Financial Incentives for Type 2 Diabetes

(LIFT-FINANCE Trial)

Not currently recruiting at 1 trial location

Overseen By Rebekah J Walker, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Medical College of Wisconsin

Disqualifiers: Dementia, Alcohol abuse, Drug abuse, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 3

Duration: 6 months

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if financial incentives can improve blood sugar levels, blood pressure, and overall quality of life for people with type 2 diabetes who struggle to afford food. Participants will receive various types of financial support, such as cash for buying healthy food or rewards for lowering blood sugar. The trial suits those with type 2 diabetes who have difficulty managing their condition and often worry about food security. As an unphased trial, this study provides a unique opportunity to explore innovative methods for managing diabetes and enhancing quality of life.

Do I need to stop my current medications for this trial?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that using financial rewards to manage type 2 diabetes is generally safe. These rewards aim to encourage better blood sugar control by offering money as motivation. Studies have found that these incentives can improve diabetes management by encouraging patients to adhere to their treatment plans.

While specific information on side effects from financial rewards is lacking, this method is not a medical treatment. It involves providing money as encouragement, so no known health risks are directly linked to the rewards. The main goal is to support lifestyle changes like healthier eating and regular diabetes education.

In summary, financial rewards for managing type 2 diabetes are well-received. They help people make healthier choices without causing harm. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores financial incentives as a way to improve glycemic control in individuals with Type 2 diabetes. Unlike traditional treatments that primarily focus on medications like metformin or insulin, this approach leverages financial motivation to encourage healthier eating habits and consistent diabetes management. The trial's unique structure includes monthly income supplements, weekly incentives for purchasing healthy foods, and bonuses for significant improvements in blood sugar levels, aiming to make healthy choices more accessible and rewarding. This innovative strategy could potentially transform diabetes management by addressing both economic and lifestyle factors, offering a holistic approach to enhance patient outcomes.

What evidence suggests that this trial's financial incentives could be effective for improving type 2 diabetes management?

Research has shown that financial rewards can help people manage diabetes more effectively. In this trial, participants in different groups will receive various financial incentives. For example, some participants will receive a financial incentive for lowering their HbA1c levels (a measure of long-term blood sugar), which studies have found can lead to improved health. Other participants will receive incentives for purchasing healthy foods, which evidence suggests can increase fruit and vegetable intake and may aid in diabetes control. Additionally, some participants will receive unconditional financial incentives. Although these do not directly improve diabetes control, they have been shown to enhance food security, potentially supporting better health indirectly. Overall, financial incentives appear promising in helping people with type 2 diabetes manage their condition more effectively. ^{6 7 8 9 10}

Who Is on the Research Team?

Rebekah J Walker, PhD

Principal Investigator

University at Buffalo

Are You a Good Fit for This Trial?

This trial is for adults over 21 with type 2 diabetes, an HbA1c of 9 or higher, and who struggle to afford food. They must speak English and not have dementia, drug/alcohol dependency, severe mental disorders, be in another diabetes study, or have less than a six-month life expectancy.

Inclusion Criteria

I have been diagnosed with type 2 diabetes.

Ability to communicate in English

You have been identified as at risk for not having enough food.

Exclusion Criteria

You currently have severe mental health issues or are experiencing a mental health crisis.

You are currently taking part in another diabetes study.

You have significant memory problems that are noticeable during an interview.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive financial incentives and diabetes education for 6 months

6 months

3 visits (in-person) at baseline, 3 months, and 6 months

Follow-up

Participants are monitored for changes in glycemic control, blood pressure, and quality of life

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Diabetes Education
• Glycemic Control Financial Incentive
• Monthly Unconditional Financial Incentive
• Weekly Food Purchasing Financial Incentive

Trial Overview

The study tests if financial rewards can help people with type 2 diabetes eat better and manage their blood sugar levels. Participants will receive one of three types of cash incentives plus monthly educational materials about managing diabetes through diet.

How Is the Trial Designed?

Group I: Monthly Unconditional Plus Healthy Food Purchasing Plus Glycemic Control Financial Incentive Experimental Treatment 4 Interventions

Individuals assigned to this group will receive diabetes education, a monthly incentive to supplement income and enhance ability to purchase healthy food options, an additional weekly incentive if receipt for purchase of healthy food items from a grocery store is provided, and an incentive at the end of the study based on absolute drop in HbA1c.

