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1.
BMC Public Health ; 24(1): 2122, 2024 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-39107696

RESUMO

Understanding health-seeking behaviors and their drivers is key for governments to manage health policies. A growing body of research explores the role of cognitive biases and heuristics in health and care-seeking behaviors, but little is known about how a context of heightened anxiety and uncertainty might influence these behavioral drivers. This study analyzes the association between four behavioral predictors-internal locus of control, impatience, optimism bias, and aspirations-and healthcare decisions among low-income women in El Salvador, controlling for other factors. We find positive associations between internal locus of control and preventive health behaviors during the COVID-19 pandemic. For instance, a one standard deviation increase in locus of control is associated with a 10% increase in an index measuring the use of masks, distancing, hand washing, and vaccination. Locus of control was also associated with women's use of preventive health services (one standard deviation improves the likelihood of having a hypertension test in the last six months by 5.8 percentage points). In a sub-sample of mothers, we find significant relationships between the four behavioral drivers and the decisions the mothers make for their children. However, we find these associations are less robust compared to the decisions they make for themselves. Some associations were stronger during the pandemic, suggesting that feelings of uncertainty and stress could amplify behavioral drivers' influence on health-related behaviors. This novel finding is relevant for designing policy responses for future shocks. JEL CODES: I12, D10, D91, I30.


Assuntos
COVID-19 , Tomada de Decisões , Aceitação pelo Paciente de Cuidados de Saúde , Pobreza , Humanos , COVID-19/prevenção & controle , COVID-19/epidemiologia , COVID-19/psicologia , Feminino , Adulto , El Salvador , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Controle Interno-Externo , Pandemias/prevenção & controle , Pessoa de Meia-Idade , Adulto Jovem , Mães/psicologia , Mães/estatística & dados numéricos , SARS-CoV-2 , Comportamentos Relacionados com a Saúde
2.
Chronic Illn ; : 17423953231187170, 2023 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-37431737

RESUMO

OBJECTIVE: To evaluate the effectiveness of blood pressure (BP) self-monitoring and peer mentoring to improve the control of hypertension in clinical practice in primary care centers (PCCs) located in low-resource settings in Argentina. METHODS: An individual randomized controlled trial was carried out to test two different approaches based on behavioral interventions in PCCs in Argentina. Hypertensive adults were randomly assigned to one of three arms: BP self-monitoring, peer mentoring, and usual care. The primary outcome was the change in BP values from baseline to the end of follow-up at 3 months. A qualitative approach of participants' experiences of the peer mentoring arm was also conducted. RESULTS: A total of 442 participants with hypertension were included in the study. Self-monitoring and peer mentoring interventions did not show a significant difference in BP control compared to usual care. However, this trial showed an improvement regarding antihypertensive medication adherence among those assigned to the peer mentoring intervention compared to the control at the end of follow-up (p = 0.031). DISCUSSION: Self-monitoring and peer mentoring interventions did not demonstrate to be effective in BP control compared to usual care. Implementing a peer support strategy was demonstrated to be feasible and effective in improving medication adherence in this population.

3.
Integr Psychol Behav Sci ; 57(4): 1284-1311, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37202583

RESUMO

This study ai ms to verify and analyze the existence of cognitive dissonance in the self-assessment of health by individuals in Brazil, that is, the difference between self-rated health and the health status of individuals. To accomplish this, we use data from the 2013 National Health Survey, which collected the self-assessments that individuals made of their health and information about their health status. This information was used to build indices that seek to represent a person's health status in relation to chronic illnesses, physical and mental well-being, eating habits and lifestyle. To identify the presence of cognitive dissonance, the CUB (Combination of a discrete Uniform and shifted Binomial distributions) model was used, which relates self-assessed health with the developed indices. Cognitive dissonance was identified in self-assessed health in relation to eating habits and lifestyle, and this dissonance may be associated with a present bias in the self-assessment of health in Brazil.


