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1.
Int J Environ Res Public Health ; 19(15)2022 Aug 03.
Article in English | MEDLINE | ID: covidwho-1969281

ABSTRACT

We provide a game-theoretical epidemiological model for the COVID-19 pandemic that takes into account that: (1) asymptomatic individuals can be contagious, (2) contagion is behavior-dependent, (3) behavior is determined by a game that depends on beliefs and social interactions, (4) there can be systematic biases in the perceptions and beliefs about the pandemic. We incorporate lockdown decisions by the government into the model. The citizens' and government's beliefs can exhibit several biases that we discuss from the point of view of behavioral economics. We provide simulations to understand the effect of lockdown decisions and the possibility of "nudging" citizens in the right direction by improving the accuracy of their beliefs.


Subject(s)
COVID-19 , COVID-19/epidemiology , Communicable Disease Control , Economics, Behavioral , Government , Humans , Pandemics
2.
Curr Opin Pediatr ; 34(4): 326-333, 2022 08 01.
Article in English | MEDLINE | ID: covidwho-1922408

ABSTRACT

PURPOSE OF REVIEW: Behavioral economics (BE) concepts have become well studied tools in addressing patient issues, such as weight loss, smoking cessation, and medication adherence. Although predominantly studied in adult populations, emerging literature has shown BE's utility for adolescent/young adult (AYA) populations, offering a practical framework to safeguard AYA health and influence healthy decision making. RECENT FINDINGS: We identified substantive areas in which BE concepts have been applied in AYA populations (e.g., substance use) and outline how these concepts have been used as a tool to identify individuals at risk for poor outcomes and to leverage behavioral insights to improve health behaviors. SUMMARY: BE research holds significant promise as a tool for clinicians and researchers to encourage healthy decision making in AYA populations. Yet, there are opportunities for BE research to expand further into current trends impacting adolescent health, such as electronic nicotine delivery systems, social media apps, and coronavirus disease 2019 vaccinations. Furthermore, the full degree of BE utility remains to be explored, as few studies demonstrate the translation of associative findings into direct interventions. Additional work is needed to formalize BE techniques into best practices that clinicians can implement in their daily practice.


Subject(s)
COVID-19 , Substance-Related Disorders , Adolescent , Delivery of Health Care , Economics, Behavioral , Health Behavior , Humans , Young Adult
3.
Gac Sanit ; 36 Suppl 1: S93-S96, 2022.
Article in Spanish | MEDLINE | ID: covidwho-1920888

ABSTRACT

Behavioural economics (a combination of economics and psychology) provides keys to understand decisions made by politicians and citizens along the COVID-19 pandemic through the so-called cognitive biases. These biases can be offset by implementing behavioural interventions named "nudges" in order to promote responsible behaviours in the "new normality". This paper analyses, from a behavioural economics perspective, past, present and future of behavioural aspects surrounding the pandemic. Besides, this paper proposes different ways to formalize nudges according to law, which needs the fulfilment of three minimum requirements, namely: transparency, non-arbitrariness and efficiency. Furthermore, it is also suggested that protocols and contingency plans are set up to face future pandemics, in which both soft (nudge-type) interventions and hard legal regulations play different roles but complementary ones. Nudges can be implemented in a fast and less coercive way, so they are particularly suitable for changing mild misbehaviour, reserving legal sanctions for the more serious ones.


Subject(s)
COVID-19 , Pandemics , COVID-19/epidemiology , Economics, Behavioral , Health , Humans
4.
Med Sci (Paris) ; 38(6-7): 594-599, 2022.
Article in French | MEDLINE | ID: covidwho-1915308

ABSTRACT

Title: Les attendus d'une approche d'économie comportementale pour les décisions individuelles face à la pandémie de COVID-19 : succès et déceptions. Abstract: Dans le cadre du premier appel à projet « Flash-COVID-19 ¼ de l'Agence nationale de la recherche, nous avons mobilisé des méthodes récentes de l'économie comportementale afin de mieux comprendre les décisions des individus face à la crise sanitaire due à la pandémie de COVID-19 (coronavirus disease 2019) et d'identifier les paramètres pouvant influencer le respect des mesures sanitaires. Cet article introduit brièvement l'économie comportementale, présente un compte rendu des attendus du projet CONFINOBS (Observance et observation des mesures barrières et du confinement : une approche d'économie comportementale) et de ses méthodes, puis il propose une synthèse des résultats obtenus.


