ONBOARD: A feasibility study of a telehealth-based continuous glucose monitoring adoption intervention for adults with type 1 diabetes.

Abstract

BACKGROUND\nContinuous glucose monitoring (CGM) can improve glycemic control for adults with Type 1 diabetes but certain barriers interfere with consistent use including: cost; data overload; alarm fatigue; physical discomfort; and unwanted social attention. This pilot study aimed to examine feasibility and acceptability of a behavioral intervention, ONBOARD (Overcoming Barriers and Obstacles to Adopting Diabetes Devices) to support adults with type 1 diabetes in optimizing CGM use.\n\n\nMETHODS\nAdults (18-50) with type 1 diabetes in their first year of CGM use were invited to participate in a tailored, multicomponent telehealth-based intervention delivered over four 60-minute sessions every 2-3 weeks. Participants completed surveys (demographics; diabetes distress, T1-DDS; satisfaction with program) and provided CGM data at baseline and post-intervention (3 months). Data were analyzed using paired t-tests and Wilcoxon signed-rank tests.\n\n\nRESULTS\nTwenty-two participants (age=30.95±8.32; 59% female; 91% Non-Hispanic; 86% White, 5% Black, 9% other; 73% pump users) completed the study. ONBOARD demonstrated acceptability and a high rate of retention. Moderate effect sizes were found for reductions in diabetes distress (p=.01, r=-.37) and increases in daytime spent in target range (70-180 mg/dL: p=.03, r=-.35). There were no significant increases in hypoglycemia.\n\n\nCONCLUSIONS\nFindings show preliminary evidence of feasibility, acceptability, and efficacy of ONBOARD for supporting adults with type 1 diabetes in optimizing CGM use while alleviating diabetes distress. Further research is needed to examine ONBOARD in a larger sample over a longer period.