When you combine these 2 interventions together, a positive feedback loop forms, said Michelle Litchman, PHD, FNP-BC, FAANP, FADCES, an assistant professor at the College of Nursing at the University of Utah. Litchman’s research will be presented at the American Diabetes Association’s (ADA) 81st Scientific Sessions.
Can you introduce yourself and describe your work?
My name is Michelle Litchman. I’m a nurse practitioner and an assistant professor at the University of Utah College of Nursing. My work focuses on the combination of diabetes, disparities, and digital health.
What prompted you to investigate continuous glucose monitoring (CGM) and online peer support interventions to address health disparities in patients with diabetes who speak Spanish?
Our team originally had a PCORI [Patient-Centered Outcomes Research Institute grant] that focused on diabetes technology use in Spanish-speaking individuals. We tested several different technology options, and the participants who all had type 2 diabetes really felt like CGM was important but they wanted to make sure that it was in a language that they could understand. Also, they were really interested in online peer support. We had a second PCORI that was really focused at online peer support generally. What that group came up with is, they were really interested in targeting a Hispanic Spanish-speaking population and this combination of CGM and online peer support. Between those 2 PCORIs, we created this intervention.
How did you conduct your research and what were the main findings?
We used community health workers to recruit participants who had type 2 diabetes that were not using insulin yet and Spanish speaking in Utah. We were really focused on combining both continuous glucose monitoring and an online peer support community. This online peer support community had 5 trained peer facilitators, so people who were living with diabetes, used CGM, and also knew how to participate in an online community. With these 2 in combination, we could post what we call personal experiments in the online community. And from there, we had these 5 people who could support participants in conducting or carrying out those personal experiments. These were experiments like, some sort of behavior change. Change your breakfast and see what happens to your glucose before and after or change a physical activity and see what happens to your glucose before and after with the CGM.
It was great, because as people went through the intervention, challenges came up. So COVID-19 was a challenge. We actually had an earthquake here; hat was a challenge as well. So these these big challenges, and then also the interpersonal challenges that people experience. As people experienced these different things that became barriers, they could talk through it within the group and then get tips and tricks to keep going.
The main finding is that we improved self-efficacy in this group. We also felt through these exit interviews, CGM really helped participants gain knowledge about how diet, exercise, medications, stress, and even sleep impacted their glucose levels. Then the online peer support community reinforced healthy behaviors and provided the social support and place to learn, so that people could continue these healthy behaviors. What we found is when you combine these 2 interventions together, there’s a positive feedback loop that forms and it just helps continue these great behaviors that people need to be engaging in.