Abstract 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.
Lai et al. (Mon,) studied this question.