Tech-Ex: A Peer Mentorship Program to Increase Equitable use of Continuous Glucose Monitoring Systems

点击翻译按钮获取中文摘要

Youth with type 1 diabetes (T1D) must follow a complex treatment regimen to approximate normal glycemic levels and avoid acute and long-term health complications. Continuous glucose monitoring (CGM) systems can improve glycemic control. However, Black and Hispanic youth with T1D have worse glycemic control than White youth and are less likely to use CGM. Disparities in the use of CGM may be one cause of disparities in diabetes health outcomes. Thus, reducing disparities in the use of CGM may be promising approach to reducing health disparities in youth with T1D. The objective of the current proposal is to refine and pilot-test Technology Experts for Equity (Tech-Ex), a technology-enhanced intervention to increase use of CGM among Black and Hispanic youth with T1D. In Tech-Ex, families will work with other families who have experience using CGM (Technology Experts) and also have access to technology supports through the Nemours App. In the Technology Expert components, youth and their caregivers will work with a mentor family to overcome common barriers to CGM use. The Technology Supports will include access to culturally-tailored educational materials, a digital journal to facilitate patient-provider communication around issues with CGM, and SDOH screening and intervention. During the first year of this proposal, we will work with patient, caregiver, and healthcare provider stakeholders to refine the technology coaching program and technology supports, develop plans to deliver the interventions, refine the measurement strategy, and recruit and train mentor families and a care manager. After incorporating stakeholder input, we will test Tech-Ex in a pilot randomized controlled trial. Families will be recruited during or after regularly scheduled clinic visits and randomized (1:1) to Tech-Ex or a 6-month waitlist control. Primary outcomes will be intervention acceptability and feasibility, perceived barriers and facilitators to using CGM, use of CGM, and glycemic control (i.e., HbA1c, time in range). Findings from the current study will inform future research aimed at testing the efficacy of the intervention in a larger, multisite randomized controlled trial.