Internet-based incentives increase blood glucose testing with a non-adherent, diverse sample of teens with type 1 diabetes mellitus: a randomized controlled Trial

Non-adherence with self-monitoring blood glucose (SMBG) among teenagers with type 1 diabetes can be a problem. The purpose of this study was to investigate the feasibility, acceptability, and preliminary efficacy of using Internet-based incentives to improve adherence with SMBG in non-adherent teenagers. Participants were randomly assigned to contingent (CS; N = 23), where they had to meet web camera-verified SMBG goals to earn incentives, or non-contingent (NS) groups (N = 18), where they earned incentives independent of adherence. Brief motivational interviewing (MI) was given prior to the intervention. Attrition was 15 % in the CS group. Participants and parents endorsed the intervention on all intervention dimensions. Daily SMBG increased after one MI session, and further increased when incentives were added, but significantly more for so for older participants. SMBG declined slowly over time, but only returned to baseline levels for younger NS participants. Internet-based incentive interventions are feasible, acceptable, and show promise for improving adherence with SMBG.