Financial Incentives And Nurse Coaching to Enhance Diabetes Outcomes (FINANCE-DM) - Diversity Supplement

提高糖尿病治疗效果的经济激励和护士指导 (FINANCE-DM) - 多样性补充

• 批准号: 10264411
• 负责人: Leonard E. Egede
• 金额: $ 1.82万
• 依托单位: MEDICAL COLLEGE OF WISCONSIN
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-15 至 2023-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10264411
• 关键词: Address; Adult; African American; Behavior; Body Weight decreased; Cessation of life; Control Groups; Data; Diabetes Mellitus; Disease; Effectiveness; Ethnic group; Feedback; Health behavior; High Prevalence; Hispanics; Home; Incentives; Intervention; Literature; Metabolic Control; Monitor; Non-Insulin-Dependent Diabetes Mellitus; Nurses; Nursing Education; Outcome; Randomized; Randomized Controlled Trials; Research Support; Risk; Smoking; Structure; Training and Education; active control; behavioral economics; caucasian American; diabetes mellitus nursing; diabetes self-management; dietary; effective intervention; efficacy testing; ethnic minority population; financial incentive; improved; intervention effect; medication compliance; novel; post intervention; racial and ethnic; skills training; telemonitoring

Ethnic minorities (African Americans –AA and Hispanics -HA) with Type 2 diabetes (T2DM) have higher prevalence of diabetes, poorer metabolic control and greater risk for complications and death compared to White Americans; and the literature shows that effective interventions for T2DM need to have multiple components including: nurse diabetes education and skills training, home monitoring with feedback, and maintain high intensity. Recent evidence from behavioral economics research supports the use of financial incentives to improve health-related behaviors and the effectiveness of financial incentives to improve health behaviors has been demonstrated across different diseases and behaviors including smoking, weight loss, dietary behavior, medication adherence, and diabetes self-management, with the most beneficial result lasting up to 18 months post-intervention. Preliminary data from our group suggest that structured financial incentives in combination with nurse education and home telemonitoring is feasible and effective in adults with T2DM. However, there are three important unanswered questions: 1) Are financial incentives layered upon nurse education and home telemonitoring superior to nurse education and home telemonitoring alone in improving metabolic control long term? 2) Are the effects of financial incentives on metabolic control sustained once the incentives are withdrawn? and 3) Are financial incentives efficacious within and across racial/ethnic groups? To address these gaps in the literature, we propose a randomized controlled trial to test the efficacy of a Financial Incentives And Nurse Coaching to Enhance Diabetes Outcomes (FINANCE-DM) intervention comprised of: 1) nurse education, 2) home telemonitoring, and 3) structured financial incentives; compared to an active control group (nurse education and home telemonitoring alone) at 12 months. The study also will evaluate whether intervention effects are sustained 6 months after the financial incentives are withdrawn (i.e. 18 months post randomization); and whether the intervention is differentially efficacious across racial/ethnic groups.

少数民族（非裔美国人-AA和西班牙裔美国人-HA）患有2型糖尿病（T2DM）