Assuntos
Dissonância Cognitiva , Humanos , Brasil , Inquéritos Epidemiológicos
4.
Front Public Health ; 11: 960321, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36844822

RESUMO

Objective: This study provides a first approach to the use of the Multiple-Choice Procedure in social media networks use, as well as empirical evidence for the application of the Behavioral Perspective Model to digital consumption behavior in young users in conjunction with a methodology based on behavioral economics. Participants/methods: The participants were part of a large university in Bogotá, Colombia, and they received an academic credit once they completed the online questionnaire. A total of 311 participants completed the experiment. Of the participants, 49% were men with a mean age of 20.6 years (SD = 3.10, Range = 15-30); 51% were women with a mean age of 20.2 years (SD = 2.84, Range = 15-29). Results: Among the total participants, 40% reported that they used social networks between 1 and 2 h a day, 38% between 2 and 3 h, 16% for 4 h or more, and the remaining 9% used them for 1 h or less per day. The factorial analysis of variance (ANOVA) allowed us to identify a statistically significant effect of the delay of the alternative reinforcer, that is, the average crossover points were higher when the monetary reinforcer was delayed 1 week, compared to the immediate delivery of the monetary reinforcer. There was no statistically significant effect of the interaction between the magnitude of the reinforcer and the delay time of the alternative reinforcer. Conclusions: This study supports the relative reinforcing value of an informational reinforcement consequence such as social media use, which is sensitive to both the magnitude of reinforcement and the delay in delivery as individual factors. The findings on reinforcer magnitude and delay effects are consistent with previous research that have applied behavioral economics to the study of non-substance-related addictions.


Assuntos
Desvalorização pelo Atraso , Mídias Sociais , Masculino , Humanos , Feminino , Adulto Jovem , Adulto , Comportamento de Escolha , Reforço Psicológico , Colômbia
5.
Am J Hosp Palliat Care ; 40(10): 1098-1105, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36564870

RESUMO

Background: An estimated 9.6 million people died from cancer globally in 2018, which is a reflection of the quality of patients' end-of-life care and its costs. Aim: To estimate direct medical costs of the last 30 days of oncology patients admitted to an inpatient clinic and to evaluate factors associated with medical costs at the end of life. Design: Cost-of-illness study with data from a retrospective cohort. Setting/Participants: We included patients aged 18 and older who were diagnosed with incurable cancer and who were admitted to a tertiary hospital in Brazil between January 1, 2018 and December 31, 2019. Results: Our sample included 109 patients with an average age of 69 (61‒76). The median overall survival was 4.3 (.9‒12.9) months. The median cost per patient per day related to hospitalization was BRL 119 (73‒181)/United States dollars [USD] 21 (13‒33). The cost of medication was BRL 66 (40‒105)/USD 12 (7‒19), representing 55.46% of costs while that of materials and supplies was BRL 30 (18‒49)/USD 5 (3‒9). In the multivariate analysis, when the limitation of interventions was recorded in the medical record, the median cost is reduced by BRL 50 (USD 9) per patient per day. Conclusions: The median cost per patient per day was BRL 119 (73‒181). The recording of limitations of therapeutic interventions in the medical record was a predictor variable that influenced the final medical cost of patients, suggesting that medical practice and decision-making in end-of-life care impact costs.


Assuntos
Neoplasias , Humanos , Idoso , Estudos Retrospectivos , Custos e Análise de Custo , Neoplasias/terapia , Hospitalização , Pacientes Internados , Custos de Cuidados de Saúde
6.
Behav Med ; 49(1): 53-61, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-34847825

RESUMO

Incentives are a useful tool in encouraging healthy behavior as part of public health initiatives. However, there remains concern about motivation crowd out-a decline in levels of motivation to undertake a behavior to below baseline levels after incentives have been removed-and few public health studies have assessed for motivation crowd out. Here, we assess the feasibility of identifying motivation crowd out following a lottery to promote participation in a Chagas disease vector control campaign. We look for evidence of crowd out in subsequent participation in the same behavior, a related behavior, and an unrelated behavior. We identified potential motivation crowd out for the same behavior, but not for related behavior or unrelated behaviors after lottery incentives are removed. Despite some limitations, we conclude that motivation crowd out is feasible to assess in large-scale trials of incentives.


