Peer Mentors and Financial Incentives to Improve Diabetes Control

Glucose control rates remain suboptimal in type 2 diabetic patients, particularly among black Americans. In this randomized trial, conducted at a Philadelphia Veterans Affairs medical center, 118 black patients with glycosylated hemoglobin (HbA_1c) levels >8% received usual care, once-weekly peer mentoring, or financial incentives. The peer mentors, who were matched by race and age to participants, were patients who had progressed from poor to good glycemic control. Each mentor received an hour-long training session on motivational interviewing techniques. People in the financial-incentive group were offered US$100 if their HbA_1c levels decreased by 1% and $200 for a 2% decrease.

At baseline, >60% of participants were receiving insulin, and m…