Designing sustainable incentives to encourage prevention and health behaviour

Abstract

At least 80% of premature heart disease, stroke and type 2 diabetes could be prevented through a healthy diet, regular physical activity and the avoidance of tobacco products (WHO, 2005). Yet many people fail to do so. Why?

It is widely recognized in economics, social-psychology, and public health, that individuals do not always behave according to what is considered optimal. In behavioural economics, the deviations from optimality are usually explained by behavioural biases such as probability weighting and myopic decision making. For example, individuals may misperceive their health risks due to cognitive limitations. In social psychology scholars emphasize the role of personality traits such as low self-efficacy and environmental barriers, to explain why individuals cannot translate intentions into behavioural actions. A multitude of possible explanations is available across different disciplines, but a comprehensive understanding is lacking.

 The goal of this project is to identify the most promising interventions (incentives and nudges) to induce healthy behaviour.

Keywords

Health behaviour, behavioural economics, theory, experiments, incentives, nudging

Approach

This project is organized in three parts: (1) develop hypotheses from economic and social psychology theories to understand (un)healthy behaviour and prevention; (2) empirically test the hypotheses using observational data and small scale lab experiments; and, (3) design field experiments to incentivize or nudge healthy behaviour and prevention.

First, the economic and social-psychology theories will be examined separately and we intend to derive testable hypotheses that allow refuting/supporting unique elements of the separate theories. Second, and more ambitiously, we will incorporate (social-)psychological phenomena into the economic models of behaviour.

The theoretical results can be validated with experimental research and surveys. For some hypotheses a laboratory setting may be required, where we can measure people’s preferences and tendency to exhibit psychological biases and confront them with their decisions in tasks simulating prevention situations. The results should also be validated in large surveys, in which both the psychological variables and people’s real prevention effort are observed.

The insights from behavioural economics can also be used in interventions to stimulate healthier lifestyles. The research approach we propose is two-fold. First, some interventions are first to be tested in a lab experiment. Lab experiments have the potential to validate the use of the interventions by measuring which mechanisms are at play, beyond the mere effectiveness of the intervention.  Second, field experiments will be implemented to assess the effectiveness of the intervention in the field.

Literature references

  • Baicker, K., D.M. Cutler, and Z. Song (2010), Workplace Wellness Programs Can Generate Savings Health Affairs 29(2): 304-311.
  • Matjasko JL, Cawley JH, Baker-Goering MM, Yokum DV (2016). Applying behavioural economics to public health policy American Journal of Preventive Medicine 50(5S1):S13-S19.
  • Volpp, K. G., Troxel, A. B., Pauly, M. V, Glick, H. A., Puig, A., Asch, D. A., …Audrain-McGovern, J. (2009). A randomized, controlled trial of financial incentives for smoking cessation. New England Journal of Medicine, 360(7), 699–709.

Cooperation

This PhD position is part of the Erasmus Initiative “Smarter choices for better health”, which is a collaborative effort between Erasmus School of Economics, the Department of Health Policy and Management, and the Public Health department at Erasmus MC. Active collaboration is expected with Professor Johan Mackenbach and staff members of the Department of Public Health, Erasmus Medical Centre.

Expected output

The candidate is expected to write at least 3 academic papers to be submitted to journals in Economics. Preferably, at least 1 of the papers will be single-authored.

Scientific relevance

The last decade has seen rising interest in applying behavioral economics insights to design interventions to stimulate healthy behavior. Whereas many of these interventions show promising effects in the short-run, most existing programs were expensive and time-consuming to administer, and the effects diminished, or even disappeared, after the experiment stopped (Volpp, 2009). Hence, there is a lack of evidence on sustainable interventions to encourage healthy behaviour. Moreover, as Matjasko et al. (2016) argue, more research is needed on the optimal design of interventions for groups of lower socioeconomic status (SES).

Societal relevance

An intervention that successfully encourages healthy behaviour is likely to improve population health, reduce health inequalities, and improve the financial sustainability of health care and disability insurance expenditures (e.g., Baicker et al. 2010).

Phd candidate profile

The candidate is expected to have (i) a (research) master degree in Economics, Econometrics, Mathematics, or another quantitative field, (ii) experience with statistical software (Stata, R, or similar programs), and (iii) excellent communication and writing skills in English. The candidate is expected to contribute to all three parts of the project, but depending on qualifications and interests the emphasis can be on either deriving hypotheses from theory, or testing hypotheses using observational or experimental data.

Supervisor(s)

Prof. dr. Han Bleichrodt

T: +31 (0)10 - 408 12 95
E: bleichrodt@remove-this.ese.eur.nl

Dr. Hans van Kippersluis

T: +31 (0)10 - 408 88 37
E: hvankippersluis@ese.eur.nl

Graduate school

This project is affiliated with the Tinbergen Institute graduate school, applicants for this project need to pass the Tinbergen Institute's admission requirements before they can be considered for a PhD position at ESE.

Note that the Tinbergen Institute requires valid GRE General Test results from all applicants. More information about the GRE test is available at http://www.ets.org/gre. Be aware that available seats for this test fill up very fast so book your test well in advance. Please contact the GRE program for specific questions about the GRE test (http://www.ets.org/gre/contact).

Deadline

Application deadline: September 1, 2017

Interested?

Apply for this project using our online application form

Tinbergen project code:

TI PhD 2017 ESE HB HvK