A Randomized Controlled Trial of Incentives for Habit Formation

习惯形成激励的随机对照试验

• 批准号: 8544386
• 负责人: Iwan Barankay
• 金额: $ 67.37万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-15 至 2016-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8544386
• 关键词: Accounting; Address; Adherence; Behavior; Behavior Therapy; Behavioral; Cardiovascular Diseases; Cardiovascular system; Cause of Death; Chronic Disease; Clinical Trials; Contracts; Deposition; Development; Diabetes Mellitus; Economics; Effectiveness; Electronics; Enrollment; Foundations; Goals; Habits; Health; Health behavior; Health behavior change; Healthcare; Hybrids; Incentives; Intervention; LDL Cholesterol Lipoproteins; Low-Density Lipoproteins; Measures; Patients; Pharmaceutical Preparations; Phase; Productivity; Randomized; Randomized Controlled Trials; Relative (related person); Rewards; Risk; Savings; Shapes; Techniques; Testing; Text; Time; United States; Validation; Visual; Work; Workplace; arm; base; cardiovascular disorder risk; cholesterol control; compare effectiveness; conditioning; cost effective; cost effectiveness; design; financial incentive; high risk; improved; insight; member; payment; pill; post intervention; primary outcome; programs; public health relevance; secondary outcome; treatment as usual

DESCRIPTION (provided by applicant): Cardiovascular disease (CVD) is the leading cause of death in the United States. Despite strong evidence that reducing low-density lipoproteins (LDL) with statins successfully lowers CVD risk, more than 50% of patients stop taking statins within one year of initial prescription though such therapy typically should be lifelong. In this study, w will test the effectiveness of different behavioral economic interventions in shaping lasting habit for statin adherence and reducing LDL cholesterol among patients with poor cholesterol control who are at very high risk for CVD. The application of conceptual approaches from behavioral economics offers considerable promise in advancing health and health care. Interventions based on financial incentives are successful in changing health behaviors during the intervention period but in many cases not thereafter. In patients with suboptimal cholesterol control who are at high risk for CVD, we propose to test the effectiveness of different behavioral economic techniques in inducing habit formation for adherence to statin use and sustained reductions in LDL cholesterol after financial incentives are discontinued. We will test these approaches among members of CVS Caremark nationwide. Using a 4-arm, randomized controlled trial, we aim to answer these questions: [1] How do daily lotteries, habit formation lotteries, and hybrid lottery deposit contracts, all of which include daily reminders, compare with daily reminders in improving statin adherence and LDL control during the intervention phase? [2] How do these 3 incentives compare to daily reminders in achieving improved adherence and improved LDL control post- intervention? [3] How do these approaches compare in cost-effectiveness?

描述（由申请人提供）：心血管疾病（CVD）是美国的主要死亡原因。尽管有强有力的证据表明，用他汀类药物降低低密度脂蛋白（LDL）成功地降低了CVD风险，但超过50%的患者在首次处方后一年内停止服用他汀类药物，尽管这种治疗通常应该是终身的。在这项研究中，我们将测试不同的行为经济干预措施在塑造持久的习惯，坚持他汀类药物和降低低密度脂蛋白胆固醇的患者胆固醇控制差，谁是在非常高的风险心血管疾病。 行为经济学的概念方法的应用在促进健康和医疗保健方面提供了相当大的希望。 基于财政激励的干预措施在干预期间成功地改变了健康行为，但在许多情况下，此后就没有了。在胆固醇控制欠佳的CVD高危患者中，我们建议测试不同行为经济学技术在诱导习惯形成方面的有效性，以坚持使用他汀类药物，并在经济激励措施停止后持续降低LDL胆固醇。我们将在全国范围内的CVS Caremark成员中测试这些方法。 使用4臂随机对照试验，我们的目标是回答这些问题：[1]每日彩票，习惯形成彩票和混合彩票存款合同，所有这些都包括每日提醒，如何与 在干预阶段每天提醒改善他汀类药物依从性和LDL控制？[2]这3种激励措施与每日提醒相比，在实现干预后改善依从性和改善LDL控制方面如何？[3]这些方法的成本效益如何比较？