Study protocol for a mobile app that delivers peer-led mental health support to adults with type 1 diabetes: The...

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.