Testing 3 Digital Health Platforms to Improve Mental Health Outcomes in Adults With Type 1 Diabetes: A Pilot Trial

Objective: Our aim in this study was to examine the potential impact of a 3 -pronged digital health pilot intervention (TRIFECTA) on diabetes distress and depressive symptoms among adults with type 1 diabetes (T1D) in British Columbia. Methods: We recruited 60 adults with T1D (mean age 38.9 +/- 15.1 years, 75% female, 77% Caucasian) who participated in the 6 -month pilot intervention involving 3 digital health platforms: monthly, providerled, group -based sessions over Zoom (virtual huddles); a WhatsApp peer texting group; and a web-based "Ask -the -expert" portal. Assessments were conducted at baseline and 6 months and measured diabetes distress (T1D Diabetes Distress Scale), depressive symptoms (9 -item Personal Health Questionnaire), and TRIFECTA engagement metrics. Results: Participation in TRIFECTA was associated with significant reductions in Overall Distress (p=0.011) and 4 distress subscales: Powerlessness (p=0.006), Management Distress (p=0.001), Hypoglycemia Distress (p=0.029), and Eating Distress (p<0.001). A higher number of virtual huddles attended predicted lower Overall Distress (p=0.019) and Family/Friends Distress (p=0.023). A higher number of "Askthe -expert" posts viewed predicted lower Overall Distress (p=0.046), whereas a higher number of WhatsApp messages posted predicted lower Management Distress (p=0.006). Furthermore, engagement in all 3 metrics was a predictor for lower Negative Social Perceptions Distress (p<0.05). No associations were seen in other distress subscales or for depressive symptoms. Conclusions: Participation in TRIFECTA was linked to reduced diabetes distress levels, but not depressive symptoms, in a platform -dependent manner. This study provides promising pilot data for a subsequent large-scale and fully powered randomized controlled trial. (c) 2023 Canadian Diabetes Association.