HCT Cash-Only INcentive to Promote Mealtime Insulin DOSE Engagement

Completed · Not applicable

Conditions studied: Type 1 Diabetes

In brief

Type 1 Diabetes (T1D) is a serious disease that happens because the body cannot control blood glucose (sugar) levels. People with T1D need insulin shots because their body does not make insulin. Insulin lowers blood sugar levels. When blood sugar levels are too high or too low it causes medical problems. Youth with T1D can really impact their own health if they follow their T1D treatment plan. However, even with the help of doctors, nurses, and family, most adolescents find it hard to follow their diabetes plan close enough to meet their A1C goal. It is very common for adolescents to forget to give an insulin bolus for meals. When insulin doses are missed, there is a greater chance for poor blood sugar control. When adolescents follow their diabetes plan closely, they have better blood sugar control and overall health. Two behavioral economic interventions will be evaluated. COIN2DOSE (Cash-Only INcentive to promote mealtime insulin DOSE Engagement) and LOAN2DOSE (Behavioral Economic concept that uses an economic loss aversion approach to promote insulin dose engagement in adolescents with Type 1 Diabetes). These programs were designed to improve blood sugar control by decreasing the number of missed mealtime boluses. For COIN2DOSE, we will offer the opportunity for youth to earn a bonus reimbursement during which they achieve at least 5 days of 3 mealtime insulin boluses. Finally, we will pay youth up for sharing their insulin use data at least two times per week with the study team during the three-month treatment phase. For LOAN2DOSE, the participants will start with a monetary "balance" and will keep it if they bolus as instructed - at least 5 days of 3 mealtime insulin boluses. If they do not do this, their balance will decrease throughout the study.

Key facts

Study ID: NCT04621890
Run by: Children's Mercy Hospital Kansas City
People needed: 39
Starts: 2022-02-14
Expected to finish: 2025-06-30
Last updated by the study team: 2025-07-25

Who can join

Age: 12 and older, up to 18. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

Aged 12-17.99 years
The youth must have been diagnosed with T1D for at least 6 months
The youth must have attended at least 2 routine T1D standard of care visits in the past 12 months
The youth must be using an insulin delivery device capable of recording, storing, and downloading insulin bolus behaviors (insulin pump or smart Bluetooth insulin pen that can be uploaded to standard clinic upload software).
The youth must have a current A1C >7.2% and/or be predicted to have a rise in A1C in of 0.3% or higher the next 90 days.
Not pregnant or planning to become pregnant by self-report.

You may not qualify if…

Participants with any type of diabetes mellitus other than T1D
Participant has any disease causing anemia or affecting red blood cell physiology (which would impact A1C)
Participant has a physical disability, which in the opinion of the investigator would interfere with individual's ability to feed themselves or use one's hands to facilitate eating
Participants with no internet access or ability to upload device(s) to data aggregation software that is accessible to study team.
For Focus Groups:
Any parent or legal guardian whose child is eligible for the study is invited to participate in a focus group discussion.

Where it is running

Children's Mercy Kansas City — Kansas City, Kansas, United States

Full record on ClinicalTrials.gov

Trial information comes from ClinicalTrials.gov and is refreshed daily. TrialsForMe does not provide medical care and does not run the studies it lists.