Peer Mentor Program for Type 1 Diabetes

(TEAM Trial)

Recruiting at 1 trial location

Overseen By Andrea MacIntosh, MSc

Age: < 18

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Recruiting

Sponsor: University of Manitoba

Disqualifiers: Recent T1D diagnosis, Cancer, Eating disorder, others

No Placebo Group

Trial Summary

What is the purpose of this trial?

The proposed study aims to improve the psychosocial health of adolescents living with type 1 diabetes (T1D). The study will generate knowledge and support knowledge mobilization about the effectiveness of a novel model of care for psychosocial health and self-management for adolescents living with type 1 diabetes (T1D). The novel model of care is the recruitment and training if young adult mentors to deliver a behavioural intervention that empowers adolescents with T1D to increase daily physical activity. The study will also advance the development and implementation of this peer mentoring model to improve the psychosocial health of adolescents with T1D.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It focuses on improving psychosocial health and physical activity for adolescents with type 1 diabetes.

What data supports the effectiveness of the 12-week TEAM peer mentor program for Type 1 Diabetes?

Research on peer support for diabetes shows that it can help improve blood sugar control and increase hope for the future. For example, a study with college students and teens with Type 1 Diabetes found that those in a peer mentoring program had better attendance at clinic visits and felt more hopeful about their future. ^{1 2 3 4 5}

Is the Peer Mentor Program for Type 1 Diabetes safe for participants?

The available research on peer mentoring programs for diabetes, including remote and technology-mediated approaches, does not report any safety concerns for participants. These programs have been implemented in various settings and have shown to be feasible and beneficial without indicating any harm to participants. ^{5 6 7 8 9}

How does the 12-week TEAM peer mentor program for Type 1 Diabetes differ from other treatments?

The 12-week TEAM peer mentor program is unique because it uses peer mentorship to support individuals with Type 1 Diabetes, focusing on social support and education rather than medication. This approach helps improve hope for the future and clinic visit attendance, which are not typically addressed by standard medical treatments. ^{2 5 7 8 10}

Research Team

Jonathan McGavock

Principal Investigator

University of Manitoba / the Children's Hospital Research Institute of Manitoba

Eligibility Criteria

This trial is for adolescents with type 1 diabetes who want to boost their daily physical activity and currently use a continuous glucose monitor. There's no mention of specific exclusions, so it seems open to those meeting the inclusion criteria.

Inclusion Criteria

I want to increase my daily physical activity.

I currently use a device to monitor my blood sugar levels continuously.

Trial Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

A 12-week peer-led behavioural intervention to increase physical activity, guided by self-determination theory, with 3 weekly contacts between participants and peer mentors.

12 weeks

3 weekly contacts (mix of in-person, virtual, and texting)

Follow-up

Participants are monitored for safety and effectiveness after treatment, with assessments at week 12 and week 24.

12 weeks

Assessments at week 12 and week 24

Extension

Adolescents in the wait-list control arm will be offered the 12-week intervention following the 24-week follow-up time point.

12 weeks

Treatment Details

Interventions

• 12-week TEAM peer mentor program (Behavioral Intervention)

Trial Overview The study tests a new care model where trained young adult mentors help teens with type 1 diabetes increase their physical activity over a 12-week program, aiming to improve both psychosocial health and self-management of T1D.

Participant Groups

Group I: 12-week TEAM peer mentor program Experimental Treatment 1 Intervention

A 12-week peer-led behavioural intervention that supports increased physical activity. It will consist of 3 weekly contacts between participants and peer mentors that will be a mix of in-person, virtual, and texting. The intervention components and communication between adolescents and peer mentors with T1D will be guided by SDT, and designed to overcome the key psychosocial barriers to PA. The peer mentors that complete the training will deliver a 12-week intervention to increase behavioural skills that foster autonomy for goal setting and overcoming barriers to PA.

Group II: 12-week waitlist control Active Control 1 Intervention

A 12-week waitlist control group that receives usual care, including standard educational resources developed by the Canadian Society of Exercise Physiology for adopting and sustaining daily PA. Adolescents randomized to the control arm will be offered the 12 week intervention following the 24 week follow-up time point.

Who Is Running the Clinical Trial?

University of Manitoba

Lead Sponsor

Trials

628

Recruited

209,000+

Juvenile Diabetes Research Foundation

Collaborator

Trials

237

Recruited

142,000+

Canadian Institutes of Health Research (CIHR)

Collaborator

Trials

1,417

Recruited

26,550,000+

Findings from Research

In a study involving 1,299 participants with type 2 diabetes, group peer support over 8-12 months led to a small but significant reduction in systolic blood pressure, particularly for those who attended at least one face-to-face session.

Despite the positive impact on blood pressure, there were no significant changes in HbA1c levels or other metabolic and psychological outcomes, suggesting that while peer support may help with blood pressure, its overall effectiveness on diabetes management needs further investigation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Impact of community based peer support in type 2 diabetes: a cluster randomised controlled trial of individual and/or group approaches. Simmons, D., Prevost, AT., Bunn, C., et al.[2022]

A pilot study involving college students with insulin-dependent diabetes showed that participation in a peer support group significantly improved their management of diabetes, as indicated by a drop in average hemoglobin A1c levels from 8.16 to 6.10 after 10 weeks (p < .001).

The results suggest that peer support groups can be an effective strategy for helping young adults with diabetes gain better metabolic control during a critical time when they are learning to manage their illness independently.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A pilot study of support and education groups for college students with insulin-dependent diabetes mellitus. Shalom, R.[2022]

A two-year peer support intervention for patients with type 2 diabetes, involving 395 participants across 20 practices, did not show significant improvements in key health measures like HbA1c, blood pressure, or cholesterol levels compared to a control group.

