Behavioral Economic Incentives to Improve Glycemic Control Among Adolescents and Young Adults

University of Pennsylvania

Status and phase: Completed; Phase 3

Conditions: Diabetes; Type 1 Diabetes

Treatments: Behavioral: Financial incentive; Behavioral: Daily feedback

Study type: Interventional

Funder types: Other

Identifiers

NCT02568501

15-012160

Details and patient eligibility

About

In this study the investigators will compare a novel approach using daily financial incentives and a tiered sponsor network to motivate adolescents and young adults with type 1 diabetes to improve glycemic control.

Full description

Participants will be given daily glucose monitoring goals of ≥4 glucose checks per day with ≥1 readings within goal range (70-180 mg/dL) and provided with iHealth wireless glucometers. Half of the study participants will be randomized to the 3-month intervention arm on Way to Health. The intervention includes daily financial incentives ($60 in an account at beginning of each month with $2 daily loss if non-adherent) and a 2-level tiered sponsor network (youth select 2 people who will be notified of non-adherence after 2 and 5 consecutive days). The primary outcome will be HbA1c at 3 months compared to baseline. Secondary outcomes will include HbA1c at 6 months and the proportion of participants adherent to daily glucose monitoring goals. Exit interviews will elicit intervention feasibility and feedback from a youth perspective.

Enrollment: 90 patients

Sex: All

Ages: 14 to 20 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Diagnosis of type 1 diabetes
• HbA1c of 8 or greater
• Receiving care from the Childrens Hospital of Philadelphia Diabetes Center
• English-speaking
• Owns a smartphone

Exclusion criteria

• New diagnosis of type 1 diabetes within past year
• Unable to provide informed consent
• Already participating in another study to improve glycemic control
• Any medical conditions that would prevent completion of the study

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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90 participants in 2 patient groups

Daily feedback

Experimental group

Description:

Participants receive daily feedback from wireless glucometers that transmit data on glucose monitoring adherence.

Treatment:

Behavioral: Daily feedback

Daily Feedback, incentives

Experimental group

Description:

Participants receive daily feedback from wireless glucometers that transmit data on glucose monitoring adherence. Participants are eligible for a financial incentive if adherent.

Treatment:

Behavioral: Daily feedback

Behavioral: Financial incentive