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A Scoping Review of Behavioral Economic Interventions for Prevention and Treatment of Type 2 Diabetes Mellitus

Abstract

Purpose of Review

The purpose of this paper was to review studies of behavioral economic interventions (financial incentives, choice architecture modifications, or commitment devices) to prevent type 2 diabetes mellitus (T2DM) among at-risk patients or improve self-management among patients with T2DM.

Recent Findings

We found 15 studies that used varied study designs and outcomes to test behavioral economic interventions in clinical, workplace, or health plan settings. Of four studies that focused on prevention of T2DM, two found that financial incentives increased weight loss and completion of a fasting blood glucose test, and two choice architecture modifications had mixed effects in encouraging completion of tests to screen for T2DM. Of 11 studies that focused on improving self-management of T2DM, four of six tests of financial incentives demonstrated increased engagement in recommended care processes or improved biometric measures, and three of five tests of choice architecture modifications found improvements in self-management behaviors.

Summary

Though few studies have tested behavioral economic interventions for prevention or treatment of T2DM, those that have suggested such approaches have the potential to improve patient behaviors and such approaches should be tested more broadly.

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Acknowledgments

We are grateful for the assistance of Judy Smith of the Taubman Health Sciences Library at the University of Michigan for her assistance with developing and refining the search strategy for our scoping review. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the US government. Support was provided by the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service. Dr. Kullgren is a VA HSR&D Career Development awardee at the Ann Arbor VA. This study also received support from the National Institute of Diabetes and Digestive and Kidney Diseases (Grant Number P30DK092926 (MCDTR)).

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Correspondence to Jeffrey T. Kullgren.

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Conflict of Interest

Jeffrey T. Kullgren has received consulting fees from SeeChange Health and HealthMine and speaking honoraria from AbilTo, Inc. Dina Hafez, Michele Heisler, and Allison Fedewa declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Economics and Policy in Diabetes

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Kullgren, J.T., Hafez, D., Fedewa, A. et al. A Scoping Review of Behavioral Economic Interventions for Prevention and Treatment of Type 2 Diabetes Mellitus. Curr Diab Rep 17, 73 (2017). https://doi.org/10.1007/s11892-017-0894-z

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Keywords

  • Behavioral economics
  • Diabetes
  • Self-management
  • Prevention
  • Interventions
  • Scoping review