Assuntos
Comportamentos Relacionados com a Saúde , Motivação , Humanos , Estudos de Viabilidade , Peru
7.
Int J Psychol Res (Medellin) ; 15(1): 98-125, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36199526

RESUMO

There are minority and stigmatized groups who face particular challenges to their full participation in society. This study's objective was to conduct a systematic review to determine theoretical and methodological underpinnings in behavioral economics that explain how stigmatization emerges within the relationship processes and social structures of individuals. Data from 1940 to 2019 were sourced from 12 relevant electronic databases such as Scopus and Web of Science. Following PRISMA guidelines for systematic reviews, 26 studies out of 3459 met the inclusion criteria. Most of the studies applied experimental economics and were published between 2002 and 2018. Overall, the articles focus their research on the experiences of discrimination based on stereotypes and test their hypotheses through economic games. The data synthesis seems to reveal weak conceptual clarity, circular reasoning, and a hint of the problem of infinite regress. Thus, these issues open new and exciting avenues for future research to explore via an array of experimental applications.


Existen grupos minoritarios y estigmatizados que enfrentan retos particulares para lograr su completa participación en sociedad. El objetivo de este estudio fue conducir una revisión sistemática para determinar los cimientos teóricos y metodológicos en economía del comportamiento que explican cómo surge la estigmatización dentro de los procesos de relacionamiento y estructuras sociales de los individuos. Los datos abarcan el período de 1940 a 2019 y se obtuvieron de 12 bases de datos electrónicas relevantes, tales como Scopus y Web of Science. Siguiendo la guía de PRISMA para revisiones sistemáticas, 26 estudios de 3459 cumplieron con los criterios de inclusión. La mayoría de los estudios aplicó economía experimental y fueron publicados entre 2002 y 2018. En general, los artículos enfocan su investigación en experiencias de discriminación basadas en estereotipos y prueban sus hipótesis a través de juegos económicos. La síntesis de los datos parece revelar una débil claridad conceptual, razonamiento circular y un atisbo del problema de regresión infinita. Lo anterior abre nuevas y emocionantes vías de investigación futura para explorar a través de una variedad de aplicaciones experimentales.

8.
Acta bioeth ; 28(1): 95-104, jun. 2022.
Artigo em Espanhol | LILACS | ID: biblio-1383293

RESUMO

Resumen: Sabemos que el mundo enfrenta una terrible pandemia. La ciencia, con esfuerzo y prontitud, ha podido desarrollar diversas vacunas contra el covid-19, generando ello grandes expectativas. Sin embargo, por diversos factores, los procesos masivos de vacunación no han avanzado a la velocidad requerida; uno de los principales es la resistencia de muchas personas a vacunarse, aduciendo diferentes razones. Frente a esta situación se ha oscilado entre la realización de campañas de publicidad hasta propuestas de imposición forzada. Una alternativa para ir más allá de lo meramente lírico y lo coercitivo es generar formas de motivación para que aquellas personas decidan voluntariamente vacunarse a través de diversas medidas, directas e indirectas, apelando a "Nudge" -o "teoría del pequeño empujón"-, con el fin de propiciar la mejor protección de la salud individual y colectiva, tema del que trata el presente artículo, a partir de la revisión bibliográfica sobre la materia y diversas experiencias en la lucha contra el coronavirus.


Abstract: We all know that the world is facing a terrible pandemic. Science, with effort and promptness, has been able to develop various vaccines against Covid-19, generating great expectations. However, mass vaccination processes have not advanced at the required speed due to various factors; one of the main ones is the resistance of many people to get vaccinated, for different reasons. Faced with this situation, it has oscillated between carrying out advertising campaigns to proposals for forced imposition. An alternative to go beyond the merely lyrical and coercive is to generate forms of motivation for those people to voluntarily decide to be vaccinated through various measures, direct and indirect, appealing to "Nudge" -or the "little push theory" - in order to promote the best protection of individual and collective health, the subject of this article, based on the bibliographic review on the matter and various experiences in the fight against coronavirus.


