Effectiveness of behavioural economics‐based financial incentives and social feedback on glycaemic control and physical activity in adults with newly diagnosed type 2 diabetes: A randomised control trial

AIMS: To assess the effectiveness of behavioural economics-based financial incentive and social comparison feedback in adults with newly diagnosed type 2 diabetes. MATERIALS AND METHODS: We conducted a pragmatic randomised control trial with 6-month intervention and 3-month post-intervention follow-up. Participants were randomised to three groups: financial incentive (FI), financial incentive and social comparison feedback (FS), and control. Intervention groups received loss-framed financial incentives to meet personalised weekly step-count targets, with the FS group additionally receiving peer encouragement. We performed intention-to-treat analysis with multiple imputation and generalised estimating equations (GEE). RESULTS: Among 99 adults newly diagnosed with type 2 diabetes, mean HbA1c at baseline in the control, FI, and FS groups were as follows: 52.5 (NSGP: 7%) (SD: 5.4), 52.9 (7%) (4.1), and 54.5 (7.1%) (4.9) mmol/mol. There were no significant decreases in HbA1c, weight, cholesterol or triglycerides in the incentive groups versus control at 6 or 9 months. There were significant increases in step count and physical activity at 6 months compared to control (FI: +1283 steps/day, p < 0.001; FS: +1545 steps/day, p < 0.001; FS group +774 MET-minutes/week, p < 0.001). CONCLUSIONS: Financial incentive and social comparison feedback improved physical activity in people newly diagnosed with type 2 diabetes but were insufficient to achieve a significant improvement in glycaemic control.