Subject(s)
COVID-19 , Economics, Behavioral , Decision Making , Emotions , Humans
5.
Behav Processes ; 198: 104640, 2022 May.
Article in English | MEDLINE | ID: covidwho-1777986

ABSTRACT

Behavioral economics is an approach to understanding behavior though integrating behavioral psychology and microeconomic principles. Advances in behavioral economics have resulted in quick-to-administer tasks to assess discounting (i.e., decrements in the subjective value of a commodity due to delayed or probabilistic receipt) and demand (i.e., effort exerted to defend baseline consumption of a commodity amidst increasing constraints)-these tasks are built upon decades of foundational work from the experimental analysis of behavior and exhibit adequate psychometric properties. We propose that the behavioral economic approach is particularly well suited, then, for experimentally evaluating potential public policy decisions, particularly during urgent times or crises. Using examples from our collaborations (e.g., cannabis legalization, happy hour alcohol pricing, severe weather alerts, COVID-19 vaccine marketing), we demonstrate how behavioral economic approaches have rendered novel insights to guide policy development and garnered widespread attention outside of academia. We conclude with implications on multidisciplinary work and other areas in need of behavioral economic investigations.


Subject(s)
COVID-19 , Economics, Behavioral , COVID-19 Vaccines , Health Policy , Humans , Public Policy
6.
J Med Internet Res ; 24(2): e32714, 2022 02 07.
Article in English | MEDLINE | ID: covidwho-1714908

ABSTRACT

The decision to accept or reject new digital health technologies remains an ongoing challenge among health care patients, providers, technology companies, and policymakers. Over the past few decades, interest in understanding the choice to adopt technology has led to the development of numerous theories and models. In 1979, however, psychologists Kahneman and Tversky published their seminal research article that has pioneered the field of behavioral economics. They named their model the prospect theory and used it to explain decision-making behaviors under conditions of risk and uncertainty as well as to provide an understanding of why individuals may make irrational or inconsistent choices. Although the prospect theory has been used to explain decision-making in economics, law, political science, and clinically, at the individual level, its application to understanding choice in the adoption of digital health technology has not been explored. Herein, we discuss how the main components of the prospect theory's editing phase (framing effect) and evaluation phase (value function and weighting function) can provide valuable insight on why health care patients, providers, technology companies, and policymakers may decide to accept or reject digital health technologies.


Subject(s)
Decision Making , Economics, Behavioral , Delivery of Health Care , Humans , Politics , Uncertainty
7.
Clin Ther ; 43(10): 1646-1648, 2021 10.
Article in English | MEDLINE | ID: covidwho-1525739
8.
Clin Ther ; 43(10): 1649-1653, 2021 10.
Article in English | MEDLINE | ID: covidwho-1525735
10.
Clin Ther ; 43(10): 1654-1667, 2021 10.
Article in English | MEDLINE | ID: covidwho-1474433

