Diabetes Mellitus
Conditions
Keywords
Diabetes, Diabetes mellitus, HbA1c
Brief summary
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.
Interventions
BEHAVIORALAssigned a peer counselor
Dyads will be given $20 per month if they have contact 4 or more times during a month.
BEHAVIORALFinancial incentives
Participants will be given $100 for reduction of HbA1c by 1 point in a 6 month period and $200 for reduction by 2 points.
Sponsors
University of Pennsylvania
Study design
Allocation
RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
50 Years to 70 Years
Healthy volunteers
No
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
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Hemoglobin A1c | Baseline, 6 months | Change in HbA1c from baseline will be the primary outcome measure. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Counts of the number of hypoglycemic events | 6 months | All events and serious events related to hypoglycemia will be counted over the 6 month intervention period, including emergency room visits and hospitalizations. |
| Number of peer encounters | 6 months | The number of peer encounters by arm will be described. |
| Experience of peer counseling | 6 months | The experience of peer counseling from both poorly controlled diabetics and counselors will be described. |
Countries
United States
Outcome results
None listed