Indigenous Youth and Young Adults With Diabetes Peer Mentorship Program

The goal of this study is to learn if an Indigenous led peer-mentor program can provide Indigenous youth and young adults with the support needed to improve their distress and improve their diabetes control. Also, we will learn about Indigenous youth and young adults experience with diabetes.

• Can a peer-mentoring program reduce diabetes distress among Indigenous youth and young adults with diabetes?
• What is it like for Indigenous youth and young adults to be live with diabetes?
• Can a peer-mentoring program reduce global distress and improve resilience among Indigenous youth and young adults with diabetes?
• Can a peer-mentoring program lead to changes in lifestyle (diet, physical activity, substance use) and diabetes related clinical outcomes among Indigenous youth and young adults with diabetes.

Researchers will compare distress, resilience, lifestyles, and diabetes related clinical outcomes before participating in the peer-mentoring program and at 6 and 12 months into the program. Additionally, participants will be asked to share their journey with diabetes through photos throughout the program

Participants will:

• Be paired with peer-mentors who also have diabetes and they will share their journey with diabetes
• Participate in activities (grocery tours, walking clubs, land-based activities, cooking classes) held by peer-mentors
• Complete questionnaires on distress, resilience, and lifestyle every 6 months.
• Participate in Photovoice workshops to share their stories through pictures.

Study Overview

• Status: Not yet recruiting
• Conditions: Diabetes Mellitus; Distress, Emotional
• Intervention / Treatment: Behavioral: Peer mentoring

Detailed Description

The rates of diabetes are increasing among youth and young adults. This rise is particularly steep among Indigenous peoples who also face high rates of depression and emotional distress due to the ongoing legacy of colonization resulting in systemic racism and intergenerational trauma. Diabetes care includes many aspects of self-care (checking sugar, taking medication, following exercise and diet advice), which is negatively impacted by emotional distress. The emotional distress specific to living with diabetes, known as diabetes distress (DD), is due to feeling overwhelmed by the demands of self-care, fears of complications, and guilt or shame over lifestyle choices. DD is known to be related to decreased wellbeing and poor diabetes control. The rate of DD has not been studied among Indigenous youth, nor have interventions aimed at reducing it to improve diabetes management.

Peer support has been shown to help empower youth and young adults by normalizing their experiences and providing a safe space to express themselves. In the Eeyou Istchee Cree community in Quebec, Jonathan Linton, an Indigenous young adult with diabetes, developed a program for youth with diabetes on management and self-care for diabetes that incorporates traditional elements. As he helps participants be more active and eat healthier, he supports them in their journey with diabetes and creates a safe space for them to voice concerns, easing their distress.

This research study will build on the initiative developed by Mr. Linton to create a community of peer-mentors to provide Indigenous youth and young adults with the support needed to improve their distress and improve their diabetes control. To evaluate the program, a combination of questionnaires to assess changes in DD and other emotional factors, measures of diabetes outcomes (glycemia, blood pressure, weight), and Photovoice, a research tool that allows participants to use images to explain their experience with diabetes, will be used.

• Study Type: Interventional
• Enrollment (Estimated): 40
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Sahar Fazeli; Phone Number: (438) 860-6079; Email: sahar.fazeli@mcgill.ca

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

Age 10-29 years old Clinical diagnosis of diabetes or gestational diabetes

Exclusion Criteria:

Age > 29 years old Not at risk of diabetes

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Peer-mentoring; Peer-mentoring which will include land based activities, nutrition and physical activity teaching.	Behavioral: Peer mentoring; Indigenous young adult peer mentors who will develop and deliver the program based on needs and wants of our participants. The program will be built on their experience and ideas. They will be empowered to guide the program in the direction they see best for their communities.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Diabetes Distress	Problem Areas in Diabetes (PAID) scale from 0-100, higher score means more distress	0,6 and 12 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Global Distress	0 item Kessler Psychological Distress scale (K10), from 10-50, the higher the score the greater the global distress.	0,6 and 12 months
Resilience-Children	Child and Youth Resilience Measure-Revised (CYRM-R), for 10-18 years old. Scale from 17-85, the higher the score the greater the resilience	0,6 and 12 months
Resilience-Adults	Adult Resilience Measure-Revised (ARM-R), for those > 18 years. Scale from 17-85, the higher the score the greater the resilience	0,6 and 12 months
Body Mass Index	Weight (kg)/[Height(m)]^2	0 and 12 months
urine albumin to creatine ratio	mg/mmol	0 and 12 months
low density lipoprotein	mmol/L	0 and 12 months
Blood pressure	mmHg	0 and 12 months
Hemoglobin A1c	Percent HbA1c	0 and 12 months
Lifestyle questionnaire	Developed by Cree Board of health to assess diet and physical activity. Not a scale	0 and 12 months

Collaborators and Investigators

• Sponsor: McGill University Health Centre/Research Institute of the McGill University Health Centre
• Investigators: Principal Investigator: Romina Pace, MUHC-RI

Study record dates

Study Major Dates

• Study Start (Estimated): September 1, 2024
• Primary Completion (Estimated): April 1, 2028
• Study Completion (Estimated): September 1, 2028

Study Registration Dates

• First Submitted: May 16, 2024
• First Submitted That Met QC Criteria: May 23, 2024
• First Posted (Actual): May 28, 2024

Study Record Updates

• Last Update Posted (Actual): May 29, 2024
• Last Update Submitted That Met QC Criteria: May 24, 2024
• Last Verified: May 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Glucose Metabolism Disorders; Metabolic Diseases; Endocrine System Diseases; Diabetes Mellitus
• Other Study ID Numbers: 2025-10728

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No