ABSTRACT

PURPOSE: Behavioral economics recognizes that contextual, psychological, social, and emotional factors powerfully influence decision-making. Behavioral economics has the potential to provide a better understanding of, and, through subtle environmental changes, or "nudges," improve persistent quality-of-care challenges, like ambulatory antibiotic overprescribing. Despite decades of admonitions and educational initiatives, in the United States, up to 50% of ambulatory antibiotic prescriptions remain inappropriate or not associated with a diagnosis. METHODS: We conducted a Medline search and performed a narrative review that examined the use of behavioral economics to understand the rationale for, and improvement of, ambulatory antibiotic prescribing. FINDINGS: Clinicians prescribe antibiotics inappropriately because of perceived patient demand, to maintain patient satisfaction, diagnostic uncertainty, or time pressure, among other reasons. Behavioral economics-informed approaches offer additional improvements in antibiotic prescribing beyond clinician education and communication training. Precommitment, in which clinicians publicize their intent to prescribe antibiotics "only when they are absolutely necessary," leverages clinicians' self-conception and a desire to act in a manner consistent with public statements. Precommitment was associated with a 20% absolute reduction in the inappropriate antibiotic prescribing for acute respiratory infections. Justification alerts, in which clinicians must provide a brief written rationale for prescribing antibiotics, leverages social accountability, redefines the status quo as an active choice, and helps clinicians to shift from fast to slow, careful thinking. With justification alerts, the absolute rate of inappropriate antibiotic prescribing decreased from 23% to 5%. Peer comparison, in which clinicians receive feedback comparing their performance to their top-performing peers, provides evidence of improved performance and leverages peoples' desire to conform to social norms. Peer comparison decreased absolute inappropriate antibiotic prescribing rates from 20% to 4%, a decrease that persisted for 12 months after the end of the intervention. Also, a one-time peer-comparison letter from a high-profile messenger to primary care practices with high rates of prescribing antibiotics, there was a 6-month, 3% decrease inantibiotic prescribing. Future directions in applying behavioral economics to the inappropriate antibiotic prescribing include paying careful attention to design details; improving intervention effectiveness and durability; making harms salient; participants' involvement in the development of interventions (the "Ikea effect"); factoring in patient satisfaction; and patient-facing nudges about antibiotic use and care-seeking. In addition, the COVID pandemic could aid in ambulatory antibiotic prescribing improvements due to changing cognitive frames around respiratory symptom evaluation and antibiotic prescribing. IMPLICATIONS: To improve ambulatory antibiotic prescribing, several behavioral economics-informed approaches-especially precommitment, justification alerts, and peer comparison-have reduced the rates of inappropriate prescribing of antibiotics to low levels.


Subject(s)
Antimicrobial Stewardship , COVID-19 , Respiratory Tract Infections , Anti-Bacterial Agents/therapeutic use , Economics, Behavioral , Humans , Inappropriate Prescribing/prevention & control , Practice Patterns, Physicians' , Respiratory Tract Infections/drug therapy , SARS-CoV-2
12.
Curr Cardiol Rep ; 23(11): 153, 2021 10 01.
Article in English | MEDLINE | ID: covidwho-1446228

ABSTRACT

PURPOSE OF REVIEW: Behavioral economics represents a promising set of principles to inform the design of health-promoting interventions. Techniques from the field have the potential to increase quality of cardiovascular care given suboptimal rates of guideline-directed care delivery and patient adherence to optimal health behaviors across the spectrum of cardiovascular care delivery. RECENT FINDINGS: Cardiovascular health-promoting interventions have demonstrated success in using a wide array of principles from behavioral economics, including loss framing, social norms, and gamification. Such approaches are becoming increasingly sophisticated and focused on clinical cardiovascular outcomes in addition to health behaviors as a primary endpoint. Many approaches can be used to improve patient decisions remotely, which is particularly useful given the shift to virtual care in the context of the COVID-19 pandemic. Numerous applications for behavioral economics exist in the cardiovascular care delivery space, though more work is needed before we will have a full understanding of ways to best leverage such applications in each clinical context.


Subject(s)
COVID-19 , Economics, Behavioral , Health Behavior , Humans , Pandemics , SARS-CoV-2
13.
Int J Environ Res Public Health ; 18(15)2021 07 27.
Article in English | MEDLINE | ID: covidwho-1346479

