The specific aims of this study are to test whether in a cohort of low-income minority veterans with poor diabetes mellitus (DM) control: 1. Peer counseling is an effective means of reducing HbA1c (a measure of glucose control). 2. Financial incentives are an effective means of reducing HbA1c. This is a randomized controlled pilot study. There will be 3 arms: 1) a control group of poorly controlled diabetics getting usual care; 2) peer counseling with no incentives; and 3) financial incentives without peers. Ultimately, contingent on the success of this intervention, the researchers plan to apply for funding for a large scale intervention employing both peer counseling and incentives to improve DM control in low income and minority patients who are at high risk for premature morbidity and mortality.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
160
Dyads will be given $20 per month if they have contact 4 or more times during a month.
Participants will be given $100 for reduction of HbA1c by 1 point in a 6 month period and $200 for reduction by 2 points.
Philadelphia Veterans Affairs Medical Center
Philadelphia, Pennsylvania, United States
Hemoglobin A1c
Change in HbA1c from baseline will be the primary outcome measure.
Time frame: Baseline, 6 months
Counts of the number of hypoglycemic events
All events and serious events related to hypoglycemia will be counted over the 6 month intervention period, including emergency room visits and hospitalizations.
Time frame: 6 months
Number of peer encounters
The number of peer encounters by arm will be described.
Time frame: 6 months
Experience of peer counseling
The experience of peer counseling from both poorly controlled diabetics and counselors will be described.
Time frame: 6 months
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