Improving Diabetes Control Through Peer Counseling and Incentives

University of Pennsylvania

Status: Completed

Conditions: Diabetes Mellitus

Treatments: Behavioral: Assigned a peer counselor; Behavioral: Financial incentives

Study type: Interventional

Funder types: Other

Identifiers

NCT01125956

01164

Details and patient eligibility

About

The specific aims of this study are to test whether in a cohort of low-income minority veterans with poor diabetes mellitus (DM) control:

1. Peer counseling is an effective means of reducing HbA1c (a measure of glucose control).
2. Financial incentives are an effective means of reducing HbA1c. This is a randomized controlled pilot study. There will be 3 arms: 1) a control group of poorly controlled diabetics getting usual care; 2) peer counseling with no incentives; and 3) financial incentives without peers. Ultimately, contingent on the success of this intervention, the researchers plan to apply for funding for a large scale intervention employing both peer counseling and incentives to improve DM control in low income and minority patients who are at high risk for premature morbidity and mortality.

Enrollment: 160 patients

Sex: All

Ages: 50 to 70 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• African American veteran
• 50-70 years old
• ICD-9CM diagnosis code consistent with DM (any ICD-9CM code starting with 250)
• For patients: last two HbA1c greater than 8% with at least one measure being within 3 months of enrollment
• For peer counselors: HbA1c of greater than 8% in the past 3 years and an HbA1c less than or equal to 7.5% within 3 months of enrollment

Exclusion criteria

• Unstable medical condition that would likely prevent the subject from completing the study
• Patients enrolled in Telehealth will be excluded as such enrollment does not constitute usual care

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Single Group Assignment

Masking: None (Open label)

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160 participants in 3 patient groups

Control

No Intervention group

Description:

This group will receive usual diabetes care through their primary care clinicians.

Peer counseling

Experimental group

Description:

A peer counselor will be assigned to each participant who currently has good diabetes control but had poor control in the past 3 years.

Treatment:

Behavioral: Assigned a peer counselor

Financial incentives

Experimental group

Description:

Patient participants in the financial incentive arm will be given $100 for reduction of HbA1c by 1 point in a 6 month period and $200 for reduction by 2 points.

Treatment:

Behavioral: Financial incentives