Pioneering Ideas

Happiness is Hot

BY PAUL TARINI, SENIOR PROGRAM OFFICER, PIONEER PORTFOLIO - @PaulTarini

Happiness is gaining currency today, particularly in relationship to health and medicine. That’s what we’ve been hearing ever since Harvard School of Public Health researchers Julia K. Boehm and Laura Kubzansky published their report “The Heart’s Content: The Association Between Positive Psychological Well-Being and Cardiovascular Health” in the Psychological Bulletin, under a grant from Pioneer. This is the first study of its kind to look closely at how positive psychological well-being—including happiness and optimism—plays a role in heart health.

The story was indeed hot – gaining attention from USA Today, The Huffington Post, TIME’s Healthland blog,WebMD, The New York Times’ Well Blog, ABCNews.com, MensHealth.com, ModernHealthcare.com, Oprah.com, and hundreds more – and being shared throughout social networks and on the web.

This review, which bases its conclusions on more than 200 studies, taps into a larger conversation going on in health care today about the role of wellness and prevention. So often in health and medicine, we look at what is wrong and try to fix it. But more recently, attention has turned toward what we can do to get and stay healthy before things start to go wrong.

Prior research has primarily focused on how risk factors, such as anxiety and depression, are associated with heart disease and cardiovascular events. This investigation is the first to establish that health assets—such as optimism and happiness—are also associated with heart health. This most recent study fits into a new concept called Positive Health, which seeks to demonstrate that people can use and strengthen these assets to achieve a healthier life. 

The intersection of happiness and health – where we flourish both mentally and physically – is where we all want to find ourselves. The findings of this study make intuitive sense: They tell us that happy people are healthy, active, and health-conscious. They also point us toward a new health care paradigm that focuses on making the most of our inherent advantages—not just on avoiding what’s “bad for us.” The next step in this field is to establish whether or not we can design interventions that help build these health assets to help people increase their chances of living a healthier, longer, and perhaps happier life.

Read more of Paul Tarini’s thoughts on the growing evidence for Positive Health.

New Evidence Continues to Build the Field of Positive Health

BY PAUL TARINI, SENIOR PROGRAM OFFICER, PIONEER PORTFOLIO -- @PaulTarini

Today, the Psychological Bulletin published research by Julia K. Boehm and Laura Kubzansky from the Harvard School of Public Health suggesting that positive psychological well-being – such as life purpose, positive emotion, life satisfaction, happiness and optimism – can help protect against and slow the progression of heart disease.

Prior research in this area has focused on how risk factors like anxiety and depression are associated with cardiovascular disease. But this study is the first of its kind to consider how a health asset –psychological well-being – plays a role in heart health.

This investigation and other emerging research suggests that in addition to diagnosis, treatment and prevention, health care should focus on promoting positive health assets – strengths that can contribute to healthier, longer lives. Health assets could include biological factors, such as high heart rate variability; subjective factors, such as optimism; and functional factors, such as a stable marriage. Not only are these assets desirable in their own right, they could also potentially protect against disease and foster stronger, more robust health. Positive Health is a new field of study that turns our attention to understanding these health assets.

When the Pioneer Portfolio first learned about the concept of Positive Health, we were intrigued by its potential to reframe the goals of our health care system. While our current system is focused on the treatment and prevention of illness, we imagined a system that was able to help build assets that make people healthier. We are excited to see that evidence is continuing to emerge finding merit for the concept and identifying areas for additional research, particularly in the context of cardiovascular health.  

Additional research published earlier this month in the Journal of Behavioral Medicine found that having a sense of purpose in life may help protect older adults with coronary heart disease from heart attacks. You can read more about the study in the post, “Life Purpose May Help Reduce Heart Attack Risk.”

Both studies indicate that there are positive health assets that lead to better health. A logical next step would be to identify interventions to enhance these assets to improve our health. The Psychological Bulletin investigation suggests one way to improve heart health may be to increase psychological well-being. With continued research, we hope the field of Positive Health can recognize new avenues for intervention to help protect us against disease, leading to healthier lives. 

Be sure to stay tuned for more results.

Congratulations to the Winners of Innovations for Health: Solutions that Cross Borders!

Today at the World Health Care Congress, Pioneer's Team Director Brian Quinn announced the winners of the Innovations for Health: Solutions that Cross Borders competition, supported by Pioneer and Ashoka Changemakers.  Innovations for Health looked to the international health community for forward-facing, transformative ideas with the potential to change health and medicine here in the United States.