ABSTRACT

The situation of labour inclusion of people with disabilities in Spain is still too negative, in spite of the different efforts carried out by public and private sector. Previous research points to social discrimination as one of the main causes of the situation. Ilunion Hotels is one of the most important hotel companies in Spain focused on labour inclusion of people with disabilities. The objective of this paper is to explore the social inclusion case of Ilunion Hotels of the Costa del Sol, the actions that they have developed to improve the labour integration of this collective, based on a behavioral economics theoretical model (with a high relevance of the influence of social stigma, stress theories and coping to stress responses). We look into the specific situation of two of the three hotels developed as Special Employment Centres (sheltered employment contexts defined by Spanish legislation) and the possible impact of their Support Units for Professional Activity. Case study methodology is considered the most appropriate, according to the research objective, supported by semi-structured interviews with the hotel managers. The results show that, although Special Employment Centres are effective in improving labour integration in the short term and could contribute to change the long-term social perspectives about workers with disabilities, they could be also reinforcing the social stigma existing in the ordinary market.


Subject(s)
Disabled Persons , Economics, Behavioral , Economics , Employment , Humans , Spain , Workforce
14.
Hastings Cent Rep ; 51(4): 7-8, 2021 07.
Article in English | MEDLINE | ID: covidwho-1306646

ABSTRACT

One of the biggest policy interventions during the last year of the COVID-19 pandemic was the Coronavirus Aid, Relief, and Economic Securities Act, instituting a novel form of economic relief similar to a universal basic income. The economic impact payments, colloquially known as "stimulus checks," were distributed based on the socioeconomic status of American citizens and legal residents and provided much-needed financial aid. However, the distribution of these payments paid little attention to other important factors that might determine the economic security of said individuals, such as race and gender. This article calls for policy-makers to pay particular attention to how structural inequity and discrimination based on identity could affect the efficacy of proposed policies and demonstrate an ethic of care informed by an understanding of intersectionality.


Subject(s)
COVID-19/economics , COVID-19/epidemiology , Cost of Illness , Economics, Behavioral/statistics & numerical data , Healthcare Financing/ethics , Health Behavior/ethics , Health Services Accessibility/economics , Humans , United Nations , United States
15.
Health Policy ; 125(8): 972-980, 2021 08.
Article in English | MEDLINE | ID: covidwho-1230501

ABSTRACT

Testing is widely seen as one core element of a successful strategy to curtail the COVID-19 pandemic and many countries have increased their efforts to provide testing at large scale. As most democratic governments refrain from enacting mandatory testing, a key emerging challenge is to increase voluntary participation. Using behavioural economics insights complemented with data from a novel survey in the US and a survey experiment in Luxembourg, we examine behavioural factors associated with the individual willingness to get tested (WTT). In our analysis, individual characteristics that correlate positively with WTT include age, altruism, conformism, the tendency to abide by government-imposed rules, concern about contracting COVID-19, and patience. Risk aversion, unemployment, and conservative political orientation correlate negatively with WTT. Building on and expanding these insights may prove fruitful for policy to effectively raise people's propensity to get tested.


Subject(s)
COVID-19 , COVID-19 Testing , Economics , Economics, Behavioral , Humans , Pandemics , SARS-CoV-2
16.
Can J Public Health ; 112(3): 417-420, 2021 06.
Article in English | MEDLINE | ID: covidwho-1229508

ABSTRACT

The COVID-19 pandemic is bringing about far-reaching structural changes on both the economy and public health, and conventional methodologies have to be fine-tuned to assist public health decision making. In this context, behavioural economics, which is situated at the crossroads between economics and social psychology, is an undeniably innovative field. In contrast with conventional models, the economic models of behavioural economics incorporate psychological and social determinants to produce more accurate predictions of individual behaviour. In the last 20 years, the scientific community has been using this approach's quantitative tool, experimental economics, in many areas of health, including prevention, promotion, human resources and social signage. Studies have come up with effective solutions that have improved best public health practices and provided sources of inspiration that should not be overlooked in the fight against COVID-19. They have allowed natural human behaviour to take a central role again, helped us to understand how the social and economic environment influences individuals, and enabled us to anticipate human reactions and so make faster adjustments to public policies.


