BEHAVIORAL CHANGE IN
PEDIATRICS:
NUDGES, CARROTS, & STICKERS
Carol Duh-Leong, MD, MPP
C h i l d r en ’ s H o s p i t a l a t M o n te f i o r e
C h i l d r en ’ s H e a l t h I n c e n t i v e s L a b
M ay 1 0 , 2 016
Never go before an
audience unless you are
asking for something.
– Ward Cates, MD, MPH and
President of Family Health
International
Can we meet the goals of pediatrics
using what we have learned in
public policy and the social sciences?
5 GOALS TODAY
1. Behavioral Economics
2. 4 Topic Areas
- Reward Incentives
- Information and Salience
- Context/Framing
- Social Forces
3. Step it Up Pedometers
4. UV Wristbands
5. Soda Study
UNDERPINNINGS:
BEHAVIORAL ECONOMICS
 Standard economic theory: individuals are fully rational,
completely selfish, forward -thinking decision makers.
 In truth: Individuals deviate from these predictions, but do it
in systematic ways.
 Why do individuals deviate from these assumptions?
 Can we use these insights to advance our models of individual
behavior (and therefore affect them and achieve our policy goals?)
 Scarcity: How does poverty change the way we make our decisions?
SIGNIFICANCE – PRESIDENT’S CALL
FOUR FORCES
1. Reward Incentives
1. Information and Salience
2. Context and Framing
3. Social Forces
CHILDREN’S HEALTH INCENTIVES LAB
The world that we live in today provides poor
incentives for kids to make healthful choices
and live nutritiously, especially in low-income
neighborhoods.
Most debilitating chronic diseases are rooted in behaviors and habits that
develop during childhood and adolescence.
STEP IT UP! @ ACHIEVEMENT FIRST
Goal Setting
Reward Incentives
Feedback Loops
Social Networks
TO THE MOON
 Walk-it Rocket is community
engagement project that uses
pedometers together with
strategies from behavioral
economics to optimize
adolescent physical activity in
an inner city school based
setting. (Achievement First
Bed-Stuy)
 The goal is to encourage
students to collectively walk
enough steps to reach the
moon.
 Each student given 4
pedometers, one for self, 3
more for people in their lives.
THE SMEAR CAMPAIGN:
UV SENSING BRACELETS FOR SUNSCREEN
UV sensing bracelets that change colors in the
presence of UV rays, nudging you to put on
sunscreen.
Children’s Hospital at Montefiore
Rheumatology Clinic Lupus Support Group
UV Wristbands
Preventing Lupus Flares
SOCIAL NETWORKS IN SODA
CONSUMPTION
• Interviewing Families in a South Bronx Clinic. Can we
predict a child’s sugar sweetened beverage consumption
based on what their social networks take?
• Does this change the way we counsel families in the
primary care setting?
MANY THANKS
 YANA
Learn More
 Children’s Health Incentives Lab: chilnyc.org
 Twitter, Facebook , Instagram: @chilnyc
 Carol Duh -Leong, MD, MPP: [email protected] , [email protected]