Resumo: Sabemos que o mundo enfrenta uma terrível pandemia. A ciência, com esforço e prontidão, pode desenvolver diversas vacinas contra a Covid-19, gerando grandes expectativas. Sem dúvida, os processos massivos de vacinação não avançaram à velocidade requerida por diversos fatores; um dos principais é a resistência de muitas pessoas a vacinar-se, alegando diferentes razões. Frente a esta situação, observou-se uma oscilação entre a realização de campanhas de publicidade a propostas de imposição forçada. Uma alternativa para ir além do meramente lírico e do coercitivo é gerar formas de motivação para que as pessoas decidam voluntariamente vacinar-se através de diversas medidas, diretas e indiretas, apelando a "Nudge" -ou a "teoria do pequeno empurrão"- a fim de propiciar a melhor proteção da saúde individual e coletiva, tema do que trata o presente artigo, a partir da revisão bibliográfica sobre a matéria e diversas experiências na luta contra o coronavírus.


Assuntos
Humanos , Vacinação/ética , Vacinas contra COVID-19 , COVID-19/prevenção & controle , Motivação/ética , Responsabilidade Social , Coerção , Paternalismo , Autonomia Pessoal , Pandemias
9.
Transl Behav Med ; 12(6): 734-741, 2022 07 07.
Artigo em Inglês | MEDLINE | ID: mdl-35608992

RESUMO

After alcohol and tobacco, cannabis is the third most used substance among young Colombian adults, and many consume alcohol and cannabis concomitantly. However, academics have debated whether these substances substitute or complement each other among consumers. Understanding the relationship between the price and demand for psychoactive substances can clarify consumption patterns and help to develop strategies to reduce harmful consumption. This paper summarizes worldwide evidence of both complementary and substitution relationships and discusses the most probable relationship types in Colombia based on its substance use patterns and current regulations. Like other countries, Colombia is considering legalizing recreational cannabis use. However, there is a growing concern that legalization would increase the negative impacts of cannabis and increase alcohol use among the young adult population. The lack of Colombian empirical studies about the impacts of legal changes on the cannabis market makes it difficult to predict how such changes would affect demand and price elasticities.


Assuntos
Cannabis , Maconha Medicinal , Transtornos Relacionados ao Uso de Substâncias , Colômbia/epidemiologia , Economia Comportamental , Humanos , Política Pública , Adulto Jovem
10.
Wellcome Open Res ; 6: 163, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34595355

RESUMO

Background: Financial incentives may improve the initiation and engagement of behaviour change that reduce the negative outcomes associated with non-communicable diseases. There is still a paucity in guidelines or recommendations that help define key aspects of incentive-oriented interventions, including the type of incentive (e.g. cash rewards, vouchers), the frequency and magnitude of the incentive, and its mode of delivery.  We aimed to systematically review the literature on financial incentives that promote healthy lifestyle behaviours or improve health profiles, and focused on the methodological approach to define the incentive intervention and its delivery. The protocol was registered at PROSPERO on 26 July 2018 ( CRD42018102556). Methods: We sought studies in which a financial incentive was delivered to improve a health-related lifestyle behaviour (e.g., physical activity) or a health profile (e.g., HbA1c in people with diabetes). The search (which took place on March 3 rd 2018) was conducted using OVID (MEDLINE and Embase), CINAHL and Scopus. Results: The search yielded 7,575 results and 37 were included for synthesis. Of the total, 83.8% (31/37) of the studies were conducted in the US, and 40.5% (15/37) were randomised controlled trials. Only one study reported the background and rationale followed to develop the incentive and conducted a focus group to understand what sort of incentives would be acceptable for their study population. There was a degree of consistency across the studies in terms of the direction, form, certainty, and recipient of the financial incentives used, but the magnitude and immediacy of the incentives were heterogeneous. Conclusions: The available literature on financial incentives to improve health-related lifestyles rarely reports on the rationale or background that defines the incentive approach, the magnitude of the incentive and other relevant details of the intervention, and the reporting of this information is essential to foster its use as potential effective interventions.

