Noah J. Goldstein's research while affiliated with University of California, Los Angeles and other places

Publications (57)

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Background: The CDC estimates that over 40% of Urgent Care visits are for acute respiratory infections (ARI), more than half involving inappropriate antibiotic prescriptions. Previous randomized trials in primary care clinics resulted in reductions in inappropriate antibiotic prescribing, but antibiotic stewardship interventions in telehealth have...
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Encouraging vaccination is a pressing policy problem. To assess whether text-based reminders can encourage pharmacy vaccination and what kinds of messages work best, we conducted a megastudy. We randomly assigned 689,693 Walmart pharmacy patients to receive one of 22 different text reminders using a variety of different behavioral science principle...
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Background: Inappropriate polypharmacy, prevalent among older patients, is associated with substantial harms. Objective: To develop measures of high-risk polypharmacy and pilot test novel electronic health record (EHR)-based nudges grounded in behavioral science to promote deprescribing. Design: We developed and validated seven measures, then...
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Background Overtesting and treatment of older patients is common and may lead to harms. The Choosing Wisely campaign has provided recommendations to reduce overtesting and overtreatment of older adults. Behavioral economics-informed interventions embedded within the electronic health record (EHR) have been shown to reduce overuse in several areas....
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Background High levels of opioid prescribing in the United States has resulted in an alarming trend in opioid-related harms. The objective of Trial 2 of the Application of Economics & Social psychology to improve Opioid Prescribing Safety (AESOPS-2) is to dampen the intensity and frequency of opioid prescribing in accordance with the Centers for Di...
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Introduction Robust randomised trial data have shown that routine preoperative (pre-op) testing for cataract surgery patients is inappropriate. While guidelines have discouraged testing since 2002, cataract pre-op testing rates have remained unchanged since the 1990s. Given the challenges of reducing low-value care despite strong consensus around t...
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Background: Since the advent of COVID-19, accelerated adoption of systems that reduce face-to-face encounters has outpaced training and best practices. Electronic consultations (eConsults), structured communications between PCPs and specialists regarding a case, have been effective in reducing face-to-face specialist encounters. As the health syst...
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Background There is a lack of evidence that long-term opioid use offers benefit for noncancer pain and an abundance of evidence of harm. Despite clinical guidelines and education, prescribing continues at a higher rate than before the opioids crisis. The objective of trial 1 of the Application of Economics & Social psychology to improve Opioid Pres...
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Despite widespread national, state, and local guidelines for COVID-19 prevention, including social distancing and mask orders, many people continue to not adhere to recommendations, including congregating in groups for non-essential activities, putting themselves and others at risk. A social psychological perspective can be used to understand reaso...
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People constantly receive information about their performance relative to others. Estimating these effects is complicated because, as we show, normative feedback includes several dimensions: Target (e.g., a reference group of average versus exemplary performers), Distance (e.g., being near versus far from a benchmark), and Valence (e.g., being bett...
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Cardiovascular disease (CVD) is a major cause of morbidity among people living with HIV (PLWH). Statins can safely and effectively reduce CVD risk in PLWH, but evidence-based statin therapy is under-prescribed in PLWH. Developed using an implementation science framework, INcreasing Statin Prescribing in HIV Behavioral Economics REsearch (INSPIRE) i...
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Introduction: Colorectal cancer (CRC) is a major cause of cancer-related morbidity and mortality in the United States. Although various interventions have improved screening rates, they often require abundant resources and can be difficult to implement. Social psychology and behavioral economics principles offer an opportunity for low-cost and eas...
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Background Uncontrolled hypertension contributes to disparities in cardiovascular outcomes. Patient intervention strategies informed by behavioral economics and social psychology could improve blood pressure (BP) control in disadvantaged minority populations. Objective To assess the impact on BP control of an intervention combining short-term fina...
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Introduction Obesity is a major public health challenge and exacerbates economic disparities through employment discrimination and increased personal health expenditures. Financial incentives for weight management may intensify individuals’ utilisation of evidence-based behavioural strategies while addressing obesity-related economic disparities in...
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The influence of social norms on behavior has been a longstanding storyline within social psychology. Our 2007 Psychological Science publication presented a new rendition of this classic telling. The reported field experiment showed that social norms could be leveraged to promote residential energy conservation, but importantly, the descriptive nor...
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This article reviews research from several behavioral disciplines to derive strategies for prompting people to perform behaviors that are individually costly and provide negligible individual or social benefits but are meaningful when performed by a large number of individuals. Whereas the term social influence encompasses all the ways in which peo...
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Inappropriate antibiotic prescribing contributes to antibiotic resistance and leads to adverse events.¹ A cluster-randomized trial of 3 behavioral interventions² intended to reduce inappropriate prescribing found that 2 of the 3 interventions were effective.³ This study examines the persistence of effects 12 months after stopping the interventions.
