Sebastian Linnemayr

Senior Economist; Professor of Policy Analysis, Pardee RAND Graduate School

Santa Monica Office

Education

Ph.D. in economics, Université de la Mediterranée; M.Phil. in economics, Oxford University; M.A. in international relations, Johns Hopkins University; M.A. in business administration, University of Vienna

One Page Bio

Overview

Sebastian Linnemayr is a senior economist at RAND and professor of policy analysis at the Pardee RAND Graduate School. His research focuses on the use of behavioral economic incentives to improve complex, chronic health behaviors. A recent strand of his research investigates how insights from behavioral economics can be combined with approaches from the psychology literature to more effectively support habit formation, with the goal of long-term behavior change. Linnemayr travels frequently to Uganda where he is implementing several interventions funded by the National Institutes of Health to increase medication adherence among people living with HIV. He received his Ph.D. in economics from the Université de la Mediterranée and joined RAND after a research fellow position at the Harvard School of Public Health.

Research Focus

Pardee RAND Graduate School Courses

Recent Projects

Goals for Adherence with Low-cost Incentives (GOALS)
Incentives and ReMINDers to Improve Long-term Medication Adherence (INMIND)
Behavioral Economics to improve Antihypertensive Therapy Adherence (BETA)
Behavioral Economics Incentives to Support HIV Treatment Adherence in Sub- Saharan Africa (BEST)
Mobile Technology and Incentives (MOTIVES) for Racial and Ethnic Minorities in Los Angeles

Selected Publications

Stecher C, Mukasa B, Linnemayr S*, "Uncovering a Behavioral Strategy for Establishing New Habits: Evidence from Incentives for Medication Adherence in Uganda," Journal of Health Economics; 16(77).

Linnemayr S, Huang H, Luoto J, Kambugu A, Thirumurthy H, Haberer J, Wagner G, Mukasa B., "Reminding Adolescents to Adhere: One-Year Results from a Randomized Trial of Text Messaging for Improving ART Adherence," American Journal of Public Health, 107(12), 2017

Linnemayr S, Stecher C, Mukasa B., "Behavioral economic incentives to improve adherence to antiretroviral medication," AIDS, 31(5), 2017

Sebastian Linnemayr, Tom Rice, "Insights from Behavioral Economics to Design More Effective Incentives for Improving Chronic Health Behaviors, with an Application to Adherence to Antiretrovirals," JAIDS, 72(2), 2016

Sebastian Linnemayr, Chad Stecher, "Behavioral Economics Matters for HIV Research: The Impact of Behavioral Biases on Adherence to Antiretrovirals (ARVs)," AIDS and Behavior, 19(11), 2015

Linnemayr, Sebastian, "HIV Prevention through the Lens of Behavioral Economics," JAIDS, 68(4), 2015

David Bloom, David Canning, Isabel Guenther, Sebastian Linnemayr, "Fertility Choice, Mortality Expectations, and Interdependent Preferences: An Empirical Analysis," European Economic Review, 63, 2013

Sebastian Linnemayr, Harold Alderman, "Almost Random: Evaluating a Large-Scale Randomized Nutrition Program in the Presence of Crossover," Journal of Development Economics, 96, 2011

Honors & Awards

RAND Silver Medal Award, RAND
Harold and Coleen Brown Faculty Chair, Pardee RAND Graduate School
Recipient of RAND-Initiated Research Award, RAND

Commentary

Family Planning

The Economic Rationale for Investing in Family Planning in Sub-Saharan Africa
Proven benefits to reduced fertility — or to delayed start to childbearing and greater spacing between births — include lower maternal mortality, fewer unsafe abortions, reduced risks from early childbearing, and women's ability to engage in more income-generating opportunities.
Aug 3, 2016
The World Bank Investing in Health Blog

