INSPIRing action to prevent diabetes (INSPIRA): Rationale and description of a pilot intervention combining peer support and food voucher incentives to increase engagement in a community health worker-led diabetes prevention program

IF 1.9 3区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Contemporary clinical trials Pub Date : 2025-05-31 DOI:10.1016/j.cct.2025.107971

Michele Heisler , Grecia Quiroga , Felix Valbuena , Ken Resnicow , Shelley Stoll , Dina H. Griauzde , Timothy Hofer , Jeffrey T. Kullgren

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引用次数: 0

Abstract

Background

Engagement in Diabetes Prevention Programs (DPPs) helps prevent or delay progression to type 2 diabetes, but engagement in these is low, especially among low-income and Black or Latina/o adults. While financial incentives can increase engagement, offering these is not feasible for safety net health systems. The INSPIRA Study is thus assessing the feasibility, acceptability, and preliminary effectiveness of a program that supplements a community health worker (CHW)-led DPP with mutual peer support and healthy food vouchers as incentives for engagement.

Design

Single site pilot randomized trial.

Setting

A federally qualified health center that serves predominantly Latina/o adults.

Participants

142 adults with prediabetes and BMI ≥25 kg/m2.

Interventions

Participants are randomized to either a 6-month version of a CHW-led DPP or to the INSPIRA intervention that supplements a six-month CHW-led DPP group with being matched with a peer partner in the same DPP cohort and the opportunity to earn weekly healthy food vouchers for attending that week's DPP session. Peer partners who both engage in at least one peer support call with each other and attend that week's session each earn double the amount in food vouchers (“yoked incentives”).

Main outcome measures

Between-group differences in number of weekly sessions attended and changes in weight. Surveys and interviews will assess acceptability and feasibility. Changes in A1c, waist circumference, diet quality, and parameters for sample size calculations for a larger RCT will also be examined.

Discussion

This pilot will inform a longer-term trial to evaluate both effectiveness and implementation of INSPIRA in clinical practice.

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鼓舞人心的预防糖尿病行动（INSPIRA）：一项结合同伴支持和食品券激励措施的试点干预措施的基本原理和描述，以提高社区卫生工作者领导的糖尿病预防计划的参与度。

背景：参与糖尿病预防计划（DPPs）有助于预防或延缓2型糖尿病的进展，但参与这些计划的人很少，特别是在低收入和黑人或拉丁裔成年人中。虽然财政激励措施可以增加参与，但提供这些措施对于安全网卫生系统来说是不可行的。设计：单点随机试验。环境：联邦认证的健康中心，主要服务于拉丁裔/非拉丁裔成年人。参与者：142名糖尿病前期成人，BMI≥25 kg/m2。干预措施：参与者被随机分配到六个月版本的chw领导的DPP或INSPIRA干预，补充了六个月版本的chw领导的DPP组，与同一DPP队列中的同伴配对，并有机会获得每周健康食品券参加当周的DPP会议。同伴伙伴如果彼此至少打过一次同伴支持电话，并参加了那一周的会议，每个人都能获得双倍的食品券（“联合激励”）。主要结果测量：组间每周参加的次数和体重变化的差异。调查和访谈将评估可接受性和可行性。还将检查糖化血红蛋白、腰围、饮食质量的变化，以及更大的随机对照试验的样本量计算参数。讨论：该试验将为长期试验提供信息，以评估INSPIRA在临床实践中的有效性和实施情况。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Contemporary clinical trials 医学-药学

CiteScore

3.70

自引率

4.50%

发文量

281

审稿时长

44 days

期刊介绍： Contemporary Clinical Trials is an international peer reviewed journal that publishes manuscripts pertaining to all aspects of clinical trials, including, but not limited to, design, conduct, analysis, regulation and ethics. Manuscripts submitted should appeal to a readership drawn from disciplines including medicine, biostatistics, epidemiology, computer science, management science, behavioural science, pharmaceutical science, and bioethics. Full-length papers and short communications not exceeding 1,500 words, as well as systemic reviews of clinical trials and methodologies will be published. Perspectives/commentaries on current issues and the impact of clinical trials on the practice of medicine and health policy are also welcome.