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1.
N Engl J Med ; 385(1): 78-86, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34192436

RESUMO

Companies have recently begun to sell a new service to patients considering in vitro fertilization: embryo selection based on polygenic scores (ESPS). These scores represent individualized predictions of health and other outcomes derived from genomewide association studies in adults to partially predict these outcomes. This article includes a discussion of many factors that lower the predictive power of polygenic scores in the context of embryo selection and quantifies these effects for a variety of clinical and nonclinical traits. Also discussed are potential unintended consequences of ESPS (including selecting for adverse traits, altering population demographics, exacerbating inequalities in society, and devaluing certain traits). Recommendations for the responsible communication about ESPS by practitioners are provided, and a call for a society-wide conversation about this technology is made. (Funded by the National Institute on Aging and others.).


Assuntos
Embrião de Mamíferos , Fertilização in vitro , Testes Genéticos , Variação Genética , Herança Multifatorial/genética , Fenótipo , Diagnóstico Pré-Implantação , Escolaridade , Interação Gene-Ambiente , Estudo de Associação Genômica Ampla , Humanos , Valor Preditivo dos Testes
2.
Proc Natl Acad Sci U S A ; 118(20)2021 05 18.
Artigo em Inglês | MEDLINE | ID: mdl-33926993

RESUMO

Many Americans fail to get life-saving vaccines each year, and the availability of a vaccine for COVID-19 makes the challenge of encouraging vaccination more urgent than ever. We present a large field experiment (N = 47,306) testing 19 nudges delivered to patients via text message and designed to boost adoption of the influenza vaccine. Our findings suggest that text messages sent prior to a primary care visit can boost vaccination rates by an average of 5%. Overall, interventions performed better when they were 1) framed as reminders to get flu shots that were already reserved for the patient and 2) congruent with the sort of communications patients expected to receive from their healthcare provider (i.e., not surprising, casual, or interactive). The best-performing intervention in our study reminded patients twice to get their flu shot at their upcoming doctor's appointment and indicated it was reserved for them. This successful script could be used as a template for campaigns to encourage the adoption of life-saving vaccines, including against COVID-19.


Assuntos
Vacinas contra COVID-19 , COVID-19/prevenção & controle , Vacinas contra Influenza , Influenza Humana/prevenção & controle , Visita a Consultório Médico/estatística & dados numéricos , Vacinação/estatística & dados numéricos , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Médicos de Atenção Primária , Sistemas de Alerta , Envio de Mensagens de Texto , Vacinação/psicologia
3.
J Econ Lit ; 58(2): 299-347, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37691693

RESUMO

We review research that measures time preferences-i.e., preferences over intertemporal tradeoffs. We distinguish between studies using financial flows, which we call "money earlier or later" (MEL) decisions and studies that use time-dated consumption/effort. Under different structural models, we show how to translate what MEL experiments directly measure (required rates of return for financial flows) into a discount function over utils. We summarize empirical regularities found in MEL studies and the predictive power of those studies. We explain why MEL choices are driven in part by some factors that are distinct from underlying time preferences.

4.
J Public Econ ; 1832020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32189814

RESUMO

Previous research has shown that some people voluntarily use commitment contracts that restrict their own choice sets. We study how people divide money between two accounts: a liquid account that permits unrestricted withdrawals and a commitment account that is randomly assigned in a between-subject design to have either a 10% early withdrawal penalty, or a 20% early withdrawal penalty, or not to allow early withdrawals at all (i.e., an infinite penalty). When the liquid account and the commitment account pay the same interest rate, higher early-withdrawal penalties attract more commitment account deposits. This pattern is predicted by the hypothesis that some participants are partially- or fully-sophisticated present-biased agents. Such agents perceive that higher penalties generate greater scope for commitment by disincentivizing (penalized) early withdrawals. The experiment also shows that when the commitment account pays a higher interest rate than the liquid account, the positive empirical slope relating penalties and commitment deposits is flattened, suggesting that naïve present-biased agents or agents with standard exponential discounting are also in our sample. Across all of our experimental treatments, higher early withdrawal penalties on the commitment account sometimes increase and never reduce allocations to the commitment account.

