Tricia S Tang 1, Gerri Klein 2, Lawrence Fisher 3, Jennifer C Davis 4, Linda Li 5, Matthias Görges 6, Jane Yardley 7, William H Polonsky 8, Danielle Hessler 9, Deanne Taylor 10, Akshay Jain 11, Joel Singer 12, Logan McLean 13, Tara Klassen 14
Abstract
Peer support and digital technology are two promising strategies to address psychosocial needs in type 1 diabetes (T1D). REACHOUT is a mobile app designed to deliver peer-led mental health support to adults with T1D living in British Columbia. This report describes the methodological design and recruitment for the REACHOUT randomized wait-list controlled (WLC) trial. The primary goal was to examine whether participation in the REACHOUT intervention was associated with reductions in diabetes distress compared to a WLC condition (eligible to receive the intervention after six months). Two-hundred twenty-five adults with T1D (age 19-81 years) completed a baseline survey;113 participants were randomized to the six-month REACHOUT intervention and 112 to the WLC condition. REACHOUT offers support that is choice-based, customizable, and just-in-time. Support delivery modalities include one-on-one support from a participant-selected peer supporter, group-based text support using a 24/7 chat room and topic-specific discussion boards, and small group virtual face-to-face support. The primary outcome of this trial was diabetes distress; secondary outcomes included depressive symptoms, perceived social support, diabetes-specific quality of life, and resilience; exploratory outcomes were A1c, time in range, health resource utilization, and cost-effectiveness. The goal of this research is to examine whether a mobile app that delivers peer-led and personalized mental health support can improve diabetes distress and other mental health outcomes among adults living with T1D.
