Financial and Social Behavioral Economic Incentives to Increase Physical Activity in Adolescents and Young Adults for Cardiovascular Health

当孩子们进入青春期和青春期时，他们就会变得明显不那么活跃。努力实现 增加青少年和青壮年(15-25岁，此后概括为 青年)面临两个挑战。第一，促进心血管健康的体力活动建议 年轻人来自于这一人群中相对较少的数据。第二，旨在增加体力的干预措施 青年方面的活动充其量也只能产生有限且喜忧参半的结果。行为经济学是一个很有前途的领域 设计激励性干预措施，促进心血管健康的健康行为。行为经济学 干预措施可能在年轻人中尤其有效。这是因为发育中的年轻人有更强的 对奖励和同伴影响的反应。这个K应用程序研究目标是开发一种行为 经济干预，以增加青年的体力活动。我会有意识地为年轻人设计一个干预方案 从三个方面来说。首先，我将分析参加国家健康与营养检查的3500名青年的数据 一项旨在确定与改善青年心血管健康有关的体力活动量的调查。 其次，我将吸引年轻人对体育活动、经济激励(例如，收益或损失框架)的偏好，以及 社会激励(例如，选择团队成员和与团队成员沟通的方法) 对400名低收入青年进行选择实验。最后，我将设计一种金融和社会激励干预 采用以青年为中心的参与式方法。激励干预将在两个月的可行性内进行试点 在低收入青年中进行试验。这项干预将利用积极青年发展理论的见解来 最大限度地发挥行为经济干预对低收入青年的影响。我将利用以下资源： 杜克大学，在那里我是儿科学助理教授和杜克临床学院的教员 杜克-马戈利斯健康政策中心和杜克儿童肥胖研究中心。 目前的应用程序将提供一个有专家指导的结构化环境，使我能够开发 作为独立调查者和未来行为经济干预的领导者 青年的心血管健康状况。我将完成一项由正式教学培训组成的职业发展计划 在心血管健康的健康行为流行病学中，混合方法研究技术，患者- 以研究为中心，进行行为经济干预试验。我已经召集了一位导师 团队在这些主题上拥有广泛的专业知识，并有成功指导初级教员的历史。我有过 包括一位年轻的倡导者作为顾问，他的青年视角将有助于指导我的研究。这 工作和培训将通知我的研究员发起的R01试验的研究建议，以测试 在青少年和年轻人中增加体力活动的行为经济激励。来自以下方面的见解 这项工作也将适用于其他一系列青少年的心血管健康行为，例如 与吸烟、健康饮食选择和服药依从性有关的问题。

When children reach adolescence and young adulthood, they become dramatically less active. Efforts to increase physical activity among adolescents and young adults (15-25 years old, henceforth summarized as youth) face two challenges. First, physical activity recommendations that promote cardiovascular health for youth stem from relatively little data in this population. Second, interventions designed to increase physical activity in youth have produced at best modest and mixed results. Behavioral economics is a promising field for designing incentive interventions to promote healthy behaviors for cardiovascular health. Behavioral economic interventions may be especially potent in youth. This is because developmentally youth have stronger reactions to reward and peer influence. The research objective of this K application is to develop a behavioral economic intervention to increase physical activity in youth. I will intentionally design an intervention for youth in three ways. First, I will analyze data from >3500 youth in the National Health and Nutrition Examination Survey to determine the amount of physical activity associated with improved cardiovascular health in youth. Second, I will elicit youth preferences on physical activity, financial incentives (e.g., gain- or loss-framed), and social incentives (e.g., methods for selecting and communicating with team members) through a discrete choice experiment with 400 low-income youth. Finally, I will design a financial and social incentive intervention using a youth-centered, participatory approach. The incentive intervention will be piloted in a 2-month feasibility trial with low-income youth. The intervention will leverage insights from Positive Youth Development theory to maximize the impact of behavioral economic interventions in low-income youth. I will capitalize on resources at Duke University, where I am an Assistant Professor of Pediatrics and a faculty member of the Duke Clinical Research Institute, Duke-Margolis Center for Health Policy, and Duke Center for Childhood Obesity Research. The current application will provide a structured environment with expert mentorship to enable me to develop as an independent investigator and future leader in behavioral economic interventions to promote cardiovascular health in youth. I will complete a career development plan comprised of formal didactic training in the epidemiology of health behaviors for cardiovascular health, mixed methods research techniques, patient- centered research, and the conduct of behavioral economic intervention trials. I have assembled a mentorship team with extensive expertise in these topics and a history of successful mentorship of junior faculty. I have included a young adult advocate as an advisor, whose youth perspective will help guide my research. This work and training will inform my investigator-initiated research proposals for R01 trials to test the efficacy of behavioral economic incentives to increase physical activity in adolescents and young adults. Insights from this work will also be applicable to a range of other youth health behaviors for cardiovascular health, such as those related to smoking, healthy diet choices, and medication adherence.