DAVRANIŞSAL İKTİSAT VE DÜRTME: SAĞLIK POLİTİKALARI ÖZELİNDE BİR İNCELEME

Year 2020, Volume: 38 Issue: 3, 531 - 559, 30.09.2020

Havva Serim Serkan Küçükşenel

https://doi.org/10.17065/huniibf.658117

Cited By: 4

Abstract

Bu çalışma, temel davranışsal iktisat dürtme yöntemlerinin sağlıklı yaşam biçimi davranışlarının geliştirilmesi için kullanılabileceğini göstermektedir. Bu amaçla öncelikle insanların sıklıkla sınırlı rasyonalite, sınırlı otokontrol veya sınırlı bencilliğe tabi olduğunu ortaya koyan davranışsal iktisat çalışmaları incelenmiştir. Daha sonra bu tarz rasyonel davranış varsayımından sapmaların sağlık davranışı üzerindeki etkileri belirlenmiştir. Son olarak, eğitsel müdahale ve ikna etme, ortamı yeniden yapılandırma ve taahhüt mekanizmaları oluşturma gibi dürtme yöntemlerinin obezite hastalığının önlenmesinde kullanılabileceği gösterilmiştir

Keywords

davranışsal iktisat, dürtme, sağlık politikaları

BEHAVIORAL ECONOMICS AND NUDGE: A STUDY ON HEALTH POLICIES

Abstract

This study shows that basic behavioral economics nudging methods can be used to develop healthy lifestyle behaviors. For this purpose, first, behavioral economics studies revealing that people are often subject to bounded rationality, bounded self-control or bounded self-interest are examined. Second, the effects of these biases on health behavior are identified. Finally, we show that nudging methods such as educational intervention and persuasion, restructuring the environment and creating commitment mechanisms can be used in the prevention of obesity disease.

