Glucose management for rewards: A randomized trial to improve glucose monitoring and associated self‐management behaviors in adolescents with type 1 diabetes

Background This randomized, controlled trial evaluated a monetary‐based reinforcement intervention for increasing self‐monitoring of blood glucose (SMBG) among youth with poorly controlled type 1 diabetes. Methods After a 2‐week baseline, 60 participants were randomized to enhanced usual care (EUC) or Reinforcers. The Reinforcers group earned monetary rewards for SMBG and associated behaviors such as uploading glucose meters. Reinforcers were withdrawn at 24 weeks. A follow‐up evaluation occurred at 36 weeks. Results Participants in the reinforcers group increased the proportion of days they completed ≥4 SMBG from 14.6% at baseline to 64.4%, 47.5%, and 37.8% at 6, 12, and 24 weeks, respectively. In contrast, EUC participants declined from 22.7% at baseline to 17.5%, 10.5%, and 11.1% (Ps