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| Name | Class |
|---|---|
| University Grants Committee, Hong Kong | OTHER_GOV |
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A randomised control trial of adults with newly diagnosed type 2 diabetes to assess the effectiveness of behavioural economics-based incentives on healthy lifestyle behaviour, using a pragmatic trial approach.
This is a randomised control trial of adults aged 30-70 with newly diagnosed type 2 diabetes within a year in Hong Kong to compare the effectiveness of financial incentives and combined financial and social incentives against a control group receiving standard care. We plan to recruit 261 participants and follow them for 9-months (6-month intervention period and a 3-month post-intervention follow-up period) to assess glycemic control and other health indicators. Participants will be randomly assigned to one of three groups (in ratio 1:1:1): arm A (financial incentives in addition to standard care), arm B (financial and social incentives in addition to standard care), and arm C (control arm receiving standard care). Financial incentives will be framed around loss aversion and the endowment effect. Social incentives will include peer competition, and social support. Financial and social incentives are to encourage increased physical activity and participants will use a pedometer to track activity. Participants are followed for an additional 3-months after the cessation of incentives to assess the sustainability of lifestyle changes.
This trial adopts a pragmatic study design based on the PRECIS-2 tool and RE-AIM frameworks.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Financial and social intervention | Experimental | Participants will receive the usual standard care (same as control group), loss-framed financial incentives, social incentives and weekly feedback on performance for 6 months. |
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| Control | No Intervention | Participants will receive standard care including patient screening and education on diet, physical activity, and smoking conducted by a multi-disciplinary team. Participants in the control group will neither be told their baseline step count nor receive any feedback messages. | |
| Financial intervention | Experimental | Participants will receive the usual standard care (same as control group), loss-framed financial incentives, and weekly feedback on performance for 6 months. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Financial and social incentives | Behavioral | Participants will be credited with HK$1,000 in their virtual accounts at the beginning of the trial. After baseline step counts are gathered in the second week, they will lose HK$40 for each subsequent week that they do not meet their personal weekly step target. Regarding social incentives, participants will be placed in teams of six, receiving feedback of their physical activity performance, rankings within their groups, and positive messages for encouragement. Nominated supporters will be informed of participants' performance for social support. |
| Measure | Description | Time Frame |
|---|---|---|
| Glycaemic control | The change in HbA1c levels | Baseline, 6-months, and 9-months |
| Measure | Description | Time Frame |
|---|---|---|
| Diabetes control | Proportion of participants with good/excellent diabetes control (HbA1c threshold ≤ 7% & ≤ 6.5%) | Baseline, 6-months, and 9-months |
| Body weight control | Change in body weight in kilograms; weight and height will be combined to report BMI in kg/m^2 |
| Measure | Description | Time Frame |
|---|---|---|
| Frequency of health service utilisation | Number of medical appointment attendances and hospital admissions | Baseline, 6-months, and 9-months |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Jianchao Quan, MPH, BM BCh | School of Public Health, The University of Hong Kong | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong | Hong Kong | Hong Kong |
Information will be shared in accordance with the University of Hong Kong Data Management Plan (DMP)
Data will become available for at least 5 years after the release of publication of this study.
Only data without personal information will be shared. The data will be shared for academic use only.
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| ID | Term |
|---|---|
| D003924 | Diabetes Mellitus, Type 2 |
| ID | Term |
|---|---|
| D003920 | Diabetes Mellitus |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
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| Financial incentives | Behavioral | Participants will be credited with HK$1,000 in their virtual accounts at the beginning of the trial. After baseline step counts are gathered in the second week, they will lose HK$40 for each subsequent week that they do not meet their personal weekly step target. |
|
| Baseline, 6-months, and 9-months |
| Changes in lipid profile | Changes in Total, HDL- and LDL-cholesterol, and Triglycerides | Baseline, 6-months, and 9-months |
| Change in blood pressure | Assessed by the change in systolic and diastolic blood pressure | Baseline, 6-months, and 9-months |
| Glycaemic control | Proportion of participants requiring an initiation of medication in diabetes management | 6-months and 9-months |
| Glycaemic control (addition of medications) | Proportion of participants requiring an addition of medication(s) or increase in drug dosage in diabetes management | 6-months and 9-months |
| Walking performance | Assessed by proportion of participants meeting their daily step counts every week | Weekly |
| Level of physical activity | Assessed by the structured and validated International Physical Activity Questionnaires (IPAQ); Both walking performance (Outcome 6) and the IPAQ score can be used for assessing the level of physical activity of participants | Baseline, 6-months and 9-months |
| D004700 | Endocrine System Diseases |