Introduction: While the diabetes distress (DD) experience is unique for adults with type 1 diabetes (T1D) compared to those with type 2 diabetes (T2D) , DD interventions involving peer support have focused largely on the T2D population. This study describes the process of screening, selecting, and training peers to provide mental health support to adults with T1D living in geographically marginalized settings.

Methods: Peer Supporter (PS) candidates (n=65) underwent a two-component screening process involving an online personality assessment and a semi-structured interview. Individuals who passed participated in a 6-hour Zoom-based Peer Supporter Training (PST) consisting of three parts: (1) identifying internal motivation, boosting resilience, and expressing empathy; (2) exercising mindfulness, sitting with difficult emotions, and exploring DD; and (3) practicing active listening, avoiding advice giving (including clinical) . Candidates were assigned a standardized patient (SP) with T1D and invited to complete a 5-day peer support trial. To graduate successfully, trainees needed to score ≥ 4 of a 5-point Likert scale for each of 8 competencies criteria.

Results: Of the 65 participants screened, 52 participated in PST. For the 5-day trial, candidates facilitated a values exercise and explored the SP’s DD profile. Mean scores for the 8 competency domains were: listening actively (4.55) ; no passing judgment (4.67) ; asking open-ended questions (4.12) ; making reflections (4.5) ; expressing empathy (4.42) ; sitting with strong emotions (4.44) ; avoiding advice giving (4.38) ; and deferring medical questions (4.58) . Forty-six of 52 participants graduated successfully.

Conclusions: A rigorous process is feasible for screening, selecting and training peers to deliver mental health support to adults with T1D. The next step is to examine the impact of this peer support intervention on DD outcomes.


T.S.Tang: None. K.Yip: None. L.Moore: None. G.Klein: None.


Juvenile Diabetes Research Foundation (2-SRA-2020-986-S-B)

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at