Roybal Center for Behavioral Interventions in Aging

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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.