Monitor on Psychology - November 2011 - (Page 41)
money. If you don’t, that $5 goes to what stickK.com founder Jordan Goldberg calls an “anti-charity,” a group that you have identified that you strongly disagree with. “If you’re for gun control, you’ll be extra-motivated to keep us from sending your money to the National Rifle Association,” says Goldberg, adding that you can choose other consequences, such as betting against friends or sending money to causes you support. Video: Click here to get a look at the drug-free workplace designed by (The company Johns Hopkins psychologists. makes money through advertising and corporate if people remember to refill their prescriptions. Adherence also partnerships.) helps people better manage chronic illness and reduces the These kinds of automated systems are driving the nation’s health-care costs, Klapow says. movement of contingency management from small-scale Of course, not everyone is enthusiastic about the idea of studies to major population-level applications, says Joe having companies electronically monitor and reward healthy Schumacher, PhD, a professor of medicine and contingency behaviors. It’s one thing to use contingency management to management researcher at the University of Alabama at help people with drug addictions, but it’s quite another to Birmingham. apply these programs to the wider population, says George “Incentive systems are going high-tech,” he says. Loewenstein, PhD, a behavioral economics professor at Schumacher is best known for his work using contingency Carnegie Mellon University. management to get homeless people with crack addictions to A case in point, he says, is weight loss. We can pay people to quit, but he’s now extending that work to larger populations eat more healthfully — in fact, he did just that in a randomized through a Birmingham-based company called ChipRewards. controlled trial in the June Journal of General Internal Medicine. ChipRewards recently collaborated with Chattanooga, In the study, participants in the contingency management Tenn., to create a program for 3,200 of the city’s workers. condition lost an average of eight more pounds than people in They adapted software originally created for business loyalty the control condition. But to address widespread obesity, it’s programs to monitor how often employees, for example, go better to lower the cost of fresh fruits and vegetables and raise to the gym, refill prescriptions or attend preventative health the cost of processed food, he says. screenings. The program automatically issues employees good“Contingency management tackles the problem at the behavior points, which can be exchanged online for a variety of individual level, but we risk losing sight of the real underlying products. causes of the problem and possibly even blaming the victim,” That means the same computer program that encourages he says. you to eat nine burritos to get one free may soon help you lose Then, there’s the larger issue of free will. As contingency the weight you gained eating all those burritos. management systems spread, will we begin to see ourselves as ChipRewards has been hired by several large companies and nothing more than rats in Skinner boxes? is being used by more than 100,000 employees, says Klapow, “There’s the potential of going overboard,” Loewenstein ChipRewards’ chief behavioral scientist. In the future, programs says. “Ending up in a ‘Walden Two’-type society doesn’t seem like his could create large-scale medication adherence programs like such a great outcome to me.” n for pharmacetical companies, since they stand to earn money
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