RéSUMé: L'épidémie de COVID-19 nous impose des changements structurels profonds tant sur les plans économiques que sanitaires et les méthodologies classiques doivent être perfectionnées pour mieux adapter les décisions de santé publique. Dans ce cadre, l'économie comportementale, au croisement des sciences économiques et de la psychologie sociale, est un domaine incontestablement innovant en la matière. En effet, contrairement aux modèles classiques, cette discipline intègre les déterminants psychosociaux dans les modèles économiques pour mieux prédire les comportements des individus. Depuis une vingtaine d'années, la communauté scientifique utilise l'outil quantitatif de cette approche, l'économie expérimentale, dans de nombreux secteurs de la santé tels que la prévention, la promotion, les ressources humaines et la signalisation sociale. Les études menées ont apporté des solutions efficaces pour améliorer les bonnes pratiques sanitaires et sont des inspirations à ne pas négliger pour la lutte contre la COVID-19. Elles ont permis notamment de redonner une place centrale au comportement naturel de l'homme, de comprendre comment l'environnement socio-économique influence les individus et d'anticiper les réactions humaines pour adapter rapidement les politiques publiques.


Subject(s)
COVID-19/prevention & control , Public Health , Public Policy , COVID-19/epidemiology , Canada/epidemiology , Economics, Behavioral , Humans
17.
Transl Behav Med ; 11(3): 821-825, 2021 04 07.
Article in English | MEDLINE | ID: covidwho-1149965

ABSTRACT

The COVID-19 vaccine development, testing, and approval processes have moved forward with unprecedented speed in 2020. Although several vaccine candidates have shown promising results in clinical trials, resulting in expedited approval for public use from the U.S. Food and Drug Administration, recent polls suggest that Americans strongly distrust the vaccine and its approval process. This mistrust stems from both the unusual speed of vaccine development and reports about side effects. This article applies insights from behavioral economics to consider how the general public may make decisions around whether or not to receive a future COVID-19 vaccine in a context of frequent side effects and preexisting mistrust. Three common cognitive biases shown to influence human decision-making under a behavioral economics framework are considered: confirmation bias, negativity bias, and optimism bias. Applying a behavioral economics framework to COVID-19 vaccine decision-making can elucidate potential barriers to vaccine uptake and points of intervention for clinicians and public health professionals.


Subject(s)
COVID-19 Vaccines , Decision Making , Economics, Behavioral , Health Knowledge, Attitudes, Practice , Adult , Humans , United States
18.
Can J Public Health ; 112(3): 417-420, 2021 06.
Article in English | MEDLINE | ID: covidwho-1145732

ABSTRACT

The COVID-19 pandemic is bringing about far-reaching structural changes on both the economy and public health, and conventional methodologies have to be fine-tuned to assist public health decision making. In this context, behavioural economics, which is situated at the crossroads between economics and social psychology, is an undeniably innovative field. In contrast with conventional models, the economic models of behavioural economics incorporate psychological and social determinants to produce more accurate predictions of individual behaviour. In the last 20 years, the scientific community has been using this approach's quantitative tool, experimental economics, in many areas of health, including prevention, promotion, human resources and social signage. Studies have come up with effective solutions that have improved best public health practices and provided sources of inspiration that should not be overlooked in the fight against COVID-19. They have allowed natural human behaviour to take a central role again, helped us to understand how the social and economic environment influences individuals, and enabled us to anticipate human reactions and so make faster adjustments to public policies.


RéSUMé: L'épidémie de COVID-19 nous impose des changements structurels profonds tant sur les plans économiques que sanitaires et les méthodologies classiques doivent être perfectionnées pour mieux adapter les décisions de santé publique. Dans ce cadre, l'économie comportementale, au croisement des sciences économiques et de la psychologie sociale, est un domaine incontestablement innovant en la matière. En effet, contrairement aux modèles classiques, cette discipline intègre les déterminants psychosociaux dans les modèles économiques pour mieux prédire les comportements des individus. Depuis une vingtaine d'années, la communauté scientifique utilise l'outil quantitatif de cette approche, l'économie expérimentale, dans de nombreux secteurs de la santé tels que la prévention, la promotion, les ressources humaines et la signalisation sociale. Les études menées ont apporté des solutions efficaces pour améliorer les bonnes pratiques sanitaires et sont des inspirations à ne pas négliger pour la lutte contre la COVID-19. Elles ont permis notamment de redonner une place centrale au comportement naturel de l'homme, de comprendre comment l'environnement socio-économique influence les individus et d'anticiper les réactions humaines pour adapter rapidement les politiques publiques.


