التفاصيل البيبلوغرافية
| العنوان: |
143-OR: Financial Incentives to Promote Adolescent Adherence to Type 1 Diabetes Self-Care: A Discrete Choice Experiment. |
| المؤلفون: |
WRIGHT, DAVENE1 (AUTHOR), CHALMERS, KRISTEN1 (AUTHOR), LEBLANC, JESSICA L.1 (AUTHOR), YI-FRAZIER, JOYCE1 (AUTHOR), SHAH, SEEMA K.1 (AUTHOR), GARVEY, KATHARINE1 (AUTHOR), SENTURIA, KIRSTEN1 (AUTHOR), PIHOKER, CATHERINE1 (AUTHOR), MALIK, FAISAL1 (AUTHOR) |
| المصدر: |
Diabetes. 2021 Supplement 1, Vol. 70, pN.PAG-N.PAG. 1p. |
| مستخلص: |
Purpose: Adolescents with type 1 diabetes (T1D) often struggle with diabetes self-care tasks and achieving optimal glycemic control. Financial incentive (FI) programs may improve T1D self-care and health outcomes. We aimed to quantify adolescent preferences for the structure of FI. Methods: We performed a discrete choice experiment with 12-18 year-olds with T1D from two pediatric hospital endocrinology clinics in Seattle (n = 185) and Boston (n = 141). We used a literature review and focus groups to identify key attributes of FI: (1) monthly value of the reward, (2) payment structure (positive vs. negative reinforcement), and (3) difficulty of behaviors being incentivized. Using these three attributes, we generated a balanced set of profiles representing hypothetical FI using a fractional factorial design. In twelve choice questions, adolescents were shown a pair of profiles and chose the FI option more likely to motivate them to increase adherence to recommended self-care. The options presented were tailored to adolescents' modes of insulin administration and glucose monitoring and to adolescents' individual rating of the difficulty of completing each behavior. We used a multinomial logit choice model to analyze data. Results: The value of the reward was the primary driver of preferences, accounting for 50% of preferences. Adolescents significantly preferred FI with a positive vs. negative reinforcement payment structure ($5.17 (95% CI: $4.11, $6.25)) and preferred higher FI for performing hard vs. easier behaviors ($6.95 (95% CI: $4.57, $8.33)). Preferences were associated with respondent age and HbA1c (p<0.05). Conclusions: Adolescent stated preferences should inform the design of a T1D FI intervention, which can then be tested in randomized controlled trials to determine the impact of FI on T1D self-care adherence and health outcomes. Latent class analyses can identify subgroups with differential preferences and will explore subgroup characteristics. Disclosure: D. Wright: None. K. Chalmers: None. J. L. Leblanc: None. J. Yi-frazier: None. S. K. Shah: None. K. Garvey: None. K. Senturia: None. C. Pihoker: None. F. Malik: None. Funding: American Diabetes Association (1-18-ICTS-100 to D.W.) [ABSTRACT FROM AUTHOR] |
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