Minnesota Medicaid Incentives to Prevent Chronic Disease

NCT02422420 | Completed

• 2 other identifiers: MinnesotaDHS1B1CMS330877-01-00
• Study Type: interventional
• Target: 1,500
• Locations: 1 country
• Sites: 1

Brief Summary

The objective of this study is to test whether two different participant financial incentive structures are more effective and cost effective than minimal financial incentives in increasing weight loss among Minnesota Medicaid beneficiaries at high risk of developing diabetes. The incentives are tied to participation and weight loss in the evidence-based group-delivered YMCA diabetes prevention program (Y-DPP). The Investigators will conduct a group randomized trial that includes up to 150 Y-DPP classes of 10-15 participants per class for up to 1500 Medicaid beneficiaries participating in the Y-DPP classes. This approach, if successful, will (a) improve weight loss. diabetes risk, and improve cardiovascular risk among Medicaid beneficiaries at risk for developing diabetes and other chronic conditions, (b) demonstrate that prevention of chronic disease risk factors using patient incentives is cost-effective, and (c) provide a patient incentive model that can be widely used among Medicaid beneficiaries at risk for developing diabetes.

Conditions

Prediabetic State

Keywords

Diabetes Prevention; Financial Incentives; Medicaid; Motivation

Outcome Measures

Primary Outcomes (2)

• DPP Attendance

  Participation in DPP core and post-core sessions

  12 months

• Weight Change

  Change in participants' weight

  12 months

Study Arms (3)

Individual Incentive

EXPERIMENTAL

Participants receive a financial incentive every time they attend a class session and goal-based incentives for attending 75% of Core sessions, 75% of Post-Core sessions, separately achieving 5%, 7%, and 10% weight loss during the Core period (i.e. separate financial incentives for each goal reached at any point during the Core period), and 5%, 7%, or 10% weight loss by the end of Post-Core Session 8 (i.e., one financial incentive based on final weight loss).

Behavioral: Financial Incentives

Group Incentive

EXPERIMENTAL

This arm receives the same routine attendance incentives as the Individual Incentive arm. Group goal-based incentives include 5% weight loss by an individual during the Core period and, separately, during the Post-Core period. Financial incentives are also received if the entire DPP group achieves 75% Core session attendance, 75% of Post-Core session attendance, 7% or 10% weight loss from baseline during the Core, and 7% or 10% weight loss from baseline at the end of the Post-Core period.

Behavioral: Financial Incentives

Minimal Incentive

OTHER

Participants receive the full Diabetes Prevention Program (DPP), but receive a nominal $25 financial incentive for attendance only at the first DPP session and no other incentives for attendance or weight loss.

Behavioral: Financial Incentives

Interventions

Financial Incentives BEHAVIORAL

Use of financial incentives to promote health behaviors.

Group Incentive; Individual Incentive; Minimal Incentive

Eligibility Criteria

• Age: 18 Years - 74 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• currently enrolled in Medical Assistance, PMAP, or MinnesotaCare (collectively referred to as Medicaid)
• years of age
• body mass index ≥ 25 kg/m2 (≥ 22 kg/m2 for those of Asian descent)
• have prediabetes or a history of gestational diabetes mellitus (GDM)

You may not qualify if:

• diagnosis of diabetes
• pregnant at the time of enrollment
• planning gastric bypass surgery within the next 12 months
• diagnosed with Alzheimer's disease (ICD-9 331.0) or dementia (ICD-9 290.0 - 294.9)
• provider judgment regarding suitability for the study based on substance abuse, uncontrolled mental illness, or other conditions that may affect the participants health or ability to participate in the study.

Sponsors & Collaborators

• Minnesota Department of Human Services: lead
• Minnesota Department of Health: collaborator
• HealthPartners Institute: collaborator

Study Sites (1)

Minnesota Department of Health

Saint Paul, Minnesota, 55164-0882, United States

Location

Related Publications (1)

• Desai JR, Vazquez-Benitez G, Taylor G, Johnson S, Anderson J, Garrett JE, Gilmer T, Vue-Her H, Rinn S, Engel K, Schiff J, O'Connor PJ. The effects of financial incentives on diabetes prevention program attendance and weight loss among low-income patients: the We Can Prevent Diabetes cluster-randomized controlled trial. BMC Public Health. 2020 Oct 21;20(1):1587. doi: 10.1186/s12889-020-09683-5.

  PMID: 33087083 DERIVED

MeSH Terms

Conditions

Prediabetic State

Condition Hierarchy (Ancestors)

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

Study Officials

• Gretchen Taylor

  Minnesota Department of Health

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER GOV
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: April 16, 2015
• First Posted: April 21, 2015
• Study Start: March 1, 2013
• Primary Completion: September 1, 2016
• Study Completion: September 1, 2016
• Last Updated: October 18, 2016

Record last verified: 2016-03

Locations

US (1)