Keywords

Behavioral Economics, Nudges, Health Care

References

• Adonis, L., Paramanund, J., Basu, D., & Luiz, J. (2017). Framing preventive care messaging and cervical cancer screening in a health-insured population in South Africa: Implications for population-based communication?. Journal of Health Psychology, 22(11), 1365-1375.
• Andreoni J. ve Miller, J.H. (2002). Giving according to GARP: An experimental test of the consistency of preferences for altruism. Econometrica, 70:737–753.
• Bryan, G., Karlan, D., & Nelson, S. (2010). Commitment devices. Annu. Rev. Econ., 2(1), 671-698. Cawley, J.H. (2011). The Oxford Handbook of the Social Science of Obesity. New York, United States: Oxford University Press.
• Chapman, G. B., Li, M., Colby, H., & Yoon, H. (2010). Opting in vs opting out of influenza vaccination. Jama, 304(1), 43-44. Christakis, N. A., & Fowler, J. H. (2007). The spread of obesity in a large social network over 32 years. New England Journal of Medicine, 357(4), 370-379.
• Cialdini, R. B., Demaine, L. J., Sagarin, B. J., Barrett, D. W., Rhoads, K., & Winter, P. L. (2006). Managing social norms for persuasive impact. Social influence, 1(1), 3-15. Cislaghi, B., & Heise, L. (2019). Using social norms theory for health promotion in low-income countries. Health Promotion International, 34, 616-623. Consedine, N. S., Horton, D., Magai, C., & Kukafka, R. (2007). Breast screening in response to gain, loss, and empowerment framed messages among diverse, low-income women. Journal of Health Care for the Poor and Underserved, 18(3), 550-566.
• Datta, S. & Mullainathan, S. (2014). Behavioral design: a new approach to development policy. Review of Income and Wealth, 60(1), 7-35. DellaVigna, S. (2009). Psychology and Economics: Evidence from the Field. Journal of Economic Literature, 47(2), 315-372. Dhami, S. (2016). The Foundations of Behavioral Economic Analysis. Oxford University Press: New York.
• Dolan, P., Hallsworth, M., Halpern, D., King, D., & Vlaev, I. (2010). MINDSPACE: Influencing behaviour for public policy. Institute for Government Report for the Cabinet Office, UK.
• Downs, J. S., Loewenstein, G., & Wisdom, J. (2009). Strategies for promoting healthier food choices. American Economic Review, 99(2), 159-164. Elster, J. (2007). Explaining social behavior: More nuts and bolts for the social sciences. Cambridge University Press: Cambridge. Fehr, E. ve Schmidt, K.M. (1999). A theory of fairness, competition and cooperation. Quarterly Journal of Economics, 114(3):817–868.
• Fogarty, A. W., Sturrock, N., Premji, K., & Prinsloo, P. (2013). Hospital clinicians’ responsiveness to assay cost feedback: a prospective blinded controlled intervention study. JAMA Internal Medicine, 173(17), 1654-1655. Forsythe, R., Horowitz, J.L., Savin, N. E. ve Sefton, M. (1994). Fairness in Simple Bargaining Experiments. Games and Economic Behavior, 6(3),347–69.
• Galizzi, Matteo M. (2014) What is really behavioral in behavioral health policy? And does it work? Applied Economic Perspectives and Policy, 36 (1), 25-60.
• Giles, E. L., Robalino, S., McColl, E., Sniehotta, F. F., & Adams, J. (2014). The effectiveness of financial incentives for health behaviour change: systematic review and meta-analysis. PloS One, 9(3), 1-16. Grant, A. M., & Hofmann, D. A. (2011). It’s not all about me: Motivating hand hygiene among health care professionals by focusing on patients. Psychological Science, 22(12), 1494-1499. Güth W., Schmittberger, R. ve Schwarze, B. (1982). An experimental analysis of ultimatum bargaining. Journal of Econonomic Behavior and Organization, 3(4):367–388.
• Hallsworth, M., Berry, D., Sanders, M., Sallis, A., King, D., Vlaev, I., & Darzi, A. (2015). Stating appointment costs in SMS reminders reduces missed hospital appointments: findings from two randomised controlled trials. PloS One, 10(9), 1-14. Halpern, S. D., Ubel, P. A., & Asch, D. A. (2007). Harnessing the power of default options to improve health care. The New England Journal of Medicine, 357, 1340-44. Hanks A.S., Just D.R., Smith L.E., Wansink B. (2012). Healthy convenience: nudging students toward healthier choices in the lunchroom. Journal of Public Health, 1-7. Hanks, A. S., Just, D. R.,Wansink, B. (2013). Smarter lunchrooms can address new school lunchroom guidelines and childhood obesity. The Journal of Pediatrics, 162(4), 867-869. John L., Loewenstein