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:
  Chronic Disease Diabetes Mellitus Humans Life Style Motivation Weight Loss
• 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
• Collection(s):
  Preventing Chronic Disease
• Main Document Checksum:
  urn:sha-512:666c3f56c549f1c72952a0e69d508e4edaffe883c8f14c556f8175066af2018965b72a554150133accbbb791bf7ec8d4dec87f977e7d87f900601d975c82776d
• Download URL:
  https://stacks.cdc.gov/view/cdc/122141/cdc_122141_DS1.pdf
• File Type:
  [PDF - 839.48 KB ]