Publications

Journal Article
Food Insecurity During the COVID-19 Pandemic: A Longitudinal Mixed-Methods Study from a Cohort of HIV Clients in Uganda
The paper utilized a longitudinal mixed-methods approach to evaluate the economic impact of COVID-19 on food security and ART-taking behaviors among people living with HIV in Kampala, Uganda.
Jan 19, 2023
Journal Article
Incentives and Reminders to Improve Long-term Medication Adherence (INMIND): Protocol for a Pilot Randomized Controlled Trial
This study aims to test the feasibility, acceptability, and preliminary efficacy of a novel intervention that uses SMS text messages and conditional incentives to support ART initiators in establishing pill-taking habits.
Nov 22, 2022
Journal Article
Randomized Controlled Trial of Rise, A Community-Based Culturally Congruent Counseling Intervention to Support Antiretroviral Therapy Adherence Among Black/African American Adults Living with HIV
We conducted a randomized controlled trial of Rise, a community-based culturally congruent adherence intervention, from January 2018 to December 2021 with 166 Black adults living with HIV in Los Angeles.
2022
Journal Article
Pilot Randomized Clinical Trial of a Text Messaging-Based Intervention for Smoking Cessation Among Young People Experiencing Homelessness
This is the first study to evaluate the feasibility of using a text messaging-based intervention (TMI) for behavior change with 18–25 year olds experiencing homelessness, and the first to test a TMI to provide ongoing support for smoking cessation.
Apr 28, 2021
Journal Article
Feasibility of Assessing Economic and Sexual Risk Behaviors Using Text Message Surveys in African-American Young Adults Experiencing Homelessness and Unemployment: Single-Group Study
Text messages offer the potential to better evaluate HIV behavioral interventions using repeated longitudinal measures at lower cost and research burden. We found that using weekly automated text message surveys with short assessments was feasible with vulnerable young adults.
2020
Journal Article
Longitudinal Assessment of Changes in Mental and Sexual Health Outcomes Due to COVID-19 Among Latinx SMM and TGW
This study provides longitudinal information on how COVID-19 is impacting the mental and sexual health of Latinx SMM and TGW across Los Angeles County.
2020
Journal Article
Rapid Mixed-Methods Assessment of COVID-19 Impact on Latinx Sexual Minority Men and Latinx Transgender Women
A rapid, mixed-methods assessment to understand how COVID-19 affected Latinx sexual minority men (LSMM) and transgender women (LTGW).
2020
Journal Article
Changes in ART Adherence Relate to Changes in Depression as Well! Evidence for the Bi-directional Longitudinal Relationship Between Depression and ART Adherence from a Prospective Study of HIV Clients in Uganda
While other research has examined and supported the influence of depression on ART adherence, our data support the reciprocal relationship: that non-adherence and changes in adherence are associated with levels and changes in depression.
2019
Journal Article
"How Am I Going to Live?": Exploring Barriers to ART Adherence Among Adolescents and Young Adults Living with HIV in Uganda
Our results highlight special needs for future public health programs and policies meant to address barriers to ART adherence among older adolescents.
Oct 16, 2018
Journal Article
Perceived Peer Norms, Health Risk Behaviors, and Clustering of Risk Behaviors Among Palestinian Youth
Prevention education programs for Palestinian youth should be structured to deal with a range of connected risk behaviors& for which certain youth may be at risk, not just single behaviors such as drug use.
Aug 28, 2018
Journal Article
Protocol for a Randomised Trial of Higher Versus Lower Intensity Patient-Provider Communication Interventions to Reduce Antibiotic Misuse in Two Paediatric Ambulatory Clinics in the US
Effective parent-provider communication about antibiotics can reduce inappropriate antibiotic prescribing and use, but there is a dearth of interventions targeting this issue.
Jun 21, 2018
Journal Article
Health risk behaviours of Palestinian youth: Findings from a representative survey
Prevention outreach for youth risk behavior in the occupied Palestinian territory, and elsewhere in the region, should be directed at subgroups and areas identified as highest risk.
Jun 19, 2018
Journal Article
Perceived Cost Advantages and Disadvantages of Purchasing HIV Self-Testing Kits Among Urban Tanzanian Men: An Inductive Content Analysis
Different strategies may be needed to increase male uptake of HIV testing across economic strata.
