Promoting Health Equity in Type 1 Diabetes through Peer Mentorship—Findings from the All for ONE Randomized Controlled Trial
Diabetes(2018)
Abstract
There are tremendous health disparities in type 1 diabetes (T1D) according to socioeconomic status (SES). Moreover, college students with T1D, regardless of SES, face serious health risks as they transition to independent living. The All for ONE (Outreach, Networks, and Education) program was piloted as a novel intervention where college students with T1D mentored publicly insured teenagers with T1D (n=88, treatment and control). Outcome measures for college students and teens included HbA1c, diabetes knowledge, and the validated College Resiliency and Children’s Hope scales. The intervention included daily text reminders for blood glucose monitoring, weekly text exchanges, social events infused with T1D education, clinic visits with mentors/mentees and a weekly training course for the mentors. Paired t-tests were used to compare changes from baseline to study conclusion among the college students, and ANCOVA was used to compare changes between intervention and control teens adjusting for baseline. Adjusting for baseline, the mean change in HbA1c was +0.09 (9% increase) in the intervention group, compared to +0.28 (31% increase) in the control group (p=0.61). College students had a mean -0.22 (27% decrease) in HbA1c (p=0.38). Treatment group teens were significantly more likely to attend clinic visits during the pilot than control group teens (p = 0.02*). Exit surveys with mentors, mentees and parents expounded on the program’s success with 98% reporting they wanted to participate again if given the opportunity. The main value of the program was listed by mentors as increased networks with other college students with T1D, by mentees as being able to talk to their mentor about the disease, and by parents as giving their child a confidant who understood T1D. This pioneering program concurrently targets two vulnerable populations, establishing critical feasibility for a model that uses routine events of texting, clinic visits, and college curriculum. Disclosure A.F. Walker: None. M.J. Haller: None. M.J. Gurka: None. H.L. Morris: None. C. Anez-Zabala: None. B.S. Bruggeman: None. D. Guiffre: None. H. Rohrs: None. M.A. Atkinson: Other Relationship; Self; Patent Issued. D. Schatz: None.
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Key words
peer mentorship—findings,diabetes,health equity
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