Community-engaged development and testing of virtual peer groups to increase technology use among Latinx adolescents...

Latinx adolescents with type 1 diabetes (T1D) have lower diabetes technology use and less optimal health outcomes compared to non-marginalized populations. In keeping with the tenants of social cognitive theory, adolescents with T1D who participate in virtual peer groups (VPGs) experience improved outcomes and technology use, but VPGs have not been developed or tested specifically in a Latinx cohort. Our previous focus groups with Latinx adolescents and caregivers revealed an urgent need for community-building, support, and culturally relevant information on multiple T1D topics, including diabetes technology. Through a community-engaged research process we developed a VPG intervention - Device use Reimagined through Education And Mentorship (DREAM) - for Latinx adolescents with T1D and their caregivers, and designed a pragmatic trial to assess the impact of this intervention. VPG content was created for both age groups and in two languages through an iterative approach with input from a multi-site community advisory council. VPG sessions covered six topics within T1D self-care, and were delivered to participants over 6-12 months. VPG facilitator recruitment prioritized linguistic and cultural congruence with participants as well as personal or professional experience with T1D. Clinical trial design was heavily influenced by stakeholder input which prioritized opportunities for community-building outside of the clinical environment. The resulting clinical trial will yield important information about how to engage a historically underrepresented group in clinical research, and build essential knowledge about the utility of VPG interventions to narrow existing disparities in T1D care.