Use of Financial Incentives to Promote Adolescent Type 1 Diabetes Self-Management:A Pilot Randomized Controlled Trial

Objective: To evaluate whether financial incentives lead to improvement in self-management behaviors and glycemia in adolescents with type 1 diabetes (T1D). Research Design and Methods: Adolescents (12–18-year-olds) with T1D selected incentivized self-management behavior and clinical outcome goals in a 3-treatment (gain frame, loss frame, no incentives) crossover randomized controlled trial. Participants could earn up to $180 in each 12-week incentive treatment arm. Results: Compared to a mean 41% behavioral goal attainment within the non-financial incentives arm, mean behavioral goal attainment under gain and loss frames was 50% (p<0.01) and 45% (p<0.01), respectively. Mean time in range (TIR) in gain frame and loss frame arms was higher 43% (p<0.01) and 42% (p<0.01), respectively, compared to when not receiving financial incentives (38%). There was no difference in A1C among the 3 arms. Conclusions: Financial incentives can improve diabetes self-management behaviors and TIR in adolescents with T1D in the short term.