Alison M. Buttenheim, PhD, MBA
Alison M. Buttenheim wants to understand how people make decisions about their health and focuses her research on the use of behavioral economics to increase the uptake of evidence-based care. Her work ranges from how households in Peru decide whether to apply insecticide to eliminate a disease-carrying insect vector to why parents in the United States request exemptions from child immunization laws.
“I am excited by the challenge of applying behavioral insights to prevent disease and improve health.”
- PhD, University of California at Los Angeles, 2007
- MBA, Stanford University, 1997
- BA, Yale University , 1992
Through her involvement with Penn’s Center for Health Incentives and Behavioral Economics, Dr. Buttenheim is working with colleagues in epidemiology, politics, statistics, and mathematics on an NIH-funded study to reduce the transmission of Chagas disease (a neglected topical parasitic disease) in Arequipa, Peru’s second largest city. The study aims both to eliminate transmission of the parasite and to use behavioral economics to understand factors that influence residents’ decisions about having their homes sprayed with insecticide.
In a large pragmatic randomized trial, households were assigned to one of three interventions: improving the schedule for spraying; creating social norms for spraying; and participating in a lottery that offered financial rewards for spraying. Data analysis is underway. Dr. Buttenheim and colleagues hope that study findings will help address other common and emerging problems such as bed bugs or the Zika virus.
Vaccination Exemption Rates and Unvaccinated Children
With funding from NIH, Dr. Buttenheim studied California laws on nonmedical exemptions from school-mandated immunizations. After examining school records, she found that 47 percent of children whose parents requested exemptions had received the first dose of the measles-mumps-rubella vaccine. This suggests that using exemption rates as a proxy for vaccination rates is misleading; and, importantly, that the risk of disease in unvaccinated populations is therefore higher than previously thought. Colleagues in biostatistics and epidemiology participated in this study.
With support from the Robert Wood Johnson Foundation, Dr. Buttenheim is part of an interdisciplinary team analyzing vaccination exemption laws in several states. The team’s goal is to identify ideal state-level exemption legislation.
Opportunities to Learn and Collaborate at Penn Nursing
After starting out as a health care management consultant, Dr. Buttenheim earned her MBA and her PhD, joining the Penn Nursing faculty in 2011. She values the cross-disciplinary culture at Penn Nursing, which allows her to teach graduate public health and epidemiology courses. She teaches in the undergraduate clinical course in community nursing in which “the population is the patient,” helping students develop skills in community needs assessment, screening, outbreak investigation, and health behavior change interventions.
Dr. Buttenheim directs the Behavioral Economics and Nursing “Lab,” a group of nursing doctoral and postdoctoral fellows interested in applying behavioral insights in their program of research. Students can discuss recent literature in the field, present work-in-progress, collaborate on grant proposals, and hear from some of the leading experts in the field.
Graduate and undergraduate students assist Dr. Buttenheim with her research, including writing grants, creating surveys, and analyzing data. She also mentors graduate public health students completing capstone projects.
Selected Career Highlights
- Robert Wood Johnson Foundation Health & Society Scholar
- Recipient, Student Undergraduate Research Group Grant
- Associate Editor, BMC Public Health
Jones M, Buttenheim AM, Salmon D, Omer SB. Mandatory Health Care Provider Counseling For Parents Led To A Decline In Vaccine Exemptions In California. Health Aff (Millwood). 2018
Jenssen BP, Buttenheim AM, Fiks AG. Using Behavioral Economics to Encourage Parent Behavior Change: Opportunities to Improve Clinical Effectiveness. Acad Pediatr. 2018 Aug 30. pii: S1876-2859(18)30574-6.
Mohanty S, Buttenheim AM, Feemster KA, Moser CA, Field RI, Yudell M, Turchi RM, Carroll-Scott A. Pediatricians’ vaccine attitudes and practices before and after a major measles outbreak. J Child Health Care. 2018 Jan 1:1367493518786011.
Mohanty S, Carroll-Scott A, Wheeler M, Davis-Hayes C, Turchi R, Feemster K, Yudell M, Buttenheim AM. Vaccine Hesitancy in Pediatric Primary Care Practices. Qual Health Res. 2018 Jun 1:1049732318782164.
Bal S, Duckles A, Buttenheim A. Visual Health and Visual Healthcare Access in Refugees and Displaced Persons: A Systematic Review. J Immigr Minor Health. 2018 Jun 2.
Buttenheim AM, Jones M, Mckown C, Salmon D, Omer SB. Conditional admission, religious exemption type, and nonmedical vaccine exemptions in California before and after a state policy change. Vaccine. 2018 May 16.
Okatch H, Sowicz TJ, Teng H, Ramogola‐Masire D, Buttenheim AM. Achieving public and global health competencies: A teaching case study of Botswana’s cervical cancer screening program. Public Health Nursing. 2018 Feb 13.
* Johnson LG, Armstrong A, Joyce CM, Teitelman AM, Buttenheim AM. Implementation strategies to improve cervical cancer prevention in sub-Saharan Africa: a systematic review. Implementation Science. 2018 Dec;13(1):28.
Delgado MK, McDonald CC, Winston FK, Halpern SD, Buttenheim AM, Setubal C, Huang Y, Saulsgiver KA, Lee YC. Attitudes on technological, social, and behavioral economic strategies to reduce cellphone use while driving in teens. Traffic injury prevention. 2018 Apr 6:1-23.
Ibarra JL, Agas JM, Lee M, Pan JL, Buttenheim AM. Comparison of Online Survey Recruitment Platforms for Hard-to-Reach Pregnant Smoking Populations: Feasibility Study. JMIR research protocols. 2018 Apr;7(4).