Way to Health, Healthy Measures
Condition: Diabetes; Hypertension
MeSH terms: Hypertension
Study type: Interventional

Summary: 
      The primary objective of the study is to assess the effect of financial incentives on the use
      of home health monitoring devices among high-risk patients. In addition, there are three
      secondary objectives: (1) obtain preliminary evidence regarding whether the monetary value of
      incentives has a differential effect on the use of home health monitoring devices; (2)
      identify potential barriers that prohibit regular use of home-based health devices using
      qualitative data; and (3) assess the usability of a newly developed web portal and its
      feasibility for future randomized clinical trials aimed at changing health-related behaviors.
    

Detailed description: 
      While home monitoring of health appears to be a promising frontier in health care, patient
      adherence to, and utilization of, such devices is often low, limiting the potential benefit
      of this technology. Financial incentives have been effective in increasing rates of weight
      loss, smoking cessation, and medication adherence and therefore may increase rates of
      utilization of home-based health monitoring devices. Therefore, in this study, we test the
      effects of lottery-based incentives on use of home-based health monitoring technologies.

      The aim of this pilot randomized controlled trial is to evaluate whether financial incentives
      delivered through a novel online platform can effectively increase use of home-based health
      monitoring technology among overweight adults with diabetes. Our primary objective is to
      assess the effects of financial incentives on the use of home health monitoring devices among
      high-risk patients. In addition, we have three secondary objectives: (1) obtain preliminary
      evidence regarding whether the monetary value of incentives has a differential effect on the
      use of home health monitoring devices; (2) identify potential barriers that prohibit regular
      use of home-based health devices using qualitative data; and (3) assess the usability of a
      newly developed web portal and its feasibility for future randomized clinical trials aimed at
      changing health-related behaviors.

      Participants will be randomized into each of the following three arms: (1) Financial
      Incentive Group I; (2) Financial Incentive Group II; (3) Control Group. Incentives for
      Financial Groups I and II are designed in a way that builds on the success of previous
      incentive-based interventions for weight loss. Both lotteries are tailored to provide
      infrequent large payoffs and frequent small payoffs since lottery players are motivated by
      both the possibility of a large reward and the opportunity for regular, immediate rewards.
      The average expected payoff value of Financial Incentive Group I will be $2.80 per day and
      $1.40 per day in Financial Incentive Group II. The interventions will run for 91 days
      starting at randomization. At the end of the intervention time period, each participant will
      be notified that the intervention period has ended and the 90-day follow-up period has begun.
      During the follow-up period each participant will continue to upload measurements daily, but
      will not receive incentives or reminders.
    

Intervention name(s): Financial Incentive Group I; Financial Incentive Group II
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Lottery with 1 in 100 odds of $100 and 18 in 100 odds of $10. The intervention involves the daily lottery itself along with feedback via email or text messaging to participants about the lottery results and whether or not they were included based on device adherence.; Lottery with 1 in 100 odds of $50 and 18 in 100 odds of $5. The intervention involves the daily lottery itself along with feedback via email or text messaging to participants about the lottery results and whether or not they were included based on device adherence.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Health Services Research