Academic Journal
Financial incentives and health coaching to improve glycemic outcomes among young adults with type 1 diabetes: A factorial randomized trial (SweetGoals).
| Τίτλος: | Financial incentives and health coaching to improve glycemic outcomes among young adults with type 1 diabetes: A factorial randomized trial (SweetGoals). |
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| Συγγραφείς: | Stanger C; Geisel School of Medicine at Dartmouth, Hanover, NH, USA. Electronic address: catherine.stanger@dartmouth.edu., Nahum-Shani I; Department of Psychiatry and Institute For Social Research, University of Michigan, Ann Arbor, MI, USA., Kowatsch T; Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland; School of Medicine, University of St. Gallen, St. Gallen, Switzerland; Centre for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zürich, Zürich, Switzerland., Lim-Liberty F; Dartmouth Health, Lebanon, NH, USA. |
| Πηγή: | Diabetes research and clinical practice [Diabetes Res Clin Pract] 2026 Sep; Vol. 239, pp. 113495. Date of Electronic Publication: 2026 Aug 11. |
| Τύπος έκδοσης: | Journal Article; Randomized Controlled Trial |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Elsevier Scientific Publishers Country of Publication: Ireland NLM ID: 8508335 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1872-8227 (Electronic) Linking ISSN: 01688227 NLM ISO Abbreviation: Diabetes Res Clin Pract Subsets: MEDLINE |
| Imprint Name(s): | Publication: 1993- : Limerick : Elsevier Scientific Publishers Original Publication: Amsterdam : Elsevier Science Publishers B.V., c1985- |
| Ιατρικοί όροι (MeSH): | Adherence Interventions*/economics , Adherence Interventions*/methods , Diabetes Mellitus, Type 1*/blood , Diabetes Mellitus, Type 1*/therapy , Diabetes Mellitus, Type 1*/psychology , Glycemic Control*/methods , Glycemic Control*/economics , Mentoring*/methods , Motivation*, Blood Glucose/analysis ; Glycated Hemoglobin/analysis ; Adolescent ; Adult ; Female ; Humans ; Male ; Young Adult |
| Περίληψη: | Aim: This study aimed to improve glycemic control among young adults with type 1 diabetes (T1D), an at-risk and understudied population. Method: N = 300 young adults with T1D recruited nationally were randomized to the factorial combination of (1) financial incentives targeting glucose checking and mealtime behaviors and (2) web health coaching focused on increasing motivation and goal setting for self-management behaviors. All received a smartphone app that accessed device data and provided weekly goal feedback. The intervention lasted 6 months. HbA1c (A1c) was assessed at baseline, +6 months, and +12 months. The mean number of glucose checking and mealtime goals met per week during the intervention were tested as mediators of intervention effects on A1c at 12 months. Results: A1c was significantly reduced from baseline to +12 months across all participants. Indirect effects of both incentives and coaching on A1c reductions were significant and partially mediated by mealtime but not glucose checking goal achievement. There was no synergistic (interaction) effect of incentives and coaching. Conclusion: Incentives and coaching both improved critical mealtime behavior but through different strategies. These results suggest that either intervention would be suitable for future testing and dissemination, and that lower cost of incentives may favor their prioritization. (Copyright © 2026 The Authors. Published by Elsevier B.V. All rights reserved.) |
| Competing Interests: | Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: CS, IN-S, and FL-L declare that they have no commercial or other associations that might pose a conflict of interest. TK is affiliated with the Centre for Digital Health Interventions (CDHI), and CDHI is funded in part by CSS, a Swiss health insurer, MavieNext, an Austrian healthcare provider, and the Swiss investor MTIP. TK was a co-founder of Pathmate Technologies, a university spin-off company that creates and delivers digital clinical pathways. However, TK has no shares since 2023 and never held a formal role with Pathmate Technologies. Moreover, neither CSS, Pathmate Technologies, MavieNext nor MTIP were involved in any way in this manuscript. |
| Contributed Indexing: | Keywords: Digital intervention; Health coaching; Incentives; Multiphase optimization strategy; Type 1 diabetes; Young adults |
| Substance Nomenclature: | 0 (Blood Glucose) 0 (Glycated Hemoglobin) 0 (hemoglobin A1c protein, human) |
| Entry Date(s): | Date Created: 20260811 Date Completed: 20260829 Latest Revision: 20260909 |
| Update Code: | 20260910 |
| DOI: | 10.1016/j.diabres.2026.113495 |
| PMID: | 42580596 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1872-8227 |
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| DOI: | 10.1016/j.diabres.2026.113495 |