Improving Diabetes Control Through Peer Counseling and Incentives

NCT01125956 | Completed DMC

• 1 other identifier: 01164
• Study Type: interventional
• Target: 160
• Locations: 1 country
• Sites: 1

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. 1.Peer counseling is an effective means of reducing HbA1c (a measure of glucose control).
2. 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.

Conditions

Diabetes Mellitus

Keywords

Diabetes; Diabetes mellitus; HbA1c

Outcome Measures

Primary Outcomes (1)

• Hemoglobin A1c

  Change in HbA1c from baseline will be the primary outcome measure.

  Baseline, 6 months

Secondary Outcomes (3)

• Counts of the number of hypoglycemic events

  6 months

• Number of peer encounters

  6 months

• Experience of peer counseling

  6 months

Study Arms (3)

Control

NO INTERVENTION

This group will receive usual diabetes care through their primary care clinicians.

Peer counseling

EXPERIMENTAL

A peer counselor will be assigned to each participant who currently has good diabetes control but had poor control in the past 3 years.

Behavioral: Assigned a peer counselor

Financial incentives

EXPERIMENTAL

Patient participants in the financial incentive arm will be given $100 for reduction of HbA1c by 1 point in a 6 month period and $200 for reduction by 2 points.

Behavioral: Financial incentives

Interventions

Assigned a peer counselor BEHAVIORAL

Dyads will be given $20 per month if they have contact 4 or more times during a month.

Peer counseling

Financial incentives BEHAVIORAL

Participants will be given $100 for reduction of HbA1c by 1 point in a 6 month period and $200 for reduction by 2 points.

Financial incentives

Eligibility Criteria

• Age: 50 Years - 70 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• African American veteran
• 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

You may not qualify if:

• 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

Sponsors & Collaborators

• University of Pennsylvania: lead

Study Sites (1)

Philadelphia Veterans Affairs Medical Center

Philadelphia, Pennsylvania, 19104, United States

Location

Related Publications (1)

• Long JA, Jahnle EC, Richardson DM, Loewenstein G, Volpp KG. Peer mentoring and financial incentives to improve glucose control in African American veterans: a randomized trial. Ann Intern Med. 2012 Mar 20;156(6):416-24. doi: 10.7326/0003-4819-156-6-201203200-00004.

  PMID: 22431674 DERIVED

Related Links

• LDI Center for Health Incentives
• VA Center for Health Equity and Promotion (CHERP)
• This research was supported by a grant from the National Institute on Aging, P30-AG036592. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Aging or the NIH

MeSH Terms

Conditions

Diabetes Mellitus

Condition Hierarchy (Ancestors)

Glucose Metabolism Disorders; Metabolic Diseases; Nutritional and Metabolic Diseases; Endocrine System Diseases

Study Officials

• Judith Long, MD

  University of Pennsylvania

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: May 17, 2010
• First Posted: May 19, 2010
• Study Start: July 1, 2009
• Primary Completion: December 1, 2010
• Study Completion: December 1, 2010
• Last Updated: February 28, 2019

Record last verified: 2019-02

Locations

US (1)