G., Troxel A., Norton L., Fassbender J., Volpp K. (2011). Financial incentives for extended weight loss: a randomized, controlled trial. Journal of General Internal Medicine, 621-626. John L., Loewenstein G., Volpp K. G. (2012). Empirical observations on longer-term use of incentives for weight loss. Preventive Medicine, 55(1), 68-74. Johnson, E. J. ve Goldstein, D. G. (2003). Do defaults save lives? Science, 302, 1338-1339. Kahneman, D. (2011). Thinking Fast and Slow. Farrar, Strauss, Giroux: New York. Kahneman, D. ve Tversky, A. (1972). Subjective Probability: A Judgment of Representativeness. Cognitive Psychology,3, 430-454. Kahneman, D. ve Tversky,A. (1979). “Prospect Theory: An Analysis of Decision under Risk.” Econometrica, 47(2), 263–291. Kao, Y. F. ve Velupillai, K. V. (2015). Behavioral Economics: Classical and modern. The European Journal of the History of Economic Thought, 22(2), 236-271. Khwaja, A., Silverman, D., Sloan, F., & Wang, Y. (2009). Are mature smokers misinformed?. Journal of Health Economics, 28(2), 385-397. Krummel, D. A., Humphries, D., & Tessaro, I. (2002). Focus groups on cardiovascular health in rural women: implications for practice. Journal of Nutrition Education and Behavior, 34(1), 38-46. Levin, I. P., Schneider, S. L., & Gaeth, G. J. (1998). All frames are not created equal: A typology and critical analysis of framing effects. Organizational Behavior and Human Decision Processes, 76(2), 149-188. Loewenstein, G. (1996). Out of Control: Visceral Influences on Behavior. Organizational Behavior and Human Decision Processes 65, 272–92.
• Luoto, J., & Carman, K. G. (2014). Behavioral economics guidelines with applications for health interventions. Inter-American Development Bank.Technical Note: No. IDB-TN-665. Meeker, D., Knight, T. K., Friedberg, M. W., Linder, J. A., Goldstein, N. J., Fox, C. R., Rothfield, A., Diaz, G.& Doctor, J. N. (2014). Nudging guideline-concordant antibiotic prescribing: a randomized clinical trial. JAMA Internal Medicine, 174(3), 425-431. Michie, S., & Lester, K. (2005). Words matter: increasing the implementation of clinical guidelines. Quality and Safety in Health Care, 14(5), 367-370. Michie, S., Van Stralen, M. M., & West, R. (2011). The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implementation Science, 6(1), 42. Mullainathan, S. ve Thaler, R. H. (2001). "Behavioral Economics". İçinde International Encyclopedia of Social Sciences N. Smelser ve P. Bates (eds). Pergamon Press, 1094-1100. Neighbors, C., Lewis, M. A., Bergstrom, R. L., & Larimer, M. E. (2006). Being controlled by normative influences: Self-determination as a moderator of a normative feedback alcohol intervention. Health Psychology, 25(5), 571-579. Neter, E., Stein, N., Barnett-Griness, O., Rennert, G., & Hagoel, L. (2014). From the bench to public health: population-level implementation intentions in colorectal cancer screening. American Journal of Preventive Medicine, 46(3), 273-280. NHS (2018). Breast Screening. Helping you decide leaflet. https://www.uhs.nhs.uk/Media/SUHTInternet/Services/BreastImagingUnit/NHS-Breast-Screening---helping-you-decide.pdf, Erişim Tarihi: 19.11.2019 Nyhus, E. K. ve Webley, P. (2006). "Discounting, Self-control, and Saving". İçinde Handbook of contemporary behavioral economics: Foundations and developments M. Altman (Ed.) M.E. Sharpe: New York, 297-325.
• O’Keefe, D.J ve Jensen, J.D. (2009). The relative persuasiveness of gain-framed and loss-framed messages for encouraging disease detection behaviors: A meta-analytic review. Journal of Communication, 59 (2) , 296-316.
• O'Donoghue, T. ve Rabin, M. (2001). Choice and Procrastination. The Quarterly Journal of Economics, 116(1), 121-160.
• Perry, C., Chhatralia, K., Damesick, D., Hobden, S., & Volpe, L. (2015). Behavioural insights in health care: Nudging to reduce inefficiency and waste. London: The Health Foundation. Prince, M. A., & Carey, K.B. (2010). The malleability of injunctive norms among college students. Addictive Behaviors, 35, 940-7. Rabin, M. (2002). A Perspective on Psychology and Economics. European Economic Review, 46(4–5): 657–85. Roth, A.E. (1995). "Introduction to experimental economics". İçinde The Handbook of Experimental Economics J.H.Kagel ve A.E. Roth (Ed). Princeton University Press: Princeton, NJ, 3–110.
