 

 

Whooping Cough On the Rise: How to Improve Caregiver Booster Immunization Rates?

Whooping cough has increased dramatically over the past five years, putting infants at risk of serious illness or death. Most are infected by a caregiver who has not received a Tdap (tetanus, diphtheria, and pertussis) booster, so caregiver immunization is key to reversing this trend.

Since many caregivers go unvaccinated, new strategies are needed to convince those living with infants to get the Tdap booster. To address this care gap, a team of researchers lead by Alison Buttenheim PhD, MBA, evaluated the feasibility and impact of different interventions aimed at increasing the number of vaccinated caregivers. Dr. Buttenheim is an Assistant Professor of Nursing and an Assistant Professor of Health Policy at the University of Pennsylvania School of Nursing

The results of their study, concluded that despite leveraging existing vaccination services at retail pharmacies, vaccine vouchers and celebrity video promotion delivered during a newborn visit were not an effective strategy for increasing Tdap vaccination. “We continue to look for alternate approaches that prioritize convenience and provide an immediate opportunity to vaccinate when the motivation to do so is high,” added Buttenheim. The study is set for publication in the February 2016 issue of Vaccine,

https://www.eurekalert.org/news-releases/884382

 

 

Wearable Fitness Devices Do Not Drive Health Behavior Changes

In the February 5 edition of The Journal of the American Medical Association,  UPenn PRC Director Kevin Volpp, MD, PhD, and Penn colleagues, Mitesh Patel, MD, MBA, MS, and David Asch, MD, MBA, discuss the efficacy of wearable fitness devices, such as Fitbit,  in a Viewpoint article. Volpp et al note that these devices appear to have more durability as facilitators for individuals already motivated to change their health behaviors than as motivators for people seeking to create new, healthier habits.

“Although wearable devices have the potential to facilitate health behavior change, this change might not be driven by these devices alone. Instead, the successful use and potential health benefits related to these devices depend more on the design of the engagement strategies than on the features of their technology. Ultimately, it is the engagement strategies—the combinations of individual encouragement, social competition and collaboration, and effective feedback loops—that connect with human behavior.”

 

http://jama.jamanetwork.com/article.aspx?articleid=2089651

Kevin Volpp. MD, PhD, advisor to new healthcare information platform

Kevin Volpp, MD, PhD is a theme leader for NEJM Catalyst, a new collaborative platform that brings together health care executives, clinician leaders, and clinicians to share innovative ideas and practical applications for enhancing the value of health care delivery.

NEJM Catalyst provides information about practical innovations, insights from experts in the health care field, and leaders from provider organizations. It contains unbiased and objective content and articles, and an exchange of ideas and perspectives from across the health care community. The platform, from the NEJM Group that includes the New England Journal of Medicine, features live web seminars, daily blogs, white papers, case studies, video presentations, a digital newsletter, and the exchange of ideas. Advisors for live seminars will be editors of a NEJM sub journal and will facilitate dialogue to get the pulse of the community and then deliver pertinent information.

The four theme areas are:

  • the new healthcare marketplace
  • patient engagement
  • care redesign
  • leadership

Theme leaders were selected because each “has successfully implemented a change in his or her own organization,” according to NEJM.

Theme leaders include:

  • Dr. Volpp, who is Professor of Medicine and Health Care Management at the Wharton School of the University of Pennsylvania
  • Amy Compton-Phillips, MD, Executive Vice President, Chief Clinical Officer, Providence Health Services
  • Leemore Dafny, PhD, Professor of Strategy and Director of Health Enterprise Management at the Kellogg School of Management, Northwestern University
  • Stephen Swensen, MD, Medical Director for Leadership and Organization Development, Mayo Clinic College of Medicine

 

 

Gun violence: location a key risk factor, according to Doug Weibe, PRC Core Lead

In the January 2016 issue of Epidemiology, Doug Wiebe, PhD, UPenn PRC Training Core Lead, and other health researchers from the University of Pennsylvania analyze detailed activity paths of urban youth to investigate the interplay between their lived experiences, time spent in different environments, and risk of violent assault.

 

Since gunshot violence is now the leading cause of death among 10- to 24-year-old African American males and the second-leading cause of death among all males in that age group in the United States, identifying the factors in exposure to violence by guns and other weapons is critical. A key finding is that location matters.

 

Building on research that suggests youth violence is the end result of a web of factors that include alcohol use, access to firearms, and disadvantaged urban environments, Wiebe and his co-authors developed a new approach for studying the dynamics of activities in an urban environment. They found that the context of young people’s activities and characteristics of the places they spent time put them at risk to be assaulted or protected them from being assaulted, and certain activities appeared to trigger the onset of assault.

 

 

Read the article here.

Development of the Perceived Nutrition Environment Measures Survey (NEMS-P)

In the American Journal of Preventive Medicine July 2015, PRC Director Dr. Karen Glanz and Sarah Green of the Center for Health Behavior Research, University of Pennsylvania, discuss the development of the Perceived Nutrition Environment Measures Survey (NEMS-P). As a result, it has the ability to discern differences between lower- and higher-SES neighborhoods.

 

One of the most widely used observational measures of the nutrition environment, the Nutrition Environment Measures Survey (NEMS), developed by Dr. Glanz’s team, is used to study a range of food environments and contexts and evaluate policy and environment interventions. NEMS data have been collected throughout the U.S. and internationally by trained researchers, nutritionists, and public health professionals.

 

The NEMS-P, developed using a multiphase systematic measurement development process, has been shown to be easy to understand and have good test-retest reliability. In addition, it discriminates between neighborhood food environments in disadvantaged compared to more affluent communities. The NEMS-P is an important step forward in developing a psychometrically sound and conceptually grounded tool that can be used in a variety of communities and complement observational and geospatial assessments of nutrition environments.

 

Read the article here.

 

Green S, Glanz K. Development of the Perceived Nutrition Environment Measures Survey. American Journal of Preventive Medicine July 2015, 49:1, 50-61.