Evidence map›Paper›PMID 31515735›Full record

Trial reportJournal of general internal medicine2020

Impact of a Patient-Centered Behavioral Economics Intervention on Hypertension Control in a Highly Disadvantaged Population: a Randomized Trial.

Martin F Shapiro, Suzanne B Shu, Noah J Goldstein, Ronald G Victor, Craig R Fox, Chi-Hong Tseng, Sitaram Vangala, Braden K Mogler, Stewart B Reed, Estivali Villa and 1 more

2 registry-linked trialsOpen access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of general internal medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
1.1field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01402453 nacompletednot on this map

Monetary Incentives and Intrinsic Motivation to Sustain Hypertension Control Pilot Study

TypeinterventionalSponsorUniversity of California, Los AngelesRan2011 to 2013Enrolled207ConditionsHypertensionArmsMonetary Incentives, Intrinsic Motivation
NCT06588127 naactive not recruitingnot on this mapstarted 2024, after this paper: background citation

Health Behavior Nudge Strategies for Chronic Disease Patients: the Study of Hypertension and Type 2 Diabetes

TypeinterventionalSponsorLin HanRan2024 to 2025Enrolled133ConditionsEconomics, Behavioral, Hypertension, Type 2 Diabetes Mellitus (T2DM), Self-management BehaviorArmsnudge
3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
  5. Article
  6. Study design of BETTER-BP: Behavioral economics trial to enhance regulation of blood pressure.International journal of cardiology. Cardiovascular risk and prevention · 2022
    Article
  7. Article
  8. Article
  9. Review
  10. Article
  11. An Intervention Study for Impact Assessment of Health Education by Empowered Community Health Workers in Improving Treatment and Diet Adherence in Hypertension.Indian journal of community medicine : official publication of Indian Association of Preventive & Social Medicine
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 1 country.

Martin F ShapiroDepartment of Medicine, University of California, Los Angeles, Los Angeles, CA, USA. mfs2004@med.cornell.edu.
Suzanne B ShuDepartment of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
Noah J GoldsteinDepartment of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
Ronald G VictorDepartment of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
Craig R FoxDepartment of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
Chi-Hong TsengDepartment of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
Sitaram VangalaDepartment of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
Braden K MoglerDepartment of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
Stewart B ReedDepartment of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
Estivali VillaDepartment of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
José J EscarceDepartment of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
University of California, Los Angeles · USAnderson University - South Carolina · USCedars-Sinai Medical Center · USCornell University · US

Funding

UCLA Clinical Translational Science InstituteUL1TR001881 · NCATS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI ARLEEN F. BROWN, ARASH NAEIM · 2016 to 2026
$118.1M
Monetary incentives and intrinsic motivation to sustain hypertension controlRC4AG039077 · NIA · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI SHAPIRO, MARTIN F. · 2010 to 2010
$1.2M
NIA NIH HHS RC4 AG039077
6 · The paper itself

Abstract

backgroundUncontrolled hypertension contributes to disparities in cardiovascular outcomes. Patient intervention strategies informed by behavioral economics and social psychology could improve blood pressure (BP) control in disadvantaged minority populations.

objectiveTo assess the impact on BP control of an intervention combining short-term financial incentives with promotion of intrinsic motivation among highly disadvantaged patients.

designRandomized controlled trial.

participantsTwo hundred seven adults (98% African American or Latino) aged 18 or older with uncontrolled hypertension attending Federally Qualified Health Centers.

interventionSix-month intervention, combining financial incentives for measuring home BP, recording medication use, BP improvement, and achieving target BP values with counseling linking hypertension control efforts to participants' personal reasons to stay healthy. MAIN MEASURES: Primary outcomes: percentage achieving systolic BP (SBP) < 140 mmHg, percentage achieving diastolic BP (DBP) < 90 mmHg, and changes in SBP and DBP, all after 6 months. Priority secondary outcomes were SBP < 140 mmHg, DBP < 90 mmHg, and BP change at 12 months, 6 months after the intervention ended. KEY

resultsAfter 6 months, rates of achieving target BP values for intervention and control subjects respectively was 57.1% vs. 40.2% for SBP < 140 mmHg (adjusted odds ratio (AOR) 2.53 (1.13-5.70)), 79.8% vs 70.1% for DBP < 90 mmHg (AOR 2.50 (0.84-7.44)), and 53.6% vs 40.2% for achieving both targets (AOR 2.04 (0.92-4.52)). However, at 12 months, the groups did not differ significantly in these 3 measures: 39.5% vs 35.0% for SBP (AOR 1.20 (0.51-2.83)), 68.4% vs 75.0% for DBP (AOR 0.70 (0.24-2.09)), and 35.5% vs 33.8% for both (AOR 1.03 (0.44-2.42)). Change in absolute SBP and DBP did not differ significantly between the groups at 6 or 12 months. Exploratory post hoc analysis revealed intervention benefit only occurred among individuals whose providers intensified their regimens, but not among those with intensification but no intervention.

conclusionsThe intervention achieved short-term improvement in SBP control in a highly disadvantaged population. Despite attempts to enhance intrinsic motivation, the effect was not sustained after incentives were withdrawn. Future research should evaluate combined patient/provider strategies to enhance such interventions and sustain their benefit.

trial registrationNCT01402453; http://clinicaltrials.gov/show/NCT01402453.

Indexed as

Economics, BehavioralHypertensionAdolescentAdultAntihypertensive AgentsBlood PressureHumansPatient-Centered CareVulnerable PopulationsAntihypertensive Agentsfinancial incentives, behavioral economicshealthcare disparitieshypertensionpatient behavior

Identifiers

PMID31515735
PMCPMC6958561
OpenAlexW2972764906

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.