NHWIP: New Hampshire Medicaid Wellness Incentive Program

Sponsor

Dartmouth-Hitchcock Medical Center (Other)

Overall Status

Completed

CT.gov ID

NCT02515981

Collaborator

State of New Hampshire Bureau of Behavioral Health (Other)

2,800

Enrollment

Locations

Arms

Duration (Months)

233.3

Patients Per Site

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

The New Hampshire Medicaid Wellness Incentive Program (WIP) will address both the health disparity and increased costs by providing incentivized health promotion programs to overweight or obese and/or tobacco-smoking Medicaid beneficiaries receiving services at New Hampshire's 10 regional Community Mental Health Centers (CMHCs).

Condition or Disease	Intervention/Treatment	Phase
Tobacco Dependence Obesity Mental Illness	Behavioral: NH Medicaid Incentives Program	N/A

Detailed Description

In the New Hampshire Medicaid Wellness Incentive Program, multiple program options will fall into two categories: (1) Supported Fitness and Weight Management and (2) Supported Smoking Cessation. Eligible participants are able to participate in 1 or both of the programs. The program options for Supported Fitness and Weight Management are: 1. Fitness Club Membership for 12 months, 2. Fitness Club Membership plus weekly meetings with a Health Mentor for 12 months (In SHAPE), 3. Weight Watchers Membership for 12 months, 4. In SHAPE plus Weight Watchers for 12 months. The options for Supported Smoking Cessation are: 1. Prescriber meeting to discuss smoking cessation treatment options, 2. Prescriber meeting plus NH State Tobacco Helpline, 3. Prescriber meeting plus Telephone-based Cognitive Behavioral Therapy for Smoking Cessation. Vouchers for memberships to community fitness centers and formal weight loss programs will be provided, as well as incentives for participation and positive outcomes. An equipoise stratified randomization design will be used to preserve the research benefits of randomization while maintaining the highly valued opportunity for consumer choice. Research assessments will be conducted at baseline, 3 months, 6 months, 9 months, and 12 months.

Study Design

Study Type:

Interventional

Anticipated Enrollment :

2800 participants

Allocation:

Randomized

Intervention Model:

Factorial Assignment

Masking:

None (Open Label)

Primary Purpose:

Health Services Research

Official Title:

New Hampshire Medicaid Wellness Incentive Program

Study Start Date :

May 1, 2012

Actual Primary Completion Date :

Apr 1, 2016

Actual Study Completion Date :

Dec 1, 2018

Arms and Interventions

Arm	Intervention/Treatment
Experimental: Incentives Participants randomly assigned to the incentive arm, will receive cash incentives for engaging in healthy lifestyle behaviors.	Behavioral: NH Medicaid Incentives Program
Experimental: No Incentives Participants randomly assigned to the no incentives arm, will not receive cash incentives for engaging in healthy lifestyle behaviors.	Behavioral: NH Medicaid Incentives Program

Arm

Intervention/Treatment

Experimental: Incentives

Participants randomly assigned to the incentive arm, will receive cash incentives for engaging in healthy lifestyle behaviors.

Behavioral: NH Medicaid Incentives Program

Experimental: No Incentives

Participants randomly assigned to the no incentives arm, will not receive cash incentives for engaging in healthy lifestyle behaviors.

Behavioral: NH Medicaid Incentives Program

Outcome Measures

Primary Outcome Measures

Change in Weight [Baseline, 3 months, 6 months, 9 months, 12 months and 1 year post program follow up]
Weight obtained using a scale at each assessment.
Change in the 6 minute walk test [Baseline, 3 months, 6 monhts, 9 months, 12 months, and 1 year post program completion follow up]
Each participant walks as many ft as possible at a brisk pace. The amount of feet covered in 6 minutes is documented.
Change in Days of Abstinence-Timeline follow back interview for tobacco smokers [Baseline, 3 months, 6 months, 9 months, 12 months, and 1 year post program completion follow up]
A timeline follow back interview is completed for the smoking cessation intervention to identify days of abstinence within the assessment period as well as amount of cigarettes smoked.
Change in Carbon Monoxide Level [Baseline, 3 months, 6 months, 9 months, 12 months, and 1 year post program completion follow up]
At each assessment and during the incentive quit cycles, carbon monoxide level is measured to confirm smoking abstinence or not.

Eligibility Criteria

Criteria

Ages Eligible for Study:

18 Years and Older

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Inclusion Criteria for smoking intervention and weight management intervention:

Participants must be Medicaid recipients receiving mental health treatment at one of the participating study sites in New Hampshire.
18 years or older

Additional Inclusion Criteria for smoking intervention only:

*Smoking 5 or more cigarettes a day or a carbon monoxide level of 5 or higher at screening.

Additional Inclusion Criteria for weight management only:

*Body Mass Index of 30 or higher or 25 or higher and sedentary lifestyle.

Exclusion Criteria for both interventions:

Diagnosis of dementia or terminal illness (expected to result in death in 1 year or less)
Nursing home
Inability to speak or understand English

Additional exclusion Criteria for weight management only:

Previous participation in the In SHAPE program
Active eating disorder diagnosis
Pregnancy

Additional exclusion Criteria for smoking intervention only:

*Active alcohol or drug dependence with use in the past 30 days

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	New Hampshire Hospital	Concord	New Hampshire	United States	03301
2	Riverbend Community Mental Health Center	Concord	New Hampshire	United States	03301
3	Center for Life Management	Derry	New Hampshire	United States	03038
4	Community Partners	Dover	New Hampshire	United States	03820
5	Mondadnock Family Services	Keene	New Hampshire	United States	03431
6	West Central Behavioral Health Care	Lebanon And Claremont	New Hampshire	United States
7	Northern Human Services	Littleton And Conway	New Hampshire	United States
8	The Mental Health Center of Greater Manchester	Manchester	New Hampshire	United States	03103
9	Greater Nashua Mental Health Center at Community Council	Nashua	New Hampshire	United States	03060
10	Harbor Homes	Nashua	New Hampshire	United States
11	Genesis Behavioral Heatlh	Plymouth And Laconia	New Hampshire	United States
12	Seacoast Mental Health Center	Portsmouth	New Hampshire	United States	03801

Sponsors and Collaborators

Dartmouth-Hitchcock Medical Center
State of New Hampshire Bureau of Behavioral Health

Investigators

Study Director: Sarah I Pratt, PhD, Dartmouth-Hitchcock Medical Center
Principal Investigator: Kelley Capuchino, State of New Hampshire, Department of Health and Human Services