Diabetes Mellitus Clinical Trial
Official title:
Combining Best Practices for Health Behavior Change: a Randomized Controlled Trial of Digital Health, Financial Incentives and Community Health Worker Support for Vulnerable Populations
This randomized controlled trial tests how digital health monitoring with financial incentives (DFI) and community health worker (CHW) support may affect how a person manages their diabetes. Participants will be randomized to one of three arms: 1) DFI intervention, 2) hybrid DFI/CHW intervention, or 3) usual care. Investigators hypothesize that compared to usual care and DFI alone, the hybrid intervention will lead to more glucose self-monitoring and greater improvements in glycosylated hemoglobin.
Low-income Americans struggle to stay healthy in the face of real-life challenges such as
housing insecurity or trauma. Two interventions show promise for promoting behavior change
and improving health outcomes: digital health interventions coupled with financial incentives
(DFI) and community health workers (CHWs). Yet, these interventions have limitations; DFI
interventions have low uptake and high attrition among vulnerable populations, while CHW
interventions are relatively resource intensive.
Investigators propose a 24-week randomized trial of a hybrid DFI/CHW intervention among a
population of 150 low-income patients with diabetes. Participants will be randomized to one
of three arms: 1) DFI intervention, 2) hybrid DFI/CHW intervention, 3) usual care.
Participants assigned to DFI will receive a free wireless glucometer and be eligible for a
lottery incentive if they use their glucometer. Participants assigned to the hybrid DFI/CHW
intervention will receive the same glucometer and incentives. If they exhibit low adherence
to self-monitoring or poor glucose control, they will also receive support from a CHW who
would help patients to address underlying socioeconomic barriers and cope with setbacks.
Investigators hypothesize that compared to usual care and DFI alone, the hybrid intervention
will lead to more glucose self-monitoring and greater improvements in glycosylated
hemoglobin.
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