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Intergroup relations research has largely focused on relations between members of dominant groups and members of disadvantaged groups. The small body of work examining intraminority intergroup relations, or relations between members of different disadvantaged groups, reveals that salient experiences of ingroup discrimination promote positive relati...
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Background Clinicians frequently prescribe antibiotics inappropriately for acute respiratory infections (ARIs). Our objective was to test information technology-enabled behavioral interventions to reduce inappropriate antibiotic prescribing for ARIs in a randomized controlled pilot test trial. Methods Primary care clinicians were randomized in a 2...
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Importance Interventions based on behavioral science might reduce inappropriate antibiotic prescribing.Objective To assess effects of behavioral interventions and rates of inappropriate (not guideline-concordant) antibiotic prescribing during ambulatory visits for acute respiratory tract infections.Design, Setting, and Participants Cluster rando...
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Although prior research indicates that power and hierarchy illegitimacy independently decrease conformity to social norms, we demonstrate that the two interact. In five studies, we find that legitimate power decreases conformity, whereas illegitimate power increases conformity. We conducted Study 1 in a business organization and found that power wa...
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Policymakers traditionally have relied upon education, economic incentives, and legal sanctions to influence behavior and effect change for the public good. But recent research in the behavioral sciences points to an exciting new approach that is highly effective and cost-efficient. By leveraging one or more of three simple yet powerful human motiv...
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Background: Healthcare professionals are rapidly adopting electronic health records (EHRs). Within EHRs, seemingly innocuous menu design configurations can influence provider decisions for better or worse. Objective: The purpose of this study was to examine whether the grouping of menu items systematically affects prescribing practices among pri...
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A great deal of psychological research has investigated the influence of perspective taking on individuals, indicating that perspective taking increases the extent to which people like, feel a sense of self-other overlap with, and help those whose perspective they take. However, previous investigations of the topic have been limited to the study of...
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Importance: "Nudges" that influence decision making through subtle cognitive mechanisms have been shown to be highly effective in a wide range of applications, but there have been few experiments to improve clinical practice. Objective: To investigate the use of a behavioral "nudge" based on the principle of public commitment in encouraging the...
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Background: Inappropriate antibiotic prescribing for nonbacterial infections leads to increases in the costs of care, antibiotic resistance among bacteria, and adverse drug events. Acute respiratory infections (ARIs) are the most common reason for inappropriate antibiotic use. Most prior efforts to decrease inappropriate antibiotic prescribing for...
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Despite a revolution in therapeutics, the ability to control chronic diseases remains elusive. We present here a conceptual model of the potential role of behavioral tools in chronic disease control. Clinicians implicitly accept the assumption that patients will act rationally to maximize their self-interest. However, patients may not always be the...
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We use two experiments to investigate “illusory power transference,” in which individuals minimally associated with powerful others act as if they themselves are powerful outside the boundaries of the association. The experiments elicit this phenomenon through social comparison processes that result in individuals’ perceptions of their own power as...
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We explored a novel reciprocity-based influence strategy to stimulate cooperation called the reciprocity-by-proxy strategy. Unlike in traditional reciprocity, in which benefactors provide direct benefits to target individuals to elicit reciprocity, the reciprocity-by-proxy strategy elicits in the target a sense of indebtedness to benefactors by pro...
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How do arousal-inducing contexts, such as frightening or romantic television programs, influence the effectiveness of basic persuasion heuristics? Different predictions are made by three theoretical models: A general arousal model predicts that arousal should increase effectiveness of heuristics; an affective valence model predicts that effectivene...
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Acts of self-control may deplete an individual's self-regulatory resources. But what are the consequences of perceiving other people's use of self-control? Mentally simulating the actions of others has been found to elicit psychological effects consistent with the actual performance of those actions. Here, we consider how simulating versus merely p...
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There is ample evidence of the power of social influence on pro-environmental behaviors. Beliefs about the conservation behavior of others (descriptive normative beliefs) have a strong positive correlation with one's own conservation actions. However, this relationship has not been investigated much further in terms of possible moderators or involv...
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Two field experiments examined the effectiveness of signs requesting hotel guests' participation in an environmental conservation program. Appeals employing descriptive norms (e.g., "the majority of guests reuse their towels") proved superior to a traditional appeal widely used by hotels that focused solely on environmental protection. Moreover, no...
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The present research investigated the persuasive impact and detectability of normative social influence. The first study surveyed 810 Californians about energy conservation and found that descriptive normative beliefs were more predictive of behavior than were other relevant beliefs, even though respondents rated such norms as least important in th...
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Despite a long tradition of effectiveness in laboratory tests, normative messages have had mixed success in changing behavior in field contexts, with some studies showing boomerang effects. To test a theoretical account of this inconsistency, we conducted a field experiment in which normative messages were used to promote household energy conservat...
