Roybal Center for Behavioral Interventions in Aging

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Abstract The Pilot Core for the Roybal Center for Behavioral Interventions in Aging will develop and test interventions based on insights from behavioral science to promote healthy aging. The specific aims of the Center are to: (1) Recruit and develop a diverse set of senior and junior researchers to initiate and support pilot projects in our focus area to better understand the consequences of current patterns of practice and interventions that will improve care delivery, the quality of care, and its value to aging adults; (2) Conduct pilot research in accordance with the NIH stage model to facilitate development and use of the most effective interventions and (3) Report and disseminate findings to health systems and government organizations who can benefit from the results of the research. The Pilot Core will support projects that span the NIH Five Stage Model for behavioral interventions. 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. All pilots funded at the Center will address the theme of behavioral economics to improve quality of care. We encourage adoption of evidence-based care and de-implementation of low-value and harmful practices. The impact of potential pilot studies is informed by simulation results that follow from the Roybal Center resources developed from our previous awards. During the course of the award, the Pilot Core will support research studies 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.