Subject(s)
COVID-19/prevention & control , Public Health , Public Policy , COVID-19/epidemiology , Canada/epidemiology , Economics, Behavioral , Humans
19.
J Subst Abuse Treat ; 120: 108150, 2021 01.
Article in English | MEDLINE | ID: covidwho-1023674

ABSTRACT

The response to the COVID-19 crisis has created direct pressure on health care providers to deliver virtual care, and has created the opportunity to develop innovations in remote treatment for people with substance use disorders. Remote treatments provide an intervention delivery framework that capitalizes on technological innovations in remote monitoring of behaviors and can efficiently use information collected from people and their environment to provide personalized treatments as needed. Interventions informed by behavioral economic theories can help to harness the largely untapped potential of virtual care in substance use treatment. Behavioral economic treatments, such as contingency management, the substance-free activity session, and episodic future thinking, are positioned to leverage remote monitoring of substance use and to use personalized medicine frameworks to deliver remote interventions in the COVID-19 era and beyond.


Subject(s)
COVID-19 , Substance-Related Disorders/therapy , Telemedicine/methods , Behavior Therapy/methods , Economics, Behavioral , Humans , Precision Medicine
20.
Front Public Health ; 8: 608852, 2020.
Article in English | MEDLINE | ID: covidwho-993481

ABSTRACT

This study was conducted to evaluate the impact of public perceptions of vaccine safety and efficacy on intent to seek COVID-19 vaccination using hypothetical vaccine acceptance scenarios. The behavioral economic methodology could be used to inform future public health vaccination campaigns designed to influence public perceptions and improve public acceptance of the vaccine. In June 2020, 534 respondents completed online validated behavioral economic procedures adapted to evaluate COVID-19 vaccine demand in relation to a hypothetical development process and efficacy. An exponential demand function was used to describe the proportion of participants accepting the vaccine at each efficacy. Linear mixed effect models evaluated development process and individual characteristic effects on minimum required vaccine efficacy required for vaccine acceptance. The rapid development process scenario increased the rate of decline in acceptance with reductions in efficacy. At 50% efficacy, 68.8% of respondents would seek the standard vaccine, and 58.8% would seek the rapid developed vaccine. Rapid vaccine development increased the minimum required efficacy for vaccine acceptance by over 9 percentage points, γ = 9.36, p < 0.001. Past-3-year flu vaccination, γ = -23.00, p < 0.001, and male respondents, γ = -4.98, p = 0.037, accepted lower efficacy. Respondents reporting greater conspiracy beliefs, γ = 0.39, p < 0.001, and political conservatism, γ = 0.32, p < 0.001, required higher efficacy. Male, γ = -4.43, p = 0.013, and more conservative, γ = -0.09, p = 0.039, respondents showed smaller changes in minimum required efficacy by development process. Information on the vaccine development process, vaccine efficacy, and individual differences impact the proportion of respondents reporting COVID-19 vaccination intentions. Behavioral economics provides an empirical method to estimate vaccine demand to target subpopulations resistant to vaccination.


Subject(s)
COVID-19 Vaccines/economics , COVID-19/prevention & control , Patient Acceptance of Health Care/psychology , Patient Acceptance of Health Care/statistics & numerical data , Perception , Vaccination/economics , Vaccination/psychology , Adult , Aged , Aged, 80 and over , COVID-19/epidemiology , Cross-Sectional Studies , Economics, Behavioral/statistics & numerical data , Female , Humans , Male , Middle Aged , Pandemics/prevention & control , SARS-CoV-2 , Surveys and Questionnaires , United States/epidemiology , Vaccination/statistics & numerical data
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