5.
J Econ Behav Organ ; 179: 743-756, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33424063

RESUMO

How well do pre-school delay of gratification and life-course measures of self-regulation predict mid-life capital formation? We surveyed 113 participants of the 1967-1973 Bing pre-school studies on delay of gratification when they were in their late 40's. They reported 11 mid-life capital formation outcomes, including net worth, permanent income, absence of high-interest debt, forward-looking behaviors, and educational attainment. To address multiple hypothesis testing and our small sample, we pre-registered an analysis plan of well-powered tests. As predicted, a newly constructed and pre-registered measure derived from preschool delay of gratification does not predict the 11 capital formation variables (i.e., the sign-adjusted average correlation was 0.02). A pre-registered composite self-regulation index, combining preschool delay of gratification with survey measures of self-regulation collected at ages 17, 27, and 37, does predict 10 of the 11 capital formation variables in the expected direction, with an average correlation of 0.19. The inclusion of the preschool delay of gratification measure in this composite index does not affect the index's predictive power. We tested several hypothesized reasons that preschool delay of gratification does not have predictive power for our mid-life capital formation variables.

6.
Proc Natl Acad Sci U S A ; 111(38): 13790-4, 2014 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-25201988

RESUMO

We identify common genetic variants associated with cognitive performance using a two-stage approach, which we call the proxy-phenotype method. First, we conduct a genome-wide association study of educational attainment in a large sample (n = 106,736), which produces a set of 69 education-associated SNPs. Second, using independent samples (n = 24,189), we measure the association of these education-associated SNPs with cognitive performance. Three SNPs (rs1487441, rs7923609, and rs2721173) are significantly associated with cognitive performance after correction for multiple hypothesis testing. In an independent sample of older Americans (n = 8,652), we also show that a polygenic score derived from the education-associated SNPs is associated with memory and absence of dementia. Convergent evidence from a set of bioinformatics analyses implicates four specific genes (KNCMA1, NRXN1, POU2F3, and SCRT). All of these genes are associated with a particular neurotransmitter pathway involved in synaptic plasticity, the main cellular mechanism for learning and memory.


Assuntos
Cognição/fisiologia , Aprendizagem/fisiologia , Herança Multifatorial/fisiologia , Plasticidade Neuronal/genética , Polimorfismo de Nucleotídeo Único , Transmissão Sináptica/genética , Proteínas de Ligação ao Cálcio , Moléculas de Adesão Celular Neuronais/genética , Feminino , Humanos , Masculino , Memória/fisiologia , Proteínas do Tecido Nervoso/genética , Moléculas de Adesão de Célula Nervosa , Fatores de Transcrição de Octâmero/genética
7.
J Public Econ ; 151: 84-95, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28966407

RESUMO

Can governments increase private savings by taxing savings up front instead of in retirement? Roth 401(k) contributions are not tax-deductible in the contribution year, but withdrawals in retirement are untaxed. The more common before-tax 401(k) contribution is tax-deductible in the contribution year, but both principal and investment earnings are taxed upon withdrawal. Using administrative data from eleven companies that added a Roth contribution option to their existing 401(k) plan between 2006 and 2010, we find no evidence that total 401(k) contribution rates differ between employees hired before versus after Roth introduction, which implies that take-home pay declines and the amount of retirement consumption being purchased by 401(k) contributions increases after Roth introduction. We reject several neoclassical explanations for our null finding. Results from a survey experiment suggest two behavioral explanations: (1) employee confusion about and neglect of the tax properties of Roth balances and (2) partition dependence.

8.
Med Care ; 54(6): 578-83, 2016 06.
Artigo em Inglês | MEDLINE | ID: mdl-27177295

RESUMO

BACKGROUND: Routine annual influenza vaccinations are recommended for persons 6 months of age and older, but less than half of US adults get vaccinated. Many employers offer employees free influenza vaccinations at workplace clinics, but even then take-up is low. OBJECTIVE: To determine whether employees are significantly more likely to get vaccinated if they have a higher probability of walking by the clinic for reasons other than vaccination. METHOD: We obtained data from an employer with a free workplace influenza vaccination clinic. Using each employee's building entry/exit swipe card data, we test whether functional proximity-the likelihood that the employee walks by the clinic for reasons other than vaccination-predicts whether the employee gets vaccinated at the clinic. We also test whether base proximity-the inverse of walking distance from the employee's desk to the clinic-predicts vaccination probability. PARTICIPANTS: A total of 1801 employees of a health benefits administrator that held a free workplace influenza vaccination clinic. RESULTS: A 2 SD increase in functional proximity is associated with a 6.4 percentage point increase in the probability of vaccination (total vaccination rate at company=40%), even though the average employee's desk is only 166 meters from the clinic. Base proximity does not predict vaccination probability. CONCLUSIONS AND RELEVANCE: Minor changes in the environment can have substantial effects on the probability of vaccination. If these results generalize, health systems should emphasize functional proximity over base proximity when locating preventive health services.


