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Using Insights From Behavioral Economics and Social Psychology to Help Patients Manage Chronic Diseases

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Abstract

Despite a revolution in therapeutics, the ability to control chronic diseases remains elusive. We present here a conceptual model of the potential role of behavioral tools in chronic disease control. Clinicians implicitly accept the assumption that patients will act rationally to maximize their self-interest. However, patients may not always be the rational actors that we imagine. Major behavioral barriers to optimal health behavior include patients’ fear of threats to health, unwillingness to think about problems when risks are known or data are ambiguous, the discounting of risks that are far in the future, failure to act due to lack of motivation, insufficient confidence in the ability to overcome a health problem, and inattention due to pressures of everyday life. Financial incentives can stimulate initiation of health-promoting behaviors by reducing or eliminating financial barriers, but may not produce long-term behavior change without additional interventions. Strategies have been developed by behavioral economists and social psychologists to address each of these barriers to better decision-making. These include: labeling positive behaviors in ways consistent with patient life goals and priorities; greater focus on more immediate risks of chronic diseases; intermediate subgoals as steps to a large health goal; and implementation of specific plans as to when, where, and how an action will be taken. Such strategies hold promise for improving health behaviors and disease control, but most have not been studied in medical settings. The effectiveness of these approaches should be evaluated for their potential as tools for the clinician.

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Funders

This publication was made possible by the NIH,1RC4AG039077 grant. Martin F. Shapiro received support from the NIH,1RC4AG039077, UCLA/ DREW Project EXPORT, NIMHD, 2P20MD000182 and NIH/NCATS/UCLA CTSI Grant # UL1TR000124. Braden K. Mogler received support from the David Geffen School of Medicine at UCLA Department of Medicine Chiefs’ Fellowship.

Prior Presentations

An earlier version of this publication was presented as a plenary at the Western Student Medical Research Forum in Carmel, CA January 26–28, 2012.

Conflict of Interest

The authors declare that they do not have any conflicts of interest.

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Authors and Affiliations

  1. Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

    Suzanne B. Shu PhD, Craig R. Fox PhD, Noah J. Goldstein PhD, Ronald G. Victor MD, José J. Escarce MD, PhD & Martin F. Shapiro MD, PhD

  2. UCLA Jonathan and Karin Fielding School of Public Health, Los Angeles, CA, USA

    José J. Escarce MD, PhD & Martin F. Shapiro MD, PhD

  3. David Geffen School of Medicine at UCLA, 911 Broxton Plaza, Los Angeles, CA, 90095, USA

    Braden K. Mogler BS & Martin F. Shapiro MD, PhD

  4. Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA

    Braden K. Mogler BS

  5. UCLA Anderson School of Management, 911 Broxton Plaza, Los Angeles, CA, 90095, USA

    Suzanne B. Shu PhD, Craig R. Fox PhD & Noah J. Goldstein PhD

  6. Department of Psychology, , UCLA, Los Angeles, CA, USA

    Craig R. Fox PhD & Noah J. Goldstein PhD

  7. Cedars-Sinai Heart Institute, Los Angeles, CA, USA

    Ronald G. Victor MD

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  1. Braden K. Mogler BS
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  2. Suzanne B. Shu PhD
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  7. Martin F. Shapiro MD, PhD
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Correspondence to Martin F. Shapiro MD, PhD.

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Mogler, B.K., Shu, S.B., Fox, C.R. et al. Using Insights From Behavioral Economics and Social Psychology to Help Patients Manage Chronic Diseases. J GEN INTERN MED 28, 711–718 (2013). https://doi.org/10.1007/s11606-012-2261-8

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  • DOI: https://doi.org/10.1007/s11606-012-2261-8

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