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

  • Economics and Policy in Diabetes (ES Huang and AA Baig, Section Editors)
  • Published:
Current Diabetes Reports Aims and scope Submit manuscript

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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Authors and Affiliations

  1. VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, PO Box 130170, Ann Arbor, MI, USA

    Jeffrey T. Kullgren, Dina Hafez & Michele Heisler

  2. Department of Internal Medicine, University of Michigan Medical School, 3101 Taubman Center, SPC 5368, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA

    Jeffrey T. Kullgren, Dina Hafez & Michele Heisler

  3. University of Michigan Institute for Healthcare Policy and Innovation, 2800 Plymouth Road, Ann Arbor, MI, 48109, USA

    Jeffrey T. Kullgren & Michele Heisler

  4. Robert Wood Johnson Foundation Clinical Scholars Program, University of Michigan, 2800 Plymouth Road, Building 10, Room G016, Ann Arbor, MI, 48109, USA

    Dina Hafez & Allison Fedewa

  5. Department of Health Behavior and Health Education, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, USA

    Michele Heisler

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  1. Jeffrey T. Kullgren
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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.

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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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