Assuntos
Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Vacinas contra Influenza/uso terapêutico , Vacinação/estatística & dados numéricos , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Probabilidade , Estados Unidos , Local de Trabalho/estatística & dados numéricos , Adulto Jovem
9.
Psychol Sci ; 26(6): 826-33, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25911124

RESUMO

Heuristic models have been proposed for many domains involving choice. We conducted an out-of-sample, cross-validated comparison of heuristic models of intertemporal choice (which can account for many of the known intertemporal choice anomalies) and discounting models. Heuristic models outperformed traditional utility-discounting models, including models of exponential and hyperbolic discounting. The best-performing models predicted choices by using a weighted average of absolute differences and relative percentage differences of the attributes of the goods in a choice set. We concluded that heuristic models explain time-money trade-off choices in experiments better than do utility-discounting models.


Assuntos
Desvalorização pelo Atraso , Heurística , Julgamento , Modelos Psicológicos , Recompensa , Humanos , Fatores de Tempo
10.
Proc Natl Acad Sci U S A ; 109(21): 8026-31, 2012 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-22566634

RESUMO

Preferences are fundamental building blocks in all models of economic and political behavior. We study a new sample of comprehensively genotyped subjects with data on economic and political preferences and educational attainment. We use dense single nucleotide polymorphism (SNP) data to estimate the proportion of variation in these traits explained by common SNPs and to conduct genome-wide association study (GWAS) and prediction analyses. The pattern of results is consistent with findings for other complex traits. First, the estimated fraction of phenotypic variation that could, in principle, be explained by dense SNP arrays is around one-half of the narrow heritability estimated using twin and family samples. The molecular-genetic-based heritability estimates, therefore, partially corroborate evidence of significant heritability from behavior genetic studies. Second, our analyses suggest that these traits have a polygenic architecture, with the heritable variation explained by many genes with small effects. Our results suggest that most published genetic association studies with economic and political traits are dramatically underpowered, which implies a high false discovery rate. These results convey a cautionary message for whether, how, and how soon molecular genetic data can contribute to, and potentially transform, research in social science. We propose some constructive responses to the inferential challenges posed by the small explanatory power of individual SNPs.


Assuntos
Comportamento de Escolha/fisiologia , Economia Comportamental/estatística & dados numéricos , Genética Comportamental/métodos , Estudo de Associação Genômica Ampla , Personalidade/genética , Política , Feminino , Estudos de Associação Genética , Humanos , Masculino , Polimorfismo de Nucleotídeo Único , Sistema de Registros/estatística & dados numéricos , Suécia/epidemiologia , Gêmeos Dizigóticos/genética , Gêmeos Monozigóticos/genética
11.
Psychol Sci ; 25(11): 1975-86, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25287667

RESUMO

A recent genome-wide-association study of educational attainment identified three single-nucleotide polymorphisms (SNPs) whose associations, despite their small effect sizes (each R (2) ≈ 0.02%), reached genome-wide significance (p < 5 × 10(-8)) in a large discovery sample and were replicated in an independent sample (p < .05). The study also reported associations between educational attainment and indices of SNPs called "polygenic scores." In three studies, we evaluated the robustness of these findings. Study 1 showed that the associations with all three SNPs were replicated in another large (N = 34,428) independent sample. We also found that the scores remained predictive (R (2) ≈ 2%) in regressions with stringent controls for stratification (Study 2) and in new within-family analyses (Study 3). Our results show that large and therefore well-powered genome-wide-association studies can identify replicable genetic associations with behavioral traits. The small effect sizes of individual SNPs are likely to be a major contributing factor explaining the striking contrast between our results and the disappointing replication record of most candidate-gene studies.


Assuntos
Logro , Estudo de Associação Genômica Ampla/métodos , Estudo de Associação Genômica Ampla/estatística & dados numéricos , Polimorfismo de Nucleotídeo Único/genética , Escolaridade , Genótipo , Humanos , Massachusetts , Análise de Componente Principal , Queensland , Sistema de Registros , Reprodutibilidade dos Testes
12.
Proc Natl Acad Sci U S A ; 108(26): 10415-20, 2011 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-21670283

RESUMO

We evaluate the results of a field experiment designed to measure the effect of prompts to form implementation intentions on realized behavioral outcomes. The outcome of interest is influenza vaccination receipt at free on-site clinics offered by a large firm to its employees. All employees eligible for study participation received reminder mailings that listed the times and locations of the relevant vaccination clinics. Mailings to employees randomly assigned to the treatment conditions additionally included a prompt to write down either (i) the date the employee planned to be vaccinated or (ii) the date and time the employee planned to be vaccinated. Vaccination rates increased when these implementation intentions prompts were included in the mailing. The vaccination rate among control condition employees was 33.1%. Employees who received the prompt to write down just a date had a vaccination rate 1.5 percentage points higher than the control group, a difference that is not statistically significant. Employees who received the more specific prompt to write down both a date and a time had a 4.2 percentage point higher vaccination rate, a difference that is both statistically significant and of meaningful magnitude.


