Behavioural Economics-based Incentives in Adults With Type 2 Diabetes (BET2)

Not Applicable

Completed

Interventions: Behavioral: Financial incentives
Behavioral: Financial and social incentives

Brief Summary: A randomised control trial of adults with newly diagnosed type 2 diabetes to assess the effectiveness of behavioural economics-based incentives on healthy lifestyle behaviour, using a pragmatic trial approach.

Detailed Description: This is a randomised control trial of adults aged 30-70 with newly diagnosed type 2 diabetes within a year in Hong Kong to compare the effectiveness of financial incentives and combined financial and social incentives against a control group receiving standard care. We plan to recruit 261 participants and follow them for 9-months (6-month intervention period and a 3-month post-intervention follow-up period) to assess glycemic control and other health indicators. Participants will be randomly assigned to one of three groups (in ratio 1:1:1): arm A (financial incentives in addition to standard care), arm B (financial and social incentives in addition to standard care), and arm C (control arm receiving standard care). Financial incentives will be framed around loss aversion and the endowment effect. Social incentives will include peer competition, and social support. Financial and social incentives are to encourage increased physical activity and participants will use a pedometer to track activity. Participants are followed for an additional 3-months after the cessation of incentives to assess the sustainability of lifestyle changes.

This trial adopts a pragmatic study design based on the PRECIS-2 tool and RE-AIM frameworks.

Recruitment & Eligibility

Inclusion Criteria

Exclusion Criteria

Planned surgery in the next 6 months
Biological impairment or health condition affecting the ability to walk, such as blindness, physical immobility, and paralysis
Pregnant or breastfeeding
On insulin for diabetes control

Arm && Interventions

Group	Intervention	Description
Financial intervention	Financial incentives	Participants will receive the usual standard care (same as control group), loss-framed financial incentives, and weekly feedback on performance for 6 months.
Financial and social intervention	Financial and social incentives	Participants will receive the usual standard care (same as control group), loss-framed financial incentives, social incentives and weekly feedback on performance for 6 months.

Primary Outcome Measures

Name	Time	Method
Glycaemic control	Baseline, 6-months, and 9-months	The change in HbA1c levels

Secondary Outcome Measures

Name	Time	Method
Glycaemic control	6-months and 9-months	Proportion of participants requiring an initiation of medication in diabetes management
Glycaemic control (addition of medications)	6-months and 9-months	Proportion of participants requiring an addition of medication(s) or increase in drug dosage in diabetes management
Level of physical activity	Baseline, 6-months and 9-months	Assessed by the structured and validated International Physical Activity Questionnaires (IPAQ); Both walking performance (Outcome 6) and the IPAQ score can be used for assessing the level of physical activity of participants
Walking performance	Weekly	Assessed by proportion of participants meeting their daily step counts every week
Changes in lipid profile	Baseline, 6-months, and 9-months	Changes in Total, HDL- and LDL-cholesterol, and Triglycerides
Change in blood pressure	Baseline, 6-months, and 9-months	Assessed by the change in systolic and diastolic blood pressure
Body weight control	Baseline, 6-months, and 9-months	Change in body weight in kilograms; weight and height will be combined to report BMI in kg/m\^2
Diabetes control	Baseline, 6-months, and 9-months	Proportion of participants with good/excellent diabetes control (HbA1c threshold ≤ 7% \& ≤ 6.5%)

Locations (1): School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong
🇭🇰
Hong Kong, Hong Kong