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.
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.
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DOI：
10.1186/s12889-020-09683-5
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发表时间：
2020-10-21
影响因子：
4.5
通讯作者：
O'Connor PJ
中科院分区：
文献类型：
--
作者：
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
普及和参与真实的生活方式的改变计划，以防止2型糖尿病的实施一直具有挑战性。在美国低收入人群中尤其如此。本研究的目的是检查参加12个月糖尿病预防计划（DPP）的医疗补助受益人的出勤率和体重减轻的经济激励措施的有效性。这是一项分组随机对照试验，包括两个经济激励研究组和一个注意力控制研究组。来自13个初级保健诊所的糖尿病前期医疗补助受益人被随机分配到个人获得的激励措施组（IND; 33组; n = 309），一个混合的个人和团体赢得的奖励（GRP; 30组; n = 259），和注意力控制（AC; 30组; n = 279）。在12个月内达到出勤率和减肥目标可以获得高达520美元的奖励。结果是相对于基线的体重减轻百分比，相对于基线实现5%的体重减轻，以及参加75%的核心DPP会议和75%的维持DPP会议。使用线性混合模型来检查16周和12个月内的体重变化和出勤率。IND、GRP和AC受试者在16周时的体重变化百分比相似，分别为-2.6%、-3.1%和-3.4%。然而，IND、GRP和AC组体重减轻5%的受试者分别为21.5%、24.0%（GRP vs AC，P < 0.05）和15.2%。IND（60.8%，P < 0.001）和GRP（64.0%，P <0.001）参与者中75%的DPP核心会议出席率显著高于AC（38.6%）参与者。尽管随着时间的推移出现了大量流失，但IND（23.0%，P < 0.001）和GRP（26.1%，P < 0.001）参与者中75%的DPP维持治疗的出席率也显著高于AC（11.0%）参与者。财政激励措施可以提高参加12个月DPP的医疗补助受益人的比例，并实现至少5%的体重减轻。ClinicalTrials.govNCT02422420;回顾性登记于2015年4月21日。补充信息随附于10.1186/s12889-020-09683-5。
Penetration and participation of real life implementation of lifestyle change programs to prevent type 2 diabetes has been challenging. This is particularly so among low income individuals in the United States. The purpose of this study is to examine the effectiveness of financial incentives on attendance and weight loss among Medicaid beneficiaries participating in the 12-month Diabetes Prevention Program (DPP). This is a cluster-randomized controlled trial with two financial incentive study arms and an attention control study arm. Medicaid beneficiaries with prediabetes from 13 primary care clinics were randomly assigned to individually earned incentives (IND; 33 groups; n = 309), a hybrid of individual- and group-earned incentives (GRP; 30 groups; n = 259), and an attention control (AC; 30 groups; n = 279). Up to $520 in incentives could be earned for attaining attendance and weight loss goals over 12 months. Outcomes are percent weight loss from baseline, achieving 5% weight loss from baseline, and attending 75% of core and 75% of maintenance DPP sessions. Linear mixed models were used to examine weight change and attendance rates over the 16 weeks and 12 months. The percent weight change at 16 weeks for the IND, GRP, and AC participants were similar, at − 2.6, − 3.1%, and − 3.4%, respectively. However, participants achieving 5% weight loss in the IND, GRP, and AC groups was 21.5, 24.0% (GRP vs AC, P < 0.05), and 15.2%. Attendance at 75% of the DPP core sessions was significantly higher among IND (60.8%, P < 0.001) and GRP (64.0%, P < 0.001) participants than among AC (38.6%) participants. Despite substantial attrition over time, attendance at 75% of the DPP maintenance sessions was also significantly higher among IND (23.0%, P < 0.001) and GRP (26.1%, P < 0.001) participants than among AC (11.0%) participants. Financial incentives can improve the proportion of Medicaid beneficiaries attending the 12-month DPP and achieving at least 5% weight loss. ClinicalTrials.govNCT02422420; retrospectively registered April 21, 2015. Supplementary information accompanies this paper at 10.1186/s12889-020-09683-5.
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影响因子：
12.7
作者：
Ackermann, Ronald T.;Liss, David T.;Saha, Chandan
通讯作者：
Saha, Chandan
个人经济激励措施改变了与健康相关的行为：系统评价和荟萃分析。
影响因子：
5.1
作者：
Mantzari E;Vogt F;Shemilt I;Wei Y;Higgins JP;Marteau TM
通讯作者：
Marteau TM
影响因子：
39.2
作者：
Kullgren JT;Troxel AB;Loewenstein G;Asch DA;Norton LA;Wesby L;Tao Y;Zhu J;Volpp KG
通讯作者：
Volpp KG
影响因子：
5.1
作者：
John, Leslie K.;Loewenstein, George;Volpp, Kevin G.
通讯作者：
Volpp, Kevin G.
影响因子：
3.4
作者：
Gilmer, Todd;O'Connor, Patrick J.;Desai, Jay
通讯作者：
Desai, Jay