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Objective: Health care overuse is pervasive in countries with advanced health care delivery systems. We hypothesize that effective interventions to reduce low-value care that targets patients or clinicians are mediated by psychological and cognitive processes that change behaviors and that interventions targeting these processes are varied. Thus, we performed a scoping review of experimental studies of interventions, including the interventions' objectives and characteristics, to reduce low-value care that targeted psychological and cognitive processes., Methods: We systematically searched databases for experimental studies of interventions to change cognitive orientations and affective states in the setting of health care overuse. Outcomes included observed overuse or a stated intention to use services. We used existing frameworks for behavior change and mechanisms of change to categorize the interventions and the mediating processes., Results: Twenty-seven articles met the inclusion criteria. Sixteen studied the provision of information to patients or clinicians, with most providing cost information. Six studies used educational interventions, including the provision of feedback about individual practice. Studies rarely used counseling, behavioral nudges, persuasion, and rewards. Mechanisms for behavior change included gain in knowledge or confidence and motivation by social norms., Conclusions: In this scoping review, we found few experiments testing interventions that directly target the psychological and cognitive processes of patients or clinicians to reduce low-value care. Most studies provided information to patients or clinicians without measuring or considering mediating factors toward behavior change. These findings highlight the need for process-driven experimental designs, including trials of behavioral nudges and persuasive language involving a trusting patient-clinician relationship, to identify effective interventions to reduce low-value care., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

In addition to their salaries, employees often receive additional variable compensation (i.e., payouts) based on the sales they generate or manage. For any single transaction, the same payout (e.g., $1,000) may be earned by a relatively high commission rate and a low sales amount (e.g., 10% commission rate on a $10,000 sale) or a relatively low commission rate and a high sales amount (e.g., 1% commission rate on a $100,000 sale). In this research, we show that individuals-including those working in sales roles and familiar with commission plans-perceive the magnitude of the same payout as larger (smaller) if it stems from a high (low) commission rate and a low (high) sales amount. Across 10 experiments with 3,484 participants, we demonstrate the robustness of this "commission effect" in a varied set of employee and consumer contexts, and we identify behavioral consequences of this bias. We also provide evidence that the effect occurs because commission rates are expressed in percentages and are therefore relatively more evaluable than sales amounts. (PsycInfo Database Record (c) 2024 APA, all rights reserved).