None listed
Conditions
Brief summary
OBJECTIVES: To assess the impact of a 12 week financial reward programme to increase self monitoring of blood glucose (SMBG) and improve diabetes control in adolescents with poorly controlled type 1 diabetes METHODS: Two-arm, randomized, controlled trial of 30 adolescents. Key eligibility criteria will be type 1 diabetes, age 16-25 years, HbA1c > 75mmol/mol, living in Counties Manukau Health area, and history of SMBG frequency of 2 or less per day. Consenting participants will be randomized 2:1 to either intervention of monetary reward dependent on monthly evidence of daily SMBG (maximum of $2 per day, $180 over 90 days of study + $20 at 12 months) or control (standard care but small financial rewards of $20 at 90 days and $20 at 12 months, for HbA1c assessment and providing BG upload at these two timepoints). Primary outcomes will be mean daily SMBG frequency and HbA1c at 12 weeks and at 1 year. Assuming a standard deviation of 13mmol/mol in HbA1c, a sample size of 20 intervention vs 10 control will provide 80% power to detect a difference of 14.8mmol/mol HbA1c between the two groups. EXPECTED OUTCOMES: This novel study design explores a potentially cost-effective intervention designed to improve health care behavior of adolescents with type 1 diabetes in effort to improve their glycemic control and reduce risk of subsequent hospitalization and diabetes complications. Given the acceptability and increased effect of financial rewards to promote health behavior, which have been seen in recipients from greater social deprivation scores in other disorders, this type of intervention has the potential to reduce health inequalities, and could be adopted in other centres.
Interventions
Reward schedule for those randomised to the reward group (2/3 chance, target 20 participants):
90-day monetary reward according to the following schedule: $0.20 per test up to a maximum of 8 tests per day, plus $0.20 bonus for 4 tests per day, and $0.20 bonus for obtaining at least 2 glucose test results between 4.5-8mmol/L per day. Maximum $2 per day, so maximum $180 over 90 days study intervention duration or minimum $20 over 90 days will be provided upon final 12 week meter review and HbA1c
Reward schedule for those randomised to the reward group (2/3 chance, target 20 participants): 90-day monetary reward according to the following schedule: $0.20 per test up to a maximum of 8 tests per day, plus $0.20 bonus for 4 tests per day, and $0.20 bonus for obtaining at least 2 glucose test results between 4.5-8mmol/L per day. Maximum $2 per day, so maximum $180 over 90 days study intervention duration or minimum $20 over 90 days will be provided upon final 12 week meter review and HbA1c result. Monetary rewards will only be provided every 4 weeks for the first 90 days, upon presentation of BG meter for checking or upon email receipt of the direct electronic meter download results. Additional $20 will provided after 1 year when HbA1c is done and BG meter is presented for review or download at this time point.
Sponsors
Rinki Murphy
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
16 Years to 25 Years
Healthy volunteers
No
Inclusion criteria
Inclusion criteria *Type 1 diabetes – at least 12 months duration *HbA1c > 75 mmol/mol in at least 2 consecutive tests *Age 16-25 years *Access to a computer to upload glucose meters and transmit proof of testing by email, or willing to come to clinic to provide this *living in Counties Manukau Health area *Mobile phone ownership to receive and send texts *Able to perform SMBG and adjust own insulin *SMBG frequency 2 or less per day (average over past 1 month)
Exclusion criteria
*Any medical condition or medications known to alter glycemic control *Plans to change insulin delivery mode *Using continuous glucose sensor *Neurocognitive impairment or significant psychiatric issues
Outcome results
None listed