Nov 30, 2017
Journal Article
Text Messaging for Improving Antiretroviral Therapy Adherence: No Effects After 1 Year in a Randomized Controlled Trial Among Adolescents and Young Adults
Short text reminders to HIV-positive young adults in Uganda did not improve their adherence to antiretroviral therapy regimens, in contrast to prior interventions that used reminder messages.
Nov 2, 2017
Journal Article
Prevalence and Correlates of Use of Safer Conception Methods in a Prospective Cohort of Ugandan HIV-affected Couples with Fertility Intentions
Among a sample of Ugandan couples with an HIV-positive partner who hope to conceive, about one-third used a "safer" conception method such as timed unprotected intercourse to reduce HIV transmission, but only about half were aware of such methods.
Mar 16, 2017
Journal Article
A Microfinance Program Targeting People Living with HIV in Uganda: Client Characteristics and Program Impact
Ugandans living with medically stable HIV are able to repay microcredit loans; paired with business training, the loans can help this vulnerable population improve their weekly income and build assets.
Sep 30, 2016
Draft
Prevalence and Patterns of Health Risk Behaviors of Palestinian Youth: Findings from a Representative Survey
Investigates the prevalence and patterns of risk behaviors as well as of mental health, perceptions of the risks of such behaviors, and the factors increasing vulnerability to as well as protection from engagement in them.
Jul 25, 2016
Journal Article
Using Insights from Behavioral Economics to Strengthen Disaster Preparedness and Response
Behavioral economics has achieved positive results in decision-making contexts similar to those surrounding disaster preparedness and response, and therefore the low cost and potentially high impact of behavioral economics-based interventions warrant further investigation.
Jun 2, 2016
Journal Article
Supporting Treatment Adherence Readiness Through Training (START) for Patients with HIV on Antiretroviral Therapy: Study Protocol for a Randomized Controlled Trial
A "new generation" adherence support program targets patients before they begin HIV treatment. If proven efficacious and cost effective, the program could give clinicians a model for assessing their patients' readiness to adhere to HIV treatment.
Apr 22, 2016
Journal Article
A Comparison of Home-Based Versus Outreach Event-Based Community HIV Testing in Ugandan Fisherfolk Communities
Among Ugandan fisherfolk, more new HIV cases were identified in home-based testing than in community-based testing, but fewer of those tested at home were linked to care.
2016
Journal Article
Substance Use Among Palestinian Youth in the West Bank, Palestine: A Qualitative Investigation
This study provides insights into the perceived prevalence and patterns of alcohol and drug use among Palestinian youth.
2016
Journal Article
Impact of Food Support on Food Security and Body Weight Among HIV Antiretroviral Therapy Recipients in Honduras: A Pilot Intervention Trial
Optimal strategies to improve food security and nutrition for people living with HIV (PLHIV) may differ in settings where overweight and obesity are prevalent and cardiovascular disease risk is a concern.
Apr 1, 2015
Report
Evaluation of the Population and Poverty Research Initiative (PopPov)
This report evaluates the Population and Poverty Research Initiative (PopPov) and its progress in building economic demography, particularly policy-relevant research; policymakers’ understanding of issues; and research capacity in sub-Saharan Africa.
May 5, 2014
Report
Evaluation of the Population and Poverty Research Initiative (PopPov): Executive Summary
This report evaluates the Population and Poverty Research Initiative (PopPov) and its progress in building economic demography, particularly policy-relevant research; policymakers' understanding of issues; and research capacity in sub-Saharan Africa.
Jan 20, 2014
Journal Article
Perceptions of Sexual Risk Behavior Among Palestinian Youth in the West Bank: A Qualitative Investigation
Young people in the Middle East and North Africa (MENA) are profoundly affected by violence, high unemployment, and economic hardship.
2014
Journal Article
Tailored Nutrition Education and Food Assistance Improve Adherence to HIV Antiretroviral Therapy: Evidence from Honduras
Food insecurity and malnutrition negatively affect adherence to antiretroviral therapy (ART) and are associated with poor HIV clinical outcomes.
2014
Journal Article
Prospective Cohort Study of the Impact of Antiretroviral Therapy on Employment Outcomes Among HIV Clients in Uganda
