New Hampshire Medicaid Wellness Incentive Program

Dartmouth-Hitchcock Medical Center2,800 enrolled

Overview

The New Hampshire Medicaid Wellness Incentive Program (WIP) will address both the health disparity and increased costs by providing incentivized health promotion programs to overweight or obese and/or tobacco-smoking Medicaid beneficiaries receiving services at New Hampshire's 10 regional Community Mental Health Centers (CMHCs).

In the New Hampshire Medicaid Wellness Incentive Program, multiple program options will fall into two categories: (1) Supported Fitness and Weight Management and (2) Supported Smoking Cessation. Eligible participants are able to participate in 1 or both of the programs. The program options for Supported Fitness and Weight Management are: 1. Fitness Club Membership for 12 months, 2. Fitness Club Membership plus weekly meetings with a Health Mentor for 12 months (In SHAPE), 3. Weight Watchers Membership for 12 months, 4. In SHAPE plus Weight Watchers for 12 months. The options for Supported Smoking Cessation are: 1. Prescriber meeting to discuss smoking cessation treatment options, 2. Prescriber meeting plus NH State Tobacco Helpline, 3. Prescriber meeting plus Telephone-based Cognitive Behavioral Therapy for Smoking Cessation. Vouchers for memberships to community fitness centers and formal weight loss programs will be provided, as well as incentives for participation and positive outcomes. An equipoise stratified randomization design will be used to preserve the research benefits of randomization while maintaining the highly valued opportunity for consumer choice. Research assessments will be conducted at baseline, 3 months, 6 months, 9 months, and 12 months.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Enrollment

2,800

Conditions

Tobacco Dependence Obesity Mental Illness

Interventions

NH Medicaid Incentives ProgramBEHAVIORAL

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria for smoking intervention and weight management intervention: * Participants must be Medicaid recipients receiving mental health treatment at one of the participating study sites in New Hampshire. * 18 years or older Additional Inclusion Criteria for smoking intervention only: \*Smoking 5 or more cigarettes a day or a carbon monoxide level of 5 or higher at screening. Additional Inclusion Criteria for weight management only: \*Body Mass Index of 30 or higher or 25 or higher and sedentary lifestyle. Exclusion Criteria for both interventions: * Diagnosis of dementia or terminal illness (expected to result in death in 1 year or less) * Nursing home * Inability to speak or understand English Additional exclusion Criteria for weight management only: * Previous participation in the In SHAPE program * Active eating disorder diagnosis * Pregnancy Additional exclusion Criteria for smoking intervention only: \*Active alcohol or drug dependence with use in the past 30 days

Locations (12)

New Hampshire Hospital

Concord, New Hampshire, United States

Riverbend Community Mental Health Center

Concord, New Hampshire, United States

Center for Life Management

Derry, New Hampshire, United States

Outcomes

Primary Outcomes

Change in Weight

Weight obtained using a scale at each assessment.

Time frame: Baseline, 3 months, 6 months, 9 months, 12 months and 1 year post program follow up

Change in the 6 minute walk test

Each participant walks as many ft as possible at a brisk pace. The amount of feet covered in 6 minutes is documented.

Time frame: Baseline, 3 months, 6 monhts, 9 months, 12 months, and 1 year post program completion follow up

Change in Days of Abstinence-Timeline follow back interview for tobacco smokers

A timeline follow back interview is completed for the smoking cessation intervention to identify days of abstinence within the assessment period as well as amount of cigarettes smoked.

Time frame: Baseline, 3 months, 6 months, 9 months, 12 months, and 1 year post program completion follow up

Change in Carbon Monoxide Level

At each assessment and during the incentive quit cycles, carbon monoxide level is measured to confirm smoking abstinence or not.

Time frame: Baseline, 3 months, 6 months, 9 months, 12 months, and 1 year post program completion follow up

Data from ClinicalTrials.gov

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