11.
Value Health ; 24(10): 1463-1469, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34593169

RESUMO

OBJECTIVES: This article illustrates the effect of a direct mail campaign that used insights from behavioral economics and psychology to increase the number of free mammograms in Chilean women aged 50 years or older. METHODS: We hypothesized 4 barriers in obtaining a mammogram based on previous literature and focus group analysis. A behavioral economic approach providing incentives was used to help overcome these barriers. We accessed a unique data set, which comprised 12 000 women 50 years old or older, with private health insurance who have not had a mammogram for 24 or more months. We conducted a randomized controlled trial with 8 treatments, each involving a specific combination of messages. RESULTS: The intervention overall led to a 167% increase in the use of free mammograms, a 1.13% to 3.03% average increase from the control to treatment groups, respectively. Regarding barriers, we found that all messages were effective, with a slightly larger and persistent effect for the less complex ones in terms of information. This finding illustrates the benefits of keeping the message simple. CONCLUSIONS: Finally, these results suggest a successful public policy for increasing use of free mammography programs. Moreover, they are potentially transferable because the study considered decision-making heuristics that are not specific to one culture or social context.


Assuntos
Economia Comportamental/estatística & dados numéricos , Mamografia/estatística & dados numéricos , Idoso , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/diagnóstico por imagem , Chile/epidemiologia , Economia Comportamental/tendências , Feminino , Grupos Focais/métodos , Humanos , Mamografia/métodos , Pessoa de Meia-Idade , Pesquisa Qualitativa
12.
Estud. pesqui. psicol. (Impr.) ; 21(3): 1271-1276, set.-dez. 2021.
Artigo em Português | LILACS, Index Psicologia - Periódicos | ID: biblio-1359132

RESUMO

Nesta resenha do livro "Misbehaving: construindo a economia comportamental", demonstra-se como a mais recente obra de Richard Thaler, ganhador do prêmio Nobel em Economia de 2017, configura-se como uma obra fundamental para todos que possuem interesse em compreender a relação entre a Psicologia e a Economia, bem como a formação dos comportamentos econômicos de indivíduos e grupos. Por meio de dezenas de exemplos apresentados com humor e alguma ironia, o autor demonstra como as pessoas se comportam quando o assunto é a tomada de decisão envolvendo escolhas econômicas desde as mais básicas, como fazer compras, até as mais complexas, como realizar investimentos financeiros. O livro também apresenta como ocorreu o surgimento e o desenvolvimento da Economia Comportamental, um campo muito próximo da Psicologia Econômica e que vem ganhando cada vez mais destaque no mundo, tanto dentro quanto fora da academia. Trata-se de uma obra essencial para profissionais e estudantes de Psicologia e Economia, assim como para todos que tenham interesse em compreender o comportamento humano relacionado a decisões econômicas e de consumo. (AU)


This review of the book "Misbehaving: the making of Behavioral Economics", demonstrates as the latest work Richard Thaler, winner of the 2017 Nobel Prize in Economics, is a fundamental work for anyone interested in understanding the relationship between psychology and economics, as well as the formation of behaviors. of individuals and groups. Through dozens of humorously presented examples and a bit of irony, the author demonstrates how people actually behave when it comes to decision making involving the most basic economic choices, such as shopping, to the most such as making financial investments. The book also presents how the emergence and development of Behavioral Economics occurred, a field very close to Economic Psychology and that has been gaining more and more prominence in the world, both inside and outside academia. It is an essential work for professionals and students of Psychology and Economics, as well as for anyone interested in understanding human behavior related to economic and consumer decisions. (AU)


Esta revisión del libro "Misbehaving: Building Behavioral Economics", demuestra cómo el último trabajo de Richard Thaler, ganador del Premio Nobel de Economía 2017, es un trabajo fundamental para cualquier persona interesada en comprender la relación entre psicología y economía, así como la formación de comportamientos de individuos y grupos. A través de docenas de ejemplos presentados con humor, y un poco de ironía, el autor demuestra cómo se comportan realmente las personas cuando se trata de la toma de decisiones que involucran las opciones económicas más básicas, como ir de compras, como hacer inversiones financieras. El libro también presenta cómo se produjo la aparición y el desarrollo de la Economía del Comportamiento, un campo muy cercano a la Psicología Económica y que ha ido ganando cada vez más protagonismo en el mundo, tanto dentro como fuera de la academia. Es un trabajo esencial para profesionales y estudiantes de psicología y economía, así como para cualquier persona interesada en comprender el comportamiento humano relacionado con las decisiones económicas y del consumidor. (AU)


