Behavioural Economics-based Incentives in Adults With Type 2 Diabetes (BET2)

The University of Hong Kong (HKU)

Status: Completed

Conditions: Diabetes Mellitus, Type 2

Treatments: Behavioral: Financial incentives; Behavioral: Financial and social incentives

Study type: Interventional

Funder types: Other

Identifiers

NCT04917926

BET2-v4-202106

Details and patient eligibility

About

A randomised control trial of adults with newly diagnosed type 2 diabetes to assess the effectiveness of behavioural economics-based incentives on healthy lifestyle behaviour, using a pragmatic trial approach.

Full description

This is a randomised control trial of adults aged 30-70 with newly diagnosed type 2 diabetes within a year in Hong Kong to compare the effectiveness of financial incentives and combined financial and social incentives against a control group receiving standard care. We plan to recruit 261 participants and follow them for 9-months (6-month intervention period and a 3-month post-intervention follow-up period) to assess glycemic control and other health indicators. Participants will be randomly assigned to one of three groups (in ratio 1:1:1): arm A (financial incentives in addition to standard care), arm B (financial and social incentives in addition to standard care), and arm C (control arm receiving standard care). Financial incentives will be framed around loss aversion and the endowment effect. Social incentives will include peer competition, and social support. Financial and social incentives are to encourage increased physical activity and participants will use a pedometer to track activity. Participants are followed for an additional 3-months after the cessation of incentives to assess the sustainability of lifestyle changes.

This trial adopts a pragmatic study design based on the PRECIS-2 tool and RE-AIM frameworks.

Enrollment: 122 patients

Sex: All

Ages: 30 to 70 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Chinese adults aged 30-70 years
• Capable of providing informed consent
• Resident in Hong Kong
• Able to communicate in English or Chinese
• Diagnosed with type 2 diabetes within past year
• 6.5% ≤ HbA1c ≤ 9.0%
• Willing to take blood tests
• Access to a phone to track physical activity and receive text messages
• Physically mobile for duration of the trial

Exclusion criteria

• Planned surgery in the next 6 months
• Biological impairment or health condition affecting the ability to walk, such as blindness, physical immobility, and paralysis
• Pregnant or breastfeeding
• On insulin for diabetes control

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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122 participants in 3 patient groups

Financial and social intervention

Experimental group

Description:

Participants will receive the usual standard care (same as control group), loss-framed financial incentives, social incentives and weekly feedback on performance for 6 months.

Treatment:

Behavioral: Financial and social incentives

Control

No Intervention group

Description:

Participants will receive standard care including patient screening and education on diet, physical activity, and smoking conducted by a multi-disciplinary team. Participants in the control group will neither be told their baseline step count nor receive any feedback messages.

Financial intervention

Experimental group

Description:

Participants will receive the usual standard care (same as control group), loss-framed financial incentives, and weekly feedback on performance for 6 months.

Treatment:

Behavioral: Financial incentives