Group II: Monthly Unconditional Plus Healthy Food Purchasing Financial Incentive Experimental Treatment 3 Interventions

Individuals assigned to this group will receive diabetes education, a monthly incentive to supplement income and enhance ability to purchase healthy food options, and an additional weekly incentive if receipt for purchase of healthy food items from a grocery store is provided.

Group III: Monthly Unconditional Financial Incentive Experimental Treatment 2 Interventions

Individuals assigned to this group will receive diabetes education and a monthly incentive to supplement income and enhance ability to purchase healthy food options.

Who Is Running the Clinical Trial?

Medical College of Wisconsin

Lead Sponsor

Trials

645

Recruited

1,180,000+

State University of New York at Buffalo

Lead Sponsor

Trials

279

Recruited

52,600+

Published Research Related to This Trial

In a study involving 78 type II diabetic outpatients, both nutrition education programs led to significant improvements in dietary goals compared to a control group, indicating their effectiveness in managing diabetes through dietary changes.

However, the addition of a social learning component did not provide any additional benefits over the standard nutrition education program, and there were minimal differences in long-term outcomes like weight or blood sugar levels.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Nutrition education and social learning interventions for type II diabetes. Glasgow, RE., Toobert, DJ., Mitchell, DL., et al.[2019]

Citations

1.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC8357673/

Process- and Outcome-Based Financial Incentives to ...

Process-based incentives can improve adherence to intermediary outcomes, while outcome-based incentives focus on glycemic control and are simpler to administer.

2.

diabetesjournals.org

diabetesjournals.org/care/article/48/3/306/157717/Financial-Incentives-Income-Supplementation-Cash

Financial Incentives, Income Supplementation, Cash Transfer ...

Group 1, single incentive at 3 months for absolute percentage drop in HbA1c from baseline to 3-month follow-up, up to $300. Group 2, single two- ...

3.

journals.plos.org

journals.plos.org/plosone/article?id=10.1371/journal.pone.0248762

Cost-effectiveness of financial incentives to improve glycemic ...

This study provides important preliminary evidence that financial incentives are a potentially cost-effective intervention for individuals with ...

4.

bmchealthservres.biomedcentral.com

bmchealthservres.biomedcentral.com/articles/10.1186/s12913-020-06029-0

Financial incentives to improve glycemic control in African ...

Those in the financial incentives group received a maximum of $200 if their HbA1c decreased by 2% at 6-months. If participants in the financial ...

5.

sciencedirect.com

sciencedirect.com/science/article/pii/S0168851024001994

Does financial incentive for diabetes management in the ...

Many studies found that financial incentives for diabetes management reduced hospitalizations, while a few found no effects.

6.

withpower.com

withpower.com/trial/phase-diabetes-mellitus-4-2022-0e46a

Financial Incentives for Type 2 Diabetes · Info for Participants

The financial incentives treatment for type 2 diabetes is unique because it uses monetary rewards to motivate patients to improve their blood sugar control, ...

7.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC12544048/

MON-543 Lowering Food Insecurity And Improving ...

Monetary interventions are shown to be effective in improving diabetes outcomes but have not been tested within the context of food insecurity.

8.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC11438360/

Financial incentives in the management of diabetes

This review found that financial incentives can positively influence patient behavior and enhance compliance, but their impact on HbA1c levels is inconsistent.

9.

studocu.com

studocu.com/en-us/document/louisiana-state-university/nursing-concepts-iii/financial-incentives-and-glycemic-control-in-type-2-diabetes-key-findings/125645462

Financial Incentives and Glycemic Control in Type 2 Diabetes

The findings revealed that participants in the incentive DGA showed a more significant reduction in A1c levels compared to those in the non-incentive group.

10.

trialnavigator.com

trialnavigator.com/trial/NCT05352022

Lowering Food Insecurity and Improving Diabetes With Financial ...

The overarching aim of this proposal is to test the efficacy of financial incentives in improving HbA1c, blood pressure, and quality of life in food insecure ...