A Pilot Study Examining a Reinforcement Approach to Improve Diabetes Management

NCT ID: NCT01829555

Last Updated: 2014-11-10

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

10 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-02-28

Study Completion Date

2014-08-31

Brief Summary

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Glucose control is necessary to avoid the immediate and long-term adverse effects associated with type 1 diabetes, and frequent self-monitoring of blood glucose is the first important step to achieving glucose control. Data suggest that large proportions of adolescents and young adults fail to adhere to standard guidelines of self-monitored of blood glucose testing and have hemoglobin A1c levels \>7.5%. A finite period of poor metabolic control can lead to increased risk of medical complications over an individual's lifespan, necessitating novel interventions to improve self-monitored blood glucose testing and metabolic control in emerging adults with type 1 diabetes. The investigators treatment approach, which provides direct tangible reinforcement for objective evidence of behavior change, is efficacious in decreasing substance use, reducing weight, and improving medication adherence.

The purpose of this project is to develop and pilot test an intervention based on behavioral economic principles for improving self-monitored blood glucose testing in young persons with type 1 diabetes. In this pilot study, patients will text in, via cell phones, each time they test, and a return text will inform them of reinforcer vouchers earned. The investigators will collect data on self-monitored blood glucose testing frequency and A1c levels preceding treatment initiation and throughout a 6 month treatment period. If promising, a randomized trial will lead to larger scale evaluations of reinforcement interventions alone, or in combination with multimodal treatment approaches, and it may be applied to other clinical issues such as adherence to continuous glucose monitoring. Importantly, this intervention can be administered remotely and in an automated fashion, allowing for widespread adoption if efficacious.

Detailed Description

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Conditions

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Type 1 Diabetes

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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contingency management

The intervention will provide escalating financial reinforcement for self-monitored blood glucose testing.

Group Type EXPERIMENTAL

contingency management

Intervention Type BEHAVIORAL

Participants will receive a voucher for each self-monitored blood glucose test completed during the target testing window, and a bonus amount for each day that 4 tests fall within the testing windows and are separated by more than 2 hours.

Interventions

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contingency management

Participants will receive a voucher for each self-monitored blood glucose test completed during the target testing window, and a bonus amount for each day that 4 tests fall within the testing windows and are separated by more than 2 hours.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* age 15-21 years old
* diagnosis of type 1 diabetes (T1D) \>12 months via ADA guidelines (Silverstein et al., 2005)
* average A1c \>7.5% and \<11% during the year before study entry, and most recent A1c \>7.5% but \<11%
* SMBG user with clinical recommendations to test \>4 times/day
* past month SMBG \<4 times/ day on average
* English speaking and able to read at \>5th grade level

Exclusion Criteria

* have a major psychiatric or neurocognitive disorder that would inhibit participation
* have a major visual impairment
* meet DSM-IV criteria for pathological gambling
* have a significant other medical condition that impacts diabetes management
* plan to switch insulin delivery mode (injection to pump or vice versa) in the next 12 months, or have recently switched
* are pregnant or trying to become pregnant
* are participating in another clinical trial
Minimum Eligible Age

15 Years

Maximum Eligible Age

21 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Yale University

OTHER

Sponsor Role collaborator

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

NIH

Sponsor Role collaborator

UConn Health

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Nancy M Petry, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

UConn Health

William Tamborlane, M.D.

Role: PRINCIPAL_INVESTIGATOR

Yale University

Locations

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Pediatric Endocrinology, Yale University

New Haven, Connecticut, United States

Site Status

Countries

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United States

Other Identifiers

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1DP3DK097705

Identifier Type: NIH

Identifier Source: secondary_id

View Link

13-043-2

Identifier Type: -

Identifier Source: org_study_id