Roybal Center for Behavioral Interventions in Aging

The Roybal Center for Behavioral Interventions in Aging at the USC Schaeffer Center conducts research that advances healthy aging for older adults who are economically insecure, culturally diverse, and historically under-served. The Roybal Center develops and tests interventions based on insights from behavioral science to promote healthy aging.  The Roybal Center aims to strengthen the ability of clinicians to choose or recommend the safest and most effective treatments for their patients through the use of behavioral insights—nudges— that are developed through the center. Ultimately, the Roybal Center will address some of the country’s most pressing population health concerns that are driven by overuse of medical services and under use of comparatively effective services.

Program Leadership

  • Co-Director, Behavioral Sciences Program, USC Schaeffer Center
    Norman Topping Chair in Medicine and Public Policy and Professor, USC Price School of Public Policy
    Chair, Department of Health Policy and Management, USC Price School of Public Policy

  • Dana Goldman, PhD

    Dean and C. Erwin and Ione L. Piper Chair, USC Sol Price School of Public Policy
    Co-Director, USC Schaeffer Center
    Distinguished Professor of Public Policy, Pharmacy, and Economics, USC

Mission | To develop simple interventions based on insights from behavioral science to promote healthy aging.

Specific Aims

  • Conduct behavioral intervention development and implementation to encourage appropriate medical treatment decisions through the use of behavioral insights from psychology and economics.
  • Leverage simulation modeling to select interventions with the greatest potential to impact population health.
  • Translate these findings for policymakers who influence aging policy.

Co-Investigators for the Roybal Center

Featured Research

Current Roybal Center Training

The Roybal Center funds one post-doctoral fellow to work on research that advances the behavioral sciences.  The selected post-doc has access to mentorship and a broad array of resources and data available through the Schaeffer Center.

Chasing Fictitious Variation: Random Outcomes are Misattributed to Skill in Competitive Environments

Craig Brimhall, PhD

Craig Brimhall is a Postdoctoral Fellow at the USC Roybal Center for Behavioral Interventions in Aging. His research interests include decision making under uncertainty, goal-achievement, and using insights from behavioral science to help people make healthier choices. He received a PhD in Management from the University of Utah, an EdM in Educational Neuroscience from Harvard University, and a BS in Finance from Utah Valley University.

Current Roybal Center Pilot Awardees

More information about current and past pilot awardees can be found here. The application for the June 1, 2023-May 31, 2024 period is now open. Information about the application process can be found here.

Precision Vaccine Promotion in Underserved Populations

PI: Daniella Meeker, PhD

Previous studies have shown that low-cost, behavioral nudges through texting can increase influenza vaccination uptake compared to usual care.  However, there are limited studies that evaluate the effect of decreasing barriers to scheduling, especially within safety net populations.  The setting for this trial, the Los Angeles County Department of Health Services, is the second largest public delivery system in the country, and serves approximately half a million diverse patients that are eligible for vaccinations annually. This pilot study (one arm in a larger randomized controlled trial) will examine the effect of text messages highlighting MediCal health plan transportation resources (vs standard text messaging) on influenza vaccination rates during the 2022-2023 flu season.

Incentives for Physical Activity

PI: Anya Samek, PhD

Inactivity is the fourth leading risk factor for global mortality, leading to chronic diseases (e.g., heart disease, diabetes, cancer) and contributing to the obesity epidemic. Much of the world’s population is inactive, and older adults are at highest risk. Incentive-based interventions show promise for improving activity levels; however, monetary incentives are often not scalable and effects fade when incentives are removed. In light of the limited success of incentives-based behavior change programs, we will design and evaluate alternative incentives that address the challenges of scalability, habit formation and crowd-out. The objective of this study is to use a randomized, controlled trial to test the effectiveness of behaviorally-motivated (“alternative”) incentives to increase walking among older adults (ages 60+). Participants in the treatment group will use an app – Vizer – which provides incentives for meeting step targets, including points that can be redeemed at participating retailers and meal donations made on behalf of the participant.

Effects of Income Supplements on 30-day Readmissions for Vulnerable Older Adults

PI: Rajan Sonik, PhD JD MPH

This study will provide a preliminary assessment of the effects of a one-time, post-discharge income supplement on 30-day unplanned readmissions among older adults with medical complexity living in socially vulnerable, medically underserved areas. By reducing the acuity of the income shocks associated with hospitalizations, income supplements have the potential disrupt common readmission pathways by improving access to medication and follow-up outpatient care, reducing the likelihood of injuries and accidents, reducing food insecurity and general stress, and improving adherence to medical guidance as the ratio of attention to self-care versus material survival can be increased. Patients will be recruited from an enhanced care coordination program at a large federally qualified health center (FQHC) serving predominantly Latinx populations, and  randomized to a treatment arm ($300 income supplement) or a control arm ($15 participation incentive, equivalent to the maximum amount of nominal gifts health plans can give to Medicare beneficiaries).

A Clinician-Focused Nudging Intervention to Optimize Post-Surgical Prescribing

PI: Daniel B. Larach, MD, MTR, MA

There are considerable data that postoperative opioids are commonly prescribed in excessive amounts but few evidence-based techniques to optimize such prescribing. The specific objectives of this study are to (1) evaluate the hypothesis that a novel nudge intervention will reduce excess postoperative opioid prescribing; and (2) determine whether this technique affects opioid consumption, refill requests, medical visits for pain, analgesia satisfaction, and opioid misuse. 

Gamification to Improve Physical Activity in Seniors at Risk for Alzheimer’s 

PI: Ryan Greysen, MD, MHS

Increased physical activity by walking further or more vigorously may prevent or delay the development of Alzheimer’s Disease and Related Dementias (ADRD) but reaching higher levels of activity and maintaining it as a long-term habit is difficult to do. This project will use concepts from behavioral science to create a mobility game that people at risk for developing ADRD can play in order to increase their levels of activity while having fun doing it. Gamification will be used to motivate, reinforce, and sustain higher physical activity levels compared to a control group which receives only devices but no gamification.

This project is supported by the National Institute on Aging under the National Institutes of Health, award number P30AG024968. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.