Assuntos
Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Sistemas de Alerta , Vacinação/estatística & dados numéricos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Meio-Oeste dos Estados Unidos
13.
J Public Econ ; 116: 2-16, 2014 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-24954961

RESUMO

We conduct and analyze two large surveys of hypothetical annuitization choices. We find that allowing individuals to annuitize a fraction of their wealth increases annuitization relative to a situation where annuitization is an "all or nothing" decision. Very few respondents choose declining real payout streams over flat or increasing real payout streams of equivalent expected present value. Highlighting the effects of inflation increases demand for cost of living adjustments. Frames that highlight flexibility, control, and investment significantly reduce annuitization. A majority of respondents prefer to receive an extra "bonus" payment during one month of the year that is funded by slightly lower payments in the remaining months. Concerns about later-life income, spending flexibility, and counterparty risk are the most important self-reported motives that influence the annuitization decision.

14.
Am J Public Health ; 103 Suppl 1: S152-66, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23927501

RESUMO

OBJECTIVES: We explain why traits of interest to behavioral scientists may have a genetic architecture featuring hundreds or thousands of loci with tiny individual effects rather than a few with large effects and why such an architecture makes it difficult to find robust associations between traits and genes. METHODS: We conducted a genome-wide association study at 2 sites, Harvard University and Union College, measuring more than 100 physical and behavioral traits with a sample size typical of candidate gene studies. We evaluated predictions that alleles with large effect sizes would be rare and most traits of interest to social science are likely characterized by a lack of strong directional selection. We also carried out a theoretical analysis of the genetic architecture of traits based on R.A. Fisher's geometric model of natural selection and empirical analyses of the effects of selection bias and phenotype measurement stability on the results of genetic association studies. RESULTS: Although we replicated several known genetic associations with physical traits, we found only 2 associations with behavioral traits that met the nominal genome-wide significance threshold, indicating that physical and behavioral traits are mainly affected by numerous genes with small effects. CONCLUSIONS: The challenge for social science genomics is the likelihood that genes are connected to behavioral variation by lengthy, nonlinear, interactive causal chains, and unraveling these chains requires allying with personal genomics to take advantage of the potential for large sample sizes as well as continuing with traditional epidemiological studies.


Assuntos
Cor de Olho/genética , Genes , Cor de Cabelo/genética , Personalidade/genética , Ciências Sociais , Adolescente , Adulto , Comportamento , Fenômenos Biológicos , Feminino , Pesquisa em Genética , Estudo de Associação Genômica Ampla , Humanos , Masculino , Polimorfismo de Nucleotídeo Único/genética , Seleção Genética , Inquéritos e Questionários , Adulto Jovem
15.
Am Econ Rev ; 103(3): 570-574, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-25125700

RESUMO

Do laboratory subjects correctly perceive the dynamics of a mean-reverting time series? In our experiment, subjects receive historical data and make forecasts at different horizons. The time series process that we use features short-run momentum and long-run partial mean reversion. Half of the subjects see a version of this process in which the momentum and partial mean reversion unfold over 10 periods ('fast'), while the other subjects see a version with dynamics that unfold over 50 periods ('slow'). Typical subjects recognize most of the mean reversion of the fast process and none of the mean reversion of the slow process.

16.
J Econ Behav Organ ; 95: 130-145, 2013 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-24443619

RESUMO

The daunting complexity of important financial decisions can lead to procrastination. We evaluate a low-cost intervention that substantially simplifies the retirement savings plan participation decision. Individuals received an opportunity to enroll in a retirement savings plan at a pre-selected contribution rate and asset allocation, allowing them to collapse a multidimensional problem into a binary choice between the status quo and the pre-selected alternative. The intervention increases plan enrollment rates by 10 to 20 percentage points. We find that a similar intervention can be used to increase contribution rates among employees who are already participating in a savings plan.

17.
Science ; 379(6632): 541-543, 2023 02 10.
Artigo em Inglês | MEDLINE | ID: mdl-36758092

RESUMO

Understanding moral acceptability and willingness to use is crucial for informing policy.


