Paying Adolescents to Improve type 1 Diabetes by testing Blood Glucose (PAID4BG)

INTERVENTION: Reward schedule for those randomised to the reward group (2/3 chance, target 20 participants): 90‐day monetary reward according to the following schedule: $0.20 per test up to a maximum of 8 tests per day, plus $0.20 bonus for 4 tests per day, and $0.20 bonus for obtaining at least 2 glucose test results between 4.5‐8mmol/L per day. Maximum $2 per day, so maximum $180 over 90 days study intervention duration or minimum $20 over 90 days will be provided upon final 12 week meter review and HbA1c result. Monetary rewards will only be provided every 4 weeks for the first 90 days, upon presentation of BG meter for checking or upon email receipt of the direct electronic meter download results. Additional $20 will provided after 1 year when HbA1c is done and BG meter is presented for review or download at this time point. CONDITION: Type 1 diabetes PRIMARY OUTCOME: HbA1c (laboratory test) Mean daily Self Monitoring of Blood Glucose (SMBG) frequency (assessed by meter download for the past 1 month) SECONDARY OUTCOME: Composite outcome of Change in diabetes self management efficacy and satisfaction by Problem Areas in Diabetes (PAID) and SF‐12 questionnaires Non‐Attendance in scheduled clinic appointments Number of hospital admissions according to clinical records (electronic health information available in clinic) Number of severe hypoglycaemia episodes (requiring assistance to recognise and/or treat) as reported by the patient and any clinical records INCLUSION CRITERIA: Inclusion criteria *Type 1 diabetes – at least 12 months duration *HbA1c > 75 mmol/mol in at least 2 consecutive tests *Age 16‐25 years *Access to a computer to upload glucose meters and transmit proof of testing by email, or willing to come to clinic to provide this *living in Counties Manukau Health area *Mobile phone ownership to receive and send texts *Able to perform SMBG and adjust own insulin *SMBG frequency 2 or less per day (average over past 1 month)