Journal of General Internal Medicine

, Volume 28, Issue 5, pp 711–718

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

Authors

  • Braden K. Mogler
    • David Geffen School of Medicine at UCLA
    • Charles R. Drew University of Medicine and Science
  • Suzanne B. Shu
    • Department of MedicineDavid Geffen School of Medicine at UCLA
    • UCLA Anderson School of Management
  • Craig R. Fox
    • Department of MedicineDavid Geffen School of Medicine at UCLA
    • UCLA Anderson School of Management
    • Department of Psychology, UCLA
  • Noah J. Goldstein
    • Department of MedicineDavid Geffen School of Medicine at UCLA
    • UCLA Anderson School of Management
    • Department of Psychology, UCLA
  • Ronald G. Victor
    • Department of MedicineDavid Geffen School of Medicine at UCLA
    • Cedars-Sinai Heart Institute
  • José J. Escarce
    • Department of MedicineDavid Geffen School of Medicine at UCLA
    • UCLA Jonathan and Karin Fielding School of Public Health
    • Department of MedicineDavid Geffen School of Medicine at UCLA
    • UCLA Jonathan and Karin Fielding School of Public Health
    • David Geffen School of Medicine at UCLA
Reviews

DOI: 10.1007/s11606-012-2261-8

Cite this article as:
Mogler, B.K., Shu, S.B., Fox, C.R. et al. J GEN INTERN MED (2013) 28: 711. doi:10.1007/s11606-012-2261-8

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.

KEY WORDS

chronic diseasebehavioral economicsfinancial incentivessocial psychology

Copyright information

© Society of General Internal Medicine 2012