Kurt M. Ribisl, PhD Jennifer Leeman, DrPH Allison M. Glasser, MPH April 16 th, 2014 Presentation to CPCRN Steering Committee Pricing Health Behavior Interventions to Promote Adoption Lessons from the Marketing and Business Literature *Based on an article in press in the American Journal of Preventative Medicine

Why are interventions adopted? Scientific evidence Colleagues use it Ease of implementation State Health Department priorities Presence of adequate staffing Cost Supportive state legislature Availability of adequate resources 1. Baker, E. A., Brownson, R. C., Dreisinger, M., McIntosh, L. D., & Karamehic-Muratovic, A. (2009). Examining the role of training in evidence-based public health: a qualitative study. Health promotion practice, 10(3), Brownson RC, Ballew P, Dieffenderfer B, et al. Evidence-based interventions to promote physical activity: what contributes to dissemination by state health departments. Am J Prev Med 2007;33(1S):S66–S78.

#1 Reason “Availability of adequate resources” 1. Brownson RC, Ballew P, Dieffenderfer B, et al. Evidence-based interventions to promote physical activity: what contributes to dissemination by state health departments. Am J Prev Med 2007;33(1S):S66–S78.

Lean Movement 1. Wilson, L. (2009). How to implement lean manufacturing. McGraw Hill Professional. 2. "Lean Manufacturing Approach Increases Total Depot Repair Capabilities by 267%."The Wall Street Journal. Dow Jones & Company, 11 June Wickramasinghe, N., Al-Hakim, L., Gonzalez, C., & Tan, J. (2014). Lean thinking for healthcare. Springer New York..

Researchers Ask You About Your: Intentions to use EBIs Attitudes about evidence Sources of information Demographics BUT NOT YOUR BUDGET!

Alternative Approaches To Value Creation: Product Led: PRODUCT OR INTERVENTION PRICEVALUECOSTCUSTOMER PRICECOSTVALUE PRODUCT OR INTERVENTION Customer Led:

Approaches to Price Setting: 1.Cost 2.Based on competitors 3.Based on value Methods for Price Setting: 1.Field Tests 2.Surveys

Quirky.com

Quirky.com Process 1.Product Evaluation 2.Engineering 3.Pricing Production Cost Value Gap

Purchase Probability Curve (adapted from Nagle et al., 2011) 1. Nagle T, Hogan J, Zale J. The strategy and tactics of pricing: a guide to growing more profitably. 5 ed. Upper Saddle River, New Jersey: Prentice Hall; 2011.

Proposed Solutions For Fixing The Disconnect Between Practitioners And Researchers Status quo PractitionersProposed solution for researchers Have limited budgets, staffing, and other resources Engage in customer research to identify the resources available to practitioners and their willingness to pay for EBIs Need EBIs that are easy to adapt to the local context and Design EBIs to be lean and maximize reach implement in practice Need to know the costs of using an EBICollect data on the costs of adapting, implementing, and delivering EBIs

Proposed Solutions For Fixing The Disconnect Between Researchers And Academic Institutions/Funders Status quo ResearchersProposed solution for academic institutions/funders Are rewarded with publications, grants, and promotions for developing maximally effective EBIs regardless of EBI cost, staffing resources, or implementation feasibility Reward based on work contributing to all phases of the research spectrum: initial discovery, refinement, further development, and delivery to practice Have few incentives to develop EBIs that meet practitioner needs and become widely adopted Give priority to proposals that design interventions with scalability in mind Have limited information about practitioners’ resource constraints Fund customer research to understand end user budgets and resources, including buy-response studies

3 Ideas for CPCRN 1.Survey local and state practitioners on their discretionary budget and importance of costs/resources for EBIs 2.Survey practitioners (e.g., 2-1-1, FQHC) on willingness to pay for ≈5 EBIs 3.Take selection of EBI’s from RTIPs and assess target audience willingness to pay