DiaBetter Together: Outcomes of a Randomized Controlled Trial Evaluating a Peer Mentor Behavioral Intervention for Young Adults With Type 1 Diabetes During the Transfer From Pediatric to Adult Care

OBJECTIVE: Transition between pediatric and adult health care is complex, with high risk for loss to follow-up and suboptimal health outcomes for young adults with type 1 diabetes. This trial evaluated the efficacy of DiaBetter Together, a 12-month strengths-based behavioral intervention delivered by trained peer mentors. The intervention aimed to help young adults navigate the transfer process to promote optimal glycemic outcomes, shorten time to adult care follow-up, and improve psychosocial outcomes. RESEARCH DESIGN AND METHODS: Using a single-site randomized clinical trial design, we compared the 12-month intervention to usual care among n = 100 young adults aged 17-25 years with type 1 diabetes following completion of pediatric diabetes care. Outcomes were measured at baseline and 6 and 12 months. The primary outcome was HbA1c, and secondary outcomes included person-reported psychosocial outcomes, self-management behaviors, and time to adult care. RESULTS: There were no statistically significant differences between study arms in HbA1c, self-management behaviors, or transfer to adult care. Significant differences in diabetes-specific health-related quality of life and diabetes distress between groups at 12 months favored the intervention arm. Intervention satisfaction was high. CONCLUSIONS: DiaBetter Together produced modest benefits for psychosocial outcomes during the challenging transfer period, although glycemic, behavioral, and transfer improvements remain difficult to achieve. Reduced sample size due to the coronavirus disease 2019 pandemic may have limited power to detect significant outcomes between groups and impacted outcomes. Peer mentor-based support may be useful to support young adults during transition to adult care, although additional intervention components are likely warranted to improve clinical outcomes.