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Financial Incentives and SMS to Improve African American Women's Glycemic Contro

财务激励和短信改善非裔美国女性的血糖控制

基本信息

批准号：
8795607
负责人：
ARLEEN F. BROWN
金额：
$ 24.36万
依托单位：
UNIVERSITY OF CALIFORNIA LOS ANGELES
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-02-01 至 2016-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8795607
关键词：
Abstinence Address Adherence Affect African American Age Anticoagulants Attention Behavior Behavior Therapy Body Weight decreased Caregivers Caring Cellular Phone Chronic Clinic Clinic Visits Clinical Collaborations Communications Media Communities Control Groups County Decision Making Diabetes Mellitus Economics Exposure to Face Feedback Frequencies Goals Health Health Personnel Health Planning Health behavior change Healthcare Healthcare Systems Hemoglobin High Prevalence Incentives Individual Instruction Intervention Lead Literature Los Angeles Morbidity - disease rate Motivation Outcome Outcome Study Participant Patient Self-Report Patients Persons Pharmaceutical Preparations Physicians Positioning Attribute Prenatal care Provider Public Health Quality of Care Quality of life Randomized Randomized Controlled Trials Recording of previous events Regimen Research Research Personnel Resources Rewards Scheme Self Care Self Management Services Solutions Substance abuse problem System Technology Telephone Text Training and Education Translations Trust Visit Weight Woman Writing arm behavior change behavioral economics blood pressure regulation burden of illness clinical practice compliance behavior cost diabetes control evidence base experience financial incentive glycemic control group counseling health disparity improved innovation insight intervention effect men minority health mortality multi-component intervention new technology patient oriented psychologic smoking cessation social socioeconomics treatment as usual

项目摘要

PROJECT SUMMARY (See instructions): Among African American women with diabetes who have inadequate glycemic control (A1c>8%) who receive care in community clinics in Los Angeles County, we propose to evaluate the impact of an intervention that identifies and supports intrinsic motivation for improved diabetes control through combined in-person, phone, and SMS contact and also, for one arm of the study, a behavioral economics intervention that uses monetary incentives to reward improved glycemic control. The randomized controlled trial (RCT), a multicomponent intervention to boost intrinsic motivation for improved glycemic control will randomize patients within participating clinics to one of three groups; 1) Usual care (("Control" condition), 2) An intervention to boost intrinsic motivation to lower A1c through in-person visits, telephone calls, and tailored text messages delivered by cell phone ("IM/SMS" condition), and 3) An intervention that adds periodic monetary incentives, whose size depends on the degree of reduction in A1c, and lottery participation to boost motivation to participate in diabetes self care and reach A1c goals ("IM/SMS+lncentives" condition). We will assess the effect ofthe IM/SMS and IM/SMS+lncentives interventions on glycemic control over a 12 month period and determine whether improvements in Ale compared to the control arm are sustained for 6 additional months after the SMS and monetary incentives are discontinued. We will also assess the costs of the interventions and their effect on resource use. The primary study outcome is change in A1c. To gain insights into possible mechanisms forthe impact ofthe intervention, we will also assess the effects of the intervention on self-management behaviors, patient activation, changes in medication regimens, number of physician visits, weight, quality of life, trust in the health care system, participants' self-reported experiences with the intervention, and spillover effects ofthe intervention on blood pressure control. We hypothesize that, compared with the control group, women in the IM/SMS or the IM/SMS+incentive arms will have lower A1c levels (and will be more likely to achieve the target A1c of 7.0%), both while the interventions are in place and 6 months after the regular contact and monetary incentives are discontinued. We also hypothesize that glycemic control will be better at 12 months forthe IM/SMS+lncentive group than the IM/SMS group, but will be similar 6 months after the interventions are discontinued.

项目概述（见说明）：