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Director, Fostering Improvement in End-of-Life Decision Science (FIELDS) Program; Deputy Director, Center for Health Incentives and Behavioral Economics, Leonard Davis Institute of Health Economics
Faculty at the University of Pennsylvania
Statistician specializing in causal inference and applications to the health sciences
Medical Student at .
Doctoral student in epidemiology at the University of Pennsylvania
Professor, Perelman School of Medicine and the Wharton School, University of Pennsylvania
Developing and testing innovative ways of applying insights from behavioral economics in improving patient health behavior and affecting provider performance
Associate Editor of the Journal of Lipid Research
Dancing Doctor, Informatics, Public Health, Predictive Analytics, Positive Deviance, Innovation
General internist with extensive experience improving the care of vulnerable patients with chronic disease
General internist studying clinical and health care policy issues at the intersection of diabetes, aging, and health economics
Senior Investigator at the Group Health Research Institute
Focusing on on improving patient-centered education for underserved patients through novel interventions
Associate Senior Medical Officer at CareMore Health System
Principal at Longwood Fund | Hospitalist at Massachusetts General Hospital
Hospitalist At Thomas Jefferson University and Medical Liaison at Jefferson's Digital Innovation and Consumer Experience (DICE) group, Leader, Entrepreneur, Sports and Food Junkie
MD/PhD candidate at Harvard Medical School and MIT
Co-Founder of Salubris Analytics
Financial incentives promote many health behaviors, but effective ways to deliver health incentives remain uncertain.
We randomly assigned CVS Caremark employees and their relatives and friends to one of four incentive programs or to usual care for smoking cessation. Two of the incentive programs targeted individuals, and two targeted groups of six participants. One of the individual-oriented programs and one of the group-oriented programs entailed rewards of approximately $800 for smoking cessation; the others entailed refundable deposits of $150 plus $650 in reward payments for successful participants. Usual care included informational resources and free smoking-cessation aids.
Overall, 2538 participants were enrolled. Of those assigned to reward-based programs, 90.0% accepted the assignment, as compared with 13.7% of those assigned to deposit-based programs (P<0.001). In intention-to-treat analyses, rates of sustained abstinence from smoking through 6 months were higher with each of the four incentive programs (range, 9.4 to 16.0%) than with usual care (6.0%) (P<0.05 for all comparisons); the superiority of reward-based programs was sustained through 12 months. Group-oriented and individual-oriented programs were associated with similar 6-month abstinence rates (13.7% and 12.1%, respectively; P = 0.29). Reward-based programs were associated with higher abstinence rates than deposit-based programs (15.7% vs. 10.2%, P<0.001). However, in instrumental-variable analyses that accounted for differential acceptance, the rate of abstinence at 6 months was 13.2 percentage points (95% confidence interval, 3.1 to 22.8) higher in the deposit-based programs than in the reward-based programs among the estimated 13.7% of the participants who would accept participation in either type of program.
Reward-based programs were much more commonly accepted than deposit-based programs, leading to higher rates of sustained abstinence from smoking. Group-oriented incentive programs were no more effective than individual-oriented pro-grams. (Funded by the National Institutes of Health and CVS Caremark; Clinical-Trials.gov number, NCT01526265.)
Director, Fostering Improvement in End-of-Life Decision Science (FIELDS) Program; Deputy Director, Center for Health Incentives and Behavioral Economics, Leonard Davis Institute of Health Economics
Faculty at the University of Pennsylvania
Statistician specializing in causal inference and applications to the health sciences
Medical Student at .
Doctoral student in epidemiology at the University of Pennsylvania
Professor, Perelman School of Medicine and the Wharton School, University of Pennsylvania
Developing and testing innovative ways of applying insights from behavioral economics in improving patient health behavior and affecting provider performance
Associate Editor of the Journal of Lipid Research
Dancing Doctor, Informatics, Public Health, Predictive Analytics, Positive Deviance, Innovation
General internist with extensive experience improving the care of vulnerable patients with chronic disease
General internist studying clinical and health care policy issues at the intersection of diabetes, aging, and health economics
Senior Investigator at the Group Health Research Institute
Focusing on on improving patient-centered education for underserved patients through novel interventions
Associate Senior Medical Officer at CareMore Health System
Principal at Longwood Fund | Hospitalist at Massachusetts General Hospital
Hospitalist At Thomas Jefferson University and Medical Liaison at Jefferson's Digital Innovation and Consumer Experience (DICE) group, Leader, Entrepreneur, Sports and Food Junkie
MD/PhD candidate at Harvard Medical School and MIT
Co-Founder of Salubris Analytics