We wanted to find cutting-edge solutions from anywhere in the world that have the potential to be applied in other countries to improve health and health care. While the Robert Wood Johnson Foundation is devoted to improving the health and health care of Americans, this competition arises from what we call our “Flat World” work. That is the name we’ve given to our efforts that look around the world for innovations that could be used to solve the health and health care challenges we’re facing here in the United States.

In March, our expert panel of judges narrowed down the competition from more than 370 entries from 73 countries to 15 finalists who best met the competition criteria of innovation, social impact, and sustainability. Today, we’re proud to announce the three winners who represent some of the best ideas for bridging gaps in health models around the world.

The winning solutions are:

• E-HealthPoint: Transforming Rural Healthcare, India
• VaxTrac: Improving Immunization in Developing Countries, Benin
• Saúde Criança: Holistic Health Solutions for Low-Income Families, Brazil

Read more about the winners on the Ashoka Changemakers blog.

Pioneer Grantees Present Game-Changing Ideas at 12gurus: Health Conference

Last month’s 12gurus: Health conference brought “resources and innovation to the forefront” by convening the world’s most accomplished leaders in health care and medicine to share new ideas that can improve the health care system. The conference focused on how to enable innovation through research, data-sharing, and mobile technology to pave the way for future breakthroughs in health care.

Three former and current Pioneer grantees attended the invitation-only conference in New York City and gave 18-minute-or-less “TED.com-style” talks:

• Scott Johnson, president and founder of the Myelin Repair Foundation, presented the session, “Breaking from the Past to Breakthrough to Cures-Accelerated Collaboration Model.”  Learn more about Scott’s recent honor as the recipient of the prestigious Gordon and Llura Gund Leadership Award from Research!America.

• Jason Hwang, executive director of health care at Innosight Institute, presented the session, “Preparing for Impending Disruptive Changes: The Innovators Prescription.”  Read more about Jason’s Pioneer-funded research, "Disruptive Innovation in Integrated Care Delivery Systems."

• Lisa Schwartz and Steve Woloshin, of the Dartmouth Institute for Health Policy & Clinical Practice, presented the session, “Ingredients of Simplicity: How to present data to patients in a way they’ll understand.” Learn more about their work creating Drug Facts Boxes and read Al Shar’s perspective on their research.  

We are always on the lookout for ideas that can exponentially change our health and health care system.  Team members John Lumpkin, Brian Quinn and Paul Tarini are attending this week’s TEDMED to gain a better understanding of the great challenges in health and medicine and what we can do to overcome them.  Whether at TEDMED or 12gurus, we’re searching for great thinkers and innovators with ideas that have potential to transform health and health care.

We Want to Know Your Thoughts About the TEDMED Great Challenges

BY BRIAN C. QUINN, PHD, team director and senior program officer, Pioneer Portfolio -- @quinnhealth

At the Robert Wood Johnson Foundation (RWJF), our mission is to improve the health and health care of all Americans. Good health and health care are fundamental measures of our success as a nation. That’s why we are pleased to support this year’s TEDMED conference (April 10-13), which brings together leaders from a wide array of medical and non-medical disciplines to explore the future of health and medicine.

In our 40 years, RWJF has learned several lessons that led us to support this year’s TEDMED conference. We’ve learned the importance of working with partners and building on the efforts of others; facilitating collaboration among unlikely allies; resisting the illusion of complete understanding; and being persistent.

For the past several years, RWJF’s Pioneer Portfolio supported the conference because it provided an opportunity to explore emerging trends and network with health care leaders driving innovative solutions to help solve health challenges. Now that the conference has pivoted to focus on Great Challenges in health and health care – issues that cut across the entire Foundation – support for TEDMED in 2012 has become a Foundation-wide endeavor.

This year, RWJF is partnering with TEDMED to help ensure all voices are heard.  TEDMED will present a set of 50 Great Challenges to the TEDMED community that will be narrowed to the most pressing 20. TEDMED selected knowledgeable individuals to serve as “Advocates” for each of the proposed Challenges. The Advocates will circulate among conference attendees – engaging their input around the importance of their individual Challenge and lobbying attendees to include it among their top 20. The Challenges range from childhood obesity to Alzheimer’s, from stress to superbugs, and are deeply rooted problems in health and medicine with multiple, interconnected causes and pathways to solutions.

Each of us could have developed our own list of 50 Great Challenges and no two lists would be identical. However, TEDMED’s proposed challenges are worthy of our attention. The dialogue will produce more engagement, new ideas, and new thinking. And if issues are missing, those attending TEDMED, as well as those participating remotely at partner sites, can add their voices to the discussion. There will also be opportunities to suggest Challenges for future years.

