Conclusions
This study demonstrates the feasibility of crowdsourcing to assess the impact of 3 behavioral interventions, or nudging options, on simulated medication safety partnership behaviors in a simulated primary care encounter. Our experiments targeted bringing medications to office visits. This patient partnership behavior is often advocated but not widely adopted. We tested and observed the expected impact from behavioral economics–based designs to nudge this behavior through psychological rewards and loss framing against a monetary reward design.Crowdsourcing platforms such as MTurk are efficient in terms of time and cost to assess design options. Thus, they can be useful to augment and complement traditional approaches to designing ways to engage patients in health behaviors. Our findings revealed that crowdsourced surveys with simulated monetary compensation resulted in the expected simulated behavioral responses as actual incentives. We also found that none of the demographic factors (age, education level, race, income level, and the presence of chronic conditions) had a significant impact on the effectiveness of the interventions. We believe that this information is important for health care practitioners and policy makers, as it suggests that the interventions may be equally effective across diverse populations. In addition, this study suggests that a psychological incentive, specifically the status effect, combined with loss framing may be a good candidate for a clinical trial.From a practice perspective, these results suggest that psychological incentives, specifically the status effect, combined with loss framing may be a good candidate for a clinical trial of behavioral interventions and medication reconciliation.This project was supported by (grant R18HS027277) from the Agency for Health care Research and Quality (AHRQ). The content is solely the responsibility of the authors and does not necessarily represent the official views of the AHRQ. We benefited from the contribution of the PROMIS (Partnership for Resilience in Medication Safety) Lab members, including Noah Hendrix, Kimberly Fulda, DrPH, and Richard Young, MD.Medical editing assistance was provided by Genevieve Walker, PhD, of Bridge Health Communications.Conflicts of Interest: Per University of Texas at Arlington policy, the following statement is included. KYC has a potential research conflict of interest due to a financial interest with companies Hewlett-Packard Enterprise, Boostr, and DecisionNext. A management plan has been created to preserve objectivity in research in accordance with University of Texas at Arlington policy. All other authors had neither competing financial interests nor other potential conflicts of interest.Survey questions.CONSORT e-HEALTH Checklist V1.6.2.