New Ways to Make People Save: A Social Marketing Approach

In this study, we use a social marketing approach to develop a planning aid to help new employees at a not-for-profit institution contribute to supplementary pensions. We employed different methods, such as surveys, focus groups and in-depth interviews, to "listen" to employees' needs and difficulties with saving. Moreover, we targeted specific groups that were less likely to save and contribute to supplementary pensions, such as women and low-income employees. The program we developed is not only effective but also inexpensive. While this program was implemented at a single institution, it is suitable to be applied to a variety of employers and demographic groups.

Rationale and design of the Novel Uses of adaptive Designs to Guide provider Engagement in Electronic Health Records (NUDGE-EHR) pragmatic adaptive randomized trial: a trial protocol

Background: The prescribing of high-risk medications to older adults remains extremely common and results in potentially avoidable health consequences. Efforts to reduce prescribing have had limited success, in part because they have been sub-optimally timed, poorly designed, or not provided actionable information. Electronic health record (EHR)-based tools are commonly used but have had limited application in facilitating deprescribing in older adults. The objective is to determine whether designing EHR tools using behavioral science principles reduces inappropriate prescribing and clinical outcomes in older adults. Methods: The Novel Uses of Designs to Guide provider Engagement in Electronic Health Records (NUDGE-EHR) project uses a two-stage, 16-arm adaptive randomized pragmatic trial with a “pick-the-winner” design to identify the most effective of many potential EHR tools among primary care providers and their patients ≥ 65 years chronically using benzodiazepines, sedative hypnotic (“Z-drugs”), or anticholinergics in a large integrated delivery system. In stage 1, we randomized providers and their patients to usual care (n = 81 providers) or one of 15 EHR tools (n = 8 providers per arm) designed using behavioral principles including salience, choice architecture, or defaulting. After 6 months of follow-up, we will rank order the arms based upon their impact on the trial’s primary outcome (for both stages): reduction in inappropriate prescribing (via discontinuation or tapering). In stage 2, we will randomize (a) stage 1 usual care providers in a 1:1 ratio to one of the up to 5 most promising stage 1 interventions or continue usual care and (b) stage 1 providers in the unselected arms in a 1:1 ratio to one of the 5 most promising interventions or usual care. Secondary and tertiary outcomes include quantities of medication prescribed and utilized and clinically significant adverse outcomes. Discussion: Stage 1 launched in October 2020. We plan to complete stage 2 follow-up in December 2021. These results will advance understanding about how behavioral science can optimize EHR decision support to improve prescribing and health outcomes. Adaptive trials have rarely been used in implementation science, so these findings also provide insight into how trials in this field could be more efficiently conducted. Trial registration: Clinicaltrials.gov (NCT04284553, registered: February 26, 2020

Regulatory Focus and Efficacy of Health Messages

Two studies support the premise that a person's regulatory focus determines the salience of self-efficacy (perceived ease) or response efficacy (perceived effectiveness) of health behaviors. The findings indicate greater regulatory-efficacy fit (experiment 1) and higher intentions to perform the advocated behaviors (experiment 2) when self-efficacy features are paired with promotion focus and when response efficacy features are paired with prevention focus. The data support the premise that self-efficacy is weighed more than response efficacy when the regulatory focus is promotion, whereas the reverse is true in prevention regulatory focus. (c) 2006 by JOURNAL OF CONSUMER RESEARCH, Inc..

Value from Regulatory Construal Fit: The Persuasive Impact of Fit between Consumer Goals and Message Concreteness

This research investigates the relationship between regulatory focus and construal level. The findings indicate that promotion-focused individuals are more likely to construe information at abstract, high levels, whereas those with a prevention focus are more likely to construe information at concrete, low levels (experiments 1 and 2). Further, such fit (vs. nonfit) between an individual's regulatory focus and the construal level at which information is represented leads to more favorable attitudes (experiments 3 and 4) and enhances performance on a subsequent task (experiment 3). These outcomes occur because fit enhances engagement that in turn induces processing fluency and intensifies reactions. (c) 2009 by JOURNAL OF CONSUMER RESEARCH, Inc..