Diabetes, Type 1 Diabetes
Conditions
Keywords
diabetes, adolescent, young adult, behavioral economics, financial incentives, social incentives
Brief summary
In this study the investigators will compare a novel approach using daily financial incentives and a tiered sponsor network to motivate adolescents and young adults with type 1 diabetes to improve glycemic control.
Detailed description
Participants will be given daily glucose monitoring goals of ≥4 glucose checks per day with ≥1 readings within goal range (70-180 mg/dL) and provided with iHealth wireless glucometers. Half of the study participants will be randomized to the 3-month intervention arm on Way to Health. The intervention includes daily financial incentives ($60 in an account at beginning of each month with $2 daily loss if non-adherent) and a 2-level tiered sponsor network (youth select 2 people who will be notified of non-adherence after 2 and 5 consecutive days). The primary outcome will be HbA1c at 3 months compared to baseline. Secondary outcomes will include HbA1c at 6 months and the proportion of participants adherent to daily glucose monitoring goals. Exit interviews will elicit intervention feasibility and feedback from a youth perspective.
Interventions
BEHAVIORALDaily feedback
Daily feedback on glucose levels from wireless glucometers
BEHAVIORALFinancial incentive
Participant receive a $2 daily financial incentive framed as a loss with money allocated upfront and taken away each day of non-adherence to goal
Sponsors
Children's Hospital of Philadelphia
University of Pennsylvania
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Investigator)
Eligibility
Sex/Gender
ALL
Age
14 Years to 20 Years
Healthy volunteers
Yes
Inclusion criteria
* Diagnosis of type 1 diabetes * HbA1c of 8 or greater * Receiving care from the Childrens Hospital of Philadelphia Diabetes Center * English-speaking * Owns a smartphone
Exclusion criteria
* New diagnosis of type 1 diabetes within past year * Unable to provide informed consent * Already participating in another study to improve glycemic control * Any medical conditions that would prevent completion of the study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in HbA1c by 3 months | 3 months | Change in HbA1c from baseline to 3 months |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in HbA1c by 6 months | 6 months | Change in HbA1c from baseline to 6 months |
| Glucose Monitoring Adherence by 3 months | 3 months | Proportion of time adherence to glucose monitoring during 3 month intervention |
| Glucose Monitoring Adherence by 6 months | 6 months | Proportion of time adherence to glucose monitoring during 3 month follow-up period |
Countries
United States
Outcome results
None listed