Behavioral Economics and Population-based Colorectal Cancer Screening

行为经济学和基于人群的结直肠癌筛查

• 批准号: 10471214
• 负责人: Shivan Jatin Mehta
• 金额: $ 25.35万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-15 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10471214
• 关键词: Adopted; Award; Behavior; Behavioral Sciences; Cancer Biology; Cancer Etiology; Cessation of life; Clinical; Clinical Trials; Colonoscopy; Colorectal Cancer; Complement; Data; Disease; Early Diagnosis; Endowment; Friction; Funding; Gastroenterology; Goals; Health; Health Policy; Health Promotion; Health Services Research; Health system; Healthcare; Home; Human; Improve Access; Industry; Intervention; Interview; Intestines; K-Series Research Career Programs; Low income; Marketing; Medicine; Mentors; Mentorship; Methods; Motivation; New Jersey; Office Visits; Patients; Pennsylvania; Persons; Population; Population Heterogeneity; Preparation; Prevention; Prevention strategy; Primary Health Care; Process; Provider; Public Health; Qualitative Methods; Qualitative Research; Recommendation; Research; Research Methodology; Research Personnel; Research Training; Schedule; Schools; Science; Services; Social Sciences; System; Techniques; Training; Training Programs; Translating; United States; Universities; Visit; Vulnerable Populations; Work; arm; behavioral economics; behavioral study; burden of illness; care providers; career; colorectal cancer prevention; colorectal cancer screening; consumer behavior; design; experience; financial incentive; health care delivery; implementation evaluation; implementation science; improved; insight; medical schools; novel strategies; outreach; patient outreach; population based; pragmatic trial; primary care services; professor; response; screening; screening guidelines; screening participation; screening program; skills; uptake; voucher

PROJECT SUMMARY/ ABSTRACT This proposal describes a 5-year comprehensive program of training and mentored research for an academic career in health care delivery research. I am an Assistant Professor of Medicine and Health Policy at the University of Pennsylvania. My goal is to become an independent investigator evaluating how health systems can leverage new insights from social science to improve access to and quality of colorectal cancer (CRC) screening. While I have a strong background in clinical gastroenterology and retrospective health services research, I will receive additional didactic and experiential training in qualitative research, methodological issues of clinical trials, and implementation science. At the University of Pennsylvania, I will take advantage of an experienced mentorship team, close partnership with the health care delivery system, and expertise in behavioral economics and consumer marketing across the Perelman School of Medicine and the Wharton School. CRC is the second leading cause of cancer death in the United States. Despite effective strategies for prevention, early detection, and treatment, and aggressive public health efforts to promote screening, national rates are limited at 62-65% The US currently relies predominantly on primary care providers to recommend screening to those who attend an office visit. There have been efforts to create proactive and organized CRC screening programs, but they have not been broadly adopted. I will collaborate with the primary care service line at the University of Pennsylvania Health System, an academic health system with 65 diverse primary care practices within the largest health system in Eastern Pennsylvania and New Jersey. I will conduct an iterative pilot of a proactive process to send colonoscopy preparation kits to eligible patients as a way to facilitate CRC screening participation (Aim 1). Then, I will conduct a 3-arm pragmatic RCT among 1182 eligible patients to evaluate if alternative ways of offering the colonoscopy preparation kit can increase response rates (Aim 2). The preparation kit is a form of a financial incentive that invokes norms of reciprocity, frames participation as the default, creates an endowment, and reduces the burden of patient effort. Finally, I will perform qualitative interviews with patients and practices to understand their experience with CRC screening outreach and develop refined and new approaches (Aim 3). This work will provide me with skills and preliminary data to apply for external funding to support a pragmatic trial evaluating a multi-level approach to population-based CRC screening. At the conclusion of this award, I will receive rigorous research training to complement existing skills, I will complete a project applying principles of behavioral economics and consumer marketing to CRC screening, and I will submit a competitive application for an R-level award to fund a trial evaluating the implementation of a state-of-the-science approach to CRC screening outreach.

