P-433: Bilingual, community-building, and supportive virtual peer group (VPG) model for Latinx youth with type 1 diabetes (T1D) increases diabetes technology use and improves T1D-distress
J C Wong, J Flores Garcia, M W Reid, A Torres Sanchez, N Garban, S A Lopez, C Acosta Navarro, M Visser, S S Crossen, J K RaymondAbstract
Introduction
Latinx youth with T1D and their caregivers experience multilevel systemic challenges to care, experience less optimal health outcomes and psychosocial stressors, and underutilize diabetes technology. DREAM (Device Use Reimagined through Education And Mentorship), a bilingual stakeholder-informed model including VPG and in-person events, was designed to provide support and knowledge about T1D technology.
Objectives
To assess the impact of DREAM on perceptions and use of diabetes technology, and T1D-related health outcomes.
Methods
Latinx youth with T1D (ages 13-17) and their caregivers were recruited from three diabetes centers in California. Participants were invited to T1D-focused VPG (every 4-6 weeks) and in-person events. Surveys collected demographics, perceptions of T1D technology, and T1D distress. Hemoglobin A1c [HbA1c], T1D technology use, and healthcare utilization were abstracted from the health record.
Results
To date, 82 youth-caregiver dyads enrolled, and 37 completed the study (57% Female youth; 89% Public Insurance). Most youth used T1D technology at baseline (87% CGM, 43% insulin pump). At study end, youth reported more technology use (95% CGM, p=0.25; 54% pump, p=0.13), perceived CGM as significantly more beneficial (+1.74, p=0.03) and less burdensome (-1.10, p=0.26), and also viewed pumps more favorably (benefit: +1.91, p=0.11; burden: -2.50, p=0.06). Caregivers reported significant reductions in T1D distress (Interpersonal: -0.39, p=0.03; Emotional Burden: -0.31, p=0.049; Physician-Related -0.18, p=0.09). Youth were hospitalized less frequently during the study than the previous year (0% vs. 11%, p=0.046), and showed reductions in HbA1c after 6 months (-0.47%, p=0.08).
Conclusions
DREAM successfully engaged Latinx youth with T1D and their families, increased T1D technology use, and reduced T1D distress, demonstrating the benefits of culturally-adapted, bilingual VPG models.