This study evaluates the impact of antiretroviral treatment (ART) on employment-related outcomes using prospective, longitudinal analysis.
Dec 1, 2013
Journal Article
Fertility Choice, Mortality Expectations, and Interdependent Preferences: An Empirical Analysis
We investigate the empirical relationship between child mortality and fertility across 46 low and middle income countries.
Oct 1, 2013
Journal Article
Fertility Desires Among HIV-infected Men and Women in Los Angeles County: Client Needs and Provider Perspectives
Combination antiretroviral therapy for persons living with HIV/AIDS (PLHA) has extended life expectancy, and enabled PLHA to live productive lives that can include having children.
May 1, 2013
Journal Article
The Impact of Natural Disasters on Child Health and Investments in Rural India
There is growing concern that climate change will lead to more frequent natural disasters that may adversely affect short- and long-term health outcomes in developing countries.
2013
Report
Negotiation Strategies for Antiretroviral Drug Purchasers in the United States
Options for negotiating lower procurement costs for antiretroviral (ARV) medications which could enable more people living with HIV in the United States to receive treatment.
Jun 29, 2012
Journal Article
Factors Associated with Intention to Conceive and Its Communication to Providers Among HIV Clients in Uganda
Persons living with HIV/AIDS (PLHA) must discuss their fertility intentions with healthcare providers to receive the support needed to have children safely and limit transmission risks.
Feb 1, 2012
Journal Article
A Qualitative Exploration of the Economic and Social Effects of Microcredit Among People Living with HIV/AIDS in Uganda
In developing countries, HIV medical care is often insufficient to achieve social and economic health, and hence innovative economic support programs are much needed.
2012
Research Brief
Improving Value for Money in Funding HIV Services in Developing Countries
This brief summarizes options for improving value for money in HIV funding by using a case study that focuses on the two largest funders, the U.S. President’s Emergency Plan for AIDS Relief and the Global Fund, and antiretroviral therapy.
Dec 12, 2011
Draft
The Impact of Natural Disasters on Child Health and Investments in Rural India
Investigates the impact of small and moderate disasters on childhood morbidity, physical growth, and immunizations by combining household data from the Indian National Family and Health Survey with an international database of natural disasters.
Nov 10, 2011
Report
Value for Money in Donor HIV Funding
This report examines options for improving value for money in HIV funding by using a case study that focuses on the two largest funders, the U.S. President's Emergency Plan for AIDS Relief and the Global Fund, and antiretroviral therapy.
Oct 6, 2011
Journal Article
Almost Random: Evaluating a Large-Scale Randomized Nutrition Program in the Presence of Crossover
Large-scale randomized interventions have the potential to uncover the causal effect of programs applying to a large population, thereby improving on the insights gained from currently dominant smaller randomized studies.
Sep 1, 2011
Journal Article
Economic Status and Coping Mechanisms of Individuals Seeking HIV Care in Uganda
This study uses novel data to conduct a comprehensive evaluation of the demographic and economic circumstances facing HIV-positive individuals who have just entered HIV care in Uganda.
Jun 1, 2011
Journal Article
Consumption Smoothing and HIV/AIDS: The Case of Two Communities in South Africa
HIV/AIDS threatens to overstretch the already frail informal safety nets in countries heavily affected by the epidemic, potentially making it difficult for households with HIV‐positive members to keep up appropriate consumption levels when experiencing shocks.
Apr 1, 2010
Journal Article
Anemia in Low-Income Countries Is Unlikely to Be Addressed by Economic Development Without Additional Programs
Looking at the rates of anemia among children and adult women across 40 Demographic and Health Surveys from 32 countries, this study found that although anemia rates do decrease as income increases, the decrease is modest.
Sep 1, 2009
Journal Article
Effectiveness of a Community-Based Intervention to Improve Nutrition in Young Children in Senegal: A Difference in Difference Analysis
The current study uses a difference in difference comparison of cohorts to assess the impact on the proportion of underweight children who lived in villages receiving services provided by the Senegal Nutrition Enhancement Project between 2004 and 2006.
May 1, 2009