Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
Diabetes Res Clin Pract. 2024 Sep;215:111798. doi: 10.1016/j.diabres.2024.111798. Epub 2024 Aug 7.
This study aimed to quantify preferences for the characteristics of a financial incentives program that would motivate adolescent engagement in type 1 diabetes (T1D) self-care.
We performed a discrete choice experiment with 12-18 year-olds with T1D from two pediatric hospital endocrinology clinics (n = 317). We identified key attributes of incentives: (1) monthly value of the reward, (2) payment structure, and (3) difficulty of incentivized behaviors. In twelve choice questions, adolescents chose the incentive option from a pair of profiles that was more likely to motivate them to increase adherence to recommended self-care. Options presented were tailored to adolescents' T1D technology use and perceived difficulty of completing each behavior. We analyzed data using a conditional logit model.
The value of the reward accounted for 60.8% of preferences. Adolescents were willing to accept lower value rewards when incentive payments used positive vs. negative reinforcement (-$10.88 (95% CI: -$12.60, -9.24)) and preferred higher incentives for performing hard vs. easier behaviors (+$14.92 (95% CI: +$12.66, +$17.28)).
Stated preferences can inform intervention design. Future research will evaluate the external validity of the discrete choice experiment-informed intervention design by assessing adolescent health and behavioral outcomes in a randomized controlled trial.
本研究旨在量化激励计划特征的偏好，以激励青少年参与 1 型糖尿病（T1D）自我护理。
我们对来自两家儿科医院内分泌科的 12-18 岁 T1D 青少年（n=317）进行了离散选择实验。我们确定了激励的关键属性：（1）奖励的月价值，（2）支付结构，和（3）激励行为的难度。在十二个选择题中，青少年从一对激励方案中选择更有可能激励他们增加对推荐自我护理的依从性的激励方案。呈现的选项针对青少年的 T1D 技术使用情况和完成每项行为的感知难度进行了定制。我们使用条件逻辑回归模型分析数据。
奖励价值占偏好的 60.8%。当激励支付使用正强化而不是负强化时，青少年愿意接受较低的奖励价值（-10.88 美元[95%CI：-12.60，-9.24]），并且更愿意为完成困难行为而不是容易行为获得更高的激励（+14.92 美元[95%CI：+12.66，+17.28]）。
陈述偏好可以为干预设计提供信息。未来的研究将通过在随机对照试验中评估青少年健康和行为结果来评估离散选择实验设计的外部有效性。
