Evaluating REACHOUT-A Mobile App That Delivers Peer-Led Mental Health Support to Adults with Type 1 Diabetes

Introduction: Recent years have witnessed a dramatic shift toward digital health technologies for mental health care delivery. While research investigating digital interventions involving peer support for children and adolescents with type 1 diabetes (T1D) has been growing, few, if any studies, have examined peer support mental health interventions for adults with T1D. Methods: We recruited 46 adults with T1D (M age= 43.9, females=71.7%) living in rural and remote communities in British Columbia to participate in REACHOUT, a 6-month intervention utilizing a mobile app to deliver three modalities of support: one-on-one with a peer supporter, group-based text messaging, and video group sessions. Participants were invited to select their own peer supporter and encouraged to access any or all of the three modalities as frequently as desired. Assessments were conducted at baseline and six months and measured diabetes distress (and seven distress subscales), depressive symptomatology, and perceived support from family/friends, peers, and the health care team. Independent mixed-effects regression models were run to examine pre-post intervention changes. Results: Thirty-eight participants completed the intervention (attrition = 17%). At six months, reductions were observed for overall distress (p=0.007) and four subscales: powerlessness (p=0.009), management distress (p=0.001), negative social perceptions (p=0.023), and eating distress (p=0.032). For secondary outcomes, depressive symptoms decreased (p=0.009) while perceived support from family/friends (p=0.023) and peers (p<0.001) increased. Conclusions: Participation in REACHOUT was associated with improvements in diabetes distress as well as other psychosocial outcomes. By offering different modalities of support delivery over a digital platform, participants, especially those living in more geographically marginalized communities, can customize support to meet their own unique needs. Disclosure T.S.Tang: Research Support; Juvenile Diabetes Research Foundation (JDRF), Speaker's Bureau; Abbott Diabetes, Insulet Corporation. G.Klein: None. M.Görges: Research Support; Careteam Technologies, IDENTOS, Smile CDR Inc., SecureKey Technologies Inc., Thrive Health, Excelar Technologies. L.Fisher: Consultant; Abbott Diabetes, Eli Lilly and Company, Research Support; Ascensia Diabetes Care. W.H.Polonsky: Consultant; Abbott Diabetes, Boehringer Ingelheim and Eli Lilly Alliance, Eli Lilly and Company, Insulet Corporation, Intuity Medical, Inc., MannKind Corporation, Provention Bio, Inc., Sanofi-Aventis U.S., Vertex Pharmaceuticals Incorporated. D.M.Hessler: Consultant; Lilly. D.Taylor: None. Funding JDRF (2-SRA-2020-986-S-B)