• Rothman, A. J., & Salovey, P. (1997). Shaping perceptions to motivate healthy behavior: the role of message framing. Psychological Bulletin, 121(1), 3.
• Rothman, A. J., Martino, S. C., Bedell, B. T., Detweiler, J. B., & Salovey, P. (1999). The Systematic Influence of Gain-and Loss-Framed Messages on Interest in and Use of Different Types of Health Behavior. Personality and Social Psychology Bulletin, 25(11), 1355–1369.
• Samuelson, W. ve Zeckhauser, R. (1988). Status quo bias in decision making. Journal of Risk and Uncertainty, 1(1), 7-59.
• Sent, E.M. (2004). Behavioral Economics: How Psychology Made Its (Limited) Way Back Into Economics. History of Political Economy, 36 (4): 735–760. Service, O., Hallsworth, M., Halpern, D., Algate, F., Gallagher, R., Nguyen, S., Ruda, S., Sanders, M.(2014). EAST Four simple ways to apply behavioural insights. The Behavioural Insights Team Publications, Cabinet Office. Simon, H.A. (1955). A Behavioral Model of Rational Choice. Quarterly Journal of Economics, 69(1), 99-118. Simon, H.A. (1956). Rational Choice and the Structure of the Environment. Psychological Review, 63(2), 129-138. Simon, H.A. (1987). "Bounded Rationality". İçinde The New Palgrave Dictionary of Economics J. Eatwell, M. Milgate ve P. Newman (Ed.). Palgrave Macmillan: UK., 472-474. Sims, H., Sanghara, H., Hayes, D., Wandiembe, S., Finch, M., Jakobsen, H.,Tsakanikos, E.,Chike Okocha, C. I.& Kravariti, E. (2012). Text message reminders of appointments: a pilot intervention at four community mental health clinics in London. Psychiatric Services, 63(2), 161-168. Squires, J., Presseau, J., Francis, J., Bond, C. M., Fraser, C., Patey, A., Porteous, T., Vachon, B.,Tonelli M., Yu, C. H.& Grimshaw, J. (2013). Self‐formulated conditional plans for changing health behaviour among healthcare consumers and health professionals. Cochrane Database of Systematic Reviews, (12),1-17. Stanovich, K. E. ve West, R. F. (2000). Individual differences in reasoning: Implications for the rationality debate? Behavioral and Brain Sciences 23(5): 645–665. Stock, C., Vallentin-Holbech, L., & Rasmussen, B. M. (2016). The GOOD life: Study protocol for a social norms intervention to reduce alcohol and other drug use among Danish adolescents. BMC Public Health, 16(1), 704-712. Streich, P. ve Levy, J. S. (2007). Time Horizons, Discounting, and Intertemporal Choice. Journal of Conflict Resolution, 51(2),199–226.
• Strotz, R. H. (1956). Myopia and Inconsistency in Dynamic Utility Maximization. The Review of Economic Studies, 23(3), 165-180.
• Sunstein, C. R. (2017). Default rules are better than active choosing (often). Trends in Cognitive Sciences, 21(8), 600-606. Tankard, M. E., & Paluck, E. L. (2016). Norm perception as a vehicle for social change. Social Issues and Policy Review, 10(1), 181-211. Thaler, R. H. (1981). Some Empirical Evidence on Dynamic Inconsistency.Economics Letters, 8(3), 201-207.
• Thaler, R. H. ve Shefrin, H. M. (1981). An Economic Theory of Self-control. Journal of Political Economy, 89(2), 392-406.
• Thaler, R. H. ve Sunstein, C.R (2008). Nudge: improving decisions about health, wealth, and happiness. Yale University Press:USA. Thorndike, A. N., Riis, J., Sonnenberg, L. M., & Levy, D. E. (2014). Traffic-light labels and choice architecture: promoting healthy food choices. American Journal of Preventive Medicine, 46(2), 143-149. Tomer, J. F. (2007).What is Behavioral Economics?. Journal of Socio-Economics, 36(3), 463-479. Tversky, A. ve Kahneman ve D. (1974). Judgment under Uncertainty: Heuristics and Biases. Science, 185(4157), 1124-1131. Volpp, K. G., John, L. K., Troxel, A. B., Norton, L., Fassbender, J., & Loewenstein, G. (2008). Financial incentive–based approaches for weight loss: a randomized trial. Jama, 300(22), 2631-2637. Wansink, B. (2004). Environmental factors that increase the food intake and consumption volume of unknowing consumers. Annual Review of Nutrition, 24, 455–479. Wansink B. ve Chandon P. (2006). Can ‘low fat’ nutritional labels lead to obesity?. Journal of Marketing Research, 43(4), 605-617.
• Wansink, B., Painter, J. E., & North, J. (2005). Bottomless bowls: why visual cues of portion size may influence intake. Obesity Research, 13(1), 93-100.
• Wansink, B., & Pope, L. (2014). When do gain-framed health messages work better than fear appeals?. Nutrition Reviews, 73(1), 4-11.
• Young, H. P. (2015). The evolution of social norms. Annual Review of Economics, 7(1), 359-387.