How a K-Award Has Advanced a Research Career: a Search for Unity in Diversity Christopher Keane

1. How a K-Award Has Advanced a Research Career: a Search for Unity in Diversity Christopher Keane Assistant Professor Behavioral & Community Health Sciences University of Pittsburgh crkcity@pitt.edu AHRQ Conference 2008

2. Disciplinary Expertise Prior to K-Award: • Experimental design and survey design • Statistical analysis, regression etc. • Sociology of public health • Organizational theory relating to contracting • Biology (had never used in my health studies)

3. New Disciplinary Approaches Mid-K-Award: • Experimental economics & game theory • Modeling of complex adaptive systems • Philosophy of sociality • Additional organizational theory & practice • Neuroeconomics & social neurology • Psychology of behavior change • Challenge: How to Integrate These Diverse Approaches?

4. New Disciplinary Approaches to Study of Trust & Cooperation (One Unifying Theme): • Experimental games of trust & cooperation • Social neurology of trust & cooperation • Modeling trust & cooperation in systems • Philosophy of trust & cooperation • Organizational theories of trust & cooperation • Psychology of behavior change & trust

5. New Disciplinary Approaches to Study of Trust & Cooperation in Health: • New Partners • Trust & cooperation games in food choices • Two new partners from experimental economic • Social neurology of trust & cooperation • No partners, yet. • Modeling trust & cooperation in health systems • Two new partners, computational modelers • Philosophy of trust & cooperation • A philosopher & computational modeler of trust • Organizational theories of trust & cooperation • Several new partners from other departments • Psychology of behavior change & trust • Several new partners

6. New Disciplinary Approaches to Study of Trust & Cooperation in Health: • New Grants (2008 onwards) • Trust & cooperation games in food choices • Funded study of my experimental game with vouchers • Social neurology of trust & cooperation • Incorporated theory into above, could study directly • Modeling trust & cooperation in health systems • Recently funded study of public health systems • Philosophy of trust & cooperation • Incorporated into above studies, especially the game • Organizational theories of trust & cooperation • Incorporated into study of public health systems • Psychology of behavior change & trust • Incorporated into above and HIV study (likely funded)

7. New Disciplinary Approaches to Study of Trust & Cooperation in Health: • Trust & cooperation games in food choices • Funded study of my experimental game with vouchers • Approaches: • Conduct several experimental games followed by interviewing • Modeling behavior using conditional rules • Computational simulation of the behavior and social networking

8. New Disciplinary Approaches to Study of Trust & Cooperation in Health: • Trust & cooperation games in food choices • Funded study of my experimental game with vouchers • Commitment, Cooperation & Dilemma in Health Choices: • Modeling Inter-temporal and Interpersonal Coordination

9. Commitment, Cooperation & Dilemma in Health Choices • Trust & cooperation games in food choices • Funded study of my experimental game with vouchers What food types do people pick when sharing with others, as opposed to when choosing only for themselves? How do unhealthy or healthy food choice behaviors spread through social networks?

10. Trust Game: At start of game, two players are each given a $10 voucher by the experimenter. All gifts are doubled, = $20 in vouchers • Choose whether or not to give your voucher: • Give b) Keep • Choose the type of food voucher: • Pizza • b) McDonald’s • c) Café One • d) Café Two We present the restaurant name, location, menu, for each restaurant. The Cafés offer healthier options, but we don't label them healthy or unhealthy. All are on campus. * Investigators will rate the restaurants with the NEMS-R (Saelens et al 2007) Please don’t quote without permission of author, Christopher Keane

11. Trust Game: At start of game, two players are each given a $10 voucher by the experimenter. All gifts are doubled, = $20 in vouchers Proposer makes 1st move Responder makes 2nd move P & R both keep (Reciprocal selfishness) P keeps the $10 voucher R keeps the $10 voucher P gives & R keeps, (P trusts, but R is selfish) P keeps the $10 voucher R keeps the $10 voucher P gives the $10 voucher R gives the $10 voucher P gives & R gives back, (Reciprocal giving) P keeps, but R gives, (not likely) P keeps the $10 voucher R gives the $10 voucher

12. All subjects choose type of $10 restaurant voucher (choose 1 of 4 restaurants) Please don’t quote without permission of author, Christopher Keane

13. Trust Game: At start of game, two players are each given a $10 voucher by the experimenter. All gifts are doubled, = $20 in vouchers Proposer makes 1st move Responder makes 2nd move P keeps or gives the $10 voucher R keeps or gives the $10 voucher Please don’t quote without permission of author, Christopher Keane

14. Trust Game with Restaurant Vouchers, Between Proposer & Responder: One Pattern I Hypothesize is Common Intending Implementing Search Search Search P Gives (Pizza) P Keeps (Café 1) R Gives (Pizza) R Keeps (Café 1) R’s View for Balance for Balance for Balance Mirroring Analogous Balancing Analogous Balancing Search for Search for Search Search Search R’s View of P’s View R Gives (Pizza) R Keeps (Café 1) P Gives (Pizza) P Keeps (Café 1) for Balance for Balance for Balance Mirror Intention Mirror Implementation Christopher Keane, 2008, Please don’t quote without permission of author.