Assuntos
Psicologia , Resenhas de Livros como Assunto , Tomada de Decisões , Economia Comportamental
13.
Prev Med ; 153: 106738, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34298028

RESUMO

In Argentina, cardiovascular disease (CVD) represents the first cause of mortality, but effective coverage for CVD prevention is low. Strategies based on behavioral economics are emerging worldwide as key pieces to increase the effectiveness of CVD prevention approaches. The aim of this study was to evaluate whether the implementation of two strategies based on financial incentives and framing increased attendance to clinical visits as proposed by the national program for CVD risk factors management among the uninsured and poor population with moderate or high CVD risk in Argentina. We conducted a cluster randomized trial in nine primary care clinics (PCCs) in Argentina. Three PCCs were assigned to financial incentives, 3 to framing-text messages (SMS) and 3 to usual care. The incentive scheme included a direct incentive for attending the first clinical visit and the opportunity to participate in a lottery when attending a second clinical visit. The framing-text messages group received messages with a gain-frame format. The main outcome was the proportion of participants who attended the clinical visits. A total of 918 individuals with a risk ≥10% of suffering a CVD event within the next 10 years were recruited to participate in the study. The financial incentive group had a significantly higher percentage of participants who attended the first (59.0% vs 33.9%, p˂ 0.001) and the follow up visit (34.4% and 16.6%, p˂ 0.001) compared to control group. However, the framing-SMS group did not show significant differences compared to the control group. TRIAL REGISTRATION: This study is registered at www.clinicaltrials.govNCT03300154.


Assuntos
Doenças Cardiovasculares , Motivação , Assistência Ambulatorial , Argentina , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/prevenção & controle , Fatores de Risco de Doenças Cardíacas , Humanos , Fatores de Risco , Populações Vulneráveis
14.
Heliyon ; 6(9): e04874, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32995598

RESUMO

This paper identifies the main determinants of errors in the allocation of spending by the Colombian Government. Using information from the Electronic Public Procurement System (SECOP), the determinants of the probability of an addition to a contract are identified. The errors of the government can be interpreted as an approximation of their corruption. The average income and educational level of a colombian department are found to directly influence the probability of an addition. Using the estimation of the binary choice models, the forecast error of an addition is estimated, it is found that public and civil works contracts have more forecast error, forming an ideal mechanism for thefts and accumulation of bribes. Our results show that predicting an addition can be done with high certainty.

15.
Proc Natl Acad Sci U S A ; 117(16): 8794-8803, 2020 04 21.
Artigo em Inglês | MEDLINE | ID: mdl-32253310

RESUMO

Multiple-choice examinations play a critical role in university admissions across the world. A key question is whether imposing penalties for wrong answers on these examinations deters guessing from women more than men, disadvantaging female test-takers. We consider data from a large-scale, high-stakes policy change that removed penalties for wrong answers on the national college entry examination in Chile. The policy change reduced a large gender gap in questions skipped. It also narrowed gender gaps in performance, primarily among high-performing test-takers, and in the fields of math, social science, and chemistry.


Assuntos
Teste de Admissão Acadêmica/estatística & dados numéricos , Estudantes/estatística & dados numéricos , Universidades/normas , Química/educação , Química/normas , Química/estatística & dados numéricos , Chile , Comportamento de Escolha , Feminino , Humanos , Masculino , Matemática/educação , Matemática/normas , Matemática/estatística & dados numéricos , Políticas , Ciências Sociais/educação , Ciências Sociais/normas , Ciências Sociais/estatística & dados numéricos , Estudantes/psicologia , Universidades/estatística & dados numéricos
16.
Heliyon ; 6(3): e03459, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32154417

