Analysing and Changing Unhealthy Behaviour

Category
Broadening minor
Minor code
GWMINOR322
Duration
10 weeks

Analysing and changing unhealthy behaviour

Content

People generally attach great importance to their health and would name it as one of the key aspects for a happy life. Nonetheless, many people do not adhere to a healthy lifestyle and therefore seem to behave in conflict with their own life goals. Smoking, physical inactivity, rejecting vaccination and screening or not adhering to physicians’ recommendations are popular examples. This raises the question as to how we can change behaviour and improve health and wellbeing. This is a question of concern to individuals, schools, companies and governments, and is the central question in this minor. The past decades have seen many different approaches as to how behaviour change can potentially be realised. Traditionally in many fields, but economics especially, individuals are seen as ‘rational decision-makers’, i.e. they know what they want, and make reasoned choices to achieve their goal of a better health and happiness. In this view, policies or interventions to promote behaviour change are only necessary when individuals are misinformed or choice is limited.  

In particular, two issues arise with this traditional approach to behaviour (change) that are the focus of this minor:

  1. For most people health is very different from most other commodities. Questions of how to approach issues in health are the domain of health economics, which is one of the core components of this minor.
     
  2. We all know that often people do not behave rationally when it concerns their own health and wellbeing. Understanding such non-rational behaviour requires insights from for example psychology and sociology, which are both central to behavioural economics – the second core component of this minor.

You will be introduced to the key concepts from behavioural and health economics, with examples related to health and healthcare. We will apply these concepts to i) understand health behaviour, both rational and non-rational, and ii) explore what this means for individuals, organisations and governments aiming to promote healthier behaviour (e.g., through nudging, boosting, incentives and regulation). Using these insights, you will select an actual health issue of your interest (e.g., excessive drinking, smartphone use in traffic), potentially involving stakeholders from the field, design an intervention, and reflect on it critically.

Learning objectives

After this minor students can:

After this minor students can:

  1. Explain and apply the traditional economic approach to rational choice, and discuss the merits and limitations of this approach for understanding and changing behaviour.
  2. Apply basic economic and mathematical tools to demonstrate and/or explain how traditional assumptions about rationality are violated (e.g. using behavioural models).
  3. Give examples of heuristics and biases in intertemporal choice, risky choice and social choice.
  4. Apply these behavioural insights to understand and analyse health behaviour, in at least two settings: lifestyle choice, and patient and physician decision-making.
  5. Differentiate between, provide arguments for and against, discuss challenges, and give examples of appropriate applications in health for the following four common (policy) interventions: a) nudging, b) boosting, c) (financial) incentives, d) regulation.
  6. Apply insights from behavioural and health economics to develop and evaluate an intervention aimed at promoting health and/or wellbeing.

Special aspects

Given that all teaching materials, lectures, working groups, exercises and exams will be in English, sufficient skills in  understanding, reading, speaking and writing in English is a requirement for succesful participation in this minor.

You will work together in small groups on developing your own health behaviour change intervention.

Teaching activities are, in principle, scheduled on two weekdays, with the remaining days reserved for preparation individual and group assignments.

Applying insights from health and behavioural economics will often involve the use of algebra and calculus. In this course, this will involve exercises requiring the equivalent of high school math skills. Nonetheless, there are no entry requirements, and material will be available at the start and during the course for students to acquire these skills.

Overview content per week

These topics will be covered per week:

Week 1: The ‘homo economicus’ – Learn about the traditional economic view on rational behaviour

In this week, you will be introduced to the minor, the basic concepts of traditional economics, and how this applies to health and health behaviour.

Week 2: Beyond rationality I – Deciding between now or later, and when options and outcomes are uncertain

In the lecture series Beyond Rationality, we will discuss deviations from traditional economics, heuristics and biases. In the first part of this series, we focus on intertemporal decision-making and decision under risk.

Week 3: Beyond rationality II – Deciding for and with others, and experimental methods

For the second part of this series of Beyond Rationality, we focus on social decision making and (intrinsic) motivation. Next, we delve a little into experimental methods, and establish them as a crucial method for understanding and changing health behaviour.

