Examining a Continuous Glucose Monitoring Plus Online Peer Support Community Intervention to Support Hispanic Adults With Type 2 Diabetes: Protocol for a Mixed Methods Feasibility Study

Ashley H Ng, Deborah A Greenwood, Eli Iacob, Nancy A Allen, Mila Ferrer, Bruno Rodriguez, Michelle L Litchman, Ashley H Ng, Deborah A Greenwood, Eli Iacob, Nancy A Allen, Mila Ferrer, Bruno Rodriguez, Michelle L Litchman

Abstract

Background: Type 2 diabetes is twice as likely to affect Hispanic people than their White counterparts. Technology and social support may be an important part of behavior change. In this study, we address gaps in diabetes care for Hispanic Spanish-speaking people with diabetes through an online peer support community (OPSC) pilot intervention using Hispanic Spanish-speaking peer facilitators with diabetes to enhance the use of continuous glucose monitoring (CGM) for diabetes management.

Objective: This study aims to address gaps in diabetes care for Hispanic Spanish-speaking people with diabetes through an OPSC pilot intervention using Hispanic Spanish-speaking peer facilitators with diabetes to enhance the use of CGM for diabetes management.

Methods: A mixed-methods, pre-post test design will be used in this feasibility study. A total of 50 Hispanic participants with type 2 diabetes willing to wear a continuous glucose monitor for 13 weeks will be recruited. Hispanic Spanish-speaking peer facilitators with diabetes and experience wearing a continuous glucose monitor will be employed and undergo training. Peer facilitators will help participants learn how CGM data can inform behavior changes via an OPSC. Participants will interact with the private OPSC at least three times a week. Weekly questions and prompts derived from the Association of Diabetes Care and Education Specialists, previously American Association of Diabetes Educators, and seven self-care behaviors will be delivered by peer facilitators to engage participants. Measures of feasibility and acceptability will be determined by the percentage of participants who enroll, complete the study, and use CGM (number of scans) and objective metrics from the OPSC. Efficacy potential outcomes include change in time in range of 70 to 180 mg/dL from baseline to 12 weeks, A1c, diabetes online community engagement, self-efficacy, and quality of life. Additionally, semistructured exit interviews will be conducted.

Results: Funding for this project was secured in November 2018 and approved by the institutional review board in April 2019. Peer facilitator recruitment and training were undertaken in the second half of 2019, with participant recruitment and data collection conducted in January and April 2020. The study has now concluded.

Conclusions: This study will generate new evidence about the use of an OPSC for Hispanic Spanish-speaking patients with diabetes to make behavior changes incorporating feedback from CGM.

Trial registration: ClinicalTrials.gov NCT03799796; https://ichgcp.net/clinical-trials-registry/NCT03799796.

International registered report identifier (irrid): RR1-10.2196/31595.

Keywords: T2D; behavior change; continuous glucose monitoring; diabetes; hispanic; online community; patient education; peer support; social support; technology; type 2 diabetes.

Conflict of interest statement

Conflicts of Interest: DAG is now an employee of Dexcom. No other conflicts of interest to declare.

©Ashley H Ng, Deborah A Greenwood, Eli Iacob, Nancy A Allen, Mila Ferrer, Bruno Rodriguez, Michelle L Litchman. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 24.02.2022.

Figures

Figure 1
Figure 1
Study timeline. CGM: continuous glucose monitoring; OPSC: online peer support community.

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