Background: Historically disadvantaged, ethnically- and racially-diverse AYA experience significantly greater challenges with T1D management when compared to White peers. To address this inequity, the patient-centered CoYoT1 Care model was adapted and implemented at a T1D clinic serving primarily ethnically- and racially-diverse AYA.
Methods: In a randomized controlled 2x2 trial, 68 AYA received either CoYoT1 Care or Standard Care via in-person or Telehealth (TH) . Hemoglobin A1c (A1c) and T1D-related distress were measured at baseline and after four quarterly clinic visits, and analyzed via linear mixed models adjusting for age, sex, and attendance.
Results: At study end, participants in TH showed reduced A1c (p=0.01) and no changes in physician-related distress (p=0.04) , compared to increased A1c and distress in those randomized to in-person care. Secondary analyses revealed that these TH benefits were attributable to Latinx AYA subgroup. Compared to Latinx participants randomized to in-person care, those in TH showed significant reductions in A1c (p=0.003; Figure) and physician distress (p=0.008) . Among non-Latinx participants, no significant differences in A1c or distress were observed.
Conclusion: The TH CoYoT1 Care model engages underserved, ethnically-diverse AYA and leads to improved outcomes. Next steps include collaborating with stakeholders to adapt and implement the model nationwide.
J.J.Flores garcia: None. M.W.Reid: None. E.Pyatak: Research Support; Abbott Diabetes. J.L.Fogel: None. D.Fox: None. E.Salcedo-rodriguez: None. J.Raymond: None.