Building Engagement Using Financial Incentives Trial - Hypertension (BENEFIT-H)

Tulane University

Status: Active, not recruiting

Conditions: Hypertension; Healthcare Patient Acceptance; Adherence, Patient; Health Behavior; Patient Engagement

Treatments: Behavioral: Immediate financial incentives; Behavioral: Remote Patient Monitoring; Behavioral: Self-monitoring of hypertension-related factors; Behavioral: Delayed financial incentives

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT06195839

2020-1600-BENH

Details and patient eligibility

About

The goal of this pilot clinical trial is to determine feasibility and explore whether immediate versus delayed patient financial incentives improve patient engagement with self-monitoring of blood pressure in patients with uncontrolled hypertension at Louisiana federally qualified health centers (FQHCs). The main questions it aims to answer are:

• Do patients randomized to receive financial incentives on a weekly basis during the study (immediate) have better adherence to blood pressure self-monitoring compared to patients randomized to receive financial incentives at the end of the study (delayed)?
• Do patients randomized to immediate financial incentives have better blood pressure control compared to patients randomized to delayed incentives?

Participants will:

• attend a baseline visit to measure blood pressure, respond to a baseline survey, and receive remote patient monitoring devices and instructions to take home with them (home blood pressure monitor, wrist-worn sensor to track sleep activity, and associated apps)
• receive a random allocation to one of two groups: control condition (receive cash incentives at the end of the study for measuring blood pressure as instructed) or intervention condition (receive weekly cash incentives throughout the study for measuring blood pressure as instructed)
• use remote patient monitoring devices during a two month study period, receive weekly reports on adherence to blood pressure monitoring, and receive weekly financial incentives (intervention condition only)
• attend one follow-up visit at 2 months to measure their blood pressure, complete a follow-up survey, return the remote patient monitoring devices, and receive financial incentives for blood pressure monitoring (control condition only)

Researchers will compare the immediate and delayed incentive groups to see if there are differences in blood pressure monitoring adherence rates and blood pressure control.

Enrollment: 50 estimated patients

Sex: All

Ages: 40+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age ≥40 years
• receive care at a participating FQHC
• taking blood pressure medication
• uncontrolled blood pressure at most recent clinic visit (systolic blood pressure ≥130 mm Hg or diastolic blood pressure ≥80 mm Hg)
• ability to understand and speak English
• able to access a smartphone

Exclusion criteria

• currently participating in another clinical trial or research study on blood pressure, medication-taking, or sleep
• unable or unwilling to give informed consent

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

---

50 participants in 2 patient groups

Immediate Financial Incentives for BP monitoring

Experimental group

Description:

* instructions for participating in a 2-month remote patient monitoring program * home blood pressure monitor and associated smartphone app, which includes a module for logging medication-taking * wrist-worn sensor and associated smartphone app * weekly adherence feedback to home blood pressure monitoring * immediate financial incentives for home blood pressure monitoring distributed weekly

Treatment:

Behavioral: Self-monitoring of hypertension-related factors

Behavioral: Immediate financial incentives

Behavioral: Remote Patient Monitoring

Delayed Financial Incentives for BP monitoring

Active Comparator group

Description:

* instructions for participating in a 2-month remote patient monitoring program * home blood pressure monitor and associated smartphone app, which includes a module for logging medication-taking * wrist-worn sensor and associated smartphone app * weekly adherence feedback to home blood pressure monitoring * delayed financial incentives for home blood pressure monitoring distributed at the end of the study

Treatment:

Behavioral: Delayed financial incentives

Behavioral: Self-monitoring of hypertension-related factors

Behavioral: Remote Patient Monitoring