RESUMO

The present paper addresses one of the most important assumptions in consumer preference patterns: transitivity. This assumption states that, logically, selections between goods are rational because of the transitivity statement, which posits that people always prefer goods in the following order: A is preferred to B, and B is preferred to C, so A is preferred to C. With the aim of proving this principle's validity, we conducted an experiment with 70 subjects and probed their preferences in relation to edible and nonedible goods. We used a survey methodology, which allowed us to analyze three distinct situations: 1) individuals faced with goods choices without restrictions; 2) individuals facing budget restrictions and price changes; and 3) individuals faced with decreased disposable income. The results mostly showed that there was no evidence of transitivity in consumer preferences. On average, transitivity appeared in only 8% of the sample, and in cases where transitivity was proved, it was revealed to be strong. The preferences were transitive primarily in relation to edible rather than nonedible goods.

17.
Transl Behav Med ; 10(3): 741-750, 2020 08 07.
Artigo em Inglês | MEDLINE | ID: mdl-30947329

RESUMO

Despite efforts to improve detection and treatment of adults with hypertension and diabetes in Argentina, many public healthcare system users remain undiagnosed or face barriers in managing these diseases. The purpose of this study is to identify health system, provider, and user-related factors that may hinder detection and treatment of hypertension and diabetes using a traditional and behavioral economics approach. We did qualitative research using in-depth semistructured interviews and focus groups with healthcare providers and adult users of Public Primary Care Clinics. Health system barriers included inadequate care accessibility; poor integration between primary care clinics and local hospitals; lack of resources; and gender bias and neglect of adult chronic disease. Healthcare provider-related barriers were inadequate training; lack of availability or reluctance to adopt Clinical Practice Guidelines; and lack of counseling prioritization. From a behavioral economics perspective, bottlenecks were related to inertia and a status quo, overconfidence, and optimism biases. User-related barriers for treatment adherence included lack of accurate information; resistance to adopt lifelong treatment; affordability; and medical advice mistrust. From a behavioral economics perspective, the most significant bottlenecks were overconfidence and optimism, limited attention, and present biases. Based on these findings, new interventions that aim to improve prevention and control of chronic conditions can be proposed. The study provides empirical evidence regarding the barriers and bottlenecks in managing chronic conditions in primary healthcare settings. Results may contribute to the design of behavioral interventions targeted towards healthcare provision for the affected population.


Assuntos
Diabetes Mellitus , Hipertensão , Adulto , Argentina , Diabetes Mellitus/terapia , Economia Comportamental , Feminino , Humanos , Hipertensão/prevenção & controle , Masculino , Atenção Primária à Saúde , Pesquisa Qualitativa , Sexismo
18.
Ann Behav Med ; 54(6): 436-446, 2020 05 25.
Artigo em Inglês | MEDLINE | ID: mdl-31850492

RESUMO

BACKGROUND: Latin America ranks among the regions with the highest level of intake of sugary beverages in the world. Innovative strategies to reduce the consumption of sugary drinks are necessary. PURPOSE: Evaluate the effect of a one-off priest-led intervention on the choice and preference of soda beverages. METHODS: We conducted a pragmatic cluster-randomized trial in Catholic parishes, paired by number of attendees, in Chimbote, Peru between March and June of 2017. The priest-led intervention, a short message about the importance of protecting one's health, was delivered during the mass. The primary outcome was the proportion of individuals that choose a bottle of soda instead of a bottle of water immediately after the service. Cluster-level estimates were used to compare primary and secondary outcomes between intervention and control groups utilizing nonparametric tests. RESULTS: Six parishes were allocated to control and six to the intervention group. The proportion of soda selection at baseline was ~60% in the intervention and control groups, and ranged from 56.3% to 63.8% in Week 1, and from 62.7% to 68.2% in Week 3. The proportion of mass attendees choosing water over soda was better in the priest-led intervention group: 8.2% higher at Week 1 (95% confidence interval 1.7%-14.6%, p = .03), and 6.2% higher at 3 weeks after baseline (p = .15). CONCLUSIONS: This study supports the proof-of-concept that a brief priest-led intervention can decrease sugary drink choice. CLINICAL TRIAL INFORMATION: ISRCTN, ISRCTN24676734. Registered 25 April 2017, https://www.isrctn.com/ISRCTN24676734.