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Social psychology theory can be applied to such mundane purposes as encouraging guests to reuse their washroom towels. In contrast to the appeals now in use to persuade guests to reuse their towels, research found that applying the norm of reciprocation and the descriptive norm for proenvironmental action improved guests' participation in one hotel...
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Self-perception theory posits that people sometimes infer their own attributes by observing their freely chosen actions. The authors hypothesized that in addition, people sometimes infer their own attributes by observing the freely chosen actions of others with whom they feel a sense of merged identity--almost as if they had observed themselves per...
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Three experiments examined how 2 fundamental social motives--self-protection and mate attraction--influenced conformity. A self-protective goal increased conformity for both men and women. In contrast, the effects of a romantic goal depended on sex, causing women to conform more to others' preferences while engendering nonconformity in men. Men mot...
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Companies deploying dishonest tactics toward customers, suppliers, distributors and others typically do so to increase short-term profits, and in that regard they might succeed. But the misconduct is likely to fuel social psychological processes within the organization that have the potential for ruinous fiscal outcomes, outweighing short-term gain...
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This review covers recent developments in the social influence literature, focusing primarily on compliance and conformity research published between 1997 and 2002. The principles and processes underlying a target's susceptibility to outside influences are considered in light of three goals fundamental to rewarding human functioning. Specifically,...
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From business owners to busboys, the ability to harness the power of persuasion is often an essential component of success in the hospitality industry.
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From business owners to busboys, the ability to harness the power of persuasion is often an essential component of success in the hospitality industry.

Citations

... These efforts focus on protecting both vaccinated individuals and the community at large. Therefore, government agencies need to develop easy-to-implement tools that can be rapidly deployed and scaled up to increase immunization coverage (Milkman et al., 2021b(Milkman et al., , 2022. ...
... Straightforward, low-cost nudges may be effective in this regard. Two recent large-scale studies in the United States found that vaccination appointment reminder messages from healthcare providers increased influenza vaccine uptake 53,54 . Similar interventions have proven effective in increasing immunization in LMIC contexts. ...
... Since the beginning of the pandemic, groups of deniers and anti-vaccination movements have spread all over the world [5,6]. People who joined these groups showed disbelief in COVID-19, distrusted their governments, and started to not adhere to preventive measures and official guidelines, putting themselves and others at risk [5,[7][8][9][10]. These groups also spread misinformation about vaccine safety, causing a worrying reduction in vaccination rates [11,12]. ...
... Previous research suggests that the impact of peer comparison may depend on baseline performance (32)(33)(34), discouraging low performers while encouraging high performers. However, our post hoc analysis found no evidence that the estimated effect of the peer comparison intervention on order rates was moderated by PCPs' baseline performance (i.e., the HM completion rate displayed in the first intervention email). ...
... Second, our findings underscore the importance of attending to the way in which implementation details of a peer comparison intervention are perceived by targeted individuals within the relevant social context. Researchers have recently argued that behavioral interventions are not experienced "in a vacuum," but rather that they are "embedded in a social ecosystem involving an implicit or explicit interaction between targeted individuals and the [intervention] designer" (45). According to this account, people attend to the details of behavioral interventions-especially interventions that have been newly introduced-to infer their leaders' beliefs and values. ...
... This study is part of the INSPIRE study, a steppedwedge cluster randomized trial to test the effects of a multi-level implementation strategy with two interventions, education and peer comparison feedback, on rates of statin prescribing to PLWH by their primary care providers [28]. ...
... It was perceived as one of the least effective and most intrusive nudges. Given previous empirical findings attesting to the potency of utilizing social norms in other fields [56], this finding was also surprising. It is possible that our participants failed to appreciate the power of social referencing just by reading the short sentence we provided. ...
... Both cervical cancer and CRC generally do not have symptoms until a very late stage when cure is not possible (World Health Organization, 2017), making early screening, even self-screening (El Khoury et al., 2021;Bakr et al., 2020;Jaklevic, 2020), a critical health imperative. ...
... Health education from well informed community health workers has indeed became a factor that improved hypertensive patients practice on hypertension self-management such as medication adherence and low salt diet compliance. [11,13,15,[17][18][19][20][21] In this study, the proportion of hypertensive patients' with good medication adherence and low salt diet compliance were increased after health education on community health worker. It showed that community health workers were able to affect the hypertensive patients' behavior in the community. ...
... The primary outcome was the percentage of patients who achieve a ≥5% reduction in baseline weight at six months. The FIReWoRk protocol has been described in detail previously [43]. Briefly, adults aged 18 to 70 years with a body mass index (BMI) ≥ 30 kg/m 2 were recruited from three primary care clinics serving racially/ethnically diverse, medically underserved populations in which the prevalence of obesity is above the national average. ...