Week 4: Behaviour change tools I: Regulation and (financial) incentives

From this week onward, we start exploring how we can apply the theories learned earlier to change behaviour. In this week we consider the tools of regulation, information provision, and incentives to stimulate healthy behaviour.

Week 5: Applications of behavioural health economics I: Patient and physician decision-making

We apply our knowledge about behavioural health economics to patient and physician decision making in this week. There will be lectures on physician risk attitudes and decision styles, and how physicians balance their self-interest with patients’ interest. For patients, we offer a lecture on vaccine and screening uptake and another on treatment choice and adherence to this treatment.

Week 6: Behaviour change tools II: Nudging and boosting

In this week we discuss two tools that have recently been introduced and have received a lot of attention from policymakers and researchers alike. Both stray away from the idea that everyone is rational, but deal with this in different manners. Nudges try to facilitate healthy behaviour by steering people to the right choice automatically, while boosts equip people with the skills to make healthy choices themselves.

Week 7: Applications of behavioural health economics II: Lifestyle choice

In this week we apply our knowledge about behavioural health economics to analyse why so many people lead unhealthy lifestyles.

Week 8: Case studies

Several guest speakers will present cases in which they have used insights from psychology, behavioural economics or health economics to analyse or change health behaviour.

Week 9 & 10: Finish portfolio & present interventions

In the final two weeks we will wrap up the minor, among others with a symposium in which all students present the intervention they have been working on for the past weeks.

Teaching methods

Each week will have several (in case of ongoing corona restrictions: video) interactive lectures, Q&As and (if needed: online) working groups, in which students will work individually and in groups on cases specific to the learning goal of that week. For example, by analysing a specific health behaviour using the new knowledge covered in the lectures, or by debating positions on different policies for health behaviour change. Throughout the minor, students develop a portfolio that includes their weekly reflection on the covered material in various forms (e.g., short essay, slides, or vlog). Furthermore, they will develop a case analysis (of a health issue of their own choice) and the intervention they developed. The case analysis and intervention are also presented to other students and teachers.

Teaching materials 

The teaching materials will be a selection of journal articles and book chapters. Suggestions for additional reading (mainly popular science books) will be offered during the course. Several case studies are discussed during the working groups, and students work on a case and intervention during the later weeks of the minor.

Examination

Method of examination
Students will be examined by means of a written exam (consisting of mostly essay questions and some numerical applications), through their portfolio and the behavioural health intervention. The portfolio contains reflection exercises focused on the material that should be completed each week. The behavioural intervention contains a case analysis for a specific unhealthy behaviour (potentially involving stakeholders from the field), and a suggested intervention to promote behaviour change in the case selected that is also presented.

Composition of final grade

The written exam counts for 50% of the grade. The portfolio with reflection exercises is worth 10% of the grade. The behavioural health intervention counts for 40% of the grade. To pass this course, students need a weighted average grade of 5.5 or higher, and get at least a 5.0 for each of the three parts. The written exam can be retaken later in the academic year, but the weekly portfolio exercises cannot. Students that receive a grade lower than 5.0 for the behavioural health intervention can hand in a resit intervention. The maximum grade for this resit intervention is a 6.0. Participation in weekly working groups is not mandatory but recommended to achieve the learning goals and successful completion of the weekly reflection in the portfolio.

Feedback method
Students will receive regular feedback on their reflection questions, will be able to interact with the teachers during the interactive lectures and working groups, and will receive feedback on their designed behavioural health intervention during the minor.

Frequently Asked Questions

Contactinformatie

Stefan Lipman
lipman@eshpm.eur.nl
(010) 4082507
Kamer J8-45

Facultaire website
https://www.eur.nl/people/stefan-lipman

 

Category
Broadening minor
Minor code
GWMINOR322
Duration
10 weeks
Organisation
Erasmus School of Health Policy & Management
Study points (EC)
15
Instruction language
English
Location
Campus Woudestein

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