Assuntos
Bebidas Gaseificadas , Comportamento de Escolha , Clero , Açúcares da Dieta , Comportamento de Ingestão de Líquido , Promoção da Saúde , Catolicismo , Água Potável , Feminino , Promoção da Saúde/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Peru , Estudo de Prova de Conceito
19.
BMC Public Health ; 19(1): 1272, 2019 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-31533762

RESUMO

BACKGROUND: Individual behavior change is a critical ingredient in efforts to improve global health. Central to the focus on behavior has been a growing understanding of how the human brain makes decisions, from motivations and mindsets to unconscious biases and cognitive shortcuts. Recent work in the field of behavioral economics and related fields has contributed to a rich menu of insights and principles that can be engineered into global health programs to increase impact and reach. However, there is little research on the process of designing and testing interventions informed by behavioral insights. METHODS: In a study focused on increasing household participation in a Chagas disease vector control campaign in Arequipa, Peru, we applied Datta and Mullainathan's "behavioral design" approach to formulate and test specific interventions. In this Technical Advance article we describe the behavioral design approach in detail, including the Define, Diagnosis, Design, and Test phases. We also show how the interventions designed through the behavioral design process were adapted for a pragmatic randomized controlled field trial. RESULTS: The behavioral design framework provided a systematic methodology for defining the behavior of interest, diagnosing reasons for household reluctance or refusal to participate, designing interventions to address actionable bottlenecks, and then testing those interventions in a rigorous counterfactual context. Behavioral design offered us a broader range of strategies and approaches than are typically used in vector control campaigns. CONCLUSIONS: Careful attention to how behavioral design may affect internal and external validity of evaluations and the scalability of interventions is needed going forward. We recommend behavioral design as a useful complement to other intervention design and evaluation approaches in global health programs.


Assuntos
Doença de Chagas/prevenção & controle , Vetores de Doenças , Comportamentos Relacionados com a Saúde , Acessibilidade aos Serviços de Saúde/organização & administração , Animais , Saúde Global , Humanos , Peru , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa
20.
Investig. psicol ; 24(1): 78-86, jun. 2019.
Artigo em Inglês | LILACS | ID: biblio-1371994

RESUMO

En los últimos cincuenta años, psicólogos y economistas han catalogado los errores que la gente adulta comete cuando toma decisiones. El objetivo de nuestro resumen narrativo es describir estos errores como ocurren en niños de edad escolar. Luego de una breve introducción a las teorías más importantes en economía comportamental (Utilidad Esperada, Prospect, Rastro Difuso, Proceso Dual) haremos un resumen de esta literatura, con énfasis en el período de edad escolar. Evaluamos si los niños comprenden el concepto de 'valor esperado', si sus respuestas cambian en base a como se hace la pregunta, y si prefieren arriesgar en vez de aceptar propuestas seguras. También describimos, desde una perspectiva del desarrollo, la tendencia a sobrevalorar las posesiones, a perseverar cuando el gasto es irrecuperable, y a tener diferentes cuentas mentales. Nuestra revisión indica que las tendencias que se ven en la adultez también suelen ocurrir en niños y niñas de edad escolar, y señala áreas en las que se carece de datos sólidos. Concluimos nuestro artículo sugiriendo futuras áreas de investigación


Over the last half century, psychologists and behavioral economists have catalogued myriad mistakes that people make when making decisions. The way those mistakes are expressed in school-aged children is the focus of this narrative review. After a brief introduction to the main theoretical positions (expected utility theory, prospect theory, fuzzy-trace theory, dual-systems theory), we do a comprehensive review of the developmental literature. We start with children's understanding of expected value, their sensitivity to framing effects, and their tendency to favor risky choices over riskless options. Next, we describe developmental research on the endowment effect, sunk cost, and mental accounting. Our review indicates that biases observed in adults are often evident in school-age children too, and singles out areas of developmental research in which solid information is not available. We conclude by highlighting areas in need of future research


Assuntos
Humanos , Pré-Escolar , Criança , Tomada de Decisões , Psicologia , Racionalização , Criança , Escolaridade
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