Antonio Trujillo’s diabetes nudge bleg

I am a junior faculty at Hopkins and my area of interest is to understand the low level of compliance with prevention among diabetics and hypertensive.  Low compliance with medical treatment happens in several health domains. My aim is to develop preventive guidelines that incorporate individual differences.  In particular, I am doing some work to measure how non-cognitive skills (eg., self-discipline, persistence, self-control) influence compliance.  I have also done research relating cognitive skills and prevention.  Most of my work is on low and middle-income countries. However, I think that some of my findings may be generalized.

I am not very familiar with tools from behavioral economics; instead my analysis is heavily based on health economics, labor economics and health policy.  Given your knowledge in behavioral economics, I wonder how you would approach this problem.  

Here is one article on the topic, and here are a few more, and here.  One intuition is that compliance is so weak because people are afraid of bad news, and so they shut the topic out of their minds altogether.  Complying reminds them of the topic.  Being less worried might help them comply.

A common economic intuition, which I usually disagree with, is to make people post expensive bonds and confiscate the bond if they do not comply.  In my view this works only once and afterwards the person wants nothing to do with the game.

An additional method is to make compliance daily, whether or not the technology of compliance requires that.  Most people develop a routine for brushing their teeth, even though it is not an intrinsically fun activity.

That many providers have moved from the word "non-compliance" to "non-adherence" is not a good sign; it suggests the actual programs are not working.

This problem is acute in Mexico.  One method for that country would be to encourage religious conversions to more extreme points of view, which would limit drinking.

Even for the United States, this is one of our most significant national problems, although it receives very little press.  As the rate of diabetes rises, it will continue to grow in import.

What other ideas do you all have?


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