Effectiveness of Incentives for Improving Diabetes-Related Health Indicators in Chronic Disease Lifestyle Modification Programs: a Systematic Review and Meta-Analysis

Details

• Journal Article:
  Preventing Chronic Disease (PCD)
• Personal Author:
  Hulbert, LaShonda R. ; Michael, Shannon L. ; Charter-Harris, Jasmine ; Atkins, Charisma ; Skeete, Renée A. ; Cannon, Michael J.
• Description:
  Introduction ; We examined the effectiveness of providing incentives to participants in lifestyle modification programs to improve diabetes-related health indicators: body weight, body mass index (BMI), blood pressure, cholesterol, and hemoglobin A1C (HbA1C). We also examined the potential effect of 4 different incentive domains (ie, type, monetary value, attainment certainty, and schedule) on those indicators. ; Methods ; We searched Medline, Embase, PsycINFO, and Cochrane Library to identify relevant studies published from January 2008 through August 2021. We used a random-effects model to pool study results and examine between-study heterogeneity by using the I2 statistic and the Cochran Q test. We also conducted moderator analyses by using a mixed-effects model to examine differences between subgroups of incentive domains (eg, incentive type cash vs other types). ; Results ; Our search yielded 10,965 articles, of which 19 randomized controlled trials met our selection criteria. The random-effects model revealed that, relative to the control group, the incentive group had significant reductions in weight (−1.85kg; 95% CI, −2.40 to −1.29; P < .001), BMI (−0.47kg/m2; 95% CI, −0.71 to −0.22; P < .001), and both systolic blood pressure (−2.59 mm HG; 95% CI, −4.98 to −0.20; P = .03) and diastolic blood pressure (−2.62 mm Hg; 95% CI, −4.61 to −0.64; P = .01). A reduction in cholesterol level was noted but was not significant (−2.81 mg/dL; 95% CI, −8.89 to −3.28; P = .37). One study found a significant reduction in hemoglobin A1c (−0.17%; 95% CI, −0.30% to −0.05%; P < .05). The moderator analyses showed that the incentive effect did not vary significantly between the subgroups of the incentive domains, except on weight loss for the attainment certainty domain, suggesting that a variety of incentive subgroups could be equally useful. ; Conclusion ; Providing incentives in lifestyle modification programs is a promising strategy to decrease weight, BMI, and blood pressure.
• Subjects:
  • Humans
  • Motivation
  • Diabetes Mellitus
  • Weight Loss
  • Life Style
  • Chronic Disease
• Source:
  Prev Chronic Dis. 2022; 19
• DOI:
  http://dx.doi.org/10.5888/pcd19.220151
• ISSN:
  1545-1151
• Pubmed ID:
  36302383
• Pubmed Central ID:
  PMC9616129
• Document Type:
  Journal Article
• Genre:
  Systematic Review
• Volume:
  19
• Download URL:
  https://stacks.cdc.gov/view/cdc/122141/cdc_122141_DS1.pdf
• File Type:
  [PDF - 839.48 KB]
• Collection(s):
  Preventing Chronic Disease
• Main Document Checksum:
  urn:sha-512:666c3f56c549f1c72952a0e69d508e4edaffe883c8f14c556f8175066af2018965b72a554150133accbbb791bf7ec8d4dec87f977e7d87f900601d975c82776d