The Policy Impact and Future of Behavioral Economics

A special lecture with Alison Buttenheim, PhD, MBA was held at the University of Pennsylvania on November 16, 2023.

Behavioral Economics: Policy Impact and Future Directions – Highlights from the NASEM Consensus Study Report

The hybrid event was co-sponsored with the Population Science Research Programs at the Abramson Cancer Center (ACC), the Health Policy Division in the Department of Medical Ethics and Health Policy (MEHP), and the Center for Health Incentives and Behavioral Economics (CHIBE). 

The Nutrition Environment Measures Survey (NEMS) – A Systematic Review

A Tool for Understanding the Food Environment

The Nutrition Environment Measures Survey (NEMS) is a set of tools that researchers use to assess the availability of healthy food options in stores and restaurants. NEMS tools have been used in research for over 15 years and have been adapted for diverse settings and populations.

A recent systematic review published in the American Journal of Preventative Medicine (AJPM) examined how NEMS tools have been used in published research. The review found that 190 articles from 18 countries had used NEMS tools. Most studies (69.5%) used a modified version of NEMS tools, and there were 23 intervention studies that used measures from NEMS tools or adaptations as outcomes, moderators, or process assessments.

 

Adapting to the times

The review also found that 41% (n=78) of the articles evaluated inter-rater reliability, and 17% (n=33) evaluated test–retest reliability. This suggests that NEMS tools are generally reliable and valid measures of the food environment.

The review concluded that NEMS measures have played an important role in the growth of research on food environments. NEMS tools have helped researchers to explore the relationships among healthy food availability, demographic variables, eating behaviors, health outcomes, and intervention-driven changes in food environments.

The review also noted that the food environment is constantly changing, so NEMS measures should continue to evolve. Researchers should document the data quality of modifications and use in new settings.

Conclusion

NEMS tools are a valuable tool for understanding the food environment. They have been used in a wide variety of research settings and have helped to advance our understanding of the relationships between the food environment and health. As the food environment continues to change, NEMS tools should continue to evolve to meet the needs of researchers.

Glanz K, Fultz AK, Sallis JF, Clawson M, McLaughlin KC, Green S, Saelens BE. Use of the Nutrition Environment Measures Survey: A Systematic Review. Am J Prev Med., 65:1, 131-142, July 2023. EPub March 2023. doi: 10.1016/j.amepre.2023.02.008. PMID: 36990939.

A review of the effects of UV filters on the environment and human health

The National Academies presented a public release webinar of a new report on Tuesday, August 9 from 1:00pm to 2:00pm EDT. The report, Review of Fate, Exposure, and Effects of Sunscreens in Aquatic Environments and Implications for Sunscreen Usage and Human Health, calls on the U.S. EPA to conduct an ecological risk assessment of UV filters to characterize possible risks to aquatic ecosystems and the species that live in them. The report contains information useful for such an assessment. It also describes the role of sunscreens in preventing skin cancer and what is known about how human health could be affected by potential changes in usage. The committee chairs shared key takeaways and responded to questions during the webinar.

For further details about the study, visit the project webpage.

UPennPRC and CHBR director and UPenn DBEI faculty, Karen Glanz, PhD, MPH, is on the committee. Dr. Glanz addressed the impact of UV filters on human health and stated the many factors involved, including correct application of sunscreen and the use of other barriers such as rash guards. Read the article on the report that she co-authored for The Conversation, here.

Download the report

View webinar slides

Watch the webinar

Making progress in the area of food insecurity & nutrition environments

NIH Virtual Workshop banner

On Tuesday, September 21, 2021, UPenn PRC director, Karen Glanz, PhD, MPH, co-chaired an NIH (trans-NIH) workshop called Food Insecurity, Neighborhood Food Environment, and Nutrition Health Disparities: State of the Science.  It was presented virtually for three days, and had over 3,500 registered participants. There were nine sessions, including lively panel discussions. These discussions gave the speakers an opportunity to address attendees’ questions.

Angela Odoms-Young, PhD, also co-chaired the event. Dr. Odoms-Young is an Associate Professor, in the Division of Nutritional Sciences, College of Human Ecology/College of Agriculture and Life Sciences, at Cornell University.

All live content is available for viewing until September 2022

The Labroots event portal.

Angela Odoms-Young, PhD and Karen Glanz, PhD, MPH, co-chairs and moderators of the workshop.

Overview

Participants viewed three days of presentations and panel discussions. On Day 3, Dr. Glanz shared key takeaways with the following observations.

 

First, “health equity is defined as the absence of unfair and avoidable or remediable differences in health among population groups defined socially, economically, demographically or geographically.”

Health equity means increasing opportunities for everyone to live the healthiest life possible, no matter who we are, where we live, or how much money we make. (RWJF)

In addition, relationships between walkability & activity inequality hold within cities in the USA of similar income, meaning, walkable environments lead to lower activity inequality.

Dr. Glanz believes that to make significant progress in the area of food insecurity & nutrition environments we need the following:

  • Innovation & flexibility
  • Collaboration & coordination
  • Balance internal & external validity
  • Address supply AND demand
  • Study individual & aggregate effects
  • Always think about people in need

 

Lastly, increasing the fluidity between research, policy and practice at the Federal level, such as the NIH, USDA, CDC, and other agencies. State and local levels can address nutrition, health, housing, safety, and economic development.

 

We can create equity by incentivizing collaboration, not competition, such as the Gates Foundation global initiatives.

In Conclusion

Dr. Glanz closed her summary with two encouraging quotes.

 

…Science and technology are powerful tools, but we must decide how best to use them. Perhaps the most important point is to ensure that science never becomes divorced from the basic human feeling of empathy with our fellow beings.

Dalai Lama

The Universe in a Single Atom: The Convergence of Science and Spirituality (2006)

Work hard,
Work smart,
And always have fun

 

Matt Wilpers

Peloton

You can see an agenda of the event here. Attendee and presenter comments, including highlights from the presentations can be seen by clicking the #NIHNutrtionEquity hashtag in Twitter. The video captured of the 3-day event will be available on October 7, 2021.

 

Healthy Weigh Study Results

What strategy works better for weight loss in overweight employees?

  • Financial incentives
  • Environment change strategies
  • A combination of the two,
  • On-your-own weight-loss efforts

 

Drs. Karen Glanz and Kevin Volpp, along with the team at the UPenn PRC, found that participants in all groups lost weight. Incidentally, the financial incentives group lost slightly more weight, but none of the strategies netted significantly greater weight losses than the others. The results from their Healthy Weigh Study are currently published in the September 2021 edition of JAMA Network Open.

 

In 2015, the University of Pennsylvania Prevention Research Center (UPenn PRC) conducted a study to test strategies to achieve weight loss and maintain weight loss in urban worksites in Philadelphia.

First, researchers collected data on participants who earned daily financial rewards, in addition to those guided on positive changes to their environment.

Second, they compared each strategy, separately and together, to see which one helped the participants achieve weight-loss.

Third, the team compared that data to those who tried to lose weight on their own.

Ultimately, the goal of the study was to manage obesity by improving nutrition and physical activity, in order to reduce the risk of cardiovascular disease and other chronic health conditions.

 

 

 

 

JAMA Healthy Weigh_visual

Publication

Glanz K, Shaw P, Kwong P, Choi J, Chung A, Zhu J, Huang Q, Hoffer K, Volpp K. Effect of Financial Incentives and Environmental Strategies on Weight Loss in The Healthy Weigh Study: A Randomized Clinical Trial. JAMA Network Open 2021;4(9): e2124132. doi:10.1001/jamanetworkopen.2021.24132