Behavioral Economic Incentives to Improve Glycemic Control Among Adolescents and Young Adults

Behavioral Economic Incentives to Improve Glycemic Control Among Adolescents and Young Adults

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.

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.

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