15. Intending & Implementing as Mirrored Balancing Intending Implementing Search Search Search Simulate Condition Perceive Condition Simulate Action Try Action Focal Domain for Balance for Balance for Balance Mirroring Analogous Balancing Analogous Balancing Search for Search for Search Search Search Simulate Condition Simulate Condition Simulate Action Simulate Action Mirror Domain for Balance for Balance for Balance Mirror Intention Mirror Implementation Christopher Keane, 2008, Please don’t quote without permission of author.

16. Significance Food is often a “social choice” that partly depends on what we project others want. Social eating may affect college students’ long-term eating habits & health. Inter-temporal and inter-personal cooperation and trust may operate similarly. A clear computational model may elucidate this more general inter-agent trust & cooperation. What we eat is a function of social ecology, including the food environment: what restaurants are available locally, what social networks surround our eating. A similar framework for modeling trust & cooperation may apply similarly between health organizations.

17. Modeling Public (P) & Private (R) Provider Decisions: A Trust Game? (Give = Provide Care to Uninsured) Intending Implementing Search Search Search R’s View P Keeps P Gives R Gives R Keeps for Balance for Balance for Balance Mirroring Analogous Balancing Analogous Balancing Search for Search for Search Search Search R’s View of P’s View P Keeps P Gives R Gives R Keeps for Balance for Balance for Balance Mirror Intention Mirror Implementation Keane 2008, Using data from Keane 2005. Please don’t quote without permission of author.

18. New Disciplinary Approaches to Study of Trust & Cooperation in Health: • Modeling trust & cooperation in health systems • Recently funded study of public health systems • Organizational theories of trust & cooperation • Incorporated into study of public health systems “Adaptive Systems Indicators” for Public Health System Emergency Response

19. “Adaptive Systems Indicators” for Public Health System Emergency Response • Designed to capture the adaptive system processes of public health emergency response. • Assumes public health systems are dynamic networks of human actors who consider: • Inter-organizational trust in their networks, • the relative complexity of emergency response rules, • the Diversity or partners, degree of centralization, • Tension between top-down & bottom-up decisions. These factors predict system performance (Choi & Brower 2006, Comfort 1999, 2005, Epstein 2006, Keane 2005, 2008 Axelrod & Cohen 2000) Christopher Keane, 2008, Please don’t quote without permission of author.

20. “Adaptive Systems Indicators” for Public Health System Emergency Response • Measures the properties of networks of public health decision makers that we hypothesize result in effective emergency response: • inter-organizational trust • degree of centralization-decentralization • connectivity • diversity and participation in decision-making • necessary redundancy in networks • relatively simple decision rules These factors predict system performance (Choi & Brower 2006, Comfort 1999, 2005, Epstein 2006, Keane 2005, 2008, Axelrod & Cohen 2000) Christopher Keane, 2008, Please don’t quote without permission of author.

21. “Adaptive Systems Indicators” (ASIs) for Public Health System Emergency Response • inter-organizational trust • degree of centralization-decentralization • connectivity • diversity and participation in decision-making • necessary redundancy in networks • relatively simple decision rules • Initial plan is to measure the ASIs in (a) 12 to 20 public health system networks, including local health departments and their private partners, and (b) approx. 300 local health departments. • The ASIs would supplement existing emergency response guidelines. The ASI is my contributions to a R01.

22. Hypothetical Public Health System Legal Network Public Health Schools Transit EMS Mental Health Level 1 We designated 3 levels of mandated relationship, Level 2 with 3 as the most directive Level 3

23. State Statutory Relationship Worksheet (network matrix) . . . etc. Rows indicate the organization that state law requires to Initiate contact with other organization (Column). Level 1 Level 2 The network framework is my contribution to R01 grant Level 3

24. Integrating New Approaches to Study of Public Health Systems & Health Behavior: • Modeling trust in adaptive network • Organizational theories of trust & decisions • Integrated Study of: • Adaptive Systems Indicators, & • Public Health System Legal Network for • Computational Modeling of PH Response System • to improve Public Health System Emergency Response • Trust & cooperation games in food choices • Current study of trust and social food choice • Experimental trust game with restaurant vouchers • Computational modeling of trust & projection in networks • Experimental trust games with policy makers? • I’m working on this one

25. Dilemma: How to flexibly expand expertise via pre-planned mentors? • Experimental economics & game theory • Neuroeconomics & social neurology • Computational modeling of adaptive systems • Philosophy of sociality • New organizational theory & practice, • Psychology of trust and behavior change etc. • One Strategy: Use “Coordinating mentor”

26. Planning Growth & Inter-Disciplinarity in my K-Award • Unlike a traditional grant, career award allows training, to develop expertise in new areas • therefore requires more flexibility for research agenda, to acquire and apply new ideas • Perhaps use “Coordinating mentor” • Flexible approach resulted in publication in very different of prestigious journals, representing sociology, anthropology, health policy, public health practice, medical practice, health management (publications in over a dozen different journals), and a diversity of grants. • diversity of research with unified theory