项目总结/摘要 该提案描述了一个为期5年的培训和指导研究的综合计划， 从事医疗保健服务研究的学术生涯。我是一名医学和卫生政策助理教授， 宾夕法尼亚大学我的目标是成为一名独立调查员， 系统可以利用社会科学的新见解来改善结直肠癌的可及性和质量 (CRC)筛选虽然我在临床胃肠病学和回顾性健康方面有很强的背景， 服务研究，我将接受定性研究的额外教学和经验培训， 临床试验的方法学问题和实施科学。在宾夕法尼亚大学， 利用经验丰富的指导团队，与医疗保健提供系统的密切合作关系， 以及佩雷尔曼医学院行为经济学和消费者营销方面的专业知识， 沃顿商学院 CRC是美国癌症死亡的第二大原因。尽管有有效的战略， 预防，早期发现和治疗，以及积极的公共卫生工作，以促进筛查，国家 率限制在62-65%，美国目前主要依靠初级保健提供者建议 筛选那些谁参加了办公室访问。一直在努力建立积极主动和有组织的儿童权利委员会 筛查计划，但尚未被广泛采用。 我将与宾夕法尼亚大学卫生系统的初级保健服务线合作， 在东部最大的卫生系统内拥有65个不同的初级保健实践的学术卫生系统 宾夕法尼亚和新泽西。我会进行一个反复的试验， 向符合条件的患者提供制备试剂盒，以促进CRC筛查的参与（目标1）。那我就 在1182名合格患者中进行了一项3组实用RCT，以评估是否有其他方法提供 结肠镜检查准备包可以提高反应率（目的2）。准备工具包是一种金融工具， 激励，调用互惠规范，框架参与作为默认，创建一个捐赠， 减轻了患者的负担。最后，我将对患者和实践进行定性访谈， 了解他们在CRC筛查外展方面的经验，并制定完善的新方法（目标3）。 这项工作将为我提供技能和初步的数据，以申请外部资金，以支持一个 一项实用的试验，评估基于人群的CRC筛查的多水平方法。在这一结论 我将接受严格的研究培训，以补充现有的技能，我将完成一个项目申请 行为经济学和消费者营销的原则，以CRC筛选，我将提交一份竞争力 申请R级奖，以资助一项评估国家科学方法实施情况的试验 到CRC筛查外展。

项目成果

COVID-19 Vaccine Perceptions Among Patients With Chronic Disease in a Large Gastroenterology and Hepatology Practice.

在大型胃肠病学和肝病学实践中，患有慢性疾病的患者的Covid-19疫苗看法。

• DOI: 10.14309/ajg.0000000000001270
• 发表时间: 2021-06-01
• 期刊: The American journal of gastroenterology
• 作者: Serper M;Reddy KR;Bewtra M;Ahmad N;Mehta SJ
• 通讯作者: Mehta SJ

An Automated Reporting System for Colonoscopy Quality: Lessons in Implementation.

结肠镜检查质量自动报告系统：实施经验教训。

• DOI: 10.1016/j.cgh.2021.10.001
• 发表时间: 2022
• 期刊: Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
• 作者: Ahmad,NuzhatA;Mehta,ShivanJ
• 通讯作者: Mehta,ShivanJ

The Impact of Introducing Patient-Reported Inflammatory Bowel Disease Symptoms via Electronic Survey on Clinic Visit Length, Patient and Provider Satisfaction, and the Environment Microbiome.

通过电子调查引入患者报告的炎症性肠病症状对就诊时间、患者和提供者满意度以及环境微生物组的影响。

• DOI: 10.1093/ibd/izaa356
• 发表时间: 2021
• 期刊: Inflammatory bowel diseases
• 影响因子: 4.9
• 作者: RoyPaladhi,Unmesha;Harb,AliH;Daniel,ScottG;Dawwas,GhadeerK;Schnellinger,ErinM;Wollack,Colin;Aberra,FatenN;Bewtra,Meenakshi;Green,JesseA;Klaproth,Jan-MichaelA;Lichtenstein,GaryR;Saxena,Akriti;Berera,Shivali;Buchner,Anna

Behavioral interventions to improve population health outreach for hepatitis C screening: randomized clinical trial.

• DOI: 10.1136/bmj.n1022
• 发表时间: 2021-05-18
• 期刊: BMJ (Clinical research ed.)
• 作者: Mehta SJ;Day SC;Norris AH;Sung J;Reitz C;Wollack C;Snider CK;Shaw PA;Asch DA
• 通讯作者: Asch DA

Effect of Text Messaging and Behavioral Interventions on COVID-19 Vaccination Uptake: A Randomized Clinical Trial.

• DOI: 10.1001/jamanetworkopen.2022.16649
• 发表时间: 2022-06-01
• 期刊: JAMA NETWORK OPEN
• 影响因子: 13.8
• 作者: Mehta, Shivan J.;Mallozzi, Colleen;Shaw, Pamela A.;Reitz, Catherine;McDonald, Caitlin;Vandertuyn, Matthew;Balachandran, Mohan;Kopinsky, Michael;Sevinc, Christianne;Johnson, Aaron;Ward, Robin;Park, Sae-Hwan;Snider, Christopher K.;Rosin, Roy;Asch, David A.
• 通讯作者: Asch, David A.