Feasibility Study on the Impact of Economic Incentives for Weight Loss to Improve the Management of Type 2 Diabetes Mellitus: REDEEM Feasibility Study

Economic incentives have been used to promote changes in habits such as smoking and weight loss. However, no studies have been done to determine the impact of this strategy on the management of type 2 diabetes mellitus (T2DM). Additionally, previous studies do not describe ways to determine the amount of an economic incentive to promote behavioral changes, e.g adherence to treatment, increased physical activity and adherence to a healthy diet. There are also questions regarding the frequency of incentives, the type of incentive (cash or other prizes), and the preferred payment method that this study will allow us to explore. Furthermore, we want to test whether a "team work approach" (mixed incentives) vs. an "individual approach" (individual incentives) can also play a role in introducing behavioral changes.

The goal of the study is to learn about the implementation process of three different interventions that use economic incentives to promote behavioral changes in patients with T2DM, and identify main barriers and facilitators tied to the implementation process of each intervention.

This feasibility study will provide key insights to inform a future larger study; specifically, we will

• Learn about the experience of participants with T2DM with economic incentives.
• Learn about the experience of the companion/team support partners of the participants with T2DM.
• Evaluate the patient's receptiveness to and comprehension of the educational materials used to promote behavioral changes.
• Evaluate the patient and the companion/team support partner's receptiveness towards the received economic incentive as a tool for promoting behavioral changes.
• Explore the companion/team support partner's activities that are most effective in helping with T2DM management of patients.
• Explore whether patients with T2DM are able to keep a daily record of their efforts to manage their diabetes.
• Evaluate the feasibility of packaging and implementing a future clinical trial that evaluates the impact of the use of economic incentives and teamwork in people with T2DM.

From a clinical perspective, we will evaluate the feasibility of reaching the proposed clinical goals in terms of weight loss and HbA1c levels after the intervention period.