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Behavioral economics used to improve patient engagement, promote healthy food choices


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A panel of experts will discuss ways to improve the effectiveness of diabetes interventions during Sunday’s symposium Which Benefit Design and Behavioral Economic Interventions Can Be Used to Facilitate Diabetes Prevention? The two-hour session begins at 2:15 p.m. in S-303 (South, Level 3). spoke with two of the symposium’s presenters about the concept of behavioral economics as it pertains to diabetes prevention and treatment.

Behavioral Economic Strategies to Improve Patient Engagement

Presenter: Jeffrey T. Kullgren, MS, MD, MPH, Research Scientist at the VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, and Assistant Professor of Internal Medicine at the University of Michigan Medical School

Jeffrey T. Kullgren, MS, MD, MPH
Jeffrey T. Kullgren, MS, MD, MPH

Dr. Kullgren: The widespread availability of proven strategies to prevent and treat type 2 diabetes has great potential to reduce the public health burden. However, the real-world impact of these strategies is limited by suboptimal patient engagement.

An important barrier to patient engagement can be cognitive biases, which represent errors in mental processing that can keep individuals from taking steps that will help them achieve their long-term goals. In recent years, such cognitive biases have been elucidated by the field of behavioral economics, which combines elements of economics and psychology to better understand and improve decision-making. Thus, strategies that are grounded in behavioral economic insights have great potential to improve patient engagement in evidence-based interventions to prevent and treat type 2 diabetes. 

Using Behavioral Economics to Promote Healthy Food Choices

Presenter: Anne N. Thorndike, MD, MPH, Associate Professor of Medicine at Harvard Medical School and Director of the Metabolic Syndrome Clinic at Massachusetts General Hospital

Anne N. Thorndike, MD, MPH
Anne N. Thorndike, MD, MPH

Dr. Thorndike: In a traditional economics approach to a problem, the assumption is that people know what’s best for themselves and they act that way. In other words, they make rational decisions.

When it comes to helping people make healthier food choices, it’s the assumption that a numeric nutrition panel or label with information about calories and saturated fat will prompt people to make the decision to purchase a healthier item with fewer calories and lower saturated fat. Unfortunately, most humans don’t always work that way. So in behavioral economics, the focus is on changing a person’s behavior and not depending on them to always make a rational or informed decision.

A lot of the work I have done, in both workplace and community-based settings, is designed to nudge people toward making healthier choices. One strategy is the use of simple, color-based labels—red, yellow, and green—as a way to convey information about the healthfulness of a food choice. Beyond just conveying information, the color is something people react to instantly. When you see a red colored label, for example, you’re less likely to purchase it without thinking about it. Another strategy is “choice architecture,” which involves product placement, such as putting the healthier items at eye level, so that it’s the first thing you see.

The goal of all of this is to address the rising prevalence of obesity and diabetes that we’re seeing. Although biology plays a strong role in obesity and diabetes, the rate at which we’re seeing this increase is largely driven by what’s in our environment and by our behavior.