Peer mentoring and financial incentives to improve glucose control in African Am

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Peer mentoring and financial incentives to improve glucose control in African American veterans: a randomized trial. Long JA, Jahnle EC, Richardson DM, Loewenstein G, Volpp KG. Ann Innern Med 2012 Mar 20; 156(6): 416-24 dol: 10.7326/0003-4819-156-5-201203200-00004. PRIMARY FUNDING SOURCE: National Institute on Aging Roybal Center. BACKGROUND: Compared with white persons, African Americans have a greater incidence of diabetes, decreased control, and higher rates of microvascular complications. A peer mentorship model could be a scalable approach to improving control in this population and reducing disparities in diabetic outcomes. OBJECTIVE: To determine whether peer mentors or financial incentives are superior to usual care in helping African American veterans decrease their hemolgobin A(1e) A(1c)) levels. DESIGN: A 6-month randomized, controlled trial. (Clinical Trials gov registration number: NCT01125956) SETTING: Philadelphia Veterans Affairs Medical Center. PATIENTS: African American veterans aged 50 to 70 years with persistently poor diabetes control. INTERVENTION: 118 patients were randomly assigned to 1 of 3 groups: usual care, a peer mentoring group, and financial incentives group. Usual care patients were notified of their starting HbA(1c) level and recommended goals for HbA(1c). Those in the peer mentoring group were assigned a mentor who formerly had poor glycemic control but now had good control (HbA(1c) level lessthanorequalto 7.5%). The mentor was asked to talk with the patient at least once per week. Per mentors were matched by race, sex, and age. Patients in the financial incentive group could earn $100 by decreasing their HbA(1c) level by 1% and $200 by it by 2% or to an HbA(lc) level of 6.5%. MEASUREMENTS: Change in HbA(1c) level at 6 months. RESULTS: Mentors and mentees talked the most in the first month (mean calls, 4; range, 0 to 30), but calls decreased to a mean of 2 calls (range, 0 to 10) by the sixth month. Levels of HbA(1c) decreased from 9.9% to 9.8% in the control mentor group, from 9.8% to 8.7% in the peer mentor group, and from 9.5% to 9.1% in the financial incentive group. Mean change in HbA(1c) level from baseline to 6 months relative to control was -1.07% (95%CI, -1.84% to -0.31%) in the peer group and -0.45% (CI, -1.23% to 0.32%) in the financial incentive group. LIMITATION: The study included only veterans and lasted only 6 months. CONCLUSION: Peer mentorship improved glucose control in a cohort of African American veterans with diabetes. What was the research question of this study? Was this basic or applied research? What kind of research design was this? Who is the target population? How were participants assigned? What was (were) the independent variable(s)? What was (were) the dependent variables? As an administrator, how would you use the results of the study for program development?

Explanation / Answer

1) To study the effect of three different methods to control diabetes on Africo americans and find out which is effective.

2) This is applied research.when we assign a group to control group and non control group this is assigned the population.

3) African american veterans aged 50 - 70, who have poor contriol over their diabetes

4) The participants are assigned into three groups.

Control group

Peer mentor group

Financial group

5. Independent variable

there are two variables, diabtes reduced percentage, treatment

treatment is indepent variable (type of treatment)

6.  diabtes reduced percentage is dependent

7. We use go for option of implementing different programs in different areas, as financial in rich group and one which shows good results is control group in most of the places

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