Assuntos
Embrião de Mamíferos , Edição de Genes , Testes Genéticos , Herança Multifatorial , Testes Genéticos/ética , Risco , Humanos , Edição de Genes/ética , Formulação de Políticas , Estados Unidos
18.
Am J Health Promot ; 37(3): 324-332, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36195982

RESUMO

PURPOSE: To evaluate if nudges delivered by text message prior to an upcoming primary care visit can increase influenza vaccination rates. DESIGN: Randomized, controlled trial. SETTING: Two health systems in the Northeastern US between September 2020 and March 2021. SUBJECTS: 74,811 adults. INTERVENTIONS: Patients in the 19 intervention arms received 1-2 text messages in the 3 days preceding their appointment that varied in their format, interactivity, and content. MEASURES: Influenza vaccination. ANALYSIS: Intention-to-treat. RESULTS: Participants had a mean (SD) age of 50.7 (16.2) years; 55.8% (41,771) were female, 70.6% (52,826) were White, and 19.0% (14,222) were Black. Among the interventions, 5 of 19 (26.3%) had a significantly greater vaccination rate than control. On average, the 19 interventions increased vaccination relative to control by 1.8 percentage points or 6.1% (P = .005). The top performing text message described the vaccine to the patient as "reserved for you" and led to a 3.1 percentage point increase (95% CI, 1.3 to 4.9; P < .001) in vaccination relative to control. Three of the top five performing messages described the vaccine as "reserved for you." None of the interventions performed worse than control. CONCLUSIONS: Text messages encouraging vaccination and delivered prior to an upcoming appointment significantly increased influenza vaccination rates and could be a scalable approach to increase vaccination more broadly.


Assuntos
Vacinas contra Influenza , Influenza Humana , Envio de Mensagens de Texto , Adulto , Humanos , Feminino , Pessoa de Meia-Idade , Masculino , Influenza Humana/prevenção & controle , Sistemas de Alerta , Vacinação , Atenção Primária à Saúde
19.
Psychol Sci ; 23(11): 1314-23, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23012269

RESUMO

General intelligence (g) and virtually all other behavioral traits are heritable. Associations between g and specific single-nucleotide polymorphisms (SNPs) in several candidate genes involved in brain function have been reported. We sought to replicate published associations between g and 12 specific genetic variants (in the genes DTNBP1, CTSD, DRD2, ANKK1, CHRM2, SSADH, COMT, BDNF, CHRNA4, DISC1, APOE, and SNAP25) using data sets from three independent, well-characterized longitudinal studies with samples of 5,571, 1,759, and 2,441 individuals. Of 32 independent tests across all three data sets, only 1 was nominally significant. By contrast, power analyses showed that we should have expected 10 to 15 significant associations, given reasonable assumptions for genotype effect sizes. For positive controls, we confirmed accepted genetic associations for Alzheimer's disease and body mass index, and we used SNP-based calculations of genetic relatedness to replicate previous estimates that about half of the variance in g is accounted for by common genetic variation among individuals. We conclude that the molecular genetics of psychology and social science requires approaches that go beyond the examination of candidate genes.


Assuntos
Inteligência/genética , Humanos , Individualidade , Polimorfismo de Nucleotídeo Único , Reprodutibilidade dos Testes
20.
BMC Geriatr ; 12: 48, 2012 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-22938391

RESUMO

BACKGROUND: The objective of this study was to test the hypothesis that cognitive function is negatively associated with temporal discounting in old age. METHODS: Participants were 388 community-dwelling older persons without dementia from the Rush Memory and Aging Project, an ongoing longitudinal epidemiologic study of aging in the Chicago metropolitan area. Temporal discounting was measured using standard questions in which participants were asked to choose between an immediate, smaller payment and a delayed, larger one. Cognition was measured using a detailed battery including 19 tests. The association between cognition and temporal discounting was examined via mixed models adjusted for age, sex, education, income, and the number of chronic medical conditions. RESULTS: Descriptive data revealed a consistent pattern whereby older persons with lower cognitive function were more likely to discount greater but delayed rewards compared to those with higher cognitive function. Further, in a mixed effect model adjusted for age, sex, education, income, and chronic medical conditions, global cognitive function was negatively associated with temporal discounting (estimate = -0.45, SE = 0.18, p = 0.015), such that a person with lower cognition exhibited greater discounting. Finally, in subsequent models examining domain specific associations, perceptual speed and visuospatial abilities were associated with temporal discounting, but episodic memory, semantic memory and working memory were not. CONCLUSION: Among older persons without dementia, a lower level of cognitive function is associated with greater temporal discounting. These findings have implications regarding the ability of older persons to make decisions that involve delayed rewards but maximize well-being.


Assuntos
Idoso/psicologia , Comportamento de Escolha , Cognição , Fatores Etários , Escolaridade , Nível de Saúde , Humanos , Renda , Testes Neuropsicológicos , Fatores Sexuais , Fatores de Tempo
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