Research Areas
Physical Activity and Cardiovascular Prevention
Physical activity is among the most effective therapies for preventing cardiovascular events, yet sustained behavior change remains challenging. The IMPACT Lab designs and evaluates interventions that use behavioral economics, gamification, and digital health technologies to increase physical activity among individuals at high risk for cardiovascular disease. Our goal is to develop scalable approaches that improve both health behaviors and clinical outcomes.
In BE ACTIVE, conducted with the Penn Center for Health Incentives and Behavioral Economics (CHIBE) and published in the American Heart Association's flagship journal Circulation, we showed that gamification and financial incentives both increase physical activity in adults at high risk for cardiovascular disease, but that gamification without financial incentives is most cost-effective. The upcoming PCORI-funded NEXT STEPS trial, again conducted with CHIBE, seeks to determine whether increasing physical activity using gamification reduces the risk of death, heart attack, and stroke.
Physical Activity and Treatment of Cardiovascular Disease
In some cardiovascular conditions, physical activity can help patients feel better. In GAMEPAD, we showed that gamification increases physical activity in patients with peripheral artery disease, and may have helped them feel better too. In the NHLBI-funded MOVE HF clinical trial, we are applying gamification to patients with heart failure, to determine whether it is effective in this population, and whether it helps improve their shortness of breath and fatigue.
Increasing Use of Evidence-Based Cardiovascular Therapies
Many patients who would benefit from proven cardiovascular medications never receive them. We study how health systems can improve the delivery of guideline-directed medical therapy through population health programs, clinician decision support, and behavioral interventions.
This work includes the SUPER LIPID Trial, conducted in partnership with CHIBE and published in JAMA Cardiology, which evaluated a population-based strategy to increase statin prescribing among high-risk patients. Working with the Penn Medicine Nuge Unit, we have also demonstrated how small changes in prescribing workflows can influence clinician behavior, including research published in JAMA Internal Medicine showing that changing the default statin prescription length to 90 days increases the proportion of patients who receive 90-day supplies and reduces disparities in prescribing patterns.
Optimizing Care Pathways for Peripheral Artery Disease
Peripheral artery disease (PAD) is common, disabling, and frequently underdiagnosed. Using administrative claims data from > 1 million patients with PAD, we study barriers to timely diagnosis and treatment, including delays from diagnosis to revascularization. By identifying inefficiencies in current care pathways, we seek to develop strategies that improve access to evidence-based vascular care and reduce disparities in treatment.
Methods
The IMPACT Lab conducts randomized clinical trials and observational studies using tools from:
- Behavioral economics
- Implementation science
- Health services research
- Digital health
- Pragmatic clinical trial design
- Population health
Our mission is to generate evidence that helps patients live healthier lives and helps health systems deliver better cardiovascular care at scale. From prevention to treatment, the IMPACT Lab develops practical solutions that improve cardiovascular outcomes in the real world.