Jones’ “Low Touch” Health Behavior System Piques Interest of World Economic Leaders
- By Carolyn Shapiro
For two days last month, the University of Vermont’s Christopher Jones, Ph.D., spent time with some of the world’s political and economic leaders explaining how their national security is closely tied to the health of their populations.
And they listened. Jones got the attention of not only the chief economist of agricultural conglomerate Monsanto Corporation, but also the CEO of Southeast Asia’s largest solar corporation, and a cadre of foreign heads of state, too.
A health economist and assistant professor of surgery, Jones was attending the World Strategic Forum, an annual conference to address global challenges sponsored by the International Economic Forum of the Americas. During the conference, titled “Engineering the Resilient Economy,” Jones described to fellow attendees his plan for using big data to improve public health and the need to make sure health information remains secure and actionable in an increasingly electronic but insecure world.
“Health data needs to be the most protected data around,” says Jones, director of the Global Health Economics Unit in UVM’s Center for Clinical and Translational Science. “It also needs to be actionable.”
The population of a healthy nation lives with less risk since it has its health needs met, making it better able to defend itself and thrive on the global stage, Jones says. The health care of the future is almost completely tied to personal behavioral decisions, he adds. Choosing to eat too much salt, saturated fat and refined sugar, without exercise, increases a person’s risk for obesity, high blood pressure, heart disease and diabetes. There are a lot of evolutionary reasons for this, going back to feast or famine times. Now, in times of cheap calories, behaviors that would otherwise lead to storing fat or sugar are maladaptive. What’s more, being non-adherent to medications places vulnerable populations at risk. Jones points out that even in the case of cancer, a patient’s behavior can improve his/her chances of survival, as well as chances for extended family members – if they have actionable and personalized information, they can share their family history and voluntarily pursue screening, for example.
Jones has launched a project to use data to develop “low-touch” incentives to motivate behavioral change. “High touch would be $100 bills,” he explains. “Low-touch would be coupons to local businesses.”
“What is the sweet spot to reward enlisted soldiers or veterans towards behavior change?” he wonders. The U.S. Department of Veterans Affairs should take note, particularly where nearly a third of our youth are too overweight to serve our nation as soldiers. “We’re going to basically take a lot of population data and evaluate it in a new way so that we are helpful, using incentives that have the right data protections in place.”
Jones has put together an “A team” of UVM colleagues in various areas of research: Asim Zia, Ph.D., associate professor in UVM’s Department of Community Development and Applied Economics; Peter Weimersheimer, M.D., associate professor of surgery and director of the Division of Emergency Medicine; Ted James M.D., associate professor of surgery and head of the Clinical Simulation Laboratory; and John Evans, Ph.D., senior advisor to the president and provost and professor emeritus of molecular physiology and biophysics. A recent addition to this initiative is Jack Caravelli, Ph.D., a longtime global health economics colleague from Jones’ time working in the United Kingdom and former White House National Security Council staffer with expertise in terrorism and nonproliferation. Jones also has partners in state government, the health insurance industry and software development industry.
He and the team are working on a data-based incentive system to change personal behavior, which Jones calls it trUStr. The program would evaluate people’s decisions, follow the resulting health consequences at a very personal level and reward positive outcomes like weight control.
“No one’s cracked it yet,” Jones says. “It’s got to be easy – super-simple on the user interface side. And it’s got to be secure, not creepy.”
Once they have a system built, Jones says, they plan to test it with 12,000 UVM Medical Center employees. At the World Strategic Forum, beyond corporations there were leaders of developing countries such as the Dominican Republic, Republic of Chad and Burkina Faso, who took particular interest in the idea of applying his proposed program to their most at-risk citizens, says Jones.
“There are a lot of potential verticals for incentives when the prize is nearly free - who wouldn’t want to sign up?” he posits. “We’re creating a business case for wellness.”