While there was a slight trend towards better control of blood pressure in the intervention group, the overall results indicate that peer support may not be effective for all patients with type 2 diabetes, suggesting limited benefits for widespread implementation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Peer support for patients with type 2 diabetes: cluster randomised controlled trial. Smith, SM., Paul, G., Kelly, A., et al.[2022]

Peer support significantly reduces HbA1c levels in patients with type 2 diabetes, with an average decrease of -0.57, based on a review of 13 randomized controlled trials.

Programs that provide moderate to high frequency of peer support contact are particularly effective, especially for patients with higher baseline HbA1c levels (≥ 8.5%), while low-frequency programs do not show significant benefits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of peer support for improving glycaemic control in patients with type 2 diabetes: a meta-analysis of randomized controlled trials. Qi, L., Liu, Q., Qi, X., et al.[2022]

The All for ONE mentoring program, which paired college students with teenagers who have type 1 diabetes, showed feasibility as an intervention to promote health equity, with 22 mentors and 42 teens participating over 9 months.

While the program did not significantly lower HbA1c levels in the treatment group compared to controls, it did improve the teens' hope for the future and increased their attendance at clinic visits, suggesting positive psychosocial impacts.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Addressing health disparities in type 1 diabetes through peer mentorship. Walker, AF., Haller, MJ., Gurka, MJ., et al.[2022]

A systematic review of 12 studies on technology-mediated peer support for children with type 1 diabetes found that while these interventions show potential, they did not significantly improve psychosocial outcomes like quality of life or stress management.

Some mixed results were noted regarding HbA1c levels, with 28.5% of studies reporting a reduced incidence of hypoglycemia, indicating that while peer support may help in some areas, more robust research is needed to confirm its effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Systematic review of technology-mediated peer support interventions in paediatric type 1 diabetes care. Titoria, R., Fung, A., Tang, TS., et al.[2023]

In a real-world evaluation of a remote diabetes intervention involving 974 patients, 71% enrolled and 90% of those participated in coaching, demonstrating high engagement in the program.

Participants who completed the program showed a significant reduction in hemoglobin A1c levels by 1.71%, indicating improved diabetes management through remote peer mentoring.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Real-world insights from launching remote peer-to-peer mentoring in a safety net healthcare delivery setting. Lyles, CR., Sarkar, U., Patel, U., et al.[2022]

A study involving 54 adolescents and 46 young adults with type 1 diabetes showed strong interest in a peer mentoring program, indicating a desire for support in managing their condition.

Participants identified various social barriers to diabetes management, such as inflexible schedules and embarrassment about blood glucose monitoring, highlighting the need for tailored support and education in peer mentoring.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Patient perspectives on peer mentoring: type 1 diabetes management in adolescents and young adults. Lu, Y., Pyatak, EA., Peters, AL., et al.[2022]

An internet-based mentoring program for adults with type 1 diabetes did not significantly improve glycemic control (HbA1c levels) after 12 weeks compared to a control group.

Despite the lack of improvement in HbA1c, the mentored group showed a higher frequency of blood glucose monitoring and website logins, suggesting that increased engagement may have potential clinical benefits in managing diabetes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A randomized controlled trial of an internet-based mentoring program for type 1 diabetes patients with inadequate glycemic control. Suh, S., Jean, C., Koo, M., et al.[2021]

The Peer-Mentor Support Scale (PMSS) is a reliable and valid tool developed to measure the specific support provided by peer mentors to parents and youths with type 1 diabetes, consisting of 17 items with a high reliability score (Cronbach's alpha of .85).

The PMSS is distinct from general social support, as it measures a unique aspect of support, and it effectively captures the contributions of peer mentorship, explaining 59.3% of the variance in peer-mentor support.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Development and Psychometric Testing of the Peer-Mentor Support Scale for Parents of Children With Type 1 Diabetes and for Youths With Type 1 Diabetes. Sullivan-Bolyai, S., Bova, C., Johnson, K.[2021]

References

1. United States pubmed.ncbi.nlm.nih.gov

Impact of community based peer support in type 2 diabetes: a cluster randomised controlled trial of individual and/or group approaches. [2022]

2. United States pubmed.ncbi.nlm.nih.gov

A pilot study of support and education groups for college students with insulin-dependent diabetes mellitus. [2022]

3. England pubmed.ncbi.nlm.nih.gov

Peer support for patients with type 2 diabetes: cluster randomised controlled trial. [2022]

4. England pubmed.ncbi.nlm.nih.gov

Effectiveness of peer support for improving glycaemic control in patients with type 2 diabetes: a meta-analysis of randomized controlled trials. [2022]

5. Denmark pubmed.ncbi.nlm.nih.gov

Addressing health disparities in type 1 diabetes through peer mentorship. [2022]

6. England pubmed.ncbi.nlm.nih.gov

Systematic review of technology-mediated peer support interventions in paediatric type 1 diabetes care. [2023]

7. England pubmed.ncbi.nlm.nih.gov

Real-world insights from launching remote peer-to-peer mentoring in a safety net healthcare delivery setting. [2022]

8. United States pubmed.ncbi.nlm.nih.gov

Patient perspectives on peer mentoring: type 1 diabetes management in adolescents and young adults. [2022]

9. Korea (South) pubmed.ncbi.nlm.nih.gov

A randomized controlled trial of an internet-based mentoring program for type 1 diabetes patients with inadequate glycemic control. [2021]

10. United States pubmed.ncbi.nlm.nih.gov

Development and Psychometric Testing of the Peer-Mentor Support Scale for Parents of Children With Type 1 Diabetes and for Youths With Type 1 Diabetes. [2021]