We want to make sure as many as possible can participate in the exchange of ideas and the voting process. To help facilitate the dialogue, RWJF will be gathering TEDMED’s 50 Advocates in the RWJF social space to meet and discuss the 50 Challenges. We invite you to join us. So, whether you’re attending the conference or participating remotely, here's how you, too, can join the conversation:

• If you’re at TEDMED, stop by the RWJF social space, where the 50 Challenge Advocates will be during the conference’s Social Breaks on Wednesday and Thursday (check the program for specific times for each Advocate).
• If you’re unable to connect with Advocates in person, use these online tools:
  • Download the TEDMED Connect app (free download available in the iTunes and Android app store, and can be viewed as a mobile website). The app will allow you to connect directly with any Advocate and to get up-to-date conference information.
  • E-mail Advocates at GCAdvocates@TEDMED.com with your thoughts and ideas.
  • Follow the conversation on Twitter: #TEDMEDChallenges
  • Follow the RWJF team on Twitter: @rwjf, @rwjf_vp, @PaulTarini, @RisaLavizzo, @babydoc44, @jisaacslowe, @annefweiss, @katiewehr, @pioneerrwjf

In addition to our activities around the Great Challenges, on Wednesday, April 11, during the session that begins at 8:45 a.m., RWJF President & CEO Risa Lavizzo-Mourey will be live on the TEDMED stage to speak about the Foundation’s experience in tackling big challenges in health and health care over the past 40 years.

All of us have the unique opportunity to shape the future of TEDMED. This is the start of a great conversation. I look forward to hearing your thoughts.

Eight Innovative Ideas to Influence Health Behavior

The majority of my work in the Department of Research and Evaluation at the Robert Wood Johnson Foundation has been predicated on the long-held assumption that if you show people convincingly that doing one thing will create the outcome they desire, you can inspire behavior change. The problem is that when it comes to health, we consistently observe individuals acting in ways guaranteed to produce poor outcomes.

The observation of seemingly “irrational” behavior by economists, psychologists and others led to the development of the field of behavioral economics, which has, in recent years, produced insight to explain some of the perplexing health behaviors we observe in a way that the classical economic theories I learned in graduate school cannot. The Robert Wood Johnson Foundation believes these emerging insights have breakthrough potential to help people make better choices for their health. That’s why I’m excited to announce that the Pioneer Portfolio and Donaghue Foundation are now supporting a group of innovative researchers who are testing simple interventions that may have widespread impact on complex problems.

Last fall we asked behavioral economists, choice theorists, and others studying habit formation or physiological mechanisms to submit new ideas to help people make the “right” decisions for their health. After narrowing the field for our Applying Behavioral Economics to Perplexing Health and Health Care Challenges solicitation from an initial 330 responses to 25 finalists, we’ve selected the following eight grantees:

• Anne Thorndike, Massachusetts General Hospital, Feedback, incentives and point-of-purchase interventions to engage employees in healthy eating behaviors
• Elizabeth Merrick and Dominic Hodgkin, Brandeis University, Using novel patient financial incentives to improve uptake of routine mammography
• Ellen Magenheim and David Huffman, Swarthmore College, Fighting viruses with viral marketing? Using online social endorsements to enhance incentives to sign up for flu vaccinations
• Gretchen Chapman and Elliot Coups, Rutgers University and University of Medicine and Dentistry New Jersey, Walking with prospect theory
• Judd Kessler, Eric Zwick and Dmitry Taubinsky, University of Pennsylvania and Harvard University, Using behavioral economics to promote medication adherence and habit formation
• Justin Sydnor, Heather Royer and Mark Stehr, University of Wisconsin, University of California and Drexel University, Improving the structure of financial incentives for exercise: insights from behavioral economics
• Karen Glanz and Jason Karlawish, University of Pennsylvania, Social goals and individual incentives to promote walking in older adults
• Paul Resnick and Caroline Richardson, University of Michigan, Impacts of public announcements of goals and outcomes on goal completion

Typically, the phrase “pioneering ideas” brings to mind cutting edge technology, and the most advanced science. What’s pioneering about these new grantees is that they recognize how small, low-cost ideas that are easy to implement can create a big change.

We are looking forward to working with the Center for Health Incentives and Behavioral Economics at the Leonard Davis Institute and seeing how these ideas pan out over the next 18 months. We embrace the risk that some of these great ideas will fail to produce lasting change. Stay tuned, because next year we’ll convene each research team to share their findings—expected and unexpected—and to look for ways to spread the best ideas to those who most need a breakthrough solution.