Roybal Center for Behavioral Interventions in Aging

摘要 Roybal老龄化行为干预中心的总体目的是加强 世界各地的临床医生能够推荐最安全和最有效的治疗方法， 通过行为经济干预来帮助患者。该中心的具体目标是： (1)进行行为干预的开发和实施，以鼓励适当的 通过使用心理学中的行为洞察力做出医疗决策， （2）为选择最有可能产生影响的干预措施提供信息 人口健康通过使用模拟模型，（3）翻译这些发现， 影响老龄化政策的决策者。我们的中心将在NIH阶段模式下运作 为行为干预创造了一个研究管道，从基础研究（阶段 0)通过全面传播干预措施（第五阶段）。工作将通过 管理和行政核心和研究是通过一个试点核心进行。两个试点 第一年提出了与美国阿片类药物危机相关的研究。第一个是建立在 我们以前的工作，在通知医生他们的病人的致命过量比较两个 在一项随机试验中，不同的字母框架与第四阶段研究一致。二是 一项可行性研究（第一阶段），以评估哪些推动可能提高医生对 丁丙诺啡治疗阿片类药物使用障碍推进这两个阶段的途径 讨论项目，并征求今后几年的新试点。与先前的连续性 Roybal奖反映在该中心使用模拟来选择飞行员， 对人口健康影响的潜力最大。该中心将支持不断增长的 研究人员社区进行行为干预，以鼓励适当使用 药物治疗：阿片类药物处方，多种药物，抗生素处方， 药物辅助治疗成瘾，以及其他医疗决定 这与指导方针不符，对人口健康产生了负面影响。

Abstract The overall purpose of the Roybal Center for Behavioral Interventions in Aging is to strengthen the ability of clinicians everywhere to recommend the safest and most effective treatments for their patients through behavioral economic interventions. The specific aims of the Center are to: (1) Conduct behavioral intervention development and implementation to encourage appropriate medical treatment decisions through the use of behavioral insights from psychology and economics; (2) Inform the selection of these interventions with the greatest potential to impact population health through the use of simulation models, and (3) Translate these findings for policy makers who influence aging policy. Our Center will operate under the NIH Stage Model for behavioral interventions creating a pipeline of studies that span from basic research (Stage 0) through full-scale dissemination of interventions (Stage V). Work will be managed through a Management and Administrative Core and research is conducted through a Pilot Core. Two pilot studies are proposed in Year 1 both relating to the opioids crisis in the US. The first builds on our previous work in informing physicians of their patient’s fatal overdose comparing two differently framed letters in a randomized trial consistent with Stage IV research. The second is a feasibility study (Stage I) to evaluate what nudges are likely to improve physician uptake of buprenorphine for opioid use disorder. Pathways toward advancing the stages of these two projects are discussed as are solicitations for new pilots in out-years. Continuity with the prior Roybal award is reflected in the Center’s use of simulation to inform selection of pilots that will have the greatest potential for population health impact. The Center will support a growing community of researchers conducting behavioral interventions to encourage appropriate use of medical treatments: Opioid prescribing, polypharmacy, antibiotic prescribing, clinical inertia in medication assisted therapy for addiction, and other areas of